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Jeong SP, Sharma N, An SSA. Role of Calcitriol and Vitamin D Receptor ( VDR) Gene Polymorphisms in Alzheimer's Disease. Int J Mol Sci 2024; 25:4806. [PMID: 38732025 PMCID: PMC11084202 DOI: 10.3390/ijms25094806] [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: 02/15/2024] [Revised: 02/21/2024] [Accepted: 04/26/2024] [Indexed: 05/13/2024] Open
Abstract
Alzheimer's disease (AD) is characterized by amyloid beta (Aβ) buildup and neuronal degeneration. An association between low serum vitamin D levels and an increased risk of AD has been reported in several epidemiological studies. Calcitriol (1,25-dihydroxycholecalciferol) is the active form of vitamin D, and is generated in the kidney and many other tissues/organs, including the brain. It is a steroid hormone that regulates important functions like calcium/phosphorous levels, bone mineralization, and immunomodulation, indicating its broader systemic significance. In addition, calcitriol confers neuroprotection by mitigating oxidative stress and neuroinflammation, promoting the clearance of Aβ, myelin formation, neurogenesis, neurotransmission, and autophagy. The receptors to which calcitriol binds (vitamin D receptors; VDRs) to exert its effects are distributed over many organs and tissues, representing other significant roles of calcitriol beyond sustaining bone health. The biological effects of calcitriol are manifested through genomic (classical) and non-genomic actions through different pathways. The first is a slow genomic effect involving nuclear VDR directly affecting gene transcription. The association of AD with VDR gene polymorphisms relies on the changes in vitamin D consumption, which lowers VDR expression, protein stability, and binding affinity. It leads to the altered expression of genes involved in the neuroprotective effects of calcitriol. This review summarizes the neuroprotective mechanism of calcitriol and the role of VDR polymorphisms in AD, and might help develop potential therapeutic strategies and markers for AD in the future.
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Affiliation(s)
| | - Niti Sharma
- Bionano Research Institute, Gachon University, 1342 Seongnam-daero, Sujung-gu, Seongnam-si 461-701, Republic of Korea
| | - Seong Soo A. An
- Bionano Research Institute, Gachon University, 1342 Seongnam-daero, Sujung-gu, Seongnam-si 461-701, Republic of Korea
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Aagaard K, Møllegaard Jepsen JR, Sevelsted A, Horner D, Vinding R, Rosenberg JB, Brustad N, Eliasen A, Mohammadzadeh P, Følsgaard N, Hernández-Lorca M, Fagerlund B, Glenthøj BY, Rasmussen MA, Bilenberg N, Stokholm J, Bønnelykke K, Ebdrup BH, Chawes B. High-dose vitamin D3 supplementation in pregnancy and risk of neurodevelopmental disorders in the children at age 10: A randomized clinical trial. Am J Clin Nutr 2024; 119:362-370. [PMID: 38072183 DOI: 10.1016/j.ajcnut.2023.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Revised: 11/28/2023] [Accepted: 12/04/2023] [Indexed: 12/28/2023] Open
Abstract
BACKGROUND Vitamin D deficiency in pregnancy may increase the risk of autism and attention deficit hyperactivity disorder (ADHD). OBJECTIVE The objective of this study was to estimate the effect of vitamin D3 supplementation in pregnancy on risk of autism and ADHD. DESIGN This randomized clinical trial was part of the COpenhagen Prospective Study on Neuro-PSYCHiatric Development (COPYCH) project nested within the Copenhagen Prospective Studies on Asthma in Childhood 2010 (COPSAC2010) cohort comprising a population-based sample of 700 healthy mother-child pairs enrolled at week 24 of pregnancy. Maternal 25-hydroxy-vitamin D (25(OH)D) was measured at inclusion and 623 mothers were randomized 1:1 to either high-dose (2800 IU/d) or standard dose (400 IU/d) vitamin D3 until 1 wk postpartum (315 received high-dose, 308 standard dose). At age 10, diagnoses and symptom load of autism and ADHD, respectively, were established using the Kiddie-Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version. RESULTS The psychopathologic evaluation was completed by 591 children aged 10 y, and 16 children (2.7%) were diagnosed with autism and 65 (11.0%) with ADHD. Hereof, 496 children participated in the vitamin D3 trial (246 received high-dose, 250 standard dose). Of these, 12 children (2.4%) were diagnosed with autism and 58 (11.7%) with ADHD. Higher maternal preintervention 25(OH)D levels were associated with a decreased risk of autism [odd ratio (OR) per 10 nmol/L: 0.76 (0.59,0.97); P = 0.034], lower autistic symptom load [β per 10 nmol/L: -0.03 (-0.05,0.00); P = 0.024), and decreased risk of ADHD diagnosis (OR per 10 nmol/L: 0.88 (0.78,0.99); P = 0.033]. High-dose vitamin D3 supplementation was not associated with risk of autism or ADHD. CONCLUSIONS Higher maternal preintervention 25(OH)D was associated with a decreased risk of autism, lower autistic symptom load, and decreased risk of ADHD diagnosis, but high-dose vitamin D3 supplementation in pregnancy had no effect on risk of autism and ADHD. This trial was registered at clinicaltrials.gov as NCT00856947.
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Affiliation(s)
- Kristina Aagaard
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Gentofte, Denmark
| | - Jens Richardt Møllegaard Jepsen
- Child and Adolescent Mental Health Center, Copenhagen University Hospital - Mental Health Services CPH, Copenhagen, Denmark; Center for Neuropsychiatric Schizophrenia Research & Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark
| | - Astrid Sevelsted
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Gentofte, Denmark
| | - David Horner
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Gentofte, Denmark
| | - Rebecca Vinding
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Gentofte, Denmark
| | - Julie Bøjstrup Rosenberg
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Gentofte, Denmark; Center for Neuropsychiatric Schizophrenia Research & Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark
| | - Nicklas Brustad
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Gentofte, Denmark
| | - Anders Eliasen
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Gentofte, Denmark; Department of Health Technology, Section for Bioinformatics, Technical University of Denmark
| | - Parisa Mohammadzadeh
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Gentofte, Denmark; Center for Neuropsychiatric Schizophrenia Research & Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark
| | - Nilofar Følsgaard
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Gentofte, Denmark
| | - María Hernández-Lorca
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Gentofte, Denmark
| | - Birgitte Fagerlund
- Child and Adolescent Mental Health Center, Copenhagen University Hospital - Mental Health Services CPH, Copenhagen, Denmark; Center for Neuropsychiatric Schizophrenia Research & Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark; Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Birte Y Glenthøj
- Center for Neuropsychiatric Schizophrenia Research & Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Morten Arendt Rasmussen
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Gentofte, Denmark; Section of Food, Microbiology and Fermentation, Department of Food Science, University of Copenhagen
| | - Niels Bilenberg
- Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark; Department of Child and Adolescent Mental Health Odense, Mental Health Services in the Region of Southern Denmark, University of Southern Denmark, Odense, Denmark
| | - Jakob Stokholm
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Gentofte, Denmark; Section of Food, Microbiology and Fermentation, Department of Food Science, University of Copenhagen
| | - Klaus Bønnelykke
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Gentofte, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Bjørn H Ebdrup
- Center for Neuropsychiatric Schizophrenia Research & Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Bo Chawes
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Gentofte, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
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Tahir H, Munir N, Iqbal SS, Bacha U, Amir S, Umar H, Riaz M, Tahir IM, Ali Shah SM, Shafiq A, Akram M. Maternal vitamin D status and attention deficit hyperactivity disorder (ADHD), an under diagnosed risk factor; A review. EUR J INFLAMM 2023. [DOI: 10.1177/1721727x231161013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023] Open
Abstract
Vitamin D is important to mediate several brain processes such as proliferation, apoptosis, and neurotransmission in early stages of life. Vitamin D deficiency during critical periods of development can lead to persistent brain alterations. Vitamin D homeostasis during pregnancy is affected by two factors which includes an increase in mother’s calcitriol levels and an increase in mother’s Vitamin D Binding protein concentrations. Attention deficient hyperactivity disorder (ADHD) is an outcome of a complicated interaction between genetic, environmental, and developmental traits, and genetic factors cover about 80% of the cases. The efficiency of the immune system can be altered by a deficiency of Vitamin D in maternal body and maternal stress during gestation such as perinatal depression. Studies have proved that during gestation if there is a deficiency of vitamin D in maternal body, it can influence the brain development of the fetus and can also alter the synthesis of the brain-derived neurotropic factor. The current manuscript has been compiled to elaborate different factors which are associated with ADHD particularly focusing on the relationship of vitamin D deficiency in mothers. References material was selected from NCBI (PUBMED), Science direct, Google scholar, Publons etc. Using the terms ADHD, Vitamin D and Maternal nutritional status. Although, controversial relationship was found between the deficiency of Vitamin D level in pregnant women and development of ADHD in children but more controlled trials are required for future direction as well as to rule out other associated causes.
