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Aulia I, Wibawa LP, Suseno LS, Manikam NRM. Correlation Among Serum Calcidiol, Sun Index, and Vitamin D Intake in Individuals With Seborrheic Keratoses Living in Coastal Area. Dermatol Pract Concept 2024; 14:dpc.1402a37. [PMID: 38810054 PMCID: PMC11135965 DOI: 10.5826/dpc.1402a37] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/01/2023] [Indexed: 05/31/2024] Open
Abstract
INTRODUCTION Seborrheic keratoses (SK) are benign epidermal tumors with high sun exposure as a major risk factor. Vitamin D deficiency is also thought to play a role in its pathogenesis. There has been no data regarding SK, calcidiol level, vitamin D intake, and sun index (SI) among people living in coastal areas in Indonesia. OBJECTIVES To assess the correlation between 1) serum calcidiol levels with SI and vitamin D intake and 2) lesion size with SI and serum calcidiol level among SK patients living in a coastal area. METHODS This is a cross-sectional study. We performed interviews using the sun index questionnaire and semiquantitative food frequency questionnaire for vitamin D; physical examination; dermoscopy to determine the largest SK lesion size; and measurement of serum calcidiol levels in participants with SK living in Cilincing District, North Jakarta. Spearman correlation test was used to assess the relationship between variables. RESULTS Thirty-nine participants with SK aged 19-59 years were analyzed. The median of the SK largest diameter, SI, serum calcidiol, and vitamin D intake was 2 (1-10) mm, 3.95 (1.1-23.52), 14.3 (5.25-35.30) ng/ml, and 4.3 (0.1-30.1) mcg/day, respectively. SI and vitamin D intake were not significantly correlated with calcidiol levels. Similarly, SI and calcidiol levels were not significantly correlated with the largest SK lesion size. CONCLUSIONS We found low calcidiol levels and vitamin D intake in this coastal population. The SI and vitamin D intake had no correlations with calcidiol levels. Furthermore, calcidiol levels and SI had no correlations with the lesion largest diameter.
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Affiliation(s)
- Izzah Aulia
- Dermatology and Venereology Department, Faculty of Medicine, Universitas Indonesia – dr. Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia
| | - Larisa Paramitha Wibawa
- Dermatology and Venereology Department, Faculty of Medicine, Universitas Indonesia – dr. Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia
| | - Lis Surachmiati Suseno
- Dermatology and Venereology Department, Faculty of Medicine, Universitas Indonesia – dr. Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia
| | - Nurul Ratna Mutu Manikam
- Department of Nutrition, Faculty of Medicine, Universitas Indonesia – dr. Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia
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Lee JK, Chee WS, Foo SH, Lee VK, Sallehuddin H, Khor HM, Arasu K, Mohamad M, Ahmad AR, A/L Puvaneswaran S, Koh KC, Hoo FK, Tan GH, Mitchell PJ. Vitamin D status and clinical implications in the adult population of Malaysia: a position paper by the Malaysian Vitamin D Special Interest Group. Osteoporos Int 2023; 34:1837-1850. [PMID: 37430004 DOI: 10.1007/s00198-023-06841-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 06/21/2023] [Indexed: 07/12/2023]
Abstract
PURPOSE Vitamin D deficiency and insufficiency is common among populations globally, and in Asia and Malaysia. The purpose of this Position Paper is to propose recommendations for both clinicians and non-clinicians to promote vitamin D sufficiency in Malaysian adults. Formation of a national multisector, multidisciplinary alliance is also proposed to progress initiatives relating to safe sun exposure, adequate vitamin D intake through food fortification, and vitamin D supplementation for high-risk groups. METHODS Literature reviews were undertaken to inform summaries of the following: vitamin D status globally and in Asian and Malaysian populations, vitamin D status among individuals with common medical conditions, and current recommendations to achieve vitamin D sufficiency through sun exposure, food intake and supplementation. Recommendations were based on the findings of the literature reviews, recent European guidance on vitamin D supplementation, the 2018 road map for action on vitamin D in low- and middle-income countries, and research recommendations proposed by the Malaysian Ministry of Health in 2017. RESULTS Recommendations on assessment of vitamin D in the adult Malaysian population include using serum or plasma 25-hydroxyvitamin D concentration as a biomarker, widespread participation by Malaysian laboratories in the Vitamin D Standardization Program, adoption of the US Endocrine Society definitions of vitamin D deficiency and insufficiency, and development of a comprehensive nationwide vitamin D status study. Specific high-risk groups are identified for vitamin D assessment and recommendations relating to loading doses and ongoing management are also made. CONCLUSION This Position Paper provides individual clinicians and national stakeholder organisations with clear recommendations to achieve vitamin D sufficiency in the adult population of Malaysia.
