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Wahlquist AE, Blanke HH, Asghari G, Baatz JE, Ebeling M, Shary JR, Howard CR, Lawrence RA, Hollis BW, Wagner CL. Factors Affecting Postpartum Bone Mineral Density in a Clinical Trial of Vitamin D Supplementation. J Womens Health (Larchmt) 2024; 33:887-900. [PMID: 38853682 DOI: 10.1089/jwh.2022.0525] [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] [Indexed: 06/11/2024] Open
Abstract
Background: Few studies evaluate the effects of vitamin D status and supplementation on maternal bone mineral density (BMD) during lactation and further lack inclusion of diverse racial/ethnic groups, body mass index (BMI), or physical activity. Objective: Determine the effects of vitamin D treatment/status, feeding type, BMI, race/ethnicity, and physical activity on postpartum women's BMD to 7 months. Methods: Women with singleton pregnancies beginning 4-6 weeks' postpartum were randomized into two treatment groups (400 or 6400 IU vitamin D/day). Participant hip, spine, femoral neck, and whole-body BMD using Dual-energy X-ray absorptiometry (DXA Hologic), serum 25-hydroxyvitamin D [25(OH)D] (RIA; Diasorin), BMI, and physical activity were measured at 1, 4, and 7 months postpartum. A general linear mixed modeling approach was undertaken to assess the effects of vitamin D status [both serum 25(OH)D concentrations and treatment groups], feeding type, race/ethnicity, BMI, and physical activity on BMD in postpartum women. Results: During the 6-month study period, lactating women had 1-3% BMD loss in all regions compared with 1-3% gain in nonlactating women. Higher maternal BMI was associated with less bone loss in femoral neck and hip regions. Black American women had less BMD loss than White/Caucasian or Hispanic lactating women in spine and hip regions. Exclusively breastfeeding women in the 6400 IU vitamin D group had less femoral neck BMD loss than the 400 IU group at 4 months sustained to 7 months. Physical activity was associated with higher hip BMD. Conclusion: While there was BMD loss during lactation to 7 months, the loss rate was less than previously reported, with notable racial/ethnic variation. Breastfeeding was associated with loss in BMD compared with formula-feeding women who gained BMD. Higher BMI and physical activity independently appeared to protect hip BMD, whereas higher vitamin D supplementation appeared protective against femoral neck BMD loss.
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Affiliation(s)
- Amy E Wahlquist
- Department of Biostatistics & Epidemiology, Center for Rural Health Research, East Tennessee State University (ETSU), Johnson City, Tennessee, USA
- Department of Public Health Sciences, MUSC, Charleston, South Carolina, USA
| | - Harry H Blanke
- Halifax Health Primary Care, New Smyrna Beach, Florida, USA
| | - Golaleh Asghari
- Nutritional Sciences, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - John E Baatz
- Division of Neonatology, Department of Pediatrics, Shawn Jenkins Children's Hospital, Medical University of South Carolina (MUSC) College of Medicine, Charleston, South Carolina, USA
| | - Myla Ebeling
- Division of Neonatology, Department of Pediatrics, Shawn Jenkins Children's Hospital, Medical University of South Carolina (MUSC) College of Medicine, Charleston, South Carolina, USA
| | - Judy R Shary
- Division of Neonatology, Department of Pediatrics, Shawn Jenkins Children's Hospital, Medical University of South Carolina (MUSC) College of Medicine, Charleston, South Carolina, USA
| | - Cynthia R Howard
- Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
| | - Ruth A Lawrence
- Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
| | - Bruce W Hollis
- Division of Neonatology, Department of Pediatrics, Shawn Jenkins Children's Hospital, Medical University of South Carolina (MUSC) College of Medicine, Charleston, South Carolina, USA
| | - Carol L Wagner
- Division of Neonatology, Department of Pediatrics, Shawn Jenkins Children's Hospital, Medical University of South Carolina (MUSC) College of Medicine, Charleston, South Carolina, USA
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Alifu X, Si S, Qiu Y, Cheng H, Huang Y, Chi P, Zhuang Y, Zhou H, Zhang L, Ainiwan D, Peng Z, Liu H, Yu Y. The Association of Vitamin D during Pregnancy and mRNA Expression Levels of Inflammatory Factors with Preterm Birth and Prelabor Rupture of Membranes. Nutrients 2023; 15:3423. [PMID: 37571360 PMCID: PMC10421124 DOI: 10.3390/nu15153423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 07/26/2023] [Accepted: 07/31/2023] [Indexed: 08/13/2023] Open
Abstract
The aim of this study was to elucidate the association between vitamin D (VD) and the risk for preterm birth (PTB) and prelabor rupture of membranes (PROM). This study included two parts, with a cohort study and a case-control study. Plasma 25-hydroxyvitamin vitamin D [25(OH)D] levels in three trimesters in the cohort study and maternal 25(OH)D before delivery in the case-control study were measured. Quantitative real-time PCR was used to detect relative mRNA expression levels of the inflammatory factors associated with pyroptosis in peripheral blood mononuclear cell (PBMC), placenta and fetal membranes. Multinomial logistic regression and the Wilcoxon test were applied to analyze the associations. In the cohort study, 6381 pregnant women were included. We found that VD deficiency in T3 (PTB without PROM: OR = 1.90, 95% CI: 1.02-3.55, Term PROM (TPROM): OR = 0.76, 95% CI: 0.59-0.98) and less change of 25(OH)D between T1 and T3 (PTB without PROM: OR = 2.32, 95% CI: 1.07-5.06, TPROM: OR = 0.73, 95% CI: 0.56-0.96) were associated with the increased risk of PTB without PROM, while there was a decreased risk of TPROM. Neither VD, nor the increase of VD during pregnancy was associated with the premature rupture of membranes preterm delivery (PPROM). In the case-control study, there were no associations between VD during delivery and PTB or PROM (TPROM: OR = 1.33, 95% CI: 0.52-3.44); PTB without PROM: OR = 1.66, 95% CI: 0.33-8.19; PPROM: OR = 1.19, 95% CI: 0.42-3.40). The mRNA expression of NLRP1 (NOD-like receptor thermal protein domain associated protein 1) (p = 0.0165) in PBMC in the TPROM group was higher than that in the term group, and IL-18 (p = 0.0064) was lower than that in the term group. Plasma 25(OH)D in T3 and the increase of 25(OH)D between T1 and T3 were associated with a lower risk for PTB without PROM but a higher risk for TPROM. Further studies are warranted to clarify the association between VD and PTB and PROM and its mechanism.
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Affiliation(s)
- Xialidan Alifu
- Department of Public Health, and Department of Anesthesiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China; (X.A.); (S.S.); (Y.Q.); (H.C.); (Y.H.); (P.C.); (Y.Z.); (H.Z.); (L.Z.); (D.A.); (Z.P.)
- Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou 310058, China
| | - Shuting Si
- Department of Public Health, and Department of Anesthesiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China; (X.A.); (S.S.); (Y.Q.); (H.C.); (Y.H.); (P.C.); (Y.Z.); (H.Z.); (L.Z.); (D.A.); (Z.P.)
- Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou 310058, China
- Yiwu Maternity and Children Hospital, Yiwu 322000, China
| | - Yiwen Qiu
- Department of Public Health, and Department of Anesthesiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China; (X.A.); (S.S.); (Y.Q.); (H.C.); (Y.H.); (P.C.); (Y.Z.); (H.Z.); (L.Z.); (D.A.); (Z.P.)
- Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou 310058, China
| | - Haoyue Cheng
- Department of Public Health, and Department of Anesthesiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China; (X.A.); (S.S.); (Y.Q.); (H.C.); (Y.H.); (P.C.); (Y.Z.); (H.Z.); (L.Z.); (D.A.); (Z.P.)
- Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou 310058, China
| | - Ye Huang
- Department of Public Health, and Department of Anesthesiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China; (X.A.); (S.S.); (Y.Q.); (H.C.); (Y.H.); (P.C.); (Y.Z.); (H.Z.); (L.Z.); (D.A.); (Z.P.)
- Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou 310058, China
| | - Peihan Chi
- Department of Public Health, and Department of Anesthesiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China; (X.A.); (S.S.); (Y.Q.); (H.C.); (Y.H.); (P.C.); (Y.Z.); (H.Z.); (L.Z.); (D.A.); (Z.P.)
- Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou 310058, China
| | - Yan Zhuang
- Department of Public Health, and Department of Anesthesiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China; (X.A.); (S.S.); (Y.Q.); (H.C.); (Y.H.); (P.C.); (Y.Z.); (H.Z.); (L.Z.); (D.A.); (Z.P.)
- Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou 310058, China
| | - Haibo Zhou
- Department of Public Health, and Department of Anesthesiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China; (X.A.); (S.S.); (Y.Q.); (H.C.); (Y.H.); (P.C.); (Y.Z.); (H.Z.); (L.Z.); (D.A.); (Z.P.)
- Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou 310058, China
| | - Libi Zhang
- Department of Public Health, and Department of Anesthesiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China; (X.A.); (S.S.); (Y.Q.); (H.C.); (Y.H.); (P.C.); (Y.Z.); (H.Z.); (L.Z.); (D.A.); (Z.P.)
- Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou 310058, China
| | - Diliyaer Ainiwan
- Department of Public Health, and Department of Anesthesiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China; (X.A.); (S.S.); (Y.Q.); (H.C.); (Y.H.); (P.C.); (Y.Z.); (H.Z.); (L.Z.); (D.A.); (Z.P.)
- Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou 310058, China
| | - Zhicheng Peng
- Department of Public Health, and Department of Anesthesiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China; (X.A.); (S.S.); (Y.Q.); (H.C.); (Y.H.); (P.C.); (Y.Z.); (H.Z.); (L.Z.); (D.A.); (Z.P.)
- Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou 310058, China
| | - Hui Liu
- Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310058, China;
| | - Yunxian Yu
- Department of Public Health, and Department of Anesthesiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China; (X.A.); (S.S.); (Y.Q.); (H.C.); (Y.H.); (P.C.); (Y.Z.); (H.Z.); (L.Z.); (D.A.); (Z.P.)
- Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou 310058, China
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Sanguesa J, Marquez S, Bustamante M, Sunyer J, Iniguez C, Vioque J, Rodriguez LSM, Jimeno-Romero A, Torrent M, Casas M, Vrijheid M. Prenatal Vitamin D Levels Influence Growth and Body Composition until 11 Years in Boys. Nutrients 2023; 15:2033. [PMID: 37432159 DOI: 10.3390/nu15092033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 04/12/2023] [Accepted: 04/19/2023] [Indexed: 07/12/2023] Open
Abstract
BACKGROUND Gestational vitamin D levels may influence offspring growth and modulate adipogenesis. Findings from prospective studies are inconsistent, and few have evaluated the persistence of these associations into late childhood. OBJECTIVE To examine the association between prenatal vitamin D levels and growth and adiposity in late childhood. METHODS We included 2027 mother-child pairs from the INMA birth cohort. 25-hydroxyvitamin D3 (vitamin D3) levels were measured in serum at 13 weeks of pregnancy. Sex- and age-specific body mass index z-scores were calculated at 7 and 11 years, overweight was defined as z-score ≥ 85th percentile, and body fat mass was measured at 11 years. Z-score body mass index (zBMI) trajectories from birth to 11 years were identified using latent class growth analysis. RESULTS The prevalence of vitamin D3 deficiency (<20 ng/mL) was 17.5%, and around 40% of the children had overweight at both ages. Associations between vitamin D levels and outcomes differed by sex. In boys, maternal vitamin D3 deficient status was associated with higher zBMI, higher fat mass percentage, higher odds of being overweight, and with an increased risk of belonging to lower birth size followed by accelerated BMI gain trajectory. In girls no associations were observed. CONCLUSION Our results support a sex-specific programming effect of early pregnancy vitamin D3 levels on offspring body composition into late childhood observed in boys.
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Affiliation(s)
- Julia Sanguesa
- ISGlobal, 08036 Barcelona, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
- Universitat Pompeu Fabra (UPF), 08002 Barcelona, Spain
| | - Sandra Marquez
- ISGlobal, 08036 Barcelona, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
- Universitat Pompeu Fabra (UPF), 08002 Barcelona, Spain
| | - Mariona Bustamante
- ISGlobal, 08036 Barcelona, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
- Universitat Pompeu Fabra (UPF), 08002 Barcelona, Spain
| | - Jordi Sunyer
- ISGlobal, 08036 Barcelona, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
- Universitat Pompeu Fabra (UPF), 08002 Barcelona, Spain
| | - Carmen Iniguez
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
- Department of Statistics and Operational Research, Universitat de València, 46010 València, Spain
| | - Jesus Vioque
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
- Alicante Institute for Health and Biomedical Research (ISABIAL-FISABIO Foundation), 03010 Alicante, Spain
- Nutritional Epidemiology Unit, University Miguel Hernandez, 03202 Elche, Spain
| | - Loreto Santa-Marina Rodriguez
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
- Biodonostia Health Research Institute, Group of Environmental Epidemiology and Child Development, 20014 San Sebastian, Spain
- Ministry of Health of the Basque Government, SubDirectorate for Public Health and Addictions of Gipuzkoa, 20010 San Sebastian, Spain
| | - Alba Jimeno-Romero
- Biodonostia Health Research Institute, Group of Environmental Epidemiology and Child Development, 20014 San Sebastian, Spain
- Preventive Medicine and Public Health Department, University of the Basque Country, 48940 Leioa, Spain
| | - Matias Torrent
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
- IB-SALUT, Area de Salud de Menorca, Menorca, Spain
| | - Maribel Casas
- ISGlobal, 08036 Barcelona, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
- Universitat Pompeu Fabra (UPF), 08002 Barcelona, Spain
| | - Martine Vrijheid
- ISGlobal, 08036 Barcelona, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
- Universitat Pompeu Fabra (UPF), 08002 Barcelona, Spain
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4
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Kinshella MLW, Omar S, Scherbinsky K, Vidler M, Magee LA, von Dadelszen P, Moore SE, Elango R. Maternal nutritional risk factors for pre-eclampsia incidence: findings from a narrative scoping review. Reprod Health 2022; 19:188. [PMID: 36064716 PMCID: PMC9442926 DOI: 10.1186/s12978-022-01485-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 07/21/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Pre-eclampsia is a leading cause of maternal mortality and morbidity that involves pregnancy-related stressors on the maternal cardiovascular and metabolic systems. As nutrition is important to support optimal development of the placenta and for the developing fetus, maternal diets may play a role in preventing pre-eclampsia. The purpose of this scoping review is to map the maternal nutritional deficiencies and imbalances associated with pre-eclampsia incidence and discuss evidence consistency and linkages with current understandings of the etiology of pre-eclampsia. METHODS A narrative scoping review was conducted to provide a descriptive account of available research, summarize research findings and identify gaps in the evidence base. Relevant observational studies and reviews of observational studies were identified in an iterative two-stage process first involving electronic database searches then more sensitive searches as familiarity with the literature increased. Results were considered in terms of their consistency of evidence, effect sizes and biological plausibility. RESULTS The review found evidence for associations between nutritional inadequacies and a greater risk of pre-eclampsia. These associations were most likely mediated through oxidative stress, inflammation, maternal endothelial dysfunction and blood pressure in the pathophysiology of pre-eclampsia. Maternal nutritional risk factors for pre-eclampsia incidence with the strongest consistency, effect and biological plausibility include vitamin C and its potential relationship with iron status, vitamin D (both on its own and combined with calcium and magnesium), and healthy dietary patterns featuring high consumption of fruits, vegetables, whole grains, fish, seafood and monounsaturated vegetable oils. Foods high in added sugar, such as sugary drinks, were associated with increased risk of pre-eclampsia incidence. CONCLUSION A growing body of literature highlights the involvement of maternal dietary factors in the development of pre-eclampsia. Our review findings support the need for further investigation into potential interactions between dietary factors and consideration of nutritional homeostasis and healthy dietary patterns. Further research is recommended to explore gestational age, potential non-linear relationships, dietary diversity and social, cultural contexts of food and meals.
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Affiliation(s)
- Mai-Lei Woo Kinshella
- Department of Obstetrics and Gynaecology, BC Children's and Women's Hospital and University of British Columbia, Vancouver, Canada
| | - Shazmeen Omar
- Department of Obstetrics and Gynaecology, BC Children's and Women's Hospital and University of British Columbia, Vancouver, Canada
| | - Kerri Scherbinsky
- Department of Obstetrics and Gynaecology, BC Children's and Women's Hospital and University of British Columbia, Vancouver, Canada
- Department of Pediatrics, Rm170, BC Children's and Women's Hospital, University of British Columbia, 950 West 28th Avenue, Vancouver, Canada
| | - Marianne Vidler
- Department of Obstetrics and Gynaecology, BC Children's and Women's Hospital and University of British Columbia, Vancouver, Canada
| | - Laura A Magee
- Department of Obstetrics and Gynaecology, BC Children's and Women's Hospital and University of British Columbia, Vancouver, Canada
- Department of Women & Children's Health, King's College London, London, UK
| | - Peter von Dadelszen
- Department of Obstetrics and Gynaecology, BC Children's and Women's Hospital and University of British Columbia, Vancouver, Canada
- Department of Women & Children's Health, King's College London, London, UK
| | - Sophie E Moore
- Department of Women & Children's Health, King's College London, London, UK
- MRC Unit The Gambia at the London, School of Hygiene and Tropical Medicine, Fajara, The Gambia
| | - Rajavel Elango
- Department of Pediatrics, Rm170, BC Children's and Women's Hospital, University of British Columbia, 950 West 28th Avenue, Vancouver, Canada.