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Affiliation(s)
- Hafsa Tahir
- Department of Nutrition Sciences, School of Health Sciences, University of Management and Technology, Lahore, Pakistan
| | - Naveed Munir
- Department of Biomedical Lab Sciences, School of Health Sciences, University of Management and Technology, Lahore, Pakistan
| | - Syeda Saira Iqbal
- Knowledge Research and Support Services, University of Management and Technology, Lahore, Pakistan
| | - Umar Bacha
- Department of Nutrition Sciences, School of Health Sciences, University of Management and Technology, Lahore, Pakistan
| | - Saira Amir
- Department of Nutrition Sciences, School of Health Sciences, University of Management and Technology, Lahore, Pakistan
| | - Hassaan Umar
- School of Pharmaceutical Sciences, Universiti Sains, Malaysia
| | - Muhammad Riaz
- Department of Allied Health Sciences, Sargodha Medical College, University of Sargodha, Sargodha, Pakistan
| | - Imtiaz Mahmood Tahir
- College of Allied Health Professional, Directorate of Medical Sciences, Government College University‐Faisalabad, Faisalabad, Pakistan
| | - Syed Muhammad Ali Shah
- Department of Eastern Medicine, Government College University Faisalabad, Faisalabad, Pakistan
| | - Almina Shafiq
- Department of Biomedical Lab Sciences, School of Health Sciences, University of Management and Technology, Lahore, Pakistan
| | - Muhammad Akram
- Department of Eastern Medicine, Government College University Faisalabad, Faisalabad, Pakistan
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Gosling CJ, Caparos S, Pinabiaux C, Schwarzer G, Rücker G, Agha SS, Alrouh H, Ambler A, Anderson P, Andiarena A, Arnold LE, Arseneault L, Asherson P, Babinski L, Barbati V, Barkley R, Barros AJD, Barros F, Bates JE, Bell LJ, Berenguer C, van Bergen E, Biederman J, Birmaher B, B⊘e T, Boomsma DI, Brandt VC, Bressan RA, Brocki K, Broughton TR, Bufferd SJ, Bussing R, Cao M, Cartigny A, Casas AM, Caspi A, Castellanos FX, Caye A, Cederkvist L, Collishaw S, Copeland WE, Cote SM, Coventry WL, Debes NMM, Denyer H, Dodge KA, Dogru H, Efron D, Eller J, Abd Elmaksoud M, Ercan ES, Faraone SV, Fenesy M, Fernández MF, Fernández-Somoano A, Findling R, Fombonne E, Fossum IN, Freire C, Friedman NP, Fristad MA, Galera C, Garcia-Argibay M, Garvan CS, González-Safont L, Groenman AP, Guxens M, Halperin JM, Hamadeh RR, Hartman CA, Hill SY, Hinshaw SP, Hipwell A, Hokkanen L, Holz N, Íñiguez C, Jahrami HA, Jansen PW, Jónsdóttir LK, Julvez J, Kaiser A, Keenan K, Klein DN, Klein RG, Kuntsi J, Langfus J, Langley K, Lansford JE, Larsen SA, Larsson H, Law E, Lee SS, Lertxundi N, Li X, Li Y, Lichtenstein P, Liu J, Lundervold AJ, Lundström S, Marks DJ, Martin J, Masi G, Matijasevich A, Melchior M, Moffitt TE, Monninger M, Morrison CL, Mulraney M, Muratori P, Nguyen PT, Nicholson JM, Øie MG, O'Neill S, O'Connor C, Orri M, Pan PM, Pascoe L, Pettit GS, Price J, Rebagliato M, Riaño-Galán I, Rohde LA, Roisman GI, Rosa M, Rosenbaum JF, Salum GA, Sammallahti S, Santos IS, Schiavone NS, Schmid L, Sciberras E, Shaw P, Silk TJ, Simpson JA, Skogli EW, Stepp S, Strandberg-Larsen K, Sudre G, Sunyer J, Tandon M, Thapar A, Thomson P, Thorell LB, Tinchant H, Torrent M, Tovo-Rodrigues L, Tripp G, Ukoumunne O, Van Goozen SHM, Vos M, Wallez S, Wang Y, Westermaier FG, Whalen DJ, Yoncheva Y, Youngstrom EA, Sayal K, Solmi M, Delorme R, Cortese S. Association between relative age at school and persistence of ADHD in prospective studies: an individual participant data meta-analysis. Lancet Psychiatry 2023; 10:922-933. [PMID: 37898142 DOI: 10.1016/s2215-0366(23)00272-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 07/27/2023] [Accepted: 08/03/2023] [Indexed: 10/30/2023]
Abstract
BACKGROUND The youngest children in a school class are more likely than the oldest to be diagnosed with ADHD, but this relative age effect is less frequent in older than in younger school-grade children. However, no study has explored the association between relative age and the persistence of ADHD diagnosis at older ages. We aimed to quantify the association between relative age and persistence of ADHD at older ages. METHODS For this meta-analysis, we searched MEDLINE, Embase, CINAHL, PsycINFO, and PubPsych up to April 1, 2022, with terms related to "cohort" and "ADHD" with no date, publication type, or language restrictions. We gathered individual participant data from prospective cohorts that included at least ten children identified with ADHD before age 10 years. ADHD was defined by either a clinical diagnosis or symptoms exceeding clinical cutoffs. Relative age was recorded as the month of birth in relation to the school-entry cutoff date. Study authors were invited to share raw data or to apply a script to analyse data locally and generate anonymised results. Our outcome was ADHD status at a diagnostic reassessment, conducted at least 4 years after the initial assessment and after age 10 years. No information on sex, gender, or ethnicity was collected. We did a two-stage random-effects individual participant data meta-analysis to assess the association of relative age with persistence of ADHD at follow-up. This study was registered with PROSPERO, CRD42020212650. FINDINGS Of 33 119 studies generated by our search, we identified 130 eligible unique studies and were able to gather individual participant data from 57 prospective studies following up 6504 children with ADHD. After exclusion of 16 studies in regions with a flexible school entry system that did not allow confident linkage of birthdate to relative age, the primary analysis included 41 studies in 15 countries following up 4708 children for a period of 4 to 33 years. We found that younger relative age was not statistically significantly associated with ADHD persistence at follow-up (odds ratio 1·02, 95% CI 0·99-1·06; p=0·19). We observed statistically significant heterogeneity in our model (Q=75·82, p=0·0011, I2=45%). Participant-level sensitivity analyses showed similar results in cohorts with a robust relative age effect at baseline and when restricting to cohorts involving children with a clinical diagnosis of ADHD or with a follow-up duration of more than 10 years. INTERPRETATION The diagnosis of ADHD in younger children in a class is no more likely to be disconfirmed over time than that of older children in the class. One interpretation is that the relative age effect decreases the likelihood of children of older relative age receiving a diagnosis of ADHD, and another is that assigning a diagnostic label of ADHD leads to unexplored carryover effects of the initial diagnosis that persist over time. Future studies should be conducted to explore these interpretations further. FUNDING None.