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Affiliation(s)
- Joon-Kiong Lee
- Beacon Hospital, 1, Jalan 215, Section 51, Off Jalan Templer, 46050, Petaling Jaya, Selangor, Malaysia.
| | - Winnie Ss Chee
- Division of Nutrition and Dietetics, School of Health Sciences, International Medical University, 126, Jalan Jalil Perkasa 19, Bukit Jalil, 57000, Kuala Lumpur, Malaysia
| | - Siew Hui Foo
- Selayang Hospital, Lebuhraya Selayang Kepong, 68100, Batu Caves, Selangor, Malaysia
| | - Verna Km Lee
- Department of Family Medicine, School of Medicine, International Medical University, Clinical Campus, Jalan Rasah, 70300, Seremban, Negeri Sembilan, Malaysia
| | - Hakimah Sallehuddin
- Geriatric Unit, Department of Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, Serdang, Selangor, Malaysia
- Malaysian Research Institute on Ageing (MyAgeing™), Universiti Putra Malaysia, 43400, Serdang, Selangor, Malaysia
| | - Hui-Min Khor
- Universiti Malaya, Jalan Profesor Diraja Ungku Aziz, Lembah Pantai, 59100, Kuala Lumpur, Malaysia
| | - K Arasu
- Division of Nutrition and Dietetics, School of Health Sciences, International Medical University, 126, Jalan Jalil Perkasa 19, Bukit Jalil, 57000, Kuala Lumpur, Malaysia
| | - Masni Mohamad
- Hospital Putrajaya, Jalan P9, Presint 7, Putrajaya, Wilayah Persekutuan Putrajaya, Malaysia
| | - A R Ahmad
- Beacon Hospital, 1, Jalan 215, Section 51, Off Jalan Templer, 46050, Petaling Jaya, Selangor, Malaysia
| | | | - Kar-Chai Koh
- Poliklinik Kepong Baru, 54, Jalan Ambong Kiri Satu, Kepong Baru, 52100, Kuala Lumpur, Malaysia
| | - Fan-Kee Hoo
- Neurology Department, Faculty of Medicine and Health Sciences, University Putra Malaysia, 43400, Serdang, Selangor, Malaysia
| | - Gie-Hooi Tan
- Beacon Hospital, 1, Jalan 215, Section 51, Off Jalan Templer, 46050, Petaling Jaya, Selangor, Malaysia
| | - P J Mitchell
- School of Medicine, University of Notre Dame Australia, Sydney Campus, 128-140 Broadway, Chippendale, Sydney, New South Wales, 2007, Australia
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Windmill Road, Oxford, OX3 7LD, UK
- Synthesis Medical NZ Limited, 28 Motu Street, St. Clair, Dunedin, 9012, New Zealand
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Md Isa Z, Amsah N, Ahmad N. The Impact of Vitamin D Deficiency and Insufficiency on the Outcome of Type 2 Diabetes Mellitus Patients: A Systematic Review. Nutrients 2023; 15:2310. [PMID: 37242192 PMCID: PMC10223393 DOI: 10.3390/nu15102310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 05/10/2023] [Accepted: 05/12/2023] [Indexed: 05/28/2023] Open
Abstract
Vitamin D deficiency and insufficiency are public health concerns that have contributed to multiple negative health outcomes. Recent studies have revealed that vitamin D deficiency and insufficiency influence glycaemic control and the development of diabetes complications. The goal of this systematic review is to summarise the latest evidence on the impact of vitamin D deficiency and insufficiency on the outcome of Type 2 Diabetes Mellitus (T2DM) patients. In this PRISMA-guided systematic review, articles were sourced from three databases, namely, PubMed, Scopus, and Web of Science. The review only included literature published from 2012 until 2022, and 33 eligible studies met the inclusion criteria for this review. The included articles were critically appraised using the Mixed Method Appraisal Tool (MMAT). According to our findings, vitamin D deficiency or insufficiency is associated with mental health status, macrovascular and microvascular complications of T2DM, metabolic syndrome, increased risk of obesity, increased blood pressure, dyslipidaemia, glycaemic control, nerve-related disease, musculoskeletal-related complications, and reduced quality of life. Due to the diverse implications of vitamin D deficiency and insufficiency, screening for vitamin D levels in T2DM patients may be beneficial.