- School of Population and Public Health, University of British Columbia, Vancouver, Canada.
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Lütke-Dörhoff M, Schulz J, Westendarp H, Visscher C, Wilkens MR. Dietary supplementation of 25-hydroxycholecalciferol as an alternative to cholecalciferol in swine diets: A review. J Anim Physiol Anim Nutr (Berl) 2022; 106:1288-1305. [PMID: 36045590 DOI: 10.1111/jpn.13768] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 07/31/2022] [Accepted: 08/11/2022] [Indexed: 12/01/2022]
Abstract
25-hydroxycholecalciferol (25-OHD3 ) formed via hepatic hydroxylation from vitamin D, cholecalciferol, represents the precursor of the biologically active vitamin D hormone, 1,25-dihydroxyvitamin D. Due to a higher absorption rate and the omission of one hydroxylation, dietary supplementation of 25-OHD3 instead of vitamin D3 is considered to be more efficient as plasma concentrations of 25-OHD3 are increased more pronounced. The present review summarises studies investigating potential beneficial effects on mineral homeostasis, bone metabolism, health status and performance in sows, piglets and fattening pigs. Results are inconsistent. While most studies could not demonstrate any or only a slight impact of partial or total replacement of vitamin D3 by 25-OHD3 , some experiments indicated that 25-OHD3 might alter physiological processes when animals are challenged, for example, by a restricted mineral supply.
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Affiliation(s)
- Michael Lütke-Dörhoff
- Institute for Animal Hygiene, Animal Welfare and Farm Animal Behaviour, University of Veterinary Medicine Hannover, Foundation, Hanover, Germany.,Department of Animal Nutrition, Faculty of Agricultural Sciences and Landscape Architecture, Hochschule Osnabrück, Osnabrück, Germany
| | - Jochen Schulz
- Institute for Animal Hygiene, Animal Welfare and Farm Animal Behaviour, University of Veterinary Medicine Hannover, Foundation, Hanover, Germany
| | - Heiner Westendarp
- Department of Animal Nutrition, Faculty of Agricultural Sciences and Landscape Architecture, Hochschule Osnabrück, Osnabrück, Germany
| | - Christian Visscher
- Institute for Animal Nutrition, University of Veterinary Medicine Hannover, Foundation, Hanover, Germany
| | - Mirja R Wilkens
- Institute of Animal Nutrition, Nutrition Diseases and Dietetics, Faculty of Veterinary Medicine, University of Leipzig, Leipzig, Germany
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Wille K, Richard A, Nieters A, Rohrmann S, Quack Lötscher K. Vitamin D and parathyroid hormone in the umbilical cord blood - Correlation with light and dark maternal skin color. Food Sci Nutr 2022; 10:4201-4208. [PMID: 36514767 PMCID: PMC9731526 DOI: 10.1002/fsn3.3013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 07/14/2022] [Accepted: 07/17/2022] [Indexed: 12/16/2022] Open
Abstract
During pregnancy, vitamin D deficiency is associated with negative health consequences for mother and child. Furthermore, dark skin color is associated with lower vitamin D levels. We investigated 25-hydroxy-vitamin D (25(OH)D) and parathyroid hormone (PTH) levels in mothers and in cord blood of their newborns depending on maternal skin color. We recruited 202 mother and child pairs at the University Hospital Zurich and measured 25(OH)D and PTH concentrations in maternal and postpartum umbilical cord blood. Skin type was self-reported based on the Fitzpatrick Scale (type I to V). Uni- and multivariate methods were used to compare the maternal and neonatal 25(OH)D and PTH levels by skin type (light: I-III vs. dark: IV-V). As many as 54.5% of all mothers and 41.1% of the neonates were 25(OH)D deficient. This was higher in the neonates of dark-skinned (55.9%) than in the neonates of light-skinned mothers (38.1%; p = .06). The correlation of 25(OH)D in the maternal with umbilical cord blood was high (light: r = 0.85, dark: r = 0.87), with higher concentrations of 25(OH) vitamin D in the umbilical cord than in maternal blood. Regression analysis revealed that country of origin and maternal 25(OH)D concentration were the only statistically significant determinants for umbilical cord blood 25(OH)D. We observed no correlation of maternal with umbilical cord PTH concentrations; median PTH concentrations in the umbilical cord (5.6 pg/ml) were significantly lower than in maternal blood (25.7 pg/ml). The recommendation of vitamin D supplementation in newborns in their first 3 years of life should be particularly emphasized to dark-skinned mothers.
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Affiliation(s)
- Klara Wille
- Department of ObstetricsUniversity Hospital ZurichZurichSwitzerland
| | - Aline Richard
- EpidemiologyBiostatistics and Prevention Institute, University of ZurichZurichSwitzerland
| | - Alexandra Nieters
- FREEZE‐Biobank, Center for Chronic Immunodeficiency, Medical Center, Faculty of MedicineUniversity of FreiburgFreiburgGermany
| | - Sabine Rohrmann
- EpidemiologyBiostatistics and Prevention Institute, University of ZurichZurichSwitzerland
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7
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Best CM, Sherwood R, Novotny JA, Zhang S, Pressman EK, O'Brien KO. Vitamin D kinetics in nonpregnant and pregnant women after a single oral dose of trideuterated vitamin D 3. J Steroid Biochem Mol Biol 2022; 216:106034. [PMID: 34843870 PMCID: PMC8749867 DOI: 10.1016/j.jsbmb.2021.106034] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 11/04/2021] [Accepted: 11/25/2021] [Indexed: 02/03/2023]
Abstract
The plasma pool of the hormone 1,25-dihydroxyvitamin D (1,25(OH)2D) is increased throughout most of human pregnancy. Mechanisms behind this adaptation are unclear, in part due to limited data on vitamin D kinetics during pregnancy. Stable isotopes make it possible to study vitamin D kinetics in vulnerable study populations like pregnant women. We conducted a pilot study of vitamin D kinetics in nonpregnant and pregnant women. We evaluated a clinical protocol and developed analytical methods to assess the serum appearance and disappearance of trideuterated vitamin D3 (d3-vitamin D3) and trideuterated 25-hydroxyvitamin D3 (d3-25(OH)D3) after a single oral dose of 25 μg of [6,19,19-2H]-vitamin D3 (d3-vitamin D3). Blood was collected at baseline and 2, 4, 6, 24, 168, 264, and 456 hours post-dosing. We then described the serum kinetic profiles of d3-vitamin D3 and d3-25(OH)D3 in nonpregnant and pregnant women. Serum kinetic profiles of d3-vitamin D3 and d3-25(OH)D3 followed a time course in line with previous pharmacokinetic studies. There was marked variability between participants in the area under the concentration-time curve (AUC) of d3-25(OH)D3 over the 20-day study period. This AUC of d3-25(OH)D3 was positively correlated with the serum vitamin D binding protein (DBP) concentration, which was higher in pregnant compared with nonpregnant women. The mean serum half-life of 25(OH)D3 was longer but not significantly different in pregnant women (18.8 days) compared with nonpregnant women (13.6 days). Our pilot study demonstrated that a single oral dose of 25 μg of d3-vitamin D3 can be used to study vitamin D kinetics. Serum DBP concentration is an important predictor of vitamin D kinetics, and more research is needed to fully understand the significance of elevated DBP concentration during pregnancy.
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Affiliation(s)
- Cora M Best
- Division of Nutritional Sciences, Cornell University, 244 Garden Avenue, Ithaca, NY, 14853, USA
| | - Robert Sherwood
- Proteomics and Metabolomics Facility, Cornell Institute of Biotechnology, 130 Biotechnology Building, Ithaca, NY, 14853, USA
| | - Janet A Novotny
- Beltsville Human Nutrition Research Center, Agricultural Research Service, U.S. Department of Agriculture, Bldg. 307-C, Rm 117, BARC-East, Beltsville, MD, 20705, USA
| | - Sheng Zhang
- Proteomics and Metabolomics Facility, Cornell Institute of Biotechnology, 130 Biotechnology Building, Ithaca, NY, 14853, USA
| | - Eva K Pressman
- Department of Obstetrics and Gynecology, University of Rochester School of Medicine and Dentistry, 601 Elmwood Avenue, Rochester, NY, 14642, USA
| | - Kimberly O O'Brien
- Division of Nutritional Sciences, Cornell University, 244 Garden Avenue, Ithaca, NY, 14853, USA.
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Fang X, Qu J, Huan S, Sun X, Li J, Liu Q, Jin S, Xia W, Xu S, Wu Y, Li J, Zheng T, Li Y. Associations of urine metals and metal mixtures during pregnancy with cord serum vitamin D Levels: A prospective cohort study with repeated measurements of maternal urinary metal concentrations. ENVIRONMENT INTERNATIONAL 2021; 155:106660. [PMID: 34052726 DOI: 10.1016/j.envint.2021.106660] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 04/16/2021] [Accepted: 05/19/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Vitamin D deficiency has been associated with the increased risk of many diseases, especially during early life. Exposure to some toxic metals may decrease vitamin D levels in adults and children in previous studies. However, less is known about the associations of maternal metals exposure during pregnancy with newborns' vitamin D status. OBJECTIVE We conducted a prospective cohort study to investigate the relationships between urine metals and metal mixtures during pregnancy and newborns' vitamin D status. METHODS Urine samples of 598 pregnant women were collected in each trimester and cord blood samples of newborns were collected at delivery. The concentrations of 20 metals in urine and 25-hydroxyvitamin D [25(OH)D] in cord serum were quantified. Generalized linear models were used to estimate the associations between individual metals and cord serum total 25(OH)D. We applied Bayesian Kernel Machine Regression (BKMR) to evaluate the mixture and interaction effects of urine metals. RESULTS In individual metals analyses, we reported that a double increase in urine vanadium (V), cobalt (Co), and thallium (Tl) throughout pregnancy was associated with a 9.91% [95% confidence interval (CI): -18.58%, -0.30%], 11.42% (95% CI: -17.73%, -4.63%), and 12.64% (95% CI: -21.44%, -2.86%) decrease in cord serum total 25(OH)D, respectively. Exposures to the three metals during the whole pregnancy were also correlated to increased odds for newborns' vitamin D deficiency (<20 ng/mL) [odds ratio (95% CI): 1.80 (1.05, 3.10) for V, 1.88 (1.25, 2.82) for Co, and 1.90 (1.07, 3.38) for Tl]. BKMR analyses revealed a negative influence of metal mixtures (V+Co+Tl) on neonatal vitamin D status, as well as potential synergism between V and Co and between V and Tl. CONCLUSIONS Our study provides evidence of negative impacts of maternal exposure to V, Co, and Tl during pregnancy on cord serum vitamin D levels at delivery. Potential synergism between V and Co and between V and Tl existed in their associations with cord serum total 25(OH)D.
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Affiliation(s)
- Xingjie Fang
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jingyu Qu
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Shu Huan
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Xiaojie Sun
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Juxiao Li
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Qi Liu
- Department of Maternal and Child Health and MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Shuna Jin
- College of Basic Medicine, Hubei University of Chinese Medicine, Wuhan, Hubei, China
| | - Wei Xia
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Shunqing Xu
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yongning Wu
- NHC Key Laboratory of Food Safety Risk Assessment, Food Safety Research Unit (2019RU014) of Chinese Academy of Medical Science, China National Center for Food Safety Risk Assessment, Beijing 100021, China
| | - Jingguang Li
- NHC Key Laboratory of Food Safety Risk Assessment, Food Safety Research Unit (2019RU014) of Chinese Academy of Medical Science, China National Center for Food Safety Risk Assessment, Beijing 100021, China
| | - Tongzhang Zheng
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI 02912, United States
| | - Yuanyuan Li
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
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9
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Yang C, Jing W, Ge S, Sun W. Vitamin D status and vitamin D deficiency risk factors among pregnancy of Shanghai in China. BMC Pregnancy Childbirth 2021; 21:431. [PMID: 34144704 PMCID: PMC8214247 DOI: 10.1186/s12884-021-03889-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 05/17/2021] [Indexed: 11/10/2022] Open
Abstract
Background There is increasing awareness that vitamin D deficiency in pregnant women may be associated with several adverse effects for the mother and newborn. The risks for vitamin D deficiency are unclear. This study was to assess vitamin D nutritional status and vitamin D deficiency risk factors among pregnant women in Shanghai in China. Methods This study is a cross-sectional study conducted in the Sixth Affiliated People’s Hospital of Shanghai Jiao Tong University. A total of 953 healthy pregnant women participated, serological examinations and other variables included serum 25-hydroxyvitamin D [25(OH)D], total blood cholesterol (TCh), high-density lipoprotein (HDL), low-density lipoprotein (LDL), and very-low-density lipoprotein (VLDL) cholesterol, triglycerides at the first antenatal visit (12–14 weeks) pregnancy parity and age, body mass index (BMI) before pregnancy, and completed OGTTs test. Associations between vitamin D deficiency and possible predictors (age group, pre-pregnancy BMI, parity, and gestational hyperlipemia) were assessed with a multinomial logistic regression analysis. And also used to investigate the effects of 25(OH)D and the other variables on the occurrence of gestational diabetes mellitus. Results The mean vitamin D level of pregnancy was 16 (a range from 11 to 21) ng/ml, and severe vitamin D deficiency was 31.8% (303); vitamin D deficiency was 40.7% (388); vitamin D insufficiency was 25.1% (239); normal vitamin D was 2.4%(23). Vitamin D deficiency risk factors were age over 30, parity over 2, overweight, obese, and hyperlipemia. The increasing level of vitamin D nutritional status in pregnancy is significantly related to reducing gestational diabetes mellitus. Vitamin D deficiency is a risk factor for gestational diabetes mellitus. Conclusions It is a high prevalence of vitamin D deficiency in Chinese pregnancy in Shanghai. Aging more than 30 years, the parity of more than 2, overweight and obesity, and hyperlipemia are risk factors for vitamin D deficiency. Vitamin D deficiency is a risk factor for gestational diabetes mellitus. Public health strategies to prevent vitamin D deficiency should focus on those risks to promote health pregnancy of Shanghai in China.
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Affiliation(s)
- Chun Yang
- Department of Nutrition and Food Hygiene, School of Public Health, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Clinical Epidemiology, Beijing, China.,Beijing Key Laboratory of Environmental Toxicology, Beijing, China
| | - Wu Jing
- Clinical Nutrition Department, The First Affiliated Hospital of Zhejiang Chinese Medical University, Zhejiang Province, China
| | - Sheng Ge
- Clinical Nutrition Department, Shanghai Sixth People's Hospital, Affiliated to Shanghai Jiao Tong University, Shanghai, China.
| | - Wenguang Sun
- School of Medicine, The International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University, Shanghai, China. .,Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China. .,Shanghai Municipal Key Clinical Specialty, Shanghai, China.
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10
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Iron, iodine and vitamin D deficiencies during pregnancy: epidemiology, risk factors and developmental impacts. Proc Nutr Soc 2021; 80:290-302. [PMID: 33988109 DOI: 10.1017/s0029665121001944] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Micronutrient deficiency persists throughout the world, and although the burden is higher in low-resource settings, it is also prevalent in wealthy countries, a phenomenon termed 'hidden hunger'. Due to their high requirements for vitamins and minerals relative to their energy intake, young women and children are particularly vulnerable to hidden hunger. As they share several risk factors and impact on overlapping outcomes, we consider how deficiency of iron, iodine and vitamin D can have profound impacts on perinatal health and infant development. We review the epidemiology of these micronutrient deficiencies during pregnancy, including social, environmental and dietary risk factors. We identify the main challenges in defining nutritional status of these nutrients using validated diagnostic criteria linked with meaningful clinical outcomes. Public health strategies are urgently required to improve the overall health and nutritional status of women of reproductive age. Obesity prevention and early detection of malnutrition with standardised screening methods would detect pregnant women at increased risk of iron deficiency. Development of sensitive, individual biomarkers of iodine status is required to protect maternal health and fetal/infant brain development. Risk assessments of vitamin D requirements during pregnancy need to be revisited from the perspective of fetal and neonatal requirements. International consensus on standardised approaches to micronutrient assessment, analysis and reporting as well as sensitive, clinically validated infant and child neuro-behavioural outcomes will enable progression of useful observational and intervention studies.
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Miyagaki S, Yamaguchi M, Ota T, Kawabe Y, Morimoto H, Oka Y, Mori J. Alfacalcidol improves the growth velocity in children with vitamin D deficiency/insufficiency: A single center retrospective cohort study. PLoS One 2021; 16:e0247886. [PMID: 33684119 PMCID: PMC7939371 DOI: 10.1371/journal.pone.0247886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 02/15/2021] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES To investigate the growth velocity-improving effects of vitamin D replacement therapy in pediatric patients diagnosed with vitamin D deficiency and insufficiency. STUDY DESIGN A retrospective cohort study was conducted in 34 pediatric patients diagnosed with vitamin D deficiency/insufficiency. Based on the clinical findings, the subjects were divided into two groups: a bowed leg (BL) group and a non-bowed leg (non-BL) group. After the initiation of alfacalcidol, the standard deviation score (SDS) of their heights, weights and growth velocities in each group were monitored. RESULTS The median age at the first visit was significantly lesser in the BL group (1.58 years old [interquartile range (IQR): 1.33, 2.17]) than that in the non-BL group (3.00 years old [IQR: 2.33, 3.67]). On the contrary, the SDS for height was significantly lower in the non-BL group (-2.27 [IQR: -2.63, -1.94]) than that in the BL group (-1.37 [IQR: -1.91, -1.07]). One-year treatment with alfacalcidol showed significant improvements in both height SDSs and growth velocity SDSs not only in the BL group but also in the non-BL group. CONCLUSIONS The current study revealed that vitamin D replacement therapy improved the growth rate in children with vitamin D deficiency/insufficiency, regardless of the presence of BL. This study emphasizes the importance of assessing the vitamin D status in children with poor growth rates and suggests that alfacalcidol could be a valid option for the treatment of short stature.