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Melough MM, Li M, Hamra G, Palmore M, Sauder KA, Dunlop AL, LeWinn KZ, Zhao Q, Kelly RS, Switkowski KM, Hipwell AE, Korrick SA, Collett BR, MacKenzie D, Nozadi SS, Kerver JM, Schmidt RJ, McGrath M, Sathyanarayana S. Greater Gestational Vitamin D Status is Associated with Reduced Childhood Behavioral Problems in the Environmental Influences on Child Health Outcomes Program. J Nutr 2023; 153:1502-1511. [PMID: 37147034 PMCID: PMC10367223 DOI: 10.1016/j.tjnut.2023.03.005] [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: 11/13/2022] [Revised: 03/02/2023] [Accepted: 03/07/2023] [Indexed: 04/07/2023] Open
Abstract
BACKGROUND Vitamin D deficiency is common in pregnancy. Vitamin D plays an important role in the developing brain, and deficiency may impair childhood behavioral development. OBJECTIVES This study examined the relationship between gestational 25(OH)D concentrations and childhood behavior in the Environmental influences on Child Health Outcomes (ECHO) Program. METHODS Mother-child dyads from ECHO cohorts with data available on prenatal (first trimester through delivery) or cord blood 25(OH)D and childhood behavioral outcomes were included. Behavior was assessed using the Strengths and Difficulties Questionnaire or the Child Behavior Checklist, and data were harmonized using a crosswalk conversion. Linear mixed-effects models examined associations of 25(OH)D with total, internalizing, and externalizing problem scores while adjusting for important confounders, including age, sex, and socioeconomic and lifestyle factors. The effect modification by maternal race was also assessed. RESULTS Early (1.5-5 y) and middle childhood (6-13 y) outcomes were examined in 1688 and 1480 dyads, respectively. Approximately 45% were vitamin D deficient [25(OH)D < 20 ng/mL], with Black women overrepresented in this group. In fully adjusted models, 25(OH)D concentrations in prenatal or cord blood were negatively associated with externalizing behavior T-scores in middle childhood [-0.73 (95% CI: -1.36, -0.10) per 10 ng/mL increase in gestational 25(OH)D]. We found no evidence of effect modification by race. In a sensitivity analysis restricted to those with 25(OH)D assessed in prenatal maternal samples, 25(OH)D was negatively associated with externalizing and total behavioral problems in early childhood. CONCLUSIONS This study confirmed a high prevalence of vitamin D deficiency in pregnancy, particularly among Black women, and revealed evidence of an association between lower gestational 25(OH)D and childhood behavioral problems. Associations were more apparent in analyses restricted to prenatal rather than cord blood samples. Interventions to correct vitamin D deficiency during pregnancy should be explored as a strategy to improve childhood behavioral outcomes.
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Affiliation(s)
- Melissa M Melough
- Department of Behavioral Health and Nutrition, University of Delaware, Newark, DE, United States.
| | - Mingyi Li
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Ghassan Hamra
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Meredith Palmore
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Katherine A Sauder
- Lifecourse Epidemiology of Adiposity and Diabetes Center, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Anne L Dunlop
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA, United States
| | - Kaja Z LeWinn
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA, United States
| | - Qi Zhao
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, United States
| | - Rachel S Kelly
- Channing Division of Network Medicine, Harvard Medical School, Boston, MA, United States
| | - Karen M Switkowski
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, United States
| | - Alison E Hipwell
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States
| | - Susan A Korrick
- Channing Division of Network Medicine, Harvard Medical School, Boston, MA, United States; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Brent R Collett
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, WA, United States
| | - Debra MacKenzie
- Community Environmental Health Program, College of Pharmacy, University of New Mexico Health Sciences Center, Albuquerque, NM, United States
| | - Sara S Nozadi
- Health Sciences Center, College of Pharmacy, University of New Mexico Health Sciences Center, Albuquerque, NM, United States
| | - Jean M Kerver
- Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, MI, United States
| | - Rebecca J Schmidt
- Department of Public Health Sciences, School of Medicine, University of California at Davis, Davis, CA, United States
| | - Monica McGrath
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Sheela Sathyanarayana
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, United States
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Dong HY, Miao CY, Zhang Y, Shan L, Feng JY, Jia FY, Du L. Risk factors for developmental quotients in ASD children: A cross-sectional study. Front Psychol 2023; 14:1126622. [PMID: 36993893 PMCID: PMC10040800 DOI: 10.3389/fpsyg.2023.1126622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Accepted: 02/24/2023] [Indexed: 03/18/2023] Open
Abstract
ObjectiveTo analyze the risk factors for developmental quotients (DQs) of children with autism spectrum disorder (ASD) and to better understand the effects of screen time on neurodevelopment in children with ASD.MethodsWe retrospectively analyzed the data of 382 children with ASD, including demographic profiles; socioeconomic status; score on the Chinese parent–child interaction scale (CPCIS); screen time questionnaire; ASD symptom rating scales, including the Autism Behavior Checklist (ABC), Childhood Autism Rating Scale (CARS), and Autism Diagnostic Observation Schedule Second Edition (ADOS-2); and DQs using Griffiths Development Scales–Chinese Edition. Univariate analysis was carried out to analyze the factors related to the DQs of children with ASD, and then the linear regression model was used to identify the independent influencing factors of the DQs of children with ASD.ResultsVitamin D (β = 0.180, p = 0.002), age (β = −0.283, p = 0.000) and CARS score (β = −0.347, p = 0.000) are risk factors related to DQ of locomotor in children with ASD. Vitamin D (β = 0.108, p = 0.034), CARS score (β = −0.503, p = 0.000), ADOS-2 severity score (β = −0.109, p = 0.045) and CPCIS score (β = 0.198, p = 0.000) are risk factors related to DQ of personal social skill in children with ASD. Vitamin D (β = 0.130, p = 0.018), CARS score (β = −0.469, p = 0.000), and CPCIS score (β = 0.133, p = 0.022) are risk factors related to DQ of hearing-speech in children with ASD. Vitamin D (β = 0.163, p = 0.003) and CARS score (β = −0.471, p = 0.000) are risk factors related to DQ of eye-hand coordination in children with ASD. Age (β = −0.140, p = 0.020), CARS score (β = −0.342, p = 0.000), ADOS-2 severity score (β = −0.133, p = 0.034) and CPCIS score (β = 0.193, p = 0.002) are risk factors related to DQ of performance in children with ASD. Vitamin D (β = 0.801, p = 0.000) and CPCIS score (β = 0.394, p = 0.019) are risk factors related to DQ of practical reasoning in children with ASD.ConclusionVitamin D status, the severity of autistic symptoms and parent-child interaction are risk factors for developmental quotients in children with ASD. Screen exposure time is negatively associated with DQs in children with ASD but is not an independent risk factor for DQs.
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Maternal Vitamin D Levels during Pregnancy and Offspring Psychiatric Outcomes: A Systematic Review. Int J Mol Sci 2022; 24:ijms24010063. [PMID: 36613505 PMCID: PMC9820292 DOI: 10.3390/ijms24010063] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 12/14/2022] [Accepted: 12/16/2022] [Indexed: 12/24/2022] Open
Abstract
Prenatal exposure to vitamin D may play a significant role in human brain development and function. Previous epidemiological studies investigating the associations between maternal vitamin D status and offspring developmental and psychiatric outcomes in humans have been inconclusive. We aimed to systematically assess the results of previously published studies that examined the associations between maternal vitamin D levels, measured as circulating 25(OH)D levels in pregnancy or at birth, and offspring neuropsychiatric and psychiatric outcomes. Systematic searches were conducted using MEDLINE, Embase, PsychINFO and Web of Science for studies published by 10 August 2022. We included human observational studies that examined associations between prenatal or perinatal vitamin D levels and offspring neuropsychiatric and psychiatric outcomes and were published in English in peer-reviewed journals. Of the 3729 studies identified, 66 studies were screened for full texts and 29 studies published between 2003 and 2022 were included in the final review. There was a small amount of evidence for the association between prenatal vitamin D deficiency and autism spectrum disorder. When studies with larger sample sizes and stricter definitions of vitamin D deficiency were considered, positive associations were also found for attention-deficit/hyperactivity disorder and schizophrenia. Future studies with larger sample sizes, longer follow-up periods and prenatal vitamin D assessed at multiple time points are needed.