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Affiliation(s)
| | | | - Norfazilah Ahmad
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, Kuala Lumpur 56000, Malaysia; (Z.M.I.); (N.A.)
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Agustina R, Rianda D, Lasepa W, Birahmatika FS, Stajic V, Mufida R. Nutrient intakes of pregnant and lactating women in Indonesia and Malaysia: Systematic review and meta-analysis. Front Nutr 2023; 10:1030343. [PMID: 37063336 PMCID: PMC10098007 DOI: 10.3389/fnut.2023.1030343] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 01/02/2023] [Indexed: 04/03/2023] Open
Abstract
IntroductionOptimizing dietary intake during pregnancy and lactation is crucial to the growth and development of children and their lifelong health. We performed a systematic review and meta-analysis to describe the nutrient intakes of pregnant and lactating women in Indonesia and Malaysia, countries that are experiencing rapid nutrition transition in Southeast Asia.MethodsWe screened 2,258 studies published between January 1980 and March 2021. The nutrient intakes of pregnant and lactating women were quantitatively analyzed to calculate the percentage of adequacy using national recommended daily allowances or nutrient intakes (RDA/RNI) and estimated average requirements (EAR) for micronutrients. Standardized mean differences (SMD) between dietary intake and RDA/RNI were determined for selected nutrients.ResultsFifty-three studies were included and showed that energy and macronutrient intakes among pregnant and lactating women in both countries were below the RDA/RNI. In addition, most studies reported that women failed to meet the EAR for vitamin D (<70% EAR), vitamin E (<50% EAR), and water-soluble vitamins (<80% EAR) except for vitamin C and A among Malaysians. Moreover, calcium, potassium, and iron intakes of pregnant women were <60% EAR in Indonesia and <80% EAR in Malaysia. Phosphorus intake among pregnant women in both countries and sodium intake among Malaysian pregnant women exceeded 100% EAR. Indonesian lactating women had <60% EAR for calcium and potassium intakes, while Malaysian women had more than 100% EAR. For 21 studies reporting overall protein intakes, the standard mean difference (SMD) was −2.26 (95% CI; −2.98, −1.54) below the RDA/RNI for pregnant women and −0.67 SMD (95% CI −15.7, −11.5) for lactating women. When the four studies from Malaysia were analyzed separately, protein intakes of pregnant women were above the RNI. Moreover, low intakes of vitamin D, vitamin C, calcium, and iron, but sufficient intakes in vitamin A, zinc, and phosphorus were observed in pregnant women in both countries.ConclusionDietary intakes of energy, macronutrients, and micronutrients (vitamin D, vitamin E, water-soluble vitamins, calcium, and iron) of pregnant and lactating women in Indonesia and Malaysia were below the recommendations. Important heterogeneities were observed even between these two countries for specific essential nutrient intakes. Innovative research and targeted programs to address specific deficiencies should be prioritized.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021252204, identifier: CRD42021252204.
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Affiliation(s)
- Rina Agustina
- Department of Nutrition, Faculty of Medicine, Universitas Indonesia - Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
- *Correspondence: Rina Agustina ;
| | - Davrina Rianda
- Human Nutrition Research Center, Indonesian Medical Education, and Research Center (HNRC-IMERI), Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Wanda Lasepa
- Human Nutrition Research Center, Indonesian Medical Education, and Research Center (HNRC-IMERI), Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Fitya S. Birahmatika
- Human Nutrition Research Center, Indonesian Medical Education, and Research Center (HNRC-IMERI), Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Vladimir Stajic
- Blackmores Institute, Blackmores Limited, Sydney, NSW, Australia
| | - Rachmi Mufida
- Human Nutrition Research Center, Indonesian Medical Education, and Research Center (HNRC-IMERI), Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
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Mohd Saffian S, Jamil NA, Mohd Tahir NA, Hatah E. Vitamin D insufficiency is high in Malaysia: A systematic review and meta-analysis of studies on vitamin D status in Malaysia. Front Nutr 2022; 9:1050745. [PMID: 36466384 PMCID: PMC9715981 DOI: 10.3389/fnut.2022.1050745] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 11/03/2022] [Indexed: 10/29/2023] Open
Abstract
PURPOSE To estimate the vitamin D status of participants residing in Malaysia. METHODS PubMed, Scopus, Web of Science, and MyJurnal were searched up to June 2022 without language restrictions. Studies that reported the 25-hydroxyvitamin D [25(OH)D] concentrations and defined their cut-off for deficiency or insufficiency from healthy participants residing in Malaysia were included. The random effects model was used to pool vitamin D status using established cut-offs of <30, <50, and <75 nmol/L according to age group. RESULTS From 299 studies screened, 32 studies were included in the meta-analysis. The pooled proportion for <30 nmol/L was 21% (95% CI 9-36, n = 2,438 from 10 studies), while the pooled proportion <50 nmol/L was 64% (95% CI 56-72, n = 13,977 from 30 studies), and <75 nmol/L was 85% (95% CI 61-100, n = 1,376 from five studies). Heterogeneity was high (I2 ranged from 98-99%). Higher proportions of vitamin D insufficiency (defined as <50 nmol/L) were found in participants living in the urban areas (compared to rural areas), in females (compared to males), and in Malays and Malaysian Indians (compared to Malaysian Chinese) ethnicities. CONCLUSION More than half of Malaysians have insufficient vitamin D levels, despite being a country that is close to the equator. We strongly urge prompt public health measures to improve the vitamin D status in Malaysia. SYSTEMATIC REVIEW REGISTRATION [https://www.crd.york.ac.uk/prospero/], identifier [CRD42021260259].