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Affiliation(s)
- Satoshi Miyagaki
- Department of Pediatrics, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
| | - Mihoko Yamaguchi
- Department of Pediatrics, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
| | - Takeshi Ota
- Department of Pediatrics, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
| | - Yasuhiro Kawabe
- Department of Pediatrics, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
| | - Hidechika Morimoto
- Department of Pediatrics, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
| | - Yoshinobu Oka
- Department of Pediatric Orthopaedics, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
| | - Jun Mori
- Department of Pediatrics, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
- * E-mail:
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12
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The Association between Maternal Serum Vitamin D Levels and Gestational Diabetes Mellitus among Filipino Patients: A Cross-Sectional Study. J ASEAN Fed Endocr Soc 2021; 35:169-175. [PMID: 33442188 PMCID: PMC7784173 DOI: 10.15605/jafes.035.02.04] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 08/16/2020] [Indexed: 11/17/2022] Open
Abstract
Objectives To determine the association between low maternal serum vitamin D and gestational diabetes mellitus (GDM) among Filipino women in St. Luke’s Medical Center, Quezon City. Methodology A cross-sectional study involving pregnant women at outpatient clinics in a tertiary hospital in the Philippines. Simultaneous testing for fasting blood sugar, 75g oral glucose tolerance test and serum vitamin D was done. Participants were classified as GDM versus non-GDM, and normal versus low serum vitamin D. Univariate and multivariate statistics were done to determine relationship between vitamin D and GDM. Results Of 211 included women, 198 (93.8%) had low vitamin D levels, and 56 (26.5%) had GDM. Vitamin D was significantly higher in the GDM group (21.0±8.1 vs 18.8±5.3 ng/mL, p=0.0189). The proportion of women with low vitamin D levels was significantly higher among those without GDM (96.1% vs 87.5%, OR=0.28, p=0.029]. After adjusting for age, parity, history of GDM and pre-pregnancy BMI, no significant association was observed (adjusted OR=0.66, p=0.522). No correlation was seen between vitamin D and FBS (r=0.28, p=0.095), 1-hour post-75 g OGTT (r=0.26, p=0.643), and 2-hour post-75 g OGTT (r=0.28, p=0.113). Conclusion There was an association found between maternal serum vitamin D level and GDM in the univariate analysis, but none was evident after adjusting for possible confounders. The unanticipated high prevalence of low vitamin D levels among pregnant Filipinos needs to be verified in future studies.
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13
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Van Winden KR, Bearden A, Kono N, Frederick T, Operskalski E, Stek A, Pandian R, Barton L, Kovacs A. Low Bioactive Vitamin D Is Associated with Pregnancy-Induced Hypertension in a Cohort of Pregnant HIV-Infected Women Sampled Over a 23-Year Period. Am J Perinatol 2020; 37:1446-1454. [PMID: 31365935 PMCID: PMC6992493 DOI: 10.1055/s-0039-1694007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
OBJECTIVE To examine the association of vitamin D insufficiency and risk of pregnancy-induced hypertension (PIH) among human immunodeficiency virus (HIV)-infected pregnant women. STUDY DESIGN This is a retrospective cohort study evaluating the impact of low maternal vitamin D levels on PIH and perinatal outcomes among HIV-infected pregnant women receiving care at an urban HIV center from 1991 to 2014. RESULTS A total of 366 pregnant women were included, of which 11% developed PIH. Lower levels of 25-hydroxyvitamin D (25(OH)D) and bioactive 1,25-dihydroxyvitamin D (1,25(OH)2D) were associated with increased HIV disease activity. 25(OH)D levels were not significantly associated with the incidence of PIH. Higher 1,25(OH)2D levels were associated with reduced incidence of PIH in univariate (odds ratio, OR: 0.87 [95% confidence interval, CI: 0.79-0.95], p = 0.004) and multivariate (OR: 0.88 [95% CI: 0.80-0.97], p = 0.010) analyses. No association was found between 25(OH)D levels and other obstetric outcomes. Lower 1,25(OH)2D levels were associated with group B Streptococcus colonization (OR: 0.92 [95% CI: 0.86-0.99]) and low birth weight (LBW) (OR: 0.90 [95% CI: 0.83-0.98]) on multivariate analysis. Mean 1,25(OH)2D levels were significantly lower in women with preterm delivery and LBW infants. CONCLUSION Lower bioactive vitamin D levels are related to PIH in HIV-infected women. This association may be related to the coexistence of abnormal placental vitamin D metabolism and abnormal placental implantation.
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Affiliation(s)
- Kristi R. Van Winden
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, California,Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, The Permanente Medical Group, Oakland, California
| | - Allison Bearden
- Department of Pediatrics, Maternal Child and Adolescent/Adult Center for Infectious Diseases and Virology, University of Southern California, Los Angeles, California
| | - Naoko Kono
- Department of Preventive Medicine, University of Southern California, Los Angeles, California
| | - Toni Frederick
- Department of Pediatrics, Maternal Child and Adolescent/Adult Center for Infectious Diseases and Virology, University of Southern California, Los Angeles, California
| | - Eva Operskalski
- Department of Pediatrics, Maternal Child and Adolescent/Adult Center for Infectious Diseases and Virology, University of Southern California, Los Angeles, California
| | - Alice Stek
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, California,Department of Obstetrics and Gynecology, Maternal Child and Adolescent/Adult Center for Infectious Diseases and Virology, University of Southern California, Los Angeles, California
| | | | - Lorayne Barton
- Division of Neonatal Medicine, Department of Pediatrics, University of Southern California, Los Angeles, California
| | - Andrea Kovacs
- Department of Pediatrics, Maternal Child and Adolescent/Adult Center for Infectious Diseases and Virology, University of Southern California, Los Angeles, California
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Prevention and Management of Gestational Diabetes Using Vitamin D Supplementation: An Overview and Appraisal of Clinical Trials. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10228141] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
A number of studies have examined the role of vitamin D in reproductive processes and disorders of pregnancy such as gestational diabetes mellitus (GDM). Although observational studies have linked maternal vitamin D deficiency with a plethora of adverse pregnancy outcomes including GDM, intervention trials generally do not support the use of vitamin D supplementation for GDM prevention or management. This narrative review provides an up-to-date overview and critical appraisal of randomised controlled trials (RCTs) to describe the current state of knowledge regarding the efficacy of vitamin D supplementation for preventing and/or managing GDM. Overall, although RCT data indicates a potential benefit of vitamin D in maternal glycaemic control, results are highly disparate and the data published to date have not conclusively established the efficacy of vitamin D in GDM prevention. There are, however, several limitations within the existing literature, including some considerable challenges that are unique to vitamin D trials, which should be carefully considered in the interpretation of the evidence and design of future studies. For now, many unanswered questions remain, and there is still a need for adequately powered and well-designed trials before routine supplementation can be recommended in the context of GDM.
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15
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Vitamin D during pregnancy and its association with birth outcomes: a Brazilian cohort study. Eur J Clin Nutr 2020; 75:489-500. [PMID: 32879447 DOI: 10.1038/s41430-020-00733-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 07/14/2020] [Accepted: 08/19/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND/OBJECTIVES Evidence is lacking on how variation in vitamin D concentrations during gestation affects perinatal outcomes. Therefore, we evaluated the association between vitamin D serum concentrations during pregnancy and neonatal outcomes. METHODS A prospective cohort of 180 healthy Brazilian pregnant women was followed and plasma 25-hydroxyvitamin [25(OH)D, nmol/L] was measured at 5-13 (baseline), 20-26 and 30-36 gestational weeks. Birth weight (BW), birth length (BL), BW z-scores, BL z-scores, first minute Apgar, small for gestational age (SGA), large for gestational age (LGA) and preterm birth were the outcomes. Multiple linear and Poisson regression models were estimated. Best linear unbiased prediction of random coefficients model was used to determine the association between the mean rate of change in vitamin D during pregnancy concentrations and neonatal outcomes. RESULTS Mean (SD) BW was 3300 (600) g, BW z-score 0.34 (1.11), BL 49.3 (3.3) cm, BL z-score 0.44 (1.5), and first minute Apgar score 8.2 (1.4). Prevalence of SGA, LGA and preterm birth were 6%, 18% and 13%, respectively. 25(OH)D was directly associated with the risk of preterm birth at all trimesters. Incidence-rate ratios were 1.02, 1.05 and 1.04 for the 1st, 2nd and 3rd trimester, respectively. Mean rate of change during pregnancy in 25(OH)D was directly associated with BW z-score (β: 0.36, 95% CI 0.07; 0.65), LGA risk (IRR: 1.97, 95% CI 1.07; 3.63) and preterm birth (IRR: 7.35, 95% CI 2.99; 18.07). CONCLUSIONS Mean 25(OH)D rate of change during pregnancy was directly associated with BW z-scores, and increased LGA and preterm birth risk.
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Correia-Branco A, Rincon MP, Pereira LM, Wallingford MC. Inorganic Phosphate in the Pathogenesis of Pregnancy-Related Complications. Int J Mol Sci 2020; 21:ijms21155283. [PMID: 32722465 PMCID: PMC7432618 DOI: 10.3390/ijms21155283] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 07/09/2020] [Accepted: 07/23/2020] [Indexed: 02/07/2023] Open
Abstract
Inorganic phosphate (Pi) is an essential nutrient that fulfills critical roles in human health. It enables skeletal ossification, supports cellular structure and organelle function, and serves key biochemical roles in energetics and molecular signaling. Pi homeostasis is modulated through diet, intestinal uptake, renal reabsorption, and mobilization of stores in bone and extracellular compartments. Disrupted Pi homeostasis is associated with phosphate wasting, mineral and bone disorders, and vascular calcification. Mechanisms of Pi homeostasis in pregnancy remain incompletely understood. The study presented herein examined biological fluid Pi characteristics over the course of gestation. Correlations with gestation age, pregnancy number, preterm birth, preeclampsia, diabetes mellitus, and placental calcification were evaluated during the last trimester. The results support that maternal urinary Pi levels increased during the third trimester of pregnancy. Reduced levels were observed with previous pregnancy. Amniotic fluid Pi levels decreased with gestation while low second trimester levels associated with preterm birth. No significant difference in urinary Pi levels was observed between preeclampsia and controls (8.50 ± 2.74 vs. 11.52 ± 2.90 mmol/L). Moreover, increased maternal urinary Pi was associated with preexisting diabetes mellitus in preeclampsia. Potential confounding factors in this study are maternal age at delivery and body mass index (BMI)—information which we do not have access to for this cohort. In conclusion, Pi levels provide clinical information regarding the pathogenesis of pregnancy-related complications, supporting that phosphate should be examined more closely and in larger populations.
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Affiliation(s)
- Ana Correia-Branco
- Mother Infant Research Institute, Tufts Medical Center, 800 Washington Street, Boston, MA 02111, USA;
| | - Monica P. Rincon
- Maternal Fetal Medicine, Oregon Health Science Center, Mailcode L-458, 3181 SW Sam Jackson Park Road, Portland, OR 97219, USA; (M.P.R.); (L.M.P.)
| | - Leonardo M. Pereira
- Maternal Fetal Medicine, Oregon Health Science Center, Mailcode L-458, 3181 SW Sam Jackson Park Road, Portland, OR 97219, USA; (M.P.R.); (L.M.P.)
| | - Mary C. Wallingford
- Mother Infant Research Institute, Tufts Medical Center, 800 Washington Street, Boston, MA 02111, USA;
- Correspondence: ; Tel.: +1-617-636-5982; Fax: +1-617-636-1469
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Vahter M, Broberg K, Harari F. Placental and Cord Blood Telomere Length in Relation to Maternal Nutritional Status. J Nutr 2020; 150:2646-2655. [PMID: 32678440 PMCID: PMC7549303 DOI: 10.1093/jn/nxaa198] [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: 02/27/2020] [Revised: 03/27/2020] [Accepted: 06/18/2020] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND The uterine environment may be important for the chromosomal telomere length (TL) at birth, which, in turn, influences disease susceptibility throughout life. However, little is known about the importance of specific nutritional factors. OBJECTIVES We assessed the impact of multiple maternal nutritional factors on TL in placenta and cord blood. METHODS In a population-based mother-child cohort in northwestern Argentina, we measured maternal weight, BMI, body fat percentage (BFP), and several nutrients [selenium, magnesium, calcium, zinc, manganese, iodine, vitamin B-12, folate, 25-hydroxycholecalciferol (25(OH)D3)], hemoglobin, and homocysteine in maternal whole blood, serum, plasma, or urine during pregnancy (mean gestational week 27). We measured the relative TL (rTL) in placenta (n = 99) and cord blood (n = 98) at delivery by real-time PCR. Associations were evaluated by multivariable-adjusted linear regression. RESULTS The women's prepregnancy BMI (kg/m2; mean ± SD: 23.7 ± 4.1), body weight (55.4 ± 9.9 kg), and BFP (29.9 ± 5.5%), but not height (153 ± 5.3 cm), were inversely associated with placental rTL (P < 0.01 for all), with ∼0.5 SD shorter rTL for an IQR increase in prepregnancy body weight, BMI, or BFP. Also, impedance-based BFP, but not lean body mass, in the third trimester was associated with shorter placental rTL. In addition, serum vitamin B-12 (232 ± 96 pmol/L) in pregnancy (P = 0.038), but not folate or homocysteine, was associated with shorter placental rTL (0.2 SD for an IQR increase). In contrast, plasma 25(OH)D3 (46 ± 15 nmol/L) was positively associated with placental rTL (P < 0.01), which increased by 0.4 SD for an IQR increase in 25(OH)D3. No clear associations of the studied maternal nutritional factors were found with cord blood rTL. CONCLUSIONS Maternal BMI, BFP, and vitamin B-12 were inversely associated, whereas 25(OH)D3 was positively associated, with placental TL. No association was observed with cord blood TL. Future studies should elucidate the role of placental TL for child health.
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Affiliation(s)
| | - Karin Broberg
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Florencia Harari
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden,Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital and University of Gothenburg, Gothenburg, Sweden
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Öcal DF, Aycan Z, Dağdeviren G, Kanbur N, Küçüközkan T, Derman O. Vitamin D deficiency in adolescent pregnancy and obstetric outcomes. Taiwan J Obstet Gynecol 2020; 58:778-783. [PMID: 31759526 DOI: 10.1016/j.tjog.2019.09.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2019] [Indexed: 10/25/2022] Open
Abstract
OBJECTIVE The aim of this study was to evaluate the rates of vitamin D deficiency in adolescent pregnants and its influence on the obstetric outcomes. MATERIALS AND METHODS A total of 300 singleton pregnant women aged between 14 and 20 years, were divided into three groups according to their gestational weeks (100 pregnant adolescents from each trimester). Randomly selected 300 singleton pregnant women older than 20 years of age with the similar gestational ages were designed as the control group at the same time period. We divided serum 25(OH)D levels into three categories deficiency, inadequacy and adequate levels according to the Endocrine Society guidelines. Serum 25(OH)D levels were also evaluated according to age, seasons and gestational periods. Adverse obstetric outcomes were recorded. RESULTS Overall, 86% of the subjects were found to have deficient 25(OH)D levels (<20 ng/ml). The levels indicated an inadequate state in 72 subjects (12%) and only 12 (2%) women had adequate 25 (OH) D levels. Among adult pregnant women the rates of deficient, inadequate and adequate levels were 88.3%, 11%, and 0.7% respectively. Among adolescent pregnant women these rates were 83.7%, 13%, and 3.3% respectively. The lowest 25(OH)D levels occurred during the winter while the highest levels were detected during the summer in both groups. Calcidiol, 25(OH)D, was a significant predictor for preterm delivery (AUC = 0,909; p < 0,001) and also for SGA (AUC = 0,915; p < 0,001). Maternal age was another significant predictor for SGA (AUC = 0,787; p < 0,001) and preterm delivery (AUC = 0,785; p < 0,001). CONCLUSION We found a high incidence of 25(OH)D deficiency in Turkish pregnant women. Adolescent age and low 25(OH)D levels are significant risk factors for PTD and SGA. Effective prophylaxis programs for vitamin D deficieny and/or fortification of foods with vitamin D are essential in pregnant women especially in the winter season.