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Madley-Dowd P, Dardani C, Wootton RE, Dack K, Palmer T, Thurston R, Havdahl A, Golding J, Lawlor D, Rai D. Maternal vitamin D during pregnancy and offspring autism and autism-associated traits: a prospective cohort study. Mol Autism 2022; 13:44. [PMID: 36371219 PMCID: PMC9652971 DOI: 10.1186/s13229-022-00523-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 11/02/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND There has been a growing interest in the association between maternal levels of vitamin D during pregnancy and offspring autism. However, whether any associations reflect causal effects is still inconclusive. METHODS We used data from a UK-based pregnancy cohort study (Avon Longitudinal Study of Parents and Children) comprising 7689 births between 1991 and 1992 with maternal blood vitamin D levels recorded during pregnancy and at least one recorded outcome measure, including autism diagnosis and autism-associated traits. The association between each outcome with seasonal and gestational age-adjusted maternal serum 25-hydroxyvitamin D during pregnancy was estimated using confounder-adjusted regression models. Multiple imputation was used to account for missing data, and restricted cubic splines were used to investigate nonlinear associations. Mendelian randomization was used to strengthen causal inference. RESULTS No strong evidence of an association between maternal serum 25-hydroxyvitamin D during pregnancy and any offspring autism-associated outcome was found using multivariable regression analysis (autism diagnosis: adjusted OR = 0.98, 95% CI = 0.90-1.06), including with multiple imputation (autism diagnosis: adjusted OR = 0.99, 95% CI = 0.93-1.06), and no evidence of a causal effect was suggested by Mendelian randomization (autism diagnosis: causal OR = 1.08, 95% CI = 0.46-2.55). Some evidence of increased odds of autism-associated traits at lower levels of maternal serum 25-hydroxyvitamin D was found using spline analysis. LIMITATIONS Our study was potentially limited by low power, particularly for diagnosed autism cases as an outcome. The cohort may not have captured the extreme lows of the distribution of serum 25-hydroxyvitamin D, and our analyses may have been biased by residual confounding and missing data. CONCLUSIONS The present study found no strong evidence of a causal link between maternal vitamin D levels in pregnancy and offspring diagnosis or traits of autism.
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Affiliation(s)
- Paul Madley-Dowd
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS8 2BN, UK.
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK.
| | - Christina Dardani
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS8 2BN, UK
| | - Robyn E Wootton
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Nic Waals Institute, Lovisenberg Diaconal Hospital, Oslo, Norway
| | - Kyle Dack
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS8 2BN, UK
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Tom Palmer
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | | | - Alexandra Havdahl
- Nic Waals Institute, Lovisenberg Diaconal Hospital, Oslo, Norway
- Department of Psychology, PROMENTA Research Center, University of Oslo, Oslo, Norway
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
| | - Jean Golding
- Centre for Academic Child Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Deborah Lawlor
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Dheeraj Rai
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS8 2BN, UK
- Avon and Wiltshire Partnership, NHS Mental Health Trust, Bristol, UK
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9
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Cui X, Eyles DW. Vitamin D and the Central Nervous System: Causative and Preventative Mechanisms in Brain Disorders. Nutrients 2022; 14:nu14204353. [PMID: 36297037 PMCID: PMC9610817 DOI: 10.3390/nu14204353] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 09/13/2022] [Accepted: 09/13/2022] [Indexed: 11/16/2022] Open
Abstract
Twenty of the last one hundred years of vitamin D research have involved investigations of the brain as a target organ for this hormone. Our group was one of the first to investigate brain outcomes resulting from primarily restricting dietary vitamin D during brain development. With the advent of new molecular and neurochemical techniques in neuroscience, there has been increasing interest in the potential neuroprotective actions of vitamin D in response to a variety of adverse exposures and how this hormone could affect brain development and function. Rather than provide an exhaustive summary of this data and a listing of neurological or psychiatric conditions that vitamin D deficiency has been associated with, here, we provide an update on the actions of this vitamin in the brain and cellular processes vitamin D may be targeting in psychiatry and neurology.
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Affiliation(s)
- Xiaoying Cui
- Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol Q4076, Australia
- Queensland Brain Institute, University of Queensland, St Lucia Q4076, Australia
| | - Darryl W. Eyles
- Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol Q4076, Australia
- Queensland Brain Institute, University of Queensland, St Lucia Q4076, Australia
- Correspondence:
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10
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Vecchione R, Wang S, Rando J, Chavarro JE, Croen LA, Fallin MD, Hertz-Picciotto I, Newschaffer CJ, Schmidt RJ, Lyall K. Maternal Dietary Patterns during Pregnancy and Child Autism-Related Traits: Results from Two US Cohorts. Nutrients 2022; 14:2729. [PMID: 35807909 PMCID: PMC9268965 DOI: 10.3390/nu14132729] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 06/10/2022] [Accepted: 06/22/2022] [Indexed: 01/27/2023] Open
Abstract
We examined the relationship between maternal intake of established dietary patterns and child autism-related outcomes in two prospective cohorts in the United States. Participants were drawn from the Early Autism Risk Longitudinal Investigation (EARLI, n = 154) and the Nurses' Health Study II (NHSII, n = 727). Dietary information was collected via food frequency questionnaires (FFQs) and used to calculate the empirical dietary inflammatory pattern (EDIP), Alternative Healthy Eating Index (AHEI), Western and Prudent dietary patterns, and the alternative Mediterranean Diet (aMED) score. Primary analyses examined associations with continuous autism-related traits as measured by the Social Responsiveness Scale (SRS), and secondary analyses with autism spectrum disorder (ASD) diagnosis. We used crude and multivariable quantile regression fixed at the 50th percentile to examine associations between quartiles of dietary patterns and SRS scores, and logistic regression to examine associations with ASD diagnosis. There was suggestion of a positive association with the Western diet (Q4 vs. Q1, ß = 11.19, 95% CI: 3.30, 19.90) in EARLI, though the association was attenuated with adjustment for total energy intake, and no clear associations were observed with other dietary patterns and ASD diagnosis or SRS scores. Further work is needed to better understand the role of maternal dietary patterns in ASD and related outcomes.
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Affiliation(s)
- Rachel Vecchione
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA 19104, USA;
| | - Siwen Wang
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA 02215, USA; (S.W.); (J.E.C.)
| | - Juliette Rando
- AJ Drexel Autism Institute, Drexel University, Philadelphia, PA 19104, USA;
| | - Jorge E. Chavarro
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA 02215, USA; (S.W.); (J.E.C.)
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA 02215, USA
- Department of Medicine, Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA 02215, USA
| | - Lisa A. Croen
- Division of Research, Kaiser Permanente Norther California, Oakland, CA 94612, USA;
| | - M. Daniele Fallin
- Department of Mental Health, Johns Hopkins, Baltimore, MD 21205, USA;
| | - Irva Hertz-Picciotto
- Department of Public Health Sciences, University of California Davis, Davis, CA 95616, USA; (I.H.-P.); (R.J.S.)
| | - Craig J. Newschaffer
- College of Health and Human Development, Pennsylvania State University, State College, PA 16801, USA;
| | - Rebecca J. Schmidt
- Department of Public Health Sciences, University of California Davis, Davis, CA 95616, USA; (I.H.-P.); (R.J.S.)
| | - Kristen Lyall
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA 19104, USA;
- AJ Drexel Autism Institute, Drexel University, Philadelphia, PA 19104, USA;
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11
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Wang J, Huang H, Liu C, Zhang Y, Wang W, Zou Z, Yang L, He X, Wu J, Ma J, Liu Y. Research Progress on the Role of Vitamin D in Autism Spectrum Disorder. Front Behav Neurosci 2022; 16:859151. [PMID: 35619598 PMCID: PMC9128593 DOI: 10.3389/fnbeh.2022.859151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 03/08/2022] [Indexed: 11/17/2022] Open
Abstract
Autism spectrum disorder (ASD) is a neurodevelopmental disorder that can lead to severe social behavioral difficulties, which mainly manifests as social communication and interaction disorders; narrow interests; and repetitive, stereotyped behaviors. In recent years, the prevalence of ASD has increased annually, and it has evolved from a rare disease to one with a high incidence among childhood developmental disorders. The pathogenesis of ASD is considered to be the interaction of genetic and environmental factors. There is increasing evidence that vitamin D deficiency in pregnancy and early childhood can lead to the occurrence of ASD. Studies have demonstrated that vitamin D intervention can significantly improve the symptoms of ASD, but the underlying mechanism is still unclear. Therefore, exploring the neuroprotective mechanism of vitamin D against ASD is a huge challenge currently being worked on by current basic and clinical researchers, a task which is of great significance for the clinical promotion and optimization of vitamin D in the treatment of ASD. To further clarify the relationship between vitamin D and ASD, this review summarizes the correlation between vitamin D level and ASD, the effects of vitamin D supplementation on ASD, the possible mechanism of vitamin D involved in ASD, and insights from ASD animal models.