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Affiliation(s)
- Shamin Mohd Saffian
- Centre for Quality Management of Medicines, Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Nor Aini Jamil
- Centre for Community Health Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Nor Asyikin Mohd Tahir
- Centre for Quality Management of Medicines, Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Ernieda Hatah
- Centre for Quality Management of Medicines, Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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An Update on Vitamin D Deficiency Status in Malaysia. Nutrients 2022; 14:nu14030567. [PMID: 35276926 PMCID: PMC8838715 DOI: 10.3390/nu14030567] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 12/24/2021] [Accepted: 12/28/2021] [Indexed: 02/04/2023] Open
Abstract
Vitamin D is essential for maintaining serum calcium levels, ensuring sufficient bone mineralization, immunomodulatory properties, and a protective effect on the cardiovascular system, renal disease, cancer, as well as in pregnancy. Vitamin D deficiency is prevalent worldwide, and it is not related to a country's development index. However, the data on vitamin D deficiencies are primarily taken from out-of-date, small-scale studies on target age groups or specific diseases, rather than from large-scale, population-based surveys. In Malaysia, for the past 16 years, studies were conducted involving adult men and women, pregnant women, postmenopausal women, adolescent, and children especially with specific diseases such as spina bifida, epilepsy, chronic liver disease, and atopic dermatitis. Only a few large surveys were conducted involving children and adolescents. Across the specific target population studied, vitamin D deficiency and insufficiency were seen particularly among females, Indians, and those of Malay ethnicity. This is related to widely known causes of vitamin D deficiency such as skin type (melanin) and sun avoidant lifestyles that include covering clothes, largely practiced by Malay Muslims in Malaysia. Other related causes or the high-risk groups are breastfed infants, the elderly, the obese, those on medications, and those characterized by fat malabsorption and geophysical factors. Vitamin D deficiency can be managed with pharmacological or non-pharmacological approaches, depending on the severity. The objective is to raise serum vitamin D to a normal level, hence, relieving the symptoms and reducing the adverse health outcomes. Despite no clear guidelines in treating vitamin D deficiency in Malaysia, this condition can be prevented with taking adequate vitamin D in food resources, sun exposure, or supplementation. Special attention should be given to high-risk groups including infants, obese patients, and the elderly.