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Affiliation(s)
- Doğa F Öcal
- Dr. Sami Ulus Women and Children Health and Research Hospital, Department of Obstetrics and Gynecology, Turkey.
| | - Zehra Aycan
- Dr. Sami Ulus Women and Children Health and Research Hospital, Department of Pediatric Endocrinology, Turkey
| | - Gülşah Dağdeviren
- Dr. Sami Ulus Women and Children Health and Research Hospital, Department of Obstetrics and Gynecology, Turkey
| | - Nuray Kanbur
- Hacettepe University, Faculty of Medicine, Department of Pediatrics, Section of Adolescent Medicine, Turkey
| | - Tuncay Küçüközkan
- Dr. Sami Ulus Women and Children Health and Research Hospital, Department of Obstetrics and Gynecology, Turkey
| | - Orhan Derman
- Hacettepe University, Faculty of Medicine, Department of Pediatrics, Section of Adolescent Medicine, Turkey
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19
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Assessing a method and reference material for quantification of vitamin D binding protein during pregnancy. CLINICAL MASS SPECTROMETRY 2020; 16:11-17. [DOI: 10.1016/j.clinms.2020.01.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 01/07/2020] [Accepted: 01/20/2020] [Indexed: 12/28/2022]
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D'Silva AM, Hyett JA, Coorssen JR. First Trimester Protein Biomarkers for Risk of Spontaneous Preterm Birth: Identifying a Critical Need for More Rigorous Approaches to Biomarker Identification and Validation. Fetal Diagn Ther 2020; 47:497-506. [PMID: 32097912 DOI: 10.1159/000504975] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Accepted: 11/25/2019] [Indexed: 11/19/2022]
Abstract
BACKGROUND Spontaneous preterm birth is the leading cause of perinatal morbidity and mortality worldwide and continues to present a major clinical dilemma. We previously reported that a number of protein species were dysregulated in maternal serum collected at 11-13+6 weeks' gestation from pregnancies that continued to labour spontaneously and deliver preterm. OBJECTIVES AND METHODS In this study, we aimed to validate changes seen in 4 candidate protein species: alpha-1-antitrypsin, vitamin D-binding protein (VDBP), alpha-1beta-glycoprotein and apolipoprotein A-1 in a larger cohort of women using a western blot approach. RESULTS Serum levels of all 4 proteins were reduced in women who laboured spontaneously and delivered preterm. This reduction was significant for VDBP (p = 0.04), which has been shown to be involved in a plethora of essential biological functions, including actin scavenging, fatty acid transport, macrophage activation and chemotaxis. CONCLUSIONS The decrease in select proteoforms of VDBP may result in an imbalance in the optimal intrauterine environment for the developing foetus as well as to a successful uncomplicated pregnancy. Thus, certain (phosphorylated) species of VDBP may be of value in developing a targeted approach to the early prediction of spontaneous preterm labour. Importantly, this study raises the importance of a focus on proteoforms and the need for any biomarker validation process to most effectively take these into account rather than the more widespread practice of simply focussing on the primary amino acid sequence of a protein.
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Affiliation(s)
- Arlene M D'Silva
- Department of Molecular Physiology, The Molecular Medicine Research Group, School of Medicine, Western Sydney University, Campbelltown, New South Wales, Australia
| | - Jon A Hyett
- Sydney Institute for Women, Children and their Families, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia,
| | - Jens R Coorssen
- Department of Health Sciences and Biological Sciences, Faculties of Applied Health Sciences and Mathematics and Science, Brock University, St. Catharines, Ontario, Canada
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21
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Bearden A, Van Winden K, Frederick T, Kono N, Operskalski E, Pandian R, Barton L, Stek A, Kovacs A. Low maternal vitamin D is associated with increased risk of congenital and peri/postnatal transmission of Cytomegalovirus in women with HIV. PLoS One 2020; 15:e0228900. [PMID: 32053638 PMCID: PMC7018030 DOI: 10.1371/journal.pone.0228900] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 01/24/2020] [Indexed: 11/30/2022] Open
Abstract
Background CMV infection of the fetus or neonate can lead to devastating disease, and there are no effective prevention strategies to date. Vitamin D is a potent immunomodulator, supports antiviral immune responses, and plays an important role in placental immunity. Methods Retrospective cohort study to evaluate the impact of low maternal vitamin D on congenital and early postnatal transmission of CMV among HIV-infected, non-breastfeeding women and their HIV exposed but negative infants from an urban HIV clinic. Vitamin D panel was performed on stored maternal plasma obtained near time of delivery. Infant CMV testing at 0–6 months included urine and oral cultures, and/or serum polymerase chain reaction testing. Results Cohort included 340 mother-infant pairs (births 1991–2014). Among 38 infants (11%) with a CMV+ test between 0–6 months, 4.7% (14/300) had congenital CMV transmission (CMV+ test 0–3 weeks), and 7.6% (24/315) had peri/postnatal CMV (CMV+ test >3 weeks-6 months). Women with lower calcitriol (1,25-dihydroxyvitamin D), the active form of vitamin D, were more likely to have an infant with congenital (OR 12.2 [95% CI 1.61–92.2] P = 0.02) and peri/postnatal (OR 9.84 [95% CI 2.63–36.8] P = 0.0007) infections in multivariate analyses, independent of maternal HIV viral load and CD4 count. Conclusion This study demonstrates an association between inadequate maternal calcitriol during pregnancy and increased congenital and early postnatal acquisition of CMV among non-breastfeeding women with HIV and their HIV negative infants.
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Affiliation(s)
- Allison Bearden
- Department of Pediatrics, Division of Infectious Diseases, Maternal, Child, Adolescent/Adult Center for Infectious Diseases and Virology, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, United States of America
- * E-mail:
| | - Kristi Van Winden
- Department of Obstetrics and Gynecology, Division of Maternal and Fetal Medicine, and Maternal, Child, Adolescent/Adult Center for Infectious Diseases and Virology, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, United States of America
| | - Toni Frederick
- Department of Pediatrics, Division of Infectious Diseases, Maternal, Child, Adolescent/Adult Center for Infectious Diseases and Virology, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, United States of America
| | - Naoko Kono
- Department of Preventive Medicine, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, United States of America
| | - Eva Operskalski
- Department of Pediatrics, Division of Infectious Diseases, Maternal, Child, Adolescent/Adult Center for Infectious Diseases and Virology, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, United States of America
| | - Raj Pandian
- Pan Laboratories, Irvine, CA, United States of America
| | - Lorayne Barton
- Department of Pediatrics, Division of Neonatology, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, United States of America
| | - Alice Stek
- Department of Obstetrics and Gynecology, Division of Maternal and Fetal Medicine, and Maternal, Child, Adolescent/Adult Center for Infectious Diseases and Virology, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, United States of America
| | - Andrea Kovacs
- Department of Pediatrics, Division of Infectious Diseases, Maternal, Child, Adolescent/Adult Center for Infectious Diseases and Virology, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, United States of America
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22
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Albahlol IA, Almaeen AH, Alduraywish AA, Dar UF, El-Metwally TH. Vitamin D Status and Pregnancy Complications: Serum 1,25-di-hydroxyl-Vitamin D and its Ratio to 25-hydroxy-Vitamin D are Superior Biomarkers than 25-hydroxy-Vitamin D. Int J Med Sci 2020; 17:3039-3048. [PMID: 33173424 PMCID: PMC7646113 DOI: 10.7150/ijms.47807] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 09/14/2020] [Indexed: 12/18/2022] Open
Abstract
Vitamin D (VitD) deficiency during pregnancy has been associated with adverse neonatal outcomes and increased risk of late pregnancy complications. We planned to correlate serum VitD biomarkers; 25-hydroxyvitamin D (25-OH-VitD) and 1,25-dihydroxyvitamin D (1,25-diOH-VitD) levels; and their ratio with the frequency of feto-maternal pregnancy complications. A prospective cross-sectional case-control study was conducted at Aljouf Maternity and Children Hospital, Sakaka, Saudi Arabia, during the period of September 1, 2017 to September 30, 2019. 322 pregnant women were stratified into 2 groups: controls (110 cases) and complicated group (212 cases). The later comprised severe preeclamptic toxemia associated with intrauterine growth restriction (58 cases), gestational diabetes mellitus (GDM; 82 cases), abortion (26 cases), undisturbed ectopic pregnancy (16 cases), premature rupture of membranes (PROM; 14 cases), and, inevitable preterm labour (16 cases). After clinical assessment, peripheral blood samples were collected. Serum biomarkers were measured using specific immunoassays. The direct 1,25-diOH-VitD/25-OH-VitD ratio was calculated. Serum 25-OH-VitD indicated widely spreading VitD deficiency among participants with significantly higher levels in controls vs. GDM subgroup only. 1,25-diOH-VitD levels and the ratio were markedly reduced in the six complicated subgroups vs. controls, with non-significant differences amongst the complicated subgroups. ROC analysis showed very high sensitivity and specificity, to differentiate patients from controls, only for 1,25-diOH-VitD (AUC = 0.965; 0.947 - 0.983, p <0.001) followed by the ratio but not 25-OH-VitD. In conclusions, 25-OH-VitD did not show significant changes except for GDM. 1,25-diOH-VitD levels and the ratio showed strong associations with pregnancy complications. Serum 1,25-di-OH-VitD and its ratio to 25-OH-VitD are more reliable and physiologically relevant biomarkers for VitD status in pregnancy.
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Affiliation(s)
- Ibrahim A Albahlol
- Department of Obstetrics and Gynecology, College of Medicine, Jouf University, Sakaka, Saudi Arabia. .,Department of Obstetrics and Gynecology, Mansoura University, Mansoura, Egypt
| | - Abdulrahman H Almaeen
- Department of Pathology, College of Medicine, Jouf University, Sakaka, Saudi Arabia.
| | | | - Umar F Dar
- Department of Family and Community Medicine, College of Medicine, Jouf University, Sakaka, Saudi Arabia.
| | - Tarek H El-Metwally
- Department of Pathology, Biochemistry Division, College of Medicine, Jouf University, Sakaka, Saudi Arabia. .,Department of Medical Biochemistry, Faculty of Medicine, Assiut University, Assiut, Egypt
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23
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Yuan Y, Tai W, Xu P, Fu Z, Wang X, Long W, Guo X, Ji C, Zhang L, Zhang Y, Wen J. Association of maternal serum 25-hydroxyvitamin D concentrations with risk of preeclampsia: a nested case-control study and meta-analysis. J Matern Fetal Neonatal Med 2019; 34:1576-1585. [PMID: 31284795 DOI: 10.1080/14767058.2019.1640675] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVES Whether the maternal vitamin D deficiency is associated with preeclampsia is still an argument. We aimed to assess the association between maternal serum 25-hydroxyvitamin D [25(OH)D] concentrations and risk of preeclampsia in a Chinese population and systematically evaluate published evidence on this association. METHODS We conducted a nested case-control study involving 122 pregnant women with preeclampsia and 488 pregnant women whose blood pressure was within the normal range (as controls). For further meta-analysis, 20 studies and our study were included for the final pooled analysis, involving 39,031 participants and 3305 preeclampsia cases with various ethnicities. RESULTS The results showed that 65.6% of women with preeclampsia had serum 25(OH)D concentrations <50.0 nmol L-1 compared with 55.3% of women in controls. The 25(OH)D concentrations were significantly lower in women with preeclampsia than controls [Median (IQR), women with preeclampsia versus controls: 43.3 (35.5, 55.2) versus 47.5 (37.6, 60.4) nmol L-1, p = .014]. For women with 25(OH)D concentrations <50.0 nmol L-1, they had a 65% increase in preeclampsia risk (95% CI = 1.02-2.69), as compared with women with 25(OH)D concentrations from 50.0 to 74.9 nmol L-1. Further, meta-analysis showed that low 25(OH)D concentrations were associated with a significantly increased risk of preeclampsia by 62% (pooled OR = 1.62, 95%CI = 1.36-1.94), and the risk effect of low 25(OH)D concentrations existed in most subgroups. CONCLUSIONS Low 25(OH)D concentration in pregnancy was significantly associated with preeclampsia risk, and it may serve as biomarkers for the surveillance of high-risk pregnant women.
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Affiliation(s)
- Yingdi Yuan
- Department of Pediatrics, the First People's Hospital of Lianyungang, Xuzhou Medical University Affiliated Hospital of Lianyungang (Lianyungang Clinical College of Nanjing Medical University), Lianyungang, China.,Nanjing Maternity and Child Health Care Institute, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China
| | - Wen Tai
- Department of Obstetrics, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China
| | - Pengfei Xu
- Nanjing Maternity and Child Health Care Institute, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China
| | - Ziyi Fu
- Nanjing Maternity and Child Health Care Institute, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China
| | - Xiaolei Wang
- Department of Neonatology, Wuxi Children's Hospital affiliated to Nanjing Medical University, Wuxi, China
| | - Wei Long
- Department of Obstetrics, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China
| | - Xirong Guo
- Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chenbo Ji
- Nanjing Maternity and Child Health Care Institute, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China
| | - Le Zhang
- Department of Neonatology, Wuxi Children's Hospital affiliated to Nanjing Medical University, Wuxi, China
| | - Yue Zhang
- School of Information Management, Nanjing University, Nanjing, China
| | - Juan Wen
- Nanjing Maternity and Child Health Care Institute, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China
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24
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Chikwati RP, Musarurwa C, Duri K, Mhandire K, Snyman T, George JA. Maternal plasma vitamin D levels and associated determinants in late pregnancy in Harare, Zimbabwe: a cross-sectional study. BMC Pregnancy Childbirth 2019; 19:218. [PMID: 31253114 PMCID: PMC6599374 DOI: 10.1186/s12884-019-2362-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Accepted: 03/22/2019] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The importance of vitamin D in bone health and calcium homeostasis has been well documented. However, emerging evidence supports the role of vitamin D beyond its recognised traditional roles. In pregnancy, vitamin D levels are crucial in sustaining both the maternal stores and optimal growth of the foetus. In Southern Africa, there is paucity of data on vitamin D in pregnancy and related outcomes. To expand this body of knowledge, we assessed vitamin D levels in late pregnancy and (if any) associated maternal determinants in Harare, Zimbabwe. METHODS Study participants comprised of 138 pregnant Zimbabwean women in their third trimester. These were stratified by HIV status; sampling median (IQR) gestation for HIV negative study participants was 34 weeks (26-41) and 31 weeks (20-40) in the HIV positive participants. Maternal plasma 25 hydroxyvitamin (OH) Dlevels were measured using the ClinPrepHigh Pressure Liquid Chromatography (HPLC) kit. Statistical analysis was carried out using the STATA statistical package version 13. A p-value of < 0.05was considered to be statistically significant. RESULTS HIV infected participants had significantly higher mean 25 (OH) D concentration (112 ± 33.4 nmol/L) compared to the HIV uninfected (100 ± 27.1 nmol/L), p = 0.032.Participants whose samples were collected during summer had higher maternal 25 (OH) D levels than those cART duration and maternal 25 (OH) D levels (p = 0.031, Spearman correlation =0.28). CONCLUSIONS Our findings show high mean levels of maternal 25 (OH) D in late pregnancy in our setting and in the absence of vitamin D supplementation. Both HIV infection and season are significant determinants of maternal vitamin D levels. Summer season is associated with higher maternal plasma 25 (OH) D levels. HIV infection is associated with increased maternal vitamin D levels. Prolonged use of cART, Tenolam E is associated with improved maternal 25(OH) D levels.
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Affiliation(s)
- Raylton P Chikwati
- Department of Chemical Pathology, University of Zimbabwe, College of Health Sciences, P.O. Box A178, Avondale, Harare, Zimbabwe.
| | - Cuthbert Musarurwa
- Department of Chemical Pathology, University of Zimbabwe, College of Health Sciences, P.O. Box A178, Avondale, Harare, Zimbabwe
| | - Kerina Duri
- Department of Immunology, University of Zimbabwe, College of Health Sciences, P.O. Box A178, Avondale, Harare, Zimbabwe
| | - Kudakwashe Mhandire
- Department of Chemical Pathology, University of Zimbabwe, College of Health Sciences, P.O. Box A178, Avondale, Harare, Zimbabwe
| | - Tracy Snyman
- Department of Chemical Pathology, National Health Laboratory Service and University of the Witwatersrand, Parktown, Johannesburg, South Africa
| | - Jaya A George
- Department of Chemical Pathology, National Health Laboratory Service and University of the Witwatersrand, Parktown, Johannesburg, South Africa
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25
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Mensink-Bout SM, van Meel ER, de Jongste JC, Voortman T, Reiss IK, De Jong NW, Jaddoe VWV, Duijts L. Maternal and neonatal 25-hydroxyvitamin D concentrations and school-age lung function, asthma and allergy. The Generation R Study. Clin Exp Allergy 2019; 49:900-910. [PMID: 30866115 PMCID: PMC6850458 DOI: 10.1111/cea.13384] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 01/29/2019] [Accepted: 02/25/2019] [Indexed: 12/27/2022]
Abstract
BACKGROUND Vitamin D deficiency in early life might affect the developing lung and immune system, and subsequently influence the risk of asthma and allergy in later life. OBJECTIVE We examined the associations of 25-hydroxyvitamin D concentrations in mid-gestation and at birth with lung function, asthma, inhalant allergic sensitization and inhalant allergy at school-age. METHODS This study among 4951 children and their mothers was embedded in a population-based prospective cohort in Rotterdam, the Netherlands. Maternal venous blood samples in mid-gestation and umbilical cord blood samples at birth were used to determine 25-hydroxyvitamin D concentrations. At age 10 years, lung function was measured by spirometry, current asthma and physician-diagnosed inhalant allergy by questionnaire, and inhalant allergic sensitization by skin prick tests. We used multivariable regression models to examine associations. RESULTS Higher 25-hydroxyvitamin D concentrations in mid-gestation were associated with a higher forced vital capacity (FVC), but a lower forced expiratory volume in 1 second/FVC (FEV1 /FVC) and a lower forced expiratory flow after exhaling 75% of FVC (FEF75 ) (Z-score differences [95% CI] 0.02 [0.00, 0.03], -0.02 [-0.03, -0.01] and -0.01 [-0.03, -0.00], respectively, per 10 nmol/L 25-hydroxyvitamin D), but not with asthma. Furthermore, higher 25-hydroxyvitamin D concentrations in mid-gestation were associated with an increased risk of inhalant allergy (Odds Ratio [95% CI] 1.07 [1.02, 1.12]), but not with inhalant allergic sensitization. After additional adjustment for child's 25-hydroxyvitamin D concentrations at the age of 6 years, only the associations of 25-hydroxyvitamin D concentrations in mid-gestation with FEV1 /FVC and FEF75 remained. We did not find consistent associations of 25-hydroxyvitamin D concentrations at birth with respiratory or allergy outcomes. CONCLUSION AND CLINICAL RELEVANCE Our results suggest that maternal 25-hydroxyvitamin D concentrations in mid-gestation may influence lung development. The clinical implications of the observed associations remain unclear.