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Affiliation(s)
- Jing Wang
- Department of Rehabilitation, Kunming Children’s Hospital, Kunming Medical University, Yunnan, China
| | - Haoyu Huang
- Department of Rehabilitation, Kunming Children’s Hospital, Kunming Medical University, Yunnan, China
| | - Chunming Liu
- Department of Rehabilitation, Kunming Children’s Hospital, Kunming Medical University, Yunnan, China
| | - Yangping Zhang
- Department of Rehabilitation, Kunming Children’s Hospital, Kunming Medical University, Yunnan, China
| | - Wenjuan Wang
- Department of Rehabilitation, Kunming Children’s Hospital, Kunming Medical University, Yunnan, China
| | - Zhuo Zou
- Department of Rehabilitation, Kunming Children’s Hospital, Kunming Medical University, Yunnan, China
| | - Lei Yang
- Department of Rehabilitation, Kunming Children’s Hospital, Kunming Medical University, Yunnan, China
| | - Xuemei He
- Department of Rehabilitation, Kunming Children’s Hospital, Kunming Medical University, Yunnan, China
| | - Jinting Wu
- Department of Rehabilitation, Kunming Children’s Hospital, Kunming Medical University, Yunnan, China
| | - Jing Ma
- Department of Otolaryngology, Head and Neck Surgery, Kunming Children’s Hospital, Kunming Medical University, Yunnan, China
- *Correspondence: Jing Ma,
| | - Yun Liu
- Department of Rehabilitation, Kunming Children’s Hospital, Kunming Medical University, Yunnan, China
- *Correspondence: Jing Ma,
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12
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Chu SH, Huang M, Kelly RS, Kachroo P, Litonjua AA, Weiss ST, Lasky-Su J. Circulating levels of maternal vitamin D and risk of ADHD in offspring: results from the Vitamin D Antenatal Asthma Reduction Trial. Int J Epidemiol 2021; 51:910-918. [PMID: 34534293 DOI: 10.1093/ije/dyab194] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/30/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Low levels of circulating 25-hydroxy-vitamin D [25(OH)D] have been shown to associate with prevalent attention-deficit/hyperactivity disorder (ADHD), but few studies have examined the association between 25(OH)D during fetal development and risk of childhood ADHD. METHODS Maternal plasma 25(OH)D was measured at 10-18 and 32-38 weeks of gestation, with sufficiency defined as 25(OH)D ≥ 30 ng/ml. Offspring ADHD status between ages 6-9 years was measured by parent report of clinical ADHD diagnosis among 680 mother-child pairs from the Vitamin D Antenatal Asthma Reduction Trial. Association between maternal 25(OH)D and child ADHD was assessed using logistic regression, adjusting for maternal age, race and ethnicity. Effect modification by offspring sex was also assessed. RESULTS No associations between maternal 25(OH)D at 10-18 weeks of gestation and offspring ADHD were observed. In the third trimester, we observed associations between maternal vitamin D sufficiency and offspring ADHD [odds ratio (OR) 0.47, 95% confidence interval (CI) 0.26-0.84], in addition to maternal 25(OH)D sufficiency category, comparing the deficient (OR 0.34, 95% CI 0.12-0.94), insufficient (OR 0.41, 95% CI 0.15-1.10) and sufficient (OR 0.20, 95% CI 0.08-0.54) categories against highly deficient 25(OH)D, respectively. Stratified analyses revealed a protective association for sufficient maternal 25(OH)D and child ADHD among males (OR 0.47, 95% CI 0.23-0.94); the synergy index for additive effect modification of risk was 1.78 (95% CI 0.62-5.08). CONCLUSIONS Higher levels of maternal vitamin D in the third trimester are associated with lower risk of ADHD in offspring, with modest evidence for a stronger effect among male offspring. However, larger studies will be necessary to confirm these findings.
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Affiliation(s)
- Su H Chu
- Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA, USA.,Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Mengna Huang
- Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA, USA.,Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Rachel S Kelly
- Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA, USA.,Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Priyadarshini Kachroo
- Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA, USA.,Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Augusto A Litonjua
- Department of Pediatrics, University of Rochester Medical Center, Rochester, NY, USA
| | - Scott T Weiss
- Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA, USA.,Department of Medicine, Harvard Medical School, Boston, MA, USA.,Center for Personalized Medicine, Mass General Brigham, Boston, MA, USA
| | - Jessica Lasky-Su
- Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA, USA.,Department of Medicine, Harvard Medical School, Boston, MA, USA
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13
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Suárez-Calleja C, Aza-Morera J, Iglesias-Cabo T, Tardón A. Vitamin D, pregnancy and caries in children in the INMA-Asturias birth cohort. BMC Pediatr 2021; 21:380. [PMID: 34479530 PMCID: PMC8414781 DOI: 10.1186/s12887-021-02857-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 08/20/2021] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Vitamin D is traditionally associated with the metabolism of calcium and phosphorus, a process essential for the mineralization of hard tissue such as bone or tooth. Deficiency of this vitamin is a problem worldwide, however. Given the possibly significant role of Vitamin D in odontogenesis in children, the objective of our study was to determine the influence of vitamin D levels in the blood on dental anomalies in children between 6 and 10 years of age, by means of 25-hydroxy vitamin D tests performed during pregnancy and the first years of life. METHODS The data analyzed were sourced from data belonging to the INMA-Asturias birth cohort, a prospective cohort study initiated in 2004 as part of the INMA Project. The 25-hydroxy vitamin D (25(OH)D) test was performed with samples from 188 children in the INMA-Asturias birth cohort with a dental examination performed between 6 and 10 years of age. The samples were taken at three stages: in the mother at 12 weeks of gestation, and subsequently in the child at 4 and 8 years of age. Diet, nutritional and oro-dental hygiene habits were also analyzed by means of questionnaires. RESULTS The results indicate a significant association between caries and correct or incorrect brushing technique. With incorrect brushing technique, the prevalence of caries was 48.89%, but this dropped to 22.38% with correct brushing technique. An association was also found between tooth decay and frequency of sugar intake. The prevalence of caries was 24.54% with occasional sugar intake, but this rose to 56% with regular sugar intake. On the other hand, levels < 20 ng/ml in both mother and child at 8 years of age would also be risk factors (ORgest = 2.51(1.01-6.36) and OR8years = 3.45(1.14-11.01)) for the presence of caries in children. The risk of caries practically tripled where 25(OH) D values were < 20 ng/ml. CONCLUSIONS Although incorrect brushing technique and regular sugar consumption was found to be the main cause of caries in the children, the low concentrations of vitamin D in the blood of the pregnant mothers may have magnified this correlation, indicating that the monitoring of vitamin D levels during pregnancy should be included in antenatal programmes. It is particularly striking that 50% of the children were deficient in vitamin D at the age of 4, and that dental floss was practically absent from regular cleaning routines.