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Yong HY, Mohd Shariff Z, Palaniveloo L, Loh SP, Mohd Yusof BN, Rejali Z, Bindels J, Tee YYS, van der Beek EM. High early pregnancy serum 25-hydroxy vitamin D level, within a sub-optimal range, is associated with gestational diabetes mellitus: a prospective cohort study. Nutr Res Pract 2022; 16:120-131. [PMID: 35116132 PMCID: PMC8784260 DOI: 10.4162/nrp.2022.16.1.120] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 02/22/2021] [Accepted: 07/13/2021] [Indexed: 11/04/2022] Open
Affiliation(s)
- Heng Yaw Yong
- Department of Nutrition, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Selangor, Malaysia
| | - Zalilah Mohd Shariff
- Department of Nutrition, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Selangor, Malaysia
| | - Lalitha Palaniveloo
- Center for Nutrition Epidemiology Research, Institute for Public Health, National Institute of Health, Ministry of Health, 40170 Selangor, Malaysia
| | - Su Peng Loh
- Department of Nutrition, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Selangor, Malaysia
| | - Barakatun Nisak Mohd Yusof
- Department of Nutrition, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Selangor, Malaysia
| | - Zulida Rejali
- Department of Obstetrics and Gynaecology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Selangor, Malaysia
| | | | | | - Eline M. van der Beek
- Danone Nutricia Research, 3584 CT Utrecht, The Netherlands
- Department of Pediatrics, University Medical Centre Groningen, University of Groningen, 9712 CP Groningen, The Netherlands
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Aji AS, Yusrawati Y, G Malik S, Lipoeto NI. The Association of Maternal Vitamin D Status during Pregnancy and Neonatal Anthropometric Measurements: A Longitudinal Study in Minangkabau Pregnant Women, Indonesia. J Nutr Sci Vitaminol (Tokyo) 2021; 66:S63-S70. [PMID: 33612650 DOI: 10.3177/jnsv.66.s63] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The prevalence of vitamin D deficiency (VDD) appears to be increasing. VDD during pregnancy has been associated with several adverse pregnancy outcomes. This study aimed to investigate the association between VDD and fetal anthropometric measurement. This prospective cohort study consisted of 232 pregnant women in their first trimester who were recruited at the antenatal clinics and they maintained to be subjects of the study until their delivery time. Serum 25-hydroxyvitamin D (25(OH)D) concentration was measured at first and third trimester using enzyme-linked immunosorbent assay. The prevalence of VDD in the first-trimester was 82.8%. Mean of 25(OH)D concentration in the third-trimester was significantly higher than in the first trimester (14.00 (6.98) vs. 21.22 (10.17) ng/mL). After adjusting age, pre-pregnancy BMI, and gestational age at delivery, it was found that VDD during pregnancy was not significantly associated with neonatal anthropometry (p>0.05). It was concluded that VDD was common in a tropical country. Large, well designed, multicentre observational studies are required to determine whether VDD enhances the risk of adverse pregnancy outcomes.
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Affiliation(s)
- Arif Sabta Aji
- Alma Ata Graduate School of Public Health, Alma Ata University.,Department of Nutrition, Faculty of Health Sciences, Alma Ata University
| | - Yusrawati Yusrawati
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Andalas University
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Lee SS, Subramaniam R, Tusimin M, Ling KH, Rahim KF, Loh SP. Inadequate vitamin D intake among pregnant women in Malaysia based on revised recommended nutrient intakes value and potential dietary strategies to tackle the inadequacy. Nutr Res Pract 2021; 15:492-503. [PMID: 34349882 PMCID: PMC8313385 DOI: 10.4162/nrp.2021.15.4.492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 06/10/2020] [Accepted: 07/21/2020] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND/OBJECTIVES Recently, the recommended nutrient intakes (RNI) for vitamin D for Malaysian aged 1-70 yrs has been revised from 5 µg/day to 15 µg/day. This study is aimed to assess the adequacy of vitamin D intake based on revised RNI and to recommend several dietary strategies to increase total vitamin D intake. SUBJECTS/METHODS Vitamin D intake from both food and supplement of 217 pregnant women was assessed using a validated food frequency questionnaire. Hypothetical effect of expanded supplementation and food fortifications strategies were modelled using the consumption data. RESULTS The results revealed that more than half (67.7%) of pregnant women had inadequate vitamin D intake (RNI < 15 µg/day). The modelling results demonstrated the potential of universal provision of 10 µg/day of multivitamins supplements in increasing vitamin D intake. Moreover, mandatory fortification of both milk and malted drink at single level of 5 µg/serving would lead to increase in vitamin D intake of Malaysians, particularly pregnant women. CONCLUSIONS The outcome of this study can be used as a reference for public health professionals to re-evaluate the existing Malaysian food fortification policies and supplementation recommendation for vitamin D for pregnant women.