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Affiliation(s)
- Sara M Mensink-Bout
- The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.,Department of Pediatrics, Division of Respiratory Medicine and Allergology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Evelien R van Meel
- The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.,Department of Pediatrics, Division of Respiratory Medicine and Allergology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Johan C de Jongste
- Department of Pediatrics, Division of Respiratory Medicine and Allergology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Trudy Voortman
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Irwin K Reiss
- Department of Pediatrics, Division of Neonatology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Nicolette W De Jong
- Department of Internal Medicine, Division of Allergology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Vincent W V Jaddoe
- The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.,Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Liesbeth Duijts
- Department of Pediatrics, Division of Respiratory Medicine and Allergology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.,Department of Pediatrics, Division of Neonatology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
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Sharma N, Nath C, Mohammad J. Vitamin D status in pregnant women visiting a tertiary care center of North Eastern India. J Family Med Prim Care 2019; 8:356-360. [PMID: 30984638 PMCID: PMC6436274 DOI: 10.4103/jfmpc.jfmpc_404_18] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Studies of vitamin D (VD) physiology suggest that effects of vitamin D deficiency (VDD) could be much broader than rickets including cardiovascular disease, cancers, diabetes, infection, and allergy and pregnancy complications. Data regarding the prevalence of hypovitaminosis in pregnancy are scanty especially in north eastern part of India. Therefore, this study has undertaken with the intention to find out prevalence and outcome of hypovitaminosis of VD in pregnancy. Materials and Method: In total, 177 pregnant women with singleton pregnancy, <16 weeks of gestational age, visited to antenatal clinic of our institute were consecutively enrolled for the study. The serum VD was estimated by Beckman coulter unicel DXI immunoassay system using the principle of Chemiluminescence. Incidence of vitamin deficiency and insufficiency calculated. VDD was defined as 25(OH)D levels in blood <20 ng/mL, and insufficiency of VD was defined as 25(OH)D levels <32 ng/mL. Antenatal complications, such as intrauterine growth restriction (IUGR), oligohydramnios, pre-eclampsia, preterm labor, gestational diabetes, if any, were noted. Labor and delivery information including induction of labor, mode of delivery, and newborn birth weight were noted. Result: In total, 177 women recruited for the study. Mean age and parity of the subjects were 26.71 ± 9.96 and 2.10 ± 1.8, respectively. For detailed statistical analysis, women were divided into three groups depending upon their VD levels: deficiency group [25(OH)D level <20 ng/mL], insufficiency group [25(OH)D level <32 ng/mL], and sufficient group [25(OH)D level >32 ng/mL]. VDD was present in 84.18% subjects. VD insufficiency was present in 12.44% of cases. There is association of preeclampsia, cesarean section, and low birth weight babies with lower level of VD. Conclusion: This study showed that the prevalence of VDD in pregnancy is astonishingly high till now there is no guideline to screen antenatal women for VDD. As the test is costly even, offering it to all at-risk women may not be cost effective compared with offering universal supplementation, particularly as treatment is regarded as being very safe.
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Affiliation(s)
- Nalini Sharma
- Department of Obstetrics and Gynaecology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India
| | - Chandan Nath
- Department of Biochemistry, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India
| | - Jamil Mohammad
- Department of Medicine, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India
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27
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Vitamin D deficiency and depressive symptoms in the perinatal period. Arch Womens Ment Health 2018; 21:745-755. [PMID: 29845325 DOI: 10.1007/s00737-018-0852-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Accepted: 05/09/2018] [Indexed: 01/13/2023]
Abstract
Depression affects 1 in 7 women during the perinatal period. Women with vitamin D deficiency may be at an increased risk for depression. This study investigated the relationship between maternal and cord blood 25-hydroxyvitamin D (25OHD) and maternal depressive symptoms over the perinatal period. Study objectives were to examine variations and relationships between maternal and cord blood vitamin D levels and maternal depressive symptoms over the perinatal period. At a large medical center in southern California, pregnant women (N = 126) were recruited for this longitudinal cohort study. Depressive symptoms (Edinburgh Postnatal Depression Screen, EPDS) and vitamin D status (25OHD) were measured at three time points in the perinatal period: time 1 (T1; N = 125) EPDS and 25OHD were collected in early pregnancy; time 2 (T2; N = 96) EPDS was conducted in the third trimester with blood collected at time of delivery; and time 3 (T3; N = 88) was collected postpartum. A significant inverse relationship between vitamin D status and depressive symptoms was observed between 25OHD and EPDS scores at all time points in this sample (T1 = - 0.18, P = 0.024; T2 = - 0.27, P = 0.009; T3 = - 0.22, P = 0.019). This association remained after controlling for confounders. Low cord blood 25OHD levels were inversely associated with higher EPDS scores in the third trimester (r = - 0.22, P = 0.02). Clinicians may want to consider screening women diagnosed with vitamin D deficiency for depression and vice versa. Vitamin D may represent an important biomarker for pregnant and postpartum women diagnosed with depression. Further studies examining underlying mechanisms and supplementation are needed.
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Francis EC, Hinkle SN, Song Y, Rawal S, Donnelly SR, Zhu Y, Chen L, Zhang C. Longitudinal Maternal Vitamin D Status during Pregnancy Is Associated with Neonatal Anthropometric Measures. Nutrients 2018; 10:nu10111631. [PMID: 30400155 PMCID: PMC6265933 DOI: 10.3390/nu10111631] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 10/23/2018] [Accepted: 10/26/2018] [Indexed: 01/09/2023] Open
Abstract
Findings on maternal 25-hydroxyvitamin D (25[OH]D) and neonatal anthropometry are inconsistent, and may at least be partly due to variations in gestational week (GW) of 25(OH)D measurement and the lack of longitudinal 25(OH)D measurements across gestation. The aim of the current study was to examine the associations of longitudinal measures of maternal 25(OH)D and neonatal anthropometry at birth. This study included 321 mother–offspring pairs enrolled in the Eunice Kennedy Shriver National Institute of Child Health and Human Development Fetal Growth Studies–Singletons. This study was a prospective cohort design without supplementation and without data on dietary supplementation. Nevertheless, measurement of plasma 25(OH)D reflects vitamin D from different sources, including supplementation. Maternal concentrations of total 25(OH)D were measured at 10–14, 15–26, 23–31, and 33–39 GW and categorized as <50 nmol/L, 50–75 nmol/L, and >75 nmol/L. Generalized linear models were used to examine associations of 25(OH)D at each time-point with neonate birthweight z-score, length, and sum of skinfolds at birth. At 10–14 GW, 16.8% and 49.2% of women had 25(OH)D <50 nmol/L and between 50–75 nmol/L, respectively. The association of maternal 25(OH)D with neonatal anthropometry differed by GW and women’s prepregnancy BMI (normal (<25.0 kg/m2), overweight/obese (25.0–44.9 kg/m2)). All analyses were stratified by prepregnancy BMI status. Among women with an overweight/obese BMI, 25(OH)D <50 nmol/L at 10–14 GW was associated with lower birthweight z-score (0.56; 95% CI: −0.99, −0.13) and length (−1.56 cm; 95% CI: −3.07, −0.06), and at 23–31 GW was associated with shorter length (−2.77 cm; 95% CI: −13.38, −4.98) and lower sum of skinfolds (−9.18 mm; 95% CI: −13.38, −4.98). Among women with a normal BMI, 25(OH)D <50 nmol/L at 10–14 GW was associated with lower sum of skinfolds (−2.64 mm; 95% CI: −5.03, −0.24), at 23–31 GW was associated with larger birthweight z-scores (0.64; 95% CI: 0.03, 1.25), and at 33-39 GW with both higher birthweight z-score (1.22; 95% CI: 0.71, 1.73) and longer length (1.94 cm; 95% CI: 0.37, 3.52). Maternal 25(OH)D status during pregnancy was associated with neonatal anthropometric measures, and the associations were specific to GW of 25(OH)D measurement and prepregnancy BMI.
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Affiliation(s)
- Ellen C Francis
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD 20892, USA.
- Department of Public Health Sciences, Clemson University, Clemson, SC 29634, USA.
| | - Stefanie N Hinkle
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD 20892, USA.
| | - Yiqing Song
- Department of Epidemiology, Indiana University Richard M. Fairbanks School of Public Health, Indianapolis, IN 47405, USA.
| | - Shristi Rawal
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD 20892, USA.
- Department of Nutritional Sciences, Rutgers School of Health Professions, Newark, NJ 07102, USA.
| | - Sarah R Donnelly
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD 20892, USA.
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg VA 24061, USA.
| | - Yeyi Zhu
- Division of Research, Kaiser Permanente Northern California, Oakland, CA 94612 USA.
| | - Liwei Chen
- Department of Public Health Sciences, Clemson University, Clemson, SC 29634, USA.
| | - Cuilin Zhang
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD 20892, USA.
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Martínez-Domínguez SJ, Tajada M, Chedraui P, Pérez-López FR. Systematic review and meta-analysis of Spanish studies regarding the association between maternal 25-hydroxyvitamin D levels and perinatal outcomes. Gynecol Endocrinol 2018; 34:987-994. [PMID: 29842806 DOI: 10.1080/09513590.2018.1472761] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/16/2022] Open
Abstract
Objective: This systematic review and meta-analysis of Spanish studies assessed the association of maternal 25-hydroxyvitamin D [25(OH)D] levels on perinatal outcomes. Methods: PubMed, Cochrane Library, Embase, Scielo, Scopus, and Web of Science research databases were searched from inception through December 30 2017 using the terms 'vitamin D', 'pregnancy', and 'Spain'. Studies that compared first or second half of pregnancy normal 25(OH)D (≥30.0 ng/mL) versus insufficient (20.0-29.9 ng/mL) or deficient (<20.0 ng/mL) circulating levels and perinatal outcomes were systematically extracted. Data are presented as pooled odds ratios and their 95% confidence intervals (CIs) for categorical variables or mean differences and CIs for continuous variables. Risk of bias was evaluated with the Newcastle-Ottawa Scale. Results: Five cohort studies met inclusion criteria. The risk of gestational diabetes mellitus, preeclampsia, preterm birth, and small-for-gestational-age infants, and birthweight was not influenced by first half of pregnancy maternal 25(OH)D levels. In addition, second half of pregnancy 25(OH) levels did not affect birthweight. Conclusion: Maternal 25(OH)D levels during pregnancy did not affect studied perinatal outcomes and birthweight.
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Affiliation(s)
| | - Mauricio Tajada
- a Facultad de Medicina , Universidad de Zaragoza , Zaragoza , Spain
- b Obstetrics Service , Miguel Servet University Hospital , Zaragoza , Spain
| | - Peter Chedraui
- c Institute of Biomedicine, Research Area for Women's Health, Facultad de Ciencias Médicas , Universidad Católica de Santiago de Guayaquil , Guayaquil , Ecuador
- d Facultad de Ciencias de la Salud , Universidad Católica "Nuestra Señora de la Asunción" , Asunción , Paraguay
| | - Faustino R Pérez-López
- a Facultad de Medicina , Universidad de Zaragoza , Zaragoza , Spain
- e Department of Obstetrics and Gynecology , Lozano-Blesa University Hospital , Zaragoza , Spain
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Hemmingway A, Kenny LC, Malvisi L, Kiely ME. Exploring the concept of functional vitamin D deficiency in pregnancy: impact of the interaction between 25-hydroxyvitamin D and parathyroid hormone on perinatal outcomes. Am J Clin Nutr 2018; 108:821-829. [PMID: 30169726 DOI: 10.1093/ajcn/nqy150] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Accepted: 06/11/2018] [Indexed: 01/01/2023] Open
Abstract
Background Associations of vitamin D with perinatal outcomes are inconsistent and few studies have considered the wider calcium metabolic system. Objectives We aimed to explore functional vitamin D deficiency in pregnancy by investigating associations between vitamin D status, parathyroid hormone (PTH), and perinatal outcomes. Design SCOPE (Screening for Pregnancy Endpoints) Ireland is a prospective cohort study of low-risk, nulliparous pregnant women. We measured serum 25-hydroxyvitamin D [25(OH)D] and PTH at 15 wk of gestation in 1754 participants. Results Mean ± SD 25(OH)D was 56.6 ± 25.8 nmol/L (22.7 ± 10.3 ng/mL) and geometric mean (95% CI) PTH was 7.84 pg/mL (7.7, 8.0 pg/mL) [0.86 pmol/L (0.85, 0.88 pmol/L)]. PTH was elevated in 34.3% of women who had 25(OH)D <30 nmol/L and in 13.9% of those with 25(OH)D ≥75 nmol/L. Whereas 17% had 25(OH)D <30 nmol/L, 5.5% had functional vitamin D deficiency, defined as 25(OH)D <30 nmol/L with elevated PTH. Elevated mean arterial pressure (MAP), gestational hypertension, pre-eclampsia, and small-for-gestational-age (SGA) birth were confirmed in 9.2%, 11.9%, 3.8%, and 10.6% of participants, respectively. In fully adjusted regression models, neither low 25(OH)D nor elevated PTH alone increased the risk of any individual outcome. The prevalence of elevated MAP (19.1% compared with 9.7%) and SGA (16.0% compared with 6.7%) were highest (P < 0.05) in those with functional vitamin D deficiency compared with the reference group [25(OH)D ≥75 nmol/L and normal PTH]. The adjusted prevalence ratio (PR) and RR (95% CIs) for elevated MAP and SGA were 1.83 (1.02, 3.27) and 1.53 (0.80, 2.93), respectively. There was no effect of functional vitamin D deficiency on the risk of gestational hypertension (adjusted RR: 1.00; 95% CI: 0.60, 1.67) or pre-eclampsia (adjusted RR: 1.17; 95% CI: 0.32, 4.20). Conclusion The concept of functional vitamin D deficiency, reflecting calcium metabolic stress, should be considered in studies of vitamin D in pregnancy. The SCOPE pregnancy cohort is registered at http://www.anzctr.org.au as ACTRN12607000551493.
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Affiliation(s)
- Andrea Hemmingway
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, University College Cork, Cork, Ireland.,The Irish Centre for Fetal and Neonatal Translational Research (INFANT), University College Cork, Cork, Ireland
| | - Louise C Kenny
- The Irish Centre for Fetal and Neonatal Translational Research (INFANT), University College Cork, Cork, Ireland.,Department of Women's and Children's Health, University of Liverpool, Liverpool, United Kingdom
| | - Lucio Malvisi
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, University College Cork, Cork, Ireland.,The Irish Centre for Fetal and Neonatal Translational Research (INFANT), University College Cork, Cork, Ireland
| | - Mairead E Kiely
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, University College Cork, Cork, Ireland.,The Irish Centre for Fetal and Neonatal Translational Research (INFANT), University College Cork, Cork, Ireland
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McCarthy EK, Murray DM, Malvisi L, Kenny LC, O'B Hourihane J, Irvine AD, Kiely ME. Antenatal Vitamin D Status Is Not Associated with Standard Neurodevelopmental Assessments at Age 5 Years in a Well-Characterized Prospective Maternal-Infant Cohort. J Nutr 2018; 148:1580-1586. [PMID: 30169669 DOI: 10.1093/jn/nxy150] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 06/26/2018] [Indexed: 12/20/2022] Open
Abstract
Background Although animal studies show evidence for a role of vitamin D during brain development, data from human studies show conflicting signals. Objective We aimed to explore associations between maternal and neonatal vitamin D status with childhood neurodevelopmental outcomes. Methods Comprehensive clinical, demographic, and lifestyle data were collected prospectively in 734 maternal-infant dyads from the Cork BASELINE Birth Cohort Study. Serum 25-hydroxyvitamin D [25(OH)D] concentrations were quantified at 15 weeks of gestation and in umbilical cord sera at birth via a CDC-accredited liquid chromatography-tandem mass spectrometry method. Children were assessed at age 5 y through the use of the Kaufman Brief Intelligence Test (2nd Edition, KBIT-2) and the Child Behaviour Checklist (CBCL). Linear regression was used to explore associations between 25(OH)D and neurodevelopmental outcomes. Results 25(OH)D concentrations were <30 nmol/L in 15% of maternal and 45% of umbilical cord sera and <50 nmol/L in 42% of mothers and 80% of cords. At age 5 y, the mean ± SD KBIT-2 intelligence quotient (IQ) composite score was 104.6 ± 8.6; scores were 107.2 ± 10.0 in verbal and 99.8 ± 8.8 in nonverbal tasks. Developmental delay (scores <85) was seen in <3% of children across all domains. The mean ± SD CBCL total problem score was 21.3 ± 17.5; scores in the abnormal/clinical range for internal, external, and total problem scales were present in 12%, 4%, and 6% of participants, respectively. KBIT-2 and CBCL subscale scores at 5 y were not different between children exposed to low antenatal vitamin D status, either at 30 or 50 nmol/L 25(OH)D thresholds. Neither maternal nor cord 25(OH)D (per 10 nmol/L) were associated with KBIT-2 IQ composite scores [adjusted β (95% CI): maternal -0.01 (-0.03, 0.02); cord 0.01 (-0.03, 0.04] or CBCL total problem scores [maternal 0.01 (-0.04, 0.05); cord 0.01 (-0.07, 0.09)]. Conclusion In this well-characterized prospective maternal-infant cohort, we found no evidence that antenatal 25(OH)D concentrations are associated with neurodevelopmental outcomes at 5 y. The BASELINE Study was registered at www.clinicaltrials.gov as NCT01498965; the SCOPE Study was registered at http://www.anzctr.org.au as ACTRN12607000551493.