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Affiliation(s)
- Claudia Suárez-Calleja
- Instituto Universitario de Oncología del Principado de Asturias (IUOPA), Instituto de Investigación Sanitaria del Principado de Asturias. ISPA. Universidad de Oviedo, Asturias, Spain
| | - Jaime Aza-Morera
- SESPA (Servicio de Salud del Principado de Asturias), Asturias, Spain
| | | | - Adonina Tardón
- Instituto Universitario de Oncología del Principado de Asturias (IUOPA), Instituto de Investigación Sanitaria del Principado de Asturias. ISPA, CIBER de Epidemiología y Salud Pública. Universidad de Oviedo, Asturias, Spain
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14
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Lyall K, Ames JL, Pearl M, Traglia M, Weiss LA, Windham GC, Kharrazi M, Yoshida CK, Yolken R, Volk HE, Ashwood P, Van de Water J, Croen LA. A profile and review of findings from the Early Markers for Autism study: unique contributions from a population-based case-control study in California. Mol Autism 2021; 12:24. [PMID: 33736683 PMCID: PMC7977191 DOI: 10.1186/s13229-021-00429-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 02/23/2021] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND The Early Markers for Autism (EMA) study is a population-based case-control study designed to learn more about early biologic processes involved in ASD. METHODS Participants were drawn from Southern California births from 2000 to 2003 with archived prenatal and neonatal screening specimens. Across two phases, children with ASD (n = 629) and intellectual disability without ASD (ID, n = 230) were ascertained from the California Department of Developmental Services (DDS), with diagnoses confirmed according to DSM-IV-TR criteria based on expert clinical review of abstracted records. General population controls (GP, n = 599) were randomly sampled from birth certificate files and matched to ASD cases by sex, birth month and year after excluding individuals with DDS records. EMA has published over 20 papers examining immune markers, endogenous hormones, environmental chemicals, and genetic factors in association with ASD and ID. This review summarizes the results across these studies, as well as the EMA study design and future directions. RESULTS EMA enabled several key contributions to the literature, including the examination of biomarker levels in biospecimens prospectively collected during critical windows of neurodevelopment. Key findings from EMA include demonstration of elevated cytokine and chemokine levels in maternal mid-pregnancy serum samples in association with ASD, as well as aberrations in other immune marker levels; suggestions of increased odds of ASD with prenatal exposure to certain endocrine disrupting chemicals, though not in mixture analyses; and demonstration of maternal and fetal genetic influence on prenatal chemical, and maternal and neonatal immune marker and vitamin D levels. We also observed an overall lack of association with ASD and measured maternal and neonatal vitamin D, mercury, and brain-derived neurotrophic factor (BDNF) levels. LIMITATIONS Covariate and outcome data were limited to information in Vital Statistics and DDS records. As a study based in Southern California, generalizability for certain environmental exposures may be reduced. CONCLUSIONS Results across EMA studies support the importance of the prenatal and neonatal periods in ASD etiology, and provide evidence for the role of the maternal immune response during pregnancy. Future directions for EMA, and the field of ASD in general, include interrogation of mechanistic pathways and examination of combined effects of exposures.
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Affiliation(s)
- Kristen Lyall
- A.J. Drexel Autism Institute, Drexel University, Suite 560, 3020 Market St, Philadelphia, PA, 19104, USA.
| | - Jennifer L Ames
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Michelle Pearl
- Environmental Health Investigations Branch, California Department of Public Health, Richmond, CA, USA
| | - Michela Traglia
- University of California, San Francisco, San Francisco, CA, USA
| | - Lauren A Weiss
- University of California, San Francisco, San Francisco, CA, USA
| | - Gayle C Windham
- Environmental Health Investigations Branch, California Department of Public Health, Richmond, CA, USA
| | - Martin Kharrazi
- Environmental Health Investigations Branch, California Department of Public Health, Richmond, CA, USA
| | - Cathleen K Yoshida
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Robert Yolken
- School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Heather E Volk
- Department of Mental Health, Johns Hopkins University, Baltimore, MD, USA
| | - Paul Ashwood
- UC Davis MIND Institute, University of California, Davis, Davis, CA, USA
| | - Judy Van de Water
- UC Davis MIND Institute, University of California, Davis, Davis, CA, USA
| | - Lisa A Croen
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
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15
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Wang Z, Ding R, Wang J. The Association between Vitamin D Status and Autism Spectrum Disorder (ASD): A Systematic Review and Meta-Analysis. Nutrients 2020; 13:E86. [PMID: 33383952 PMCID: PMC7824115 DOI: 10.3390/nu13010086] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 12/21/2020] [Accepted: 12/25/2020] [Indexed: 12/22/2022] Open
Abstract
The association between vitamin D status and autism spectrum disorder (ASD) is well-investigated but remains to be elucidated. We quantitatively combined relevant studies to estimate whether vitamin D status was related to ASD in this work. PubMed, EMBASE, Web of Science, and the Cochrane Library were searched to include eligible studies. A random-effects model was applied to pool overall estimates of vitamin D concentration or odds ratio (OR) for ASD. In total, 34 publications involving 20,580 participants were identified in this present study. Meta-analysis of 24 case-control studies demonstrated that children and adolescents with ASD had significantly lower vitamin D concentration than that of the control group (mean difference (MD): -7.46 ng/mL, 95% confidence interval (CI): -10.26; -4.66 ng/mL, p < 0.0001, I2 = 98%). Quantitative integration of 10 case-control studies reporting OR revealed that lower vitamin D was associated with higher risk of ASD (OR: 5.23, 95% CI: 3.13; 8.73, p < 0.0001, I2 = 78.2%). Analysis of 15 case-control studies barring data from previous meta-analysis reached a similar result with that of the meta-analysis of 24 case-control studies (MD: -6.2, 95% CI: -9.62; -2.78, p = 0.0004, I2 = 96.8%), which confirmed the association. Furthermore, meta-analysis of maternal and neonatal vitamin D showed a trend of decreased early-life vitamin D concentration in the ASD group (MD: -3.15, 95% CI: -6.57; 0.26, p = 0.07, I2 = 99%). Meta-analysis of prospective studies suggested that children with reduced maternal or neonatal vitamin D had 54% higher likelihood of developing ASD (OR: 1.54, 95% CI: 1.12; 2.10, p = 0.0071, I2 = 81.2%). These analyses indicated that vitamin D status was related to the risk of ASD. The detection and appropriate intervention of vitamin D deficiency in ASD patients and pregnant and lactating women have clinical and public significance.
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Affiliation(s)
- Zuqun Wang
- Department of Biomedical Informatics, School of Basic Medical Sciences, Peking University, Beijing 100191, China; (Z.W.); (R.D.)
- Autism Research Center, Peking University Health Science Center, Beijing 100191, China
| | - Rui Ding
- Department of Biomedical Informatics, School of Basic Medical Sciences, Peking University, Beijing 100191, China; (Z.W.); (R.D.)
- Autism Research Center, Peking University Health Science Center, Beijing 100191, China
| | - Juan Wang
- Department of Biomedical Informatics, School of Basic Medical Sciences, Peking University, Beijing 100191, China; (Z.W.); (R.D.)
- Autism Research Center, Peking University Health Science Center, Beijing 100191, China
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16
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Windham GC, Pearl M, Poon V, Berger K, Soriano JW, Eyles D, Lyall K, Kharrazi M, Croen LA. Maternal Vitamin D Levels During Pregnancy in Association With Autism Spectrum Disorders (ASD) or Intellectual Disability (ID) in Offspring; Exploring Non-linear Patterns and Demographic Sub-groups. Autism Res 2020; 13:2216-2229. [PMID: 33135392 PMCID: PMC11068065 DOI: 10.1002/aur.2424] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 08/21/2020] [Accepted: 09/27/2020] [Indexed: 12/20/2022]
Abstract
Increasing vitamin D deficiency and evidence for vitamin D's role in brain and immune function have recently led to studies of neurodevelopment; however, few are specific to autism spectrum disorder (ASD) and vitamin D in pregnancy, a likely susceptibility period. We examined this in a case-control study of 2000-2003 Southern Californian births; ASD and intellectual disability (ID) were identified through the Department of Developmental Services and controls from birth certificates (N = 534, 181, and 421, respectively, in this analysis). Total 25-Hydroxyvitamin D (25(OH)D) was measured in mid-pregnancy serum, categorized as deficient (<50 nmol/L), insufficient (50-74 nmol/L), or sufficient (≥75 nmol/L, referent category), and examined continuously (per 25 nmol/L). Crude and adjusted odds ratios (AORs) and 95% confidence intervals (95% CI) were calculated. Non-linearity was examined with cubic splines. AORs (95% CI) for ASD were 0.79 (0.49-1.3) for maternal deficiency (9.5%), 0.93 (0.68-1.3) for insufficiency (25.6%), and 0.95 (0.86, 1.05) for linear continuous 25(OH)D. Results were similarly null for ASD with or without ID, and ID only. Interactions were observed; non-Hispanic whites (NHW) (AOR = 0.82, 95% CI = 0.69-0.98) and males (AOR = 0.89, 95% CI = 0.80-0.99) had protective associations for ASD with continuous 25(OH)D. A positive association with ASD was observed in females (AOR = 1.40, 95% CI = 1.06-1.85). With splines, a non-linear inverted j-shaped pattern was seen overall (P = 0.009 for non-linearity), with the peak around 100 nmol/L; a non-linear pattern was not observed among NHW, females, nor for ID. Our findings from a large study of ASD and prenatal vitamin D levels indicate that further research is needed to investigate non-linear patterns and potentially vulnerable sub-groups. LAY SUMMARY: We studied whether mothers' vitamin D levels during pregnancy were related to their children having autism (or low IQ) later. Low vitamin D levels were not related to greater risk of autism or low IQ in children overall. With higher levels of mothers' vitamin D, risk of autism went down in boys, but went up in girls. Risk of autism also went down in children of non-Hispanic white mothers with higher vitamin D levels, but we did not find a relation in other race/ethnic groups.