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Affiliation(s)
- Siew Siew Lee
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia (UPM), 43400 UPM Serdang, Selangor Darul Ehsan, Malaysia
| | - Raman Subramaniam
- Fetal Medicine and Gynaecology Centre (FMGC), 46200 Petaling Jaya, Malaysia
| | - Maiza Tusimin
- Prince Court Medical Centre, 50450 Kuala Lumpur, Malaysia
| | - King Hwa Ling
- Department of Biomedical Sciences, Universiti Putra Malaysia (UPM), 43400 UPM Serdang, Selangor Darul Ehsan, Malaysia
- Department of Genetics, Harvard Medical School, Boston, MA 02115, USA
| | | | - Su Peng Loh
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia (UPM), 43400 UPM Serdang, Selangor Darul Ehsan, Malaysia
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Mustapa Kamal Basha MA, Abdul Majid H, Razali N, Abd Rashed A, Muhammad H, Yahya A. Longitudinal Vitamin D Deficiency Among Malaysian Pregnant Women and Its Correlation With Neonatal Serum 25-Hydroxyvitamin D Levels. Front Public Health 2021; 9:654292. [PMID: 34268285 PMCID: PMC8275926 DOI: 10.3389/fpubh.2021.654292] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 06/03/2021] [Indexed: 12/30/2022] Open
Abstract
Objective: This study aimed to investigate the longitudinal relationship between maternal vitamin D concentrations during pregnancy and neonatal vitamin D concentrations at birth. Materials and Methods: A prospective cohort of 236 healthy pregnant women from various ethnicity in early pregnancy (≤20 weeks of pregnancy) was followed at late pregnancy (28–40 weeks of pregnancy) and birth. Maternal serum 25-hydroxyvitamin D (25(OH)D) was assessed at early pregnancy (baseline) and late pregnancy, while neonatal cord serum 25(OH)D at birth. General estimating equations (GEE) were used to analyze the longitudinal association of maternal serum 25(OH)D levels during pregnancy and neonatal cord serum 25(OH)D levels at birth with adjusting for the time exposure, maternal weight gain, ethnicity, and skin type. Results: The results showed that the prevalence of vitamin D deficiency (25(OH)D <50 nmol/L) was at 89.9, 92.2, and 96.1% in early, late pregnancy and in neonatal cord serum, respectively. The GEE analysis showed a trend that longitudinal vitamin D deficiency during pregnancy leads to lower vitamin D concentrations in neonatal cord blood (RR = 1.17; 95% CI (1.05–1.36); p = 0.04). Conclusion: Longitudinal vitamin D deficiency during pregnancy leads to vitamin D deficiency in neonates at birth. A further trial is needed to affirm this association.
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Affiliation(s)
- Muzaitul Akma Mustapa Kamal Basha
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.,Department of Special Care Nursing, Kulliyyah of Nursing, International Islamic University Malaysia, Kuantan, Malaysia
| | - Hazreen Abdul Majid
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.,Department of Nutrition, Faculty of Public Health, University of Airlangga, Surabaya, Indonesia
| | - Nuguelis Razali
- Department of Obstetrics & Gynaecology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Aswir Abd Rashed
- Nutrition, Metabolism & Cardiovascular Research Centre, Institute for Medical Research, Kuala Lumpur, Malaysia
| | - Hussin Muhammad
- Herbal Medicine Research Centre, Institute for Medical Research, Kuala Lumpur, Malaysia
| | - Abqariyah Yahya
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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Jeyakumar A, Shinde V, Ravindran R. Pooled estimate of vitamin D deficiency among pregnant women in India: a systematic review and meta-analysis. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2021; 40:28. [PMID: 34187594 PMCID: PMC8243731 DOI: 10.1186/s41043-021-00253-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Accepted: 06/02/2021] [Indexed: 04/12/2023]
Abstract
BACKGROUND Vitamin D deficiency among pregnant women is a public health concern globally. In India, individual studies report high prevalence. However, lack of national data masks the true burden. This work determined the pooled prevalence of vitamin D deficiency among pregnant women in India through a systematic review of literature and meta-analysis. METHODS Three different search engines yielded 15 eligible articles. Study quality was assessed by 10 different criteria and summary of study quality was categorized as per Cochrane standards. Meta-analysis was performed to estimate pooled prevalence of vitamin D deficiency among healthy pregnant women and heterogeneity among selected studies. A sample of n = 4088 was used to study the pooled prevalence among pregnant women. RESULTS The random effects combined estimate was 32.35% (95% CI, (12.58-117.48). High heterogeneity (tau2 = 0.39, I2 = 100%) and high risk of bias was observed among the selected studies. The test for overall effect was observed to be z = 2.54(P = 0.01). CONCLUSION Pooled estimate > 30% emphasizes the need for screening through antenatal care services and initiate preventive measures to address the deficiency.