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Affiliation(s)
- Elaine K McCarthy
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences.,The Irish Centre for Fetal and Neonatal Translational Research (INFANT)
| | - Deirdre M Murray
- The Irish Centre for Fetal and Neonatal Translational Research (INFANT).,Department of Paediatrics and Child Health, University College Cork, Cork, Republic of Ireland
| | - Lucio Malvisi
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences.,The Irish Centre for Fetal and Neonatal Translational Research (INFANT)
| | - Louise C Kenny
- Department of Women's and Children's Health, University of Liverpool, Liverpool, United Kingdom
| | - Jonathan O'B Hourihane
- The Irish Centre for Fetal and Neonatal Translational Research (INFANT).,Department of Paediatrics and Child Health, University College Cork, Cork, Republic of Ireland
| | - Alan D Irvine
- The Irish Centre for Fetal and Neonatal Translational Research (INFANT).,Department of Clinical Medicine, Trinity College, Dublin, Republic of Ireland.,Department of Paediatric Dermatology, Our Lady's Children's Hospital, Dublin, Republic of Ireland.,National Children's Research Centre, Dublin, Republic of Ireland
| | - Mairead E Kiely
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences.,The Irish Centre for Fetal and Neonatal Translational Research (INFANT)
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Wang J, Liu N, Sun W, Chen D, Zhao J, Zhang W. Association between vitamin D deficiency and antepartum and postpartum depression: a systematic review and meta-analysis of longitudinal studies. Arch Gynecol Obstet 2018; 298:1045-1059. [PMID: 30264203 DOI: 10.1007/s00404-018-4902-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Accepted: 09/06/2018] [Indexed: 11/28/2022]
Abstract
PURPOSE The two previous reviews performed on the association of vitamin D deficiency in pregnancy with antepartum and postpartum depression were limited in reporting forms as they were both systematic reviews and the conclusions were also deemed to be inconclusive. Considering the high prevalence of vitamin D deficiency and depression during and after pregnancy as well as their numerous hazards to pregnancy outcomes, it is of great need to synthesize existing evidence in a more accurate statistical method, so that reliable guidance related to vitamin D supplementation during pregnancy could be provided for clinical decision making. METHODS We performed a systematic review and meta-analysis to investigate the association of vitamin D deficiency with antepartum and postpartum depression. RESULTS Nine longitudinal studies with 8470 participants were included in the meta-analysis. We found serum 25(OH)D levels < 50 nmol/l was associated with 2.67 times (OR 3.67; 95% CI 1.72-7.85) increased risk of postpartum depression than those 25(OH)D levels ≥ 50 nmol/l, but we did not find a significant association between low vitamin D levels and depressive symptoms during pregnancy with a serum 25(OH)D cut-off level of 30 nmol/l (OR 1.47; 95% CI 0.92-2.36). CONCLUSIONS The low status of maternal vitamin D could be an adverse factor for postpartum depression, but the available evidence suggested no association between vitamin D deficiency and depressive symptoms during pregnancy. However, this result should be interpreted with caution owning to the small number of studies. Well-designed intervention studies are also needed to further evaluate the benefits of vitamin D supplementation during pregnancy.
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Affiliation(s)
- Jie Wang
- School of Nursing, Jilin University, Changchun, China
| | - Na Liu
- School of Nursing, Jilin University, Changchun, China
| | - Weijia Sun
- School of Nursing, Jilin University, Changchun, China
| | - Dandan Chen
- School of Nursing, Jilin University, Changchun, China
| | - Jingxia Zhao
- School of Nursing, Jilin University, Changchun, China
| | - Wei Zhang
- School of Nursing, Jilin University, Changchun, China.
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Hemmingway A, O'Callaghan KM, Hennessy Á, Hull GLJ, Cashman KD, Kiely ME. Interactions between Vitamin D Status, Calcium Intake and Parathyroid Hormone Concentrations in Healthy White-Skinned Pregnant Women at Northern Latitude. Nutrients 2018; 10:E916. [PMID: 30018262 PMCID: PMC6073976 DOI: 10.3390/nu10070916] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 07/10/2018] [Accepted: 07/11/2018] [Indexed: 01/02/2023] Open
Abstract
Adverse effects of low vitamin D status and calcium intakes in pregnancy may be mediated through functional effects on the calcium metabolic system. Little explored in pregnancy, we aimed to examine the relative importance of serum 25-hydroxyvitamin D (25(OH)D) and calcium intake on parathyroid hormone (PTH) concentrations in healthy white-skinned pregnant women. This cross-sectional analysis included 142 participants (14 ± 2 weeks' gestation) at baseline of a vitamin D intervention trial at 51.9 °N. Serum 25(OH)D, PTH, and albumin-corrected calcium were quantified biochemically. Total vitamin D and calcium intakes (diet and supplements) were estimated using a validated food frequency questionnaire. The mean ± SD vitamin D intake was 10.7 ± 5.2 μg/day. With a mean ± SD serum 25(OH)D of 54.9 ± 22.6 nmol/L, 44% of women were <50 nmol/L and 13% <30 nmol/L. Calcium intakes (mean ± SD) were 1182 ± 488 mg/day and 23% of participants consumed <800 mg/day. The mean ± SD serum albumin-adjusted calcium was 2.2 ± 0.1 mmol/L and geometric mean (95% CI) PTH was 9.2 (8.4, 10.2) pg/mL. PTH was inversely correlated with serum 25(OH)D (r = -0.311, p < 0.001), but not with calcium intake or serum calcium (r = -0.087 and 0.057, respectively, both p > 0.05). Analysis of variance showed that while serum 25(OH)D (dichotomised at 50 nmol/L) had a significant effect on PTH (p = 0.025), calcium intake (<800, 800⁻1000, ≥1000 mg/day) had no effect (p = 0.822). There was no 25(OH)D-calcium intake interaction effect on PTH (p = 0.941). In this group of white-skinned women with largely sufficient calcium intakes, serum 25(OH)D was important for maintaining normal PTH concentration.
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Affiliation(s)
- Andrea Hemmingway
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, University College Cork, T12 Y337 Cork, Ireland.
- The Irish Centre for Fetal and Neonatal Translational Research (INFANT), University College Cork, T12 Y337 Cork, Ireland.
| | - Karen M O'Callaghan
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, University College Cork, T12 Y337 Cork, Ireland.
- The Irish Centre for Fetal and Neonatal Translational Research (INFANT), University College Cork, T12 Y337 Cork, Ireland.
| | - Áine Hennessy
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, University College Cork, T12 Y337 Cork, Ireland.
- The Irish Centre for Fetal and Neonatal Translational Research (INFANT), University College Cork, T12 Y337 Cork, Ireland.
| | - George L J Hull
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, University College Cork, T12 Y337 Cork, Ireland.
| | - Kevin D Cashman
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, University College Cork, T12 Y337 Cork, Ireland.
- Department of Medicine, University College Cork, T12 Y337 Cork, Ireland.
| | - Mairead E Kiely
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, University College Cork, T12 Y337 Cork, Ireland.
- The Irish Centre for Fetal and Neonatal Translational Research (INFANT), University College Cork, T12 Y337 Cork, Ireland.
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O'Callaghan KM, Hennessy Á, Hull GLJ, Healy K, Ritz C, Kenny LC, Cashman KD, Kiely ME. Estimation of the maternal vitamin D intake that maintains circulating 25-hydroxyvitamin D in late gestation at a concentration sufficient to keep umbilical cord sera ≥25-30 nmol/L: a dose-response, double-blind, randomized placebo-controlled trial in pregnant women at northern latitude. Am J Clin Nutr 2018; 108:77-91. [PMID: 29878035 PMCID: PMC6600055 DOI: 10.1093/ajcn/nqy064] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Revised: 10/30/2017] [Accepted: 03/14/2018] [Indexed: 12/14/2022] Open
Abstract
Background In the absence of dose-response data, Dietary Reference Values for vitamin D in nonpregnant adults are extended to pregnancy. Objective The aim was to estimate vitamin D intake needed to maintain maternal 25-hydroxyvitamin D [25(OH)D] in late gestation at a concentration sufficient to prevent newborn 25(OH)D <25-30 nmol/L, a threshold indicative of increased risk of nutritional rickets. Design We conducted a 3-arm, dose-response, double-blind, randomized placebo-controlled trial in Cork, Ireland (51.9oN). A total of 144 white-skinned pregnant women were assigned to receive 0, 10 (400 IU), or 20 (800 IU) µg vitamin D3/d from ≤18 wk of gestation. Vitamin D metabolites at 14, 24, and 36 wk of gestation and in cord sera, including 25(OH)D3, 3-epi-25(OH)D3, 24,25(OH)2D3, and 25(OH)D2 were quantified by liquid chromatography-tandem mass spectrometry. A curvilinear regression model predicted the total vitamin D intake (from diet and antenatal supplements plus treatment dose) that maintained maternal 25(OH)D in late gestation at a concentration sufficient to maintain cord 25(OH)D at ≥25-30 nmol/L. Results Mean ± SD baseline 25(OH)D was 54.9 ± 10.7 nmol/L. Total vitamin D intakes at the study endpoint (36 wk of gestation) were 12.1 ± 8.0, 21.9 ± 5.3, and 33.7 ± 5.1 µg/d in the placebo and 10-µg and 20-µg vitamin D3 groups, respectively; and 25(OH)D was 24.3 ± 5.8 and 29.2 ± 5.6 nmol/L higher in the 10- and 20-µg groups, respectively, compared with placebo (P < 0.001). For maternal 25(OH)D concentrations ≥50 nmol/L, 95% of cord sera were ≥30 nmol/L and 99% were >25 nmol/L. The estimated vitamin D intake required to maintain serum 25(OH)D at ≥50 nmol/L in 97.5% of women was 28.9 µg/d. Conclusions Thirty micrograms of vitamin D per day safely maintained serum 25(OH)D concentrations at ≥50 nmol/L in almost all white-skinned women during pregnancy at a northern latitude, which kept 25(OH)D at >25 nmol/L in 99% and ≥30 nmol/L in 95% of umbilical cord sera. This trial was registered at www.clinicaltrials.gov as NCT02506439.
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Affiliation(s)
- Karen M O'Callaghan
- Cork Center for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences
- Irish Center for Fetal and Neonatal Translational Research (INFANT)
| | - Áine Hennessy
- Cork Center for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences
- Irish Center for Fetal and Neonatal Translational Research (INFANT)
| | - George L J Hull
- Cork Center for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences
| | - Karina Healy
- Cork Center for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences
| | - Christian Ritz
- Department of Nutrition, Exercise, and Sports, Faculty of Science, University of Copenhagen, Frederiksberg, Denmark
| | - Louise C Kenny
- Irish Center for Fetal and Neonatal Translational Research (INFANT)
| | - Kevin D Cashman
- Cork Center for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences
- Department of Medicine, University College Cork, Cork, Ireland
| | - Mairead E Kiely
- Cork Center for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences
- Irish Center for Fetal and Neonatal Translational Research (INFANT)
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Longitudinal measures of maternal vitamin D and neonatal body composition. Eur J Clin Nutr 2018; 73:424-431. [PMID: 29895850 PMCID: PMC6291375 DOI: 10.1038/s41430-018-0212-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Revised: 05/08/2018] [Accepted: 05/10/2018] [Indexed: 11/18/2022]
Abstract
Background/Objectives Vitamin D status has been associated with fetal growth and offspring’s bone mass in some observational studies. We characterize the trajectory of total maternal serum 25-hydroxyvitamin D [25(OH)D] concentration by race and examine whether vitamin D status is associated with neonatal anthropometry and body composition as assessed by dual energy X-ray absorptiometry (DXA). Methods Three longitudinal pregnancy samples from the Memphis site of the Calcium for Preeclampsia Prevention trial (1992-1995) were used. Racial differences in total 25(OH)D trajectories (n=343 women) were tested using an interaction term between blood draw gestational week and race in linear mixed-effects models. Linear regression and linear mixed-effects models estimated adjusted associations between total 25(OH)D concentration with neonatal anthropometry and body composition (n=252 with DXA), including interactions with infant sex and serum calcium. Results Total 25(OH)D concentration increased with gestational age but its trajectory over pregnancy did not differ between African-American and Caucasian women. Deficient maternal vitamin D (25(OH)D concentration <20 ng/ml) was associated with lower neonatal total bone mineral density (β −0.009 g/cm2; 95% CI −0.016, −0.002). Among male newborns, deficiency was also associated with lower lean mass (−217 g; −391, −43) and birthweight (−308 g; −540, −76). Deficient maternal vitamin D was also associated with lower ponderal index (β –2.3 kg/m3; 95% CI −4.0, −0.5) among those in the lowest calcium tertile. Conclusion Vitamin D deficiency during pregnancy is associated with lower bone density and smaller size at birth in certain subgroups suggesting its importance in fetal development.
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Best CM, Pressman EK, Queenan RA, Cooper E, Vermeylen F, O'Brien KO. Gestational Age and Maternal Serum 25-hydroxyvitamin D Concentration Interact to Affect the 24,25-dihydroxyvitamin D Concentration in Pregnant Adolescents. J Nutr 2018; 148:868-875. [PMID: 29796622 PMCID: PMC6014295 DOI: 10.1093/jn/nxy043] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 02/13/2018] [Indexed: 11/13/2022] Open
Abstract
Background Interpretation of serum vitamin D biomarkers across pregnancy is complex due to limited understanding of pregnancy adaptations in vitamin D metabolism. During pregnancy, both gestational age and serum 25-hydroxyvitamin D [25(OH)D] concentrations may influence the concentrations of 1,25-dihydroxyvitamin D [1,25(OH)2D], 24,25-dihydroxyvitamin D [24,25(OH)2D], and parathyroid hormone (PTH). Objective We aimed to identify predictors of change in serum 25(OH)D across gestation in pregnant adolescents and to assess the contribution made by cholecalciferol (vitamin D3) supplementation. We sought to determine whether gestational age and 25(OH)D concentration interacted to affect serum 1,25(OH)2D, 24,25(OH)2D, or PTH. Methods Pregnant adolescents (n = 78, 59% African American, mean ± SD age: 17 ± 1 y) living in Rochester, NY (latitude 43°N) were supplemented with 200 IU or 2000 IU vitamin D3/d and allowed to continue their daily prenatal supplement that contained 400 IU vitamin D3. Serum was collected at study entry (18 ± 5 wk of gestation), halfway through study participation, and at delivery (40 ± 2 wk). Serum concentrations of the biochemical markers were modeled with linear mixed-effects regression models. Results Vitamin D3 supplement intake and season of delivery determined change in 25(OH)D across pregnancy. Fall-winter delivery was associated with a decline in 25(OH)D unless vitamin D3 supplement intake was >872 IU/d. The interaction of gestational age and 25(OH)D affected 24,25(OH)2D concentrations. For a given 25(OH)D concentration, model-predicted serum 24,25(OH)2D increased across gestation except when 25(OH)D was <13 ng/mL. Below this threshold, 24,25(OH)2D was predicted to decline over time. Mean serum 1,25(OH)2D was elevated (>100 pg/mL) throughout the study. Conclusion Our results suggest that when maternal serum 25(OH)D was low, its catabolism into 24,25(OH)2D decreased or remained stable as pregnancy progressed in order to maintain persistently elevated serum 1,25(OH)2D. Furthermore, in adolescents living at latitude 43°N, standard prenatal supplementation did not prevent a seasonal decline in 25(OH)D during pregnancy. This study was registered at clinicaltrials.gov as NCT01815047.