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Affiliation(s)
- Gayle C Windham
- Environmental Health Investigations Branch, California Department of Public Health, Richmond, California, USA
| | - Michelle Pearl
- Environmental Health Investigations Branch, California Department of Public Health, Richmond, California, USA
| | - Victor Poon
- Sequoia Foundation, La Jolla, California, USA
| | | | | | - Darryl Eyles
- Queensland Brain Institute, University of Queensland, Brisbane, Queensland, Australia
| | - Kristen Lyall
- A.J. Drexel Autism Institute, Drexel University, Philadelphia, Pennsylvania, USA
| | - Martin Kharrazi
- Environmental Health Investigations Branch, California Department of Public Health, Richmond, California, USA
| | - Lisa A Croen
- Kaiser Permanente Division of Research, Oakland, California, USA
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17
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Zhong C, Tessing J, Lee BK, Lyall K. Maternal Dietary Factors and the Risk of Autism Spectrum Disorders: A Systematic Review of Existing Evidence. Autism Res 2020; 13:1634-1658. [PMID: 33015977 PMCID: PMC9234972 DOI: 10.1002/aur.2402] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 08/07/2020] [Accepted: 09/12/2020] [Indexed: 01/15/2023]
Abstract
Prenatal maternal diet is a critical factor in offspring neurodevelopment. Emerging evidence suggests that prenatal diet may also play a role in the etiology autism spectrum disorder (ASD). This review summarizes studies published in English that examined prenatal nutrients or maternal diet in association with ASD from PubMed as of July 2020. Thiry-six studies from nine countries were included in this systematic review; these focused on multivitamin (n = 5), prenatal vitamin (n = 3), folic acid (FA; n = 14), Vitamin D (n = 11), polyunsaturated fatty acid or fish/supplement intake (n = 7), iron (n = 3), Vitamin B12 (n = 1), calcium (n = 1), magnesium (n = 1), and broad maternal dietary habits (n = 3). Overall, higher or moderate intake of prenatal/multivitamin, FA, and Vitamin D was associated with reductions in odds of ASD, though results have not been uniform and there is a need to clarify differences in findings based on biomarkers versus reported intake. Evidence was inconclusive or insufficient for other nutrients. Differences in the timing and measurement of these dietary factors, as well as potential residual confounding, may contribute to existing discrepancies. Key areas for future research to better understand the role of maternal diet in ASD include the need to address potential critical windows, examine the combined effect of multiple nutrients, and consider interactions with genetic or environmental factors. LAY SUMMARY: Maternal diet during pregnancy is important for child neurodevelopment. We reviewed 36 studies examining maternal diet and autism spectrum disorder (ASD) and found that prenatal vitamin/multivitamin use and adequate intake of folic acid and Vitamin D were each associated with lower likelihood of having a child with ASD. Future studies on these and other dietary factors are needed to better understand the role of maternal diet in the development of ASD. Autism Res 2020, 13: 1634-1658. © 2020 International Society for Autism Research and Wiley Periodicals LLC.
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Affiliation(s)
- Caichen Zhong
- Department of Epidemiology and Biostatistics, Drexel University School of Public Health, Philadelphia, Pennsylvania, USA
| | | | - Brian K Lee
- Department of Epidemiology and Biostatistics, Drexel University School of Public Health, Philadelphia, Pennsylvania, USA
| | - Kristen Lyall
- A.J. Drexel Autism Institute, Philadelphia, Pennsylvania, USA
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18
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How 25(OH)D Levels during Pregnancy Affect Prevalence of Autism in Children: Systematic Review. Nutrients 2020; 12:nu12082311. [PMID: 32752078 PMCID: PMC7468823 DOI: 10.3390/nu12082311] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 07/25/2020] [Accepted: 07/27/2020] [Indexed: 12/27/2022] Open
Abstract
Autism spectrum disorder (ASD) is a group of dysfunctions in social interaction, communication, and behaviors. The etiology of ASD is not yet fully understood; however, it consists of the interaction between genetics and the environment. An increasing amount of evidence points to the possibility that gestational and early-childhood vitamin D deficiency may be involved in the etiology of some cases of ASD. Herein, we systematically review the literature for studies on vitamin D status during pregnancy and ASD outcomes. Forty-three studies in the PubMed and 124 studies in EMBASE databases were initially found. After screening, 26 were identified as candidate studies for inclusion. Finally, 14 articles met the inclusion criteria, which originated from nine countries. The studies included 10 original research studies and four review studies conducted between 2012 and 2020. The strength of evidence that vitamin D levels during pregnancy increase the risk of developing autism is very low. This is because the evidence relies exclusively on observational studies that did not equally consider all important confounders and that assessed the indirect relationship between vitamin D as a surrogate for sunlight exposure and autism risk. The findings of this systematic review are consistent with the hypothesis that low vitamin D levels might contribute to the development of autism. However, we must also recognize the possible confusion bias and therefore experimental studies with very large sample sizes, given incidence of autism, that allow us to detect blood levels in pregnant women would be helpful to clarify this point.
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19
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Mutua AM, Mogire RM, Elliott AM, Williams TN, Webb EL, Abubakar A, Atkinson SH. Effects of vitamin D deficiency on neurobehavioural outcomes in children: a systematic review. Wellcome Open Res 2020; 5:28. [PMID: 32399499 PMCID: PMC7194460 DOI: 10.12688/wellcomeopenres.15730.2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/04/2020] [Indexed: 01/14/2023] Open
Abstract
Introduction: Vitamin D plays an important role in brain development in experimental studies; however, the effect of vitamin D deficiency on child development remains inadequately characterized. We aimed to estimate the effects of vitamin D deficiency on neurobehavioural outcomes in children up to 18 years of age. Methods: We searched PubMed, EMBASE, PsycINFO, Scopus, Cochrane Library, Web of Science and Open Grey for published studies up to 10th January 2020. We included all studies that assessed the effects of maternal or child vitamin D status or vitamin D supplementation on neurobehavioural outcomes in children. Study findings were synthesized qualitatively as the high level of heterogeneity in study populations and methodologies precluded a quantitative meta-analysis. Results: Our search identified 5,633 studies, of which 31 studies with 31,375 participants from 18 countries were included in the systematic review. Of the studies identified, one was a randomised controlled trial (RCT) of vitamin D supplementation in children, while 30 were observational. The RCT (n=55) reported a beneficial effect of supplementation with lower doses compared to higher doses of vitamin D on motor development. Twelve mother-child studies (n=17,136) and five studies in children (n=1,091) reported an association between low maternal or child 25-hydroxyvitamin D levels and impaired neurobehavioural outcomes in children, while 15 mother-child studies (n=20,778) and eight studies in children (n=7,496) reported no association. Conclusions: Although animal studies point to an effect of vitamin D deficiency on brain development, there are few studies on the effects of vitamin D deficiency on neurobehavioural outcomes in children and their findings are inconsistent. There is a need for well-conducted, adequately powered studies to further determine these effects in children. Registration: PROSPERO ID CRD42018087619; registered on 15 February 2018.