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Affiliation(s)
- Angeline Jeyakumar
- Interdisciplinary School of Health Sciences, Savitribai Phule Pune University, Maharashtra, India
- School of Hospitality Management, University of Johannesburg, Johannesburg, South Africa
| | - Vidhya Shinde
- Interdisciplinary School of Health Sciences, Savitribai Phule Pune University, Maharashtra, India
| | - Reshma Ravindran
- Interdisciplinary School of Health Sciences, Savitribai Phule Pune University, Maharashtra, India
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Karamizadeh M, Seif M, Holick MF, Akbarzadeh M. Developing a Model for Prediction of Serum 25-Hydroxyvitamin D Level: The Use of Linear Regression and Machine Learning Methods. J Am Coll Nutr 2021; 41:191-200. [PMID: 33555236 DOI: 10.1080/07315724.2020.1869624] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Because vitamin D status affects many organs and tissues of the body, it is important to determine the factors affecting it. The purpose of this study was to develop a model for predicting the serum 25-hydroxyvitamin D [25(OH)D] level in healthy young adults. METHOD This cross-sectional study was conducted on 201 healthy individuals aged 20 to 40 years old in Shiraz, Iran. Data regarding demographic characteristics, vitamin D intake through supplements, and sun exposure habits were gathered. Serum 25(OH)D concentration was also measured. Data were analyzed with R software using linear regression and different machine learning methods such as conditional tree, conditional forest and random forest. RESULTS Based on the linear regression, male sex (p < 0.001), taking 50,000 IU vitamin D3 supplement monthly (p < 0.001), and lower waist circumference (p = 0.018) were identified as effective factors in increasing serum 25(OH)D levels. According to the conditional tree, taking 50,000 IU vitamin D3 supplement monthly (p < 0.001) and sex (p < 0.001) were two main factors in the classification of individuals in terms of serum 25(OH)D levels. Besides, conditional forest and random forest results showed that the most important variable was taking 50,000 IU vitamin D3 supplement monthly. CONCLUSIONS Supplement use is the first and most important predictor of 25(OH)D levels and other factors, including sex and waist circumference, are ranked thereafter, and the importance of these factors is greater in those who do not take vitamin D3 supplements.
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Affiliation(s)
- Malihe Karamizadeh
- Nutrition Research Center, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mozhgan Seif
- Department of Epidemiology, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Michael F Holick
- Section Endocrinology, Diabetes, Nutrition and Weight Management, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Marzieh Akbarzadeh
- Nutrition Research Center, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
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Ismail NA, Mohamed Ismail NA, Bador KM. Vitamin D in gestational diabetes mellitus and its association with hyperglycaemia, insulin sensitivity and other factors. J OBSTET GYNAECOL 2020; 41:899-903. [PMID: 33962550 DOI: 10.1080/01443615.2020.1820462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
We investigated if vitamin D is independently associated with hyperglycaemia in gestational diabetes mellitus (GDM). Serum 25 hydroxy vitamin D (25OHD), fasting blood glucose (FBG), HbA1c, fructosamine, insulin sensitivity (QUICKI equation), body mass index, clothing style and outdoor activity were measured in 58 pregnant women with GDM during the third trimester. 25OHD was also measured in 20 women with normal pregnancies. There was no significant difference in mean 25OHD concentrations between GDM (14.43 ± 5.27 ng/ml) and normal (15.45 ± 5.29 ng/ml) pregnancies, p = .354. However, a higher percentage of GDM subjects had 25OHD concentration <19.8 ng/ml (86 versus 65%, p = .003). 25OHD did not correlate with FBG, HbA1c, fructosamine, insulin sensitivity or insulin dosage (p > .05). On multivariate analysis, only ethnicity (p = .006) and outdoor activity (p = .004) were associated with 25OHD. We conclude that the lower 25OHD levels in our GDM patients were related to ethnicity and outdoor activity (Study FF-2017-111, National University of Malaysia, 16 March 2017).IMPACT STATEMENTWhat is already known on this subject? Vitamin D deficiency in pregnancy is widespread and particularly in certain ethnic groups. Low vitamin D levels may be an aetiological factor for gestational diabetes mellitus (GDM) but previous studies provide conflicting results perhaps due to confounding factors.What do the results of this study add? In this study of pregnant women with GDM from different ethnic backgrounds, we analysed serum 25-hydroxy vitamin D (25OHD) levels together with other confounding factors, that is, body mass index, ethnicity and sunlight exposure. Furthermore, instead of using consensus values, we determined cut-offs for different vitamin D status from normal pregnancies matched for gestational age and ethnicity. We found that a higher percentage of GDM subjects had lower vitamin D status but there was no correlation with hyperglycaemia or insulin sensitivity. The study showed that lower vitamin D levels in GDM was associated with ethnicity and less outdoor activity.What the implications are of these findings for clinical practice and/or further research? In GDM patients, low vitamin D levels may be modifiable by supplementation or lifestyle change. Longitudinal studies are needed to determine whether this would impact on the occurrence of GDM.