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Affiliation(s)
- Cora M Best
- Division of Nutritional Sciences, Cornell University, Ithaca, NY
| | - Eva K Pressman
- Department of Obstetrics and Gynecology, University of Rochester School of Medicine and Dentistry, Rochester, NY
| | - Ruth Anne Queenan
- Department of Obstetrics and Gynecology, University of Rochester School of Medicine and Dentistry, Rochester, NY
| | - Elizabeth Cooper
- Department of Obstetrics and Gynecology, University of Rochester School of Medicine and Dentistry, Rochester, NY
| | | | - Kimberly O O'Brien
- Division of Nutritional Sciences, Cornell University, Ithaca, NY,Address correspondence to KOO (e-mail: )
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Curtis EM, Moon RJ, Harvey NC, Cooper C. Maternal vitamin D supplementation during pregnancy. Br Med Bull 2018; 126:57-77. [PMID: 29684104 PMCID: PMC6003599 DOI: 10.1093/bmb/ldy010] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Accepted: 03/26/2018] [Indexed: 12/19/2022]
Abstract
Introduction Maternal vitamin D status in pregnancy has been linked to many health outcomes in mother and offspring. A wealth of observational studies have reported on both obstetric outcomes and complications, including pre-eclampsia, gestational diabetes, mode and timing of delivery. Many foetal and childhood outcomes are also linked to vitamin D status, including measures of foetal size, body composition and skeletal mineralization, in addition to later childhood outcomes, such as asthma. Sources of data Synthesis of systematic and narrative reviews. Areas of agreement and controversy The findings are generally inconsistent in most areas, and, at present, there is a lack of data from high-quality intervention studies to confirm a causal role for vitamin D in these outcomes. In most areas, the evidence tends towards maternal vitamin D being of overall benefit, but often does not reach statistical significance in meta-analyses. Growing points and areas timely for developing research The most conclusive evidence is in the role of maternal vitamin D supplementation in the prevention of neonatal hypocalcaemia; as a consequence the UK department of health recommends that pregnant women take 400 IU vitamin D daily. High-quality randomized placebo-controlled trials, such as the UK-based MAVIDOS trial, will inform the potential efficacy and safety of vitamin D supplementation in pregnancy across a variety of outcomes.
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Affiliation(s)
- Elizabeth M Curtis
- MRC Lifecourse Epidemiology Unit, University of Southampton,
Southampton, SO16 6YD, UK
| | - Rebecca J Moon
- MRC Lifecourse Epidemiology Unit, University of Southampton,
Southampton, SO16 6YD, UK
- Paediatric Endocrinology, Southampton University Hospitals NHS
Foundation Trust, Southampton, SO16 6YD, UK
| | - Nicholas C Harvey
- MRC Lifecourse Epidemiology Unit, University of Southampton,
Southampton, SO16 6YD, UK
- NIHR Southampton Biomedical Research Centre, University of
Southampton and University Hospital Southampton NHS Foundation Trust, Tremona Road,
Southampton, SO16 6YD, UK
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton,
Southampton, SO16 6YD, UK
- NIHR Southampton Biomedical Research Centre, University of
Southampton and University Hospital Southampton NHS Foundation Trust, Tremona Road,
Southampton, SO16 6YD, UK
- NIHR Oxford Biomedical Research Centre, University of Oxford,
Oxford, OX3 7LD, UK
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Y de Vries J, Pundir S, Mckenzie E, Keijer J, Kussmann M. Maternal Circulating Vitamin Status and Colostrum Vitamin Composition in Healthy Lactating Women-A Systematic Approach. Nutrients 2018; 10:E687. [PMID: 29843443 PMCID: PMC6024806 DOI: 10.3390/nu10060687] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 05/21/2018] [Accepted: 05/24/2018] [Indexed: 12/18/2022] Open
Abstract
Colostrum is the first ingested sole nutritional source for the newborn infant. The vitamin profile of colostrum depends on the maternal vitamin status, which in turn is influenced by diet and lifestyle. Yet, the relationship between maternal vitamin status and colostrum vitamin composition has not been systematically reviewed. This review was conducted with the aim to generate a comprehensive overview on the relationship between maternal serum (plasma) vitamin concentration and corresponding colostrum composition. Three electronic databases, Embase (Ovid), Medline (Ovid), and Cochrane, were systematically searched based on predefined inclusion and exclusion criteria. Finally, a total of 11 eligible publications were included that examined the vitamins A, C, D, E, and K in both biological fluids. Maternal vitamin A, D, E, and K blood levels were unrelated to colostrum content of the respective vitamins, and serum vitamin A was inversely correlated with colostrum vitamin E. Colostrum versus maternal serum vitamins were higher for vitamins A, C, and K, lower for vitamin D, and divergent results were reported for vitamin E levels. Colostrum appears typically enriched in vitamin A, C, and K compared to maternal serum, possibly indicative of active mammary gland transport mechanisms. Inter-individual and inter-study high variability in colostrum's vitamin content endorses its sensitivity to external factors.
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Affiliation(s)
- Jasmijn Y de Vries
- Physiology, Wageningen University, De Elst 1, Building 122, 6708 WD Wageningen, The Netherlands.
| | - Shikha Pundir
- Liggins Institute, University of Auckland, 85 Park Road, Grafton, Private Bag 92019, Auckland 1142, New Zealand.
| | - Elizabeth Mckenzie
- Liggins Institute, University of Auckland, 85 Park Road, Grafton, Private Bag 92019, Auckland 1142, New Zealand.
| | - Jaap Keijer
- Human and Animal Physiology, Wageningen University, De Elst 1, Building 122, 6708 WD Wageningen, The Netherlands.
| | - Martin Kussmann
- Liggins Institute, University of Auckland, 85 Park Road, Grafton, Private Bag 92019, Auckland 1142, New Zealand.
- New Zealand National Science Challenge "High-Value Nutrition", University of Auckland, Auckland 1142, New Zealand.
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Abstract
The WHO recommends exclusive breastfeeding for the first 6 mo of life to promote optimal infant health and development. Understanding the micro- and macronutrient concentrations of human milk and how each nutrient fluctuates with lactational stage, maternal factors, and supplementation is imperative for supporting good breastfeeding practices. Where maternal undernutrition compromises human milk quality, a thorough awareness of the effectiveness of interventions can direct efforts to achieve both maternal and infant nutrient sufficiency. This review of current knowledge covers trends in nutrient concentrations over the course of lactation and describes the influence of maternal intake, status, supplementation, and other factors on human milk concentrations of each nutrient.
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Affiliation(s)
- Daphna K Dror
- US Department of Agriculture, Agricultural Research Service, Western Human Nutrition Research Center, Davis, CA
| | - Lindsay H Allen
- US Department of Agriculture, Agricultural Research Service, Western Human Nutrition Research Center, Davis, CA
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Lee-Sarwar K, Litonjua AA. As You Eat It: Effects of Prenatal Nutrition on Asthma. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2018; 6:711-718. [PMID: 29412180 PMCID: PMC5948171 DOI: 10.1016/j.jaip.2018.01.026] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Revised: 01/08/2018] [Accepted: 01/10/2018] [Indexed: 02/08/2023]
Abstract
Asthma most frequently develops early in life, and increased recognition of the role of lifestyle and environmental factors in asthma susceptibility raises the possibility that dietary exposures during pregnancy may influence the risk of asthma in offspring. This review discusses the latest evidence with regard to the effect of diet during pregnancy on childhood asthma risk, including potential mechanisms, outcomes of randomized clinical trials, and results from observational studies. Vitamin D and polyunsaturated fatty acid intake during pregnancy are highlighted as areas with large and growing bodies of literature to support a potential role in prenatal modulation of subsequent asthma risk. Several other nutritional interventions are under active investigation, and recommendations regarding dietary modifications during pregnancy will likely need to be personalized based on factors such as maternal smoking and genetic variants. Although nutrition during pregnancy is uniquely challenging to investigate, and definitive recommendations cannot be made without additional high-quality evidence and knowledge regarding long-term effects of interventions, the modifiable nature of the diet and sizeable potential reduction of morbidity supports ongoing research to determine how to optimize nutrition during pregnancy to prevent asthma in offspring.
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Affiliation(s)
- Kathleen Lee-Sarwar
- Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital and Harvard Medical School, Boston, Mass
| | - Augusto A Litonjua
- Division of Pediatric Pulmonary Medicine, Golisano Children's Hospital at University of Rochester Medical Center, Rochester, NY.
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Liu NQ, Larner DP, Yao Q, Chun RF, Ouyang Y, Zhou R, Tamblyn JA, Wagner CL, Hewison M. Vitamin D-deficiency and sex-specific dysregulation of placental inflammation. J Steroid Biochem Mol Biol 2018; 177:223-230. [PMID: 28676458 DOI: 10.1016/j.jsbmb.2017.06.012] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Revised: 06/14/2017] [Accepted: 06/18/2017] [Indexed: 12/21/2022]
Abstract
To investigate an immunomodulatory role for vitamin D in pregnancy we used mice raised on vitamin D-sufficient (SUFF), or -deficient (DEF) diets. At embryonic day 14, pregnant mice received intraperitoneal injection of lipopolysaccharide (LPS) or vehicle for 24h, with age-matched non-pregnant mice as controls. In non-pregnant mice, 6 serum analytes (IL-1β, IL-18, MDC/CCL22, MIP-1α/CCL3, EGF, IgA) were lower in DEF mice. In pregnant DEF mice only GH was higher. In non-pregnant mice LPS induced 28 analytes, with 5 (IL-18, IP-10/CXCL10, MCP-1/CCL2, MIP-1β/CCL4, MIP-3β/CCL19) being highest in DEF mice. In pregnant SUFF mice 16 serum analytes increased with LPS, and 6 of these (IP-10/CXCL10, MCP-1/CCL2, SAP, TIMP-1, VCAM-1, vWF) were higher and 1 (GCP-2/CXCL6) lower in DEF mice. Parallel analysis of placental mRNAs showed elevated mRNA for Il-6, Ccl2 and Cxcl10 in placentae from male and female fetuses in LPS-DEF mice. However, LPS-induced expression of Ifnγ, Tnfα, and Cxcl6 was only observed in female placentae from DEF mice. LPS-DEF mice also showed smaller litter sizes relative to control SUFF mice. Numbers of female fetuses per dam were significantly lower for DEF mice with or without LPS challenge. LPS had no effect on numbers of male fetuses from DEF mothers, but significantly decreased male fetuses from SUFF mothers. These data indicate that vitamin D is an important component of anti-inflammatory immune responses during pregnancy, with the placenta and fetal sex playing pivotal roles in this process.
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Affiliation(s)
- Nancy Q Liu
- Dept of Orthopaedic Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, 90095, USA
| | - Dean P Larner
- Institute of Metabolism and Systems Research, The University of Birmingham, Birmingham B15 2TT, UK; Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham B15 2TH, UK
| | - Qingqiang Yao
- Dept of Orthopaedic Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, 90095, USA
| | - Rene F Chun
- Dept of Orthopaedic Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, 90095, USA
| | - Yuxin Ouyang
- Dept of Orthopaedic Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, 90095, USA
| | - Rui Zhou
- Dept of Orthopaedic Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, 90095, USA
| | - Jennifer A Tamblyn
- Institute of Metabolism and Systems Research, The University of Birmingham, Birmingham B15 2TT, UK; Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham B15 2TH, UK
| | - Carol L Wagner
- Division of Neonatology, Department of Pediatrics, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Martin Hewison
- Dept of Orthopaedic Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, 90095, USA; Institute of Metabolism and Systems Research, The University of Birmingham, Birmingham B15 2TT, UK; Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham B15 2TH, UK.
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Abstract
OBJECTIVE To determine the prevalence and correlates of healthy vitamin D status in lactating Inuit women living in remote regions of the Arctic. DESIGN Cross-sectional. SETTING Households were selected randomly in thirty-six communities of Nunavut, Nunatsiavut and Inuvialuit Settlement Region. Dietary intake was assessed using a 24 h recall and an FFQ. Anthropometric measurements, household living conditions, supplement use and health status were assessed. In fasting samples, serum 25-hydroxyvitaimn D (25(OH)D) was measured using a chemiluminescent assay (LIAISON; Diasorin Inc.). SUBJECTS Lactating Inuit women participating in the 2007-2008 International Polar Year Inuit Health Survey conducted in the months of August to October. RESULTS Among participants (n 34), 8·8, 26·5 and 50·0 % had 25(OH)D concentrations at or above 75, 50 and 40 nmol/l, respectively. More than one-third of participants did not consume traditional foods during the previous day and only 11·3 % of total energy intake was derived from traditional foods. Only 14·7 % of the sample consumed the daily number of milk servings recommended by Canada's Food Guide (two servings) for First Nations, Inuit and Métis. Using multivariable logistic regression to examine 25(OH)D≥40 nmol/l, only higher body fat was inversely correlated with 25(OH)D concentration. CONCLUSIONS The present study is the first to assess simultaneously vitamin D status and other known factors that affect it among lactating Inuit women living in remote communities in the Arctic. Healthy maternal vitamin D status was observed in 25 % of participants during the late summer and early autumn. This requires further assessment in a larger sample spanning more seasons.
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Shi A, Wen J, Liu G, Liu H, Fu Z, Zhou J, Zhu Y, Liu Y, Guo X, Xu J. Genetic variants in vitamin D signaling pathways and risk of gestational diabetes mellitus. Oncotarget 2018; 7:67788-67795. [PMID: 27636996 PMCID: PMC5356519 DOI: 10.18632/oncotarget.11984] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Accepted: 09/07/2016] [Indexed: 12/31/2022] Open
Abstract
Vitamin D (VD) deficiency during pregnancy has been repeatedly linked to an increased gestational diabetes mellitus (GDM) risk. We sought to determine the influences of genetic variants in vitamin D signaling pathways on the risk of GDM. In this study, we genotyped 15 single nucleotide polymorphisms (SNPs) within 8 representative genes (CYP27A1, CYP27B1, CYP24A1, VDR, RXRA, RXRB, RXRG and GC) of the vitamin D signaling pathways in a case-control study with 964 GDM cases and 1,021 controls using the Sequenom MassARRAY iPLEX platform. Logistic regression analyses in additive model showed that GC rs16847024 C>T, RXRG rs17429130 G>C and RXRA rs4917356 T>C were significantly associated with the increased risk of GDM (adjusted OR = 1.31, 95% CI = 1.10-1.58 for rs16847024; adjusted OR = 1.28, 95% CI = 1.04-1.57 for rs17429130; adjusted OR = 1.28, 95% CI = 1.06-1.54 for rs4917356). And GDM risk significantly increased with the increasing number of variant alleles of the three SNPs in a dose-dependent manner (P for trend < 0.001). Moreover, the combined effect of the three SNPs on GDM occurrence was more prominent in older women (age > 30). Further interactive analyses also detected a significantly multiplicative interaction between the combined variant alleles and age on GDM risk (P = 0.035). Together, these findings indicate that GC rs16847024, RXRG rs17429130 and RXRA rs4917356 were candidate susceptibility markers for GDM in Chinese females. Further validation studies with different ethnic background and biological function analyses were needed.
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Affiliation(s)
- Aiwu Shi
- Department of Anaesthesiology, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, China.,Department of MICU, Nanjing Maternity and Child Health Care Hospital Affiliated to Nanjing Medical University, Nanjing, China.,State Key Laboratory of Reproductive Medicine, Nanjing Maternity and Child Health Care Hospital Affiliated to Nanjing Medical University, Nanjing, China
| | - Juan Wen
- State Key Laboratory of Reproductive Medicine, Nanjing Maternity and Child Health Care Hospital Affiliated to Nanjing Medical University, Nanjing, China.,Nanjing Maternity and Child Health Care Institute, Nanjing Maternity and Child Health Care Hospital Affiliated to Nanjing Medical University, Nanjing, China.,Department of Children Health Care, Nanjing Maternity and Child Health Care Hospital Affiliated to Nanjing Medical University, Nanjing, China
| | - Guangquan Liu
- Nanjing Maternity and Child Health Care Institute, Nanjing Maternity and Child Health Care Hospital Affiliated to Nanjing Medical University, Nanjing, China
| | - Heng Liu
- Nanjing Maternity and Child Health Care Institute, Nanjing Maternity and Child Health Care Hospital Affiliated to Nanjing Medical University, Nanjing, China
| | - Ziyi Fu
- State Key Laboratory of Reproductive Medicine, Nanjing Maternity and Child Health Care Hospital Affiliated to Nanjing Medical University, Nanjing, China.,Nanjing Maternity and Child Health Care Institute, Nanjing Maternity and Child Health Care Hospital Affiliated to Nanjing Medical University, Nanjing, China
| | - Jing Zhou
- Department of MICU, Nanjing Maternity and Child Health Care Hospital Affiliated to Nanjing Medical University, Nanjing, China
| | - Yao Zhu
- Department of MICU, Nanjing Maternity and Child Health Care Hospital Affiliated to Nanjing Medical University, Nanjing, China
| | - Yaoqiu Liu
- Department of MICU, Nanjing Maternity and Child Health Care Hospital Affiliated to Nanjing Medical University, Nanjing, China
| | - Xirong Guo
- State Key Laboratory of Reproductive Medicine, Nanjing Maternity and Child Health Care Hospital Affiliated to Nanjing Medical University, Nanjing, China.,Nanjing Maternity and Child Health Care Institute, Nanjing Maternity and Child Health Care Hospital Affiliated to Nanjing Medical University, Nanjing, China.,Department of Children Health Care, Nanjing Maternity and Child Health Care Hospital Affiliated to Nanjing Medical University, Nanjing, China
| | - Jianguo Xu
- Department of Anaesthesiology, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, China
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Ganz AB, Park H, Malysheva OV, Caudill MA. Vitamin D binding protein rs7041 genotype alters vitamin D metabolism in pregnant women. FASEB J 2018; 32:2012-2020. [PMID: 29196501 DOI: 10.1096/fj.201700992r] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Research has identified reduced circulating 25-hydroxyvitamin D [25(OH)D] in individuals with the rs7041 (c.1296T>G) T allele in the vitamin D binding protein gene ( GC); however, the effects of the T allele on vitamin D biomarkers during pregnancy and lactation are unknown. Thus, we examined the metabolic effects of GC rs7041 on vitamin D biomarkers among third-trimester pregnant ( n = 26), lactating ( n = 28), and nonpregnant/nonlactating ( n = 21) women consuming a single amount of vitamin D (511 IU/d) and related nutrients for 10-12 wk. T allele carriers had less circulating 25(OH)D, regardless of reproductive state [thymine-thymine (TT): 80% of guanine-guanine (GG), P = 0.05; guanine-thymine (GT): 85% of GG, P = 0.1]. Among pregnant women, the T allele attenuated the expected increase in vitamin D binding protein (DBP). Specifically, although GG pregnant women exhibited greater DBP (216%, P < 0.0001) than did GG nonpregnant women, that difference was lessened among GT women, and TT pregnant women did not exhibit greater DBP than TT nonpregnant women. Furthermore, TT pregnant women had greater placental 25(OH)D3 to 24,25-dihydroxyvitamin D ratios (251% of GG, P = 0.07) and less osteocalcin, a bone formation marker, in the cord blood of their neonates (24% of GT, P = 0.02). Overall, the GC rs7041 genotype modified the effects of pregnancy on maternal and placental vitamin D metabolism, with possible functional consequences for fetal bone development and infant health.-Ganz, A. B., Park, H., Malysheva, O. V., Caudill, M. A. Vitamin D binding protein rs7041 genotype alters vitamin D metabolism in pregnant women.