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Affiliation(s)
- Agnes M. Mutua
- KEMRI-Wellcome Trust Research Programme, Kilifi, 80108, Kenya
- Department of Public Health, School of Human and Health Sciences, Pwani University, Kilifi, 80108, Kenya
| | - Reagan M. Mogire
- KEMRI-Wellcome Trust Research Programme, Kilifi, 80108, Kenya
- Open University, KEMRI-Wellcome Trust Research Programme - Accredited Research Centre, Kilifi, 80108, Kenya
| | - Alison M. Elliott
- Medical Research Council / Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK
| | - Thomas N. Williams
- KEMRI-Wellcome Trust Research Programme, Kilifi, 80108, Kenya
- Department of Medicine, Imperial College London, London, W21N, UK
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, OX3 7FZ, UK
| | - Emily L. Webb
- MRC Tropical Epidemiology Group, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK
| | - Amina Abubakar
- KEMRI-Wellcome Trust Research Programme, Kilifi, 80108, Kenya
- Department of Public Health, School of Human and Health Sciences, Pwani University, Kilifi, 80108, Kenya
- Department of Psychiatry, University of Oxford, Oxford, OX3 7JX, UK
- Institute for Human Development, Aga Khan University, Nairobi, 00100, Kenya
| | - Sarah H. Atkinson
- KEMRI-Wellcome Trust Research Programme, Kilifi, 80108, Kenya
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, OX3 7FZ, UK
- Department of Paediatrics, University of Oxford, Oxford, OX3 9DU, UK
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20
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Mutua AM, Mogire RM, Elliott AM, Williams TN, Webb EL, Abubakar A, Atkinson SH. Effects of vitamin D deficiency on neurobehavioural outcomes in children: a systematic review. Wellcome Open Res 2020; 5:28. [PMID: 32399499 PMCID: PMC7194460 DOI: 10.12688/wellcomeopenres.15730.1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/07/2020] [Indexed: 12/14/2022] Open
Abstract
Introduction: Vitamin D plays an important role in brain development in experimental studies; however, the effect of vitamin D deficiency on child development remains inadequately characterized. We aimed to estimate the effects of vitamin D deficiency on neurobehavioural outcomes in children up to 18 years of age. Methods: We searched PubMed, EMBASE, PsycINFO, Scopus, Cochrane Library, Web of Science and Open Grey for published studies up to 10th January 2020. We included all studies that assessed the effects of maternal or child vitamin D status or vitamin D supplementation on neurobehavioural outcomes in children. Study findings were synthesized qualitatively as the high level of heterogeneity in study populations and methodologies precluded a quantitative meta-analysis. Results: Our search identified 5,633 studies, of which 32 studies with 31,445 participants from 18 countries were included in the systematic review. Of the studies identified, two were randomized controlled trials (RCTs) of vitamin D supplementation in children, while 30 were observational. One RCT (n=55) reported a beneficial effect of supplementation with lower doses compared to higher doses of vitamin D on motor development while the other RCT (n=70) found no beneficial effect of vitamin D supplementation on cognition in extremely preterm infants. Twelve mother-child studies (n=17,136) and five studies in children (n=1,091) reported an association between low maternal or child 25-hydroxyvitamin D levels and impaired neurobehavioural outcomes in children, while 15 mother-child studies (n=20,778) and eight studies in children (n=7,496) reported no association. Conclusions: Although animal studies point to an effect of vitamin D deficiency on brain development, there are few studies on the effects of vitamin D deficiency on neurobehavioural outcomes in children and their findings are inconsistent. There is a need for well-conducted, adequately powered studies to further determine these effects in children. Registration: PROSPERO ID CRD42018087619; registered on 15 February 2018.
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Affiliation(s)
- Agnes M. Mutua
- KEMRI-Wellcome Trust Research Programme, Kilifi, 80108, Kenya
- Department of Public Health, School of Human and Health Sciences, Pwani University, Kilifi, 80108, Kenya
| | - Reagan M. Mogire
- KEMRI-Wellcome Trust Research Programme, Kilifi, 80108, Kenya
- Open University, KEMRI-Wellcome Trust Research Programme - Accredited Research Centre, Kilifi, 80108, Kenya
| | - Alison M. Elliott
- Medical Research Council / Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK
| | - Thomas N. Williams
- KEMRI-Wellcome Trust Research Programme, Kilifi, 80108, Kenya
- Department of Medicine, Imperial College London, London, W21N, UK
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, OX3 7FZ, UK
| | - Emily L. Webb
- MRC Tropical Epidemiology Group, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK
| | - Amina Abubakar
- KEMRI-Wellcome Trust Research Programme, Kilifi, 80108, Kenya
- Department of Public Health, School of Human and Health Sciences, Pwani University, Kilifi, 80108, Kenya
- Department of Psychiatry, University of Oxford, Oxford, OX3 7JX, UK
- Institute for Human Development, Aga Khan University, Nairobi, 00100, Kenya
| | - Sarah H. Atkinson
- KEMRI-Wellcome Trust Research Programme, Kilifi, 80108, Kenya
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, OX3 7FZ, UK
- Department of Paediatrics, University of Oxford, Oxford, OX3 9DU, UK
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21
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Zou R, El Marroun H, McGrath JJ, Muetzel RL, Hillegers M, White T, Tiemeier H. A prospective population-based study of gestational vitamin D status and brain morphology in preadolescents. Neuroimage 2020; 209:116514. [PMID: 31904491 DOI: 10.1016/j.neuroimage.2020.116514] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 12/19/2019] [Accepted: 01/01/2020] [Indexed: 11/19/2022] Open
Abstract
Low vitamin D level during pregnancy has been associated with adverse neurodevelopmental outcomes such as autism spectrum disorders (ASD) in children. However, the underlying neurobiological mechanism remains largely unknown. This study investigated the association between gestational 25-hydroxyvitamin D [25(OH)D] concentration and brain morphology in 2597 children at the age of 10 years in the population-based Generation R Study. We studied both 25(OH)D in maternal venous blood in mid-gestation and in umbilical cord blood at delivery, in relation to brain volumetric measures and surface-based cortical metrics including cortical thickness, surface area, and gyrification using linear regression. We found exposure to higher maternal 25(OH)D concentrations in mid-gestation was associated with a larger cerebellar volume in children (b = 0.02, 95%CI 0.001 to 0.04), however this association did not remain after correction for multiple comparisons. In addition, children exposed to persistently deficient (i.e., <25 nmol/L) 25(OH)D concentration from mid-gestation to delivery showed less cerebral gray matter and white matter volumes, as well as smaller surface area and less gyrification at 10 years than those with persistently sufficient (i.e., ≥50 nmol/L) 25(OH)D concentration. These results suggest temporal relationships between gestational vitamin D concentration and brain morphological development in children.
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Affiliation(s)
- Runyu Zou
- Department of Child and Adolescent Psychiatry, Erasmus MC University Medical Center Rotterdam, Rotterdam, the Netherlands; The Generation R Study Group, Erasmus MC University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Hanan El Marroun
- Department of Child and Adolescent Psychiatry, Erasmus MC University Medical Center Rotterdam, Rotterdam, the Netherlands; Department of Pediatrics, Erasmus MC University Medical Center Rotterdam, Rotterdam, the Netherlands; Department of Psychology, Education, and Child Studies, Erasmus School of Social and Behavioral Sciences, Erasmus University Rotterdam, Rotterdam, the Netherlands.
| | - John J McGrath
- Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, Queensland, Australia; Queensland Brain Institute, The University of Queensland, St Lucia, Queensland, Australia; National Centre for Register-based Research, Aarhus University, Aarhus, Denmark
| | - Ryan L Muetzel
- Department of Child and Adolescent Psychiatry, Erasmus MC University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Manon Hillegers
- Department of Child and Adolescent Psychiatry, Erasmus MC University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Tonya White
- Department of Child and Adolescent Psychiatry, Erasmus MC University Medical Center Rotterdam, Rotterdam, the Netherlands; Department of Radiology & Nuclear Medicine, Erasmus MC University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Henning Tiemeier
- Department of Child and Adolescent Psychiatry, Erasmus MC University Medical Center Rotterdam, Rotterdam, the Netherlands; Department of Social and Behavioral Sciences, T.H. Chan School of Public Health, Harvard University, Boston, MA, United States
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