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Affiliation(s)
- Ariel B Ganz
- Division of Nutritional Sciences, Cornell University, Ithaca, New York, USA
| | - Heyjun Park
- Division of Nutritional Sciences, Cornell University, Ithaca, New York, USA
| | - Olga V Malysheva
- Division of Nutritional Sciences, Cornell University, Ithaca, New York, USA
| | - Marie A Caudill
- Division of Nutritional Sciences, Cornell University, Ithaca, New York, USA
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Karras SN, Koufakis T, Fakhoury H, Kotsa K. Deconvoluting the Biological Roles of Vitamin D-Binding Protein During Pregnancy: A Both Clinical and Theoretical Challenge. Front Endocrinol (Lausanne) 2018; 9:259. [PMID: 29875736 PMCID: PMC5974103 DOI: 10.3389/fendo.2018.00259] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2018] [Accepted: 05/07/2018] [Indexed: 12/04/2022] Open
Abstract
The teleological purpose of an ongoing pregnancy is to fulfill its fundamental role of a successful, uncomplicated delivery, in conjunction with an optimal intrauterine environment for the developing fetus. Vitamin D metabolism is adapted to meet both these demands during pregnancy; first by stimulation of calcium absorption for adequate intrauterine bone mineral accrual of the fetus, and second, by enhancing systemic and local maternal tolerance to paternal and fetal alloantigens. Vitamin D-binding protein (VDBP) is one of the key biomolecules that optimize vitamin D homeostasis and also contributes as an immune regulator for a healthy, ongoing pregnancy. In this regard, recent results indicate that dysregulation of VDBP equilibrium could be a risk factor for adverse fetal, maternal, and neonatal outcomes, including preeclampsia, preterm birth, and gestational diabetes. Moreover, it has been hypothesized to be also implicated in the interpretation of vitamin D status in the pregnant state. The aim of this review is to assess available literature regarding the association of VDBP with clinical outcomes during pregnancy, as a potential biomarker for future clinical practice, with a discourse on current knowledge gaps and future research agenda.
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Affiliation(s)
- Spyridon N. Karras
- Division of Endocrinology and Metabolism, First Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA University Hospital, Thessaloniki, Greece
- *Correspondence: Spyridon N. Karras,
| | - Theocharis Koufakis
- Division of Endocrinology and Metabolism, First Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA University Hospital, Thessaloniki, Greece
| | - Hana Fakhoury
- Department of Biochemistry and Molecular Biology, College of Medicine, AlFaisal University, Riyadh, Saudi Arabia
| | - Kalliopi Kotsa
- Division of Endocrinology and Metabolism, First Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA University Hospital, Thessaloniki, Greece
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Sørensen IM, Joner G, Jenum PA, Eskild A, Dahl SR, Stene LC. Maternal serum calcitriol during pregnancy and risk of childhood onset type 1 diabetes. Acta Diabetol 2017; 54:1143-1145. [PMID: 28875306 DOI: 10.1007/s00592-017-1045-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Accepted: 08/26/2017] [Indexed: 01/20/2023]
Affiliation(s)
- Ingvild M Sørensen
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, PO Box 4956, 0424, Nydalen, Oslo, Norway.
| | - Geir Joner
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, PO Box 4956, 0424, Nydalen, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Pål A Jenum
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Laboratory Medicine, Medical Microbiology, Vestre Viken Hospital Trust, Oslo, Norway
| | - Anne Eskild
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Obstetrics and Gynaecology, Akershus University Hospital, Oslo, Norway
| | - Sandra R Dahl
- Hormone Laboratory, Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway
| | - Lars C Stene
- Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway
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Cunha Figueiredo AC, Trujillo J, Freitas-Vilela AA, Franco-Sena AB, Rebelo F, Cunha GM, de Castro MBT, Farnum A, Mokhtar RR, Holick MF, Kac G. Association between plasma concentrations of vitamin D metabolites and depressive symptoms throughout pregnancy in a prospective cohort of Brazilian women. J Psychiatr Res 2017; 95:1-8. [PMID: 28755554 DOI: 10.1016/j.jpsychires.2017.07.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 06/04/2017] [Accepted: 07/13/2017] [Indexed: 11/18/2022]
Abstract
Plasma concentrations of vitamin D metabolites can be inversely associated with depressive symptoms. However, few longitudinal studies have investigated this association, especially during pregnancy. The aim of this study was to investigate the association between concentrations of 25-hydroxyvitamin D [25(OH)D] and 1,25-dihydroxivitamin D [1,25(OH)2D] with the occurrence of depressive symptoms throughout pregnancy. A prospective cohort of 179 women was followed at 5th-13th, 20th-26th and 30th-36th gestational weeks. At each trimester of pregnancy, the plasma concentrations of 25(OH)D and 1,25(OH)2D were analyzed by liquid chromatography tandem mass spectroscopy. Vitamin D status was categorized according to the Endocrine Society Practice Guidelines and the Institute of Medicine. Depressive symptoms were measured at each trimester using the Edinburgh Postnatal Depressive Scale (cutoff ≥13). Statistical analyses included random intercept logistic regression models for longitudinal analyses. In the first trimester, the prevalence of 25(OH)D <75, <50 and <30 nmol/L were 69.3%, 14.0% and 1.7%, respectively. Prevalence of depressive symptoms were 20.1%, 14.7% and 7.8% for the first, second and third trimesters, respectively. The probability of occurrence of depressive symptoms decreased throughout pregnancy (p-value = 0.005). Women with higher concentrations of 25(OH)D in the first trimester presented a lower odds ratio (OR) for the development of depressive symptoms during pregnancy (OR = 0.98; 95%CI: 0.96 to 0.99, p-value = 0.047) in the adjusted model. In conclusion, there was a higher prevalence of vitamin D inadequacy and depressive symptoms during the first trimester. Higher 25(OH)D concentrations in the first trimester were associated with a decrease of 2% in the odds for presenting depressive symptoms throughout pregnancy.
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Affiliation(s)
- Amanda C Cunha Figueiredo
- Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Institute of Nutrition Josué de Castro, Rio de Janeiro Federal University, RJ, Brazil
| | - Janet Trujillo
- Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Institute of Nutrition Josué de Castro, Rio de Janeiro Federal University, RJ, Brazil
| | - Ana Amélia Freitas-Vilela
- Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Institute of Nutrition Josué de Castro, Rio de Janeiro Federal University, RJ, Brazil; Special Academic Unit of Health Sciences, Goiás Federal University, GO, Brazil
| | - Ana Beatriz Franco-Sena
- Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Institute of Nutrition Josué de Castro, Rio de Janeiro Federal University, RJ, Brazil; Department of Social Nutrition, Emília de Jesus Ferreiro Nutrition School, Fluminense Federal University, Niteroi, Brazil
| | - Fernanda Rebelo
- Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Institute of Nutrition Josué de Castro, Rio de Janeiro Federal University, RJ, Brazil; Division of Clinical Trials and Drug Development, National Institute of Cancer, Ministry of Health, RJ, Brazil
| | - Geraldo Marcelo Cunha
- National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil
| | - Maria Beatriz Trindade de Castro
- Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Institute of Nutrition Josué de Castro, Rio de Janeiro Federal University, RJ, Brazil; Graduate Program in Nutrition, Institute of Nutrition Josué de Castro, Rio de Janeiro Federal University, RJ, Brazil
| | - Amanda Farnum
- Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Institute of Nutrition Josué de Castro, Rio de Janeiro Federal University, RJ, Brazil
| | | | | | - Gilberto Kac
- Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Institute of Nutrition Josué de Castro, Rio de Janeiro Federal University, RJ, Brazil; Graduate Program in Nutrition, Institute of Nutrition Josué de Castro, Rio de Janeiro Federal University, RJ, Brazil.
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48
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Ethnic disparities in the dietary requirement for vitamin D during pregnancy: considerations for nutrition policy and research. Proc Nutr Soc 2017; 77:164-173. [PMID: 29182508 DOI: 10.1017/s0029665117004116] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Despite the inverse association between skin colour and efficiency of cutaneous vitamin D synthesis, in addition to the widely accepted racial disparity in vitamin D status, populations of ethnic minority are understudied in terms of setting target serum 25-hydroxyvitamin D concentrations and corresponding dietary requirements for vitamin D. In minority groups, prevention of vitamin D deficiency on a population basis is challenging due to the lack of clarity surrounding the metabolism and transport of vitamin D. Authoritative agencies have been unable to define pregnancy-specific dietary recommendations for vitamin D, owing to an absence of sufficient evidence to confirm whether nutritional requirements for vitamin D are altered during pregnancy. While the question of setting race- and pregnancy-specific dietary reference values for vitamin D has not been addressed to date, endemic vitamin D deficiency has been reported among gravidae worldwide, specifically among ethnic minorities and white women resident at high latitude. In light of the increased risk of nutritional rickets among infants of ethnic minority, coupled with growing evidence for potential non-skeletal roles of vitamin D in perinatal health, determination of the dietary vitamin D requirement that will prevent deficiency during pregnancy is a research priority. However, systematic approaches to establishing dietary requirements are limited by the quality of the available evidence and the under-representation of minority groups in clinical research. This review considers the evidence for racial differences in vitamin D status and response to vitamin D supplementation, with particular application to pregnancy-specific requirements among ethnic minorities resident at high latitudes.
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Baca KM, Govil M, Zmuda JM, Simhan HN, Marazita ML, Bodnar LM. Vitamin D metabolic loci and vitamin D status in Black and White pregnant women. Eur J Obstet Gynecol Reprod Biol 2017; 220:61-68. [PMID: 29175129 DOI: 10.1016/j.ejogrb.2017.11.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Revised: 10/19/2017] [Accepted: 11/13/2017] [Indexed: 01/08/2023]
Abstract
BACKGROUND Several candidate genes and genome wide association studies have reported significant associations between vitamin D metabolism genes and 25-hydroxyvitamin D. Few studies have examined these relationships in pregnancy. OBJECTIVE We evaluated the relationship between maternal allelic variants in three vitamin D metabolism genes and 25-hydroxyvitamin D (25(OH)D) concentration in pregnancy. STUDY DESIGN In two case-control studies, samples were drawn from women who delivered at Magee Womens Hospital in Pittsburgh, PA from 1999 to 2010 and twelve recruiting sites across the United States from 1959 to 65. For 882 Black and 1796 White pregnant women from these studies, 25(OH)D concentration was measured and single nucleotide polymorphisms (SNPs) were genotyped 50 kilobases up- and down-stream in three genes (VDR, GC, and CYP27B1). Using multivariable linear regression, we estimated the associations between allelic variation of each locus and log-transformed 25(OH)D concentration separately by race and study group. Meta-analysis was used to estimate the association across the four groups for each SNP. RESULTS Minor alleles of several variants in VDR, GC, and CYP27B1 were associated with differences in log-transformed 25(OH)D concentration compared to the corresponding major alleles [beta, 95% confidence intervals (CI)]. The meta-analysis confirmed the associations for differences in log-transformed 25(OH)D by allelic loci for one intron VDR variant [rs2853559 0.08 (0.02, 0.13), p<0.01] and a variant in the GC flanking region [rs13150174: 0.04 (0.02, 0.07), p<0.01], and a GC missense mutation [rs7041 0.05 (0.01, 0.09), p<0.01]. The meta-analysis also revealed possible associations for SNPs in linkage disequilibrium with variants in the VDR 3-prime untranslated region, another GC missense variant (rs4588), and a variant of the 3-prime untranslated region of CYP27B1. CONCLUSION We observed associations between VDR, GC, and CYP27B1 variants and maternal 25-hydroxyvitamin D concentration. Our results provide additional support for a possible role of genetic variation in vitamin D metabolism genes on vitamin D status during pregnancy.
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Affiliation(s)
- Katharyn M Baca
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, 15261, USA
| | - Manika Govil
- Center for Craniofacial and Dental Genetics, Department of Oral Biology, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA, 15213, USA
| | - Joseph M Zmuda
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, 15261, USA; Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, 15261, USA
| | - Hyagriv N Simhan
- Department of Obstetrics, Gynecology, and Reproductive Sciences, School of Medicine, University of Pittsburgh, 300 Halket Street, Pittsburgh, PA, 15213, USA; Magee-Womens Research Institute, Pittsburgh, PA, 15213, USA
| | - Mary L Marazita
- Center for Craniofacial and Dental Genetics, Department of Oral Biology, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA, 15213, USA; Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, 15261, USA; Clinical and Translational Science Institute, School of Medicine, University of Pittsburgh, Pittsburgh, PA, 15213, USA
| | - Lisa M Bodnar
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, 15261, USA; Department of Obstetrics, Gynecology, and Reproductive Sciences, School of Medicine, University of Pittsburgh, 300 Halket Street, Pittsburgh, PA, 15213, USA; Magee-Womens Research Institute, Pittsburgh, PA, 15213, USA.
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50
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Størdal K, Mårild K, Tapia G, Haugen M, Cohen AS, Lie BA, Stene LC. Fetal and Maternal Genetic Variants Influencing Neonatal Vitamin D Status. J Clin Endocrinol Metab 2017; 102:4072-4079. [PMID: 28938476 PMCID: PMC5673272 DOI: 10.1210/jc.2017-00827] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Accepted: 08/15/2017] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Several genetic polymorphisms determine vitamin D status. We aimed to estimate the strength of association of established 25-hydroyxvitamin D (25OHD)-associated variants in the mother and in the fetus, with 25OHD concentration in newborn umbilical cord plasma. METHODS We randomly selected 578 mother and child dyads from the prospective Norwegian Mother and Child Cohort study. 25OHD was assayed in maternal samples taken shortly after delivery and in cord samples. We genotyped the mother and child for single nucleotide polymorphisms in or near GC, DHCR7, CYP2R1, and CYP24A1, previously confirmed to be associated with 25OHD, and computed genetic risk score (GRS). The genetic associations were replicated in an independent sample of 594 subjects. RESULTS Although both fetal and maternal GRS were associated with cord 25OHD, only fetal GRS remained significantly associated with cord 25OHD in a regression model with maternal and fetal GRS simultaneously (1.6 nmol/L per fetal 25OHD-increasing allele; 95% confidence interval, 0.6 to 2.5, P = 0.0001). Two fetal single nucleotide polymorphisms in the GC gene (rs2282679 and rs222040) were the strongest genetic predictors of cord 25OHD [4.0 (2.1 to 5.9) and 3.0 (1.3 to 4.8) nmol/L per fetal allele, P < 0.001], followed by rs12785878 in DHCR7 [2.0 (0.1 to 3.8) nmol/L, P = 0.037]. The independent replication sample gave similar results. With fetal genotype included in a regression model with environmental factors, R2 for cord 25OHD was 0.28. CONCLUSIONS We show that fetal 25OHD-modifying genotype was a stronger predictor of cord 25OHD than corresponding maternal genotype. This raises interesting questions about fetal acquisition and placental transfer of 25OHD.
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Affiliation(s)
- Ketil Størdal
- Norwegian Institute of Public Health, 0403 Oslo, Norway
- Department of Pediatrics, Østfold Hospital Trust, 1714 Grålum, Norway
| | - Karl Mårild
- Norwegian Institute of Public Health, 0403 Oslo, Norway
| | - German Tapia
- Norwegian Institute of Public Health, 0403 Oslo, Norway
| | | | - Arieh S. Cohen
- Danish Center for Newborn Screening, Statens Serum Institut, 2300 Copenhagen, Denmark
| | - Benedicte A. Lie
- Department of Medical Genetics, University of Oslo and Oslo University Hospital, 0424 Oslo, Norway
| | - Lars C. Stene
- Norwegian Institute of Public Health, 0403 Oslo, Norway
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