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Affiliation(s)
- Nor Azlizan Ismail
- Department of Pathology, Faculty of Medicine, Universiti Kebangsaan Malaysia (National University of Malaysia), Kuala Lumpur, Malaysia
| | - Nor Azlin Mohamed Ismail
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Universiti Kebangsaan Malaysia (National University of Malaysia), Kuala Lumpur, Malaysia
| | - Khalidah Mazlan Bador
- Department of Pathology, Faculty of Medicine, Universiti Kebangsaan Malaysia (National University of Malaysia), Kuala Lumpur, Malaysia
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Lee SS, Ling KH, Tusimin M, Subramaniam R, Rahim KF, Loh SP. Influence of vitamin D binding protein polymorphism, demographics and lifestyle factors on vitamin D status of healthy Malaysian pregnant women. BMC Pregnancy Childbirth 2020; 20:714. [PMID: 33228578 PMCID: PMC7684735 DOI: 10.1186/s12884-020-03397-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 11/05/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Vitamin D deficiency (VDD) has been related to vitamin D binding protein (GC) gene polymorphism, demographics and lifestyle factors in different populations. However, previous studies only focused on demographic and lifestyle factors or genetic factors alone. Therefore, this cross-sectional study aimed to assess the association between GC gene polymorphism, demographics and lifestyle factors with VDD among Malaysian pregnant women. METHOD Information on demographic characteristics, dietary vitamin D intake from supplement and food, time spent outdoors, skin type and clothing were collected using a questionnaire. Plasma total 25-hydroxyvitamin D (25OHD) levels were measured using an Ultra-High-Performance Liquid Chromatography (UHPLC). Maternal GC single nucleotide polymorphisms (SNPs) (rs4588 and rs7041) were determined using restriction fragment length polymorphism (RFLP) technique. RESULTS Results showed that 50.2% of pregnant women were vitamin D deficient (25OHD < 30 nmol/L). VDD (25OHD < 30 nmol/L) was significantly associated with age, veiled clothing, maternal vitamin D intakes from both food and supplements, and GC rs7041(and GC diplotypes). In contrast to previous studies that reported for non-pregnant population, a significant positive association was found between CC genotype for SNP GC rs7041, GC 1s-1s and GC If-2 with risk of VDD (25OHD < 30 nmol/L). CONCLUSIONS The high prevalence of maternal VDD found in this study suggests the need for urgent development and implementation of vitamin D supplementation or fortification strategies to reduce VDD among pregnant women. The discrepancy in the association between GC rs7041 gene polymorphism and VDD reflects the variation in the factors associated with VDD in pregnancy compared to non-pregnant state.
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Affiliation(s)
- Siew-Siew Lee
- Department of Nutrition, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 UPM, Serdang, Selangor, Malaysia
| | - King-Hwa Ling
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 UPM, Serdang, Selangor, Malaysia.,Department of Genetics, Harvard Medical School, Boston, MA, 02115, USA
| | - Maiza Tusimin
- Prince Court Medical Centre, 50450, Kuala Lumpur, Malaysia
| | - Raman Subramaniam
- Fetal Medicine and Gynaecology Centre (FMGC), 46200, Petaling Jaya, Selangor, Malaysia
| | | | - Su-Peng Loh
- Department of Nutrition, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 UPM, Serdang, Selangor, Malaysia. .,Research Centre of Excellence for Nutrition and Non-Communicable Diseases, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43300 UPM, Serdang, Selangor, Malaysia.
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Mustapa Kamal Basha MA, Majid HA, Razali N, Yahya A. Risk of eczema, wheezing and respiratory tract infections in the first year of life: A systematic review of vitamin D concentrations during pregnancy and at birth. PLoS One 2020; 15:e0233890. [PMID: 32542014 PMCID: PMC7295196 DOI: 10.1371/journal.pone.0233890] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Accepted: 05/14/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Allergic conditions and respiratory tract infections (RTIs) are common causes of morbidity and mortality in childhood. The relationship between vitamin D status in pregnancy (mothers), early life (infants) and health outcomes such as allergies and RTIs in infancy is unclear. To date, studies have shown conflicting results. OBJECTIVE This systematic review aims to gather and appraise existing evidence on the associations between serum vitamin D concentrations during pregnancy and at birth and the development of eczema, wheezing, and RTIs in infants. DATA SOURCES PubMed, MEDLINE, ProQuest, Scopus, CINAHL, Cochrane Library and Academic Search Premier databases were searched systematically using specified search terms and keywords. STUDY SELECTION Articles on the associations between serum vitamin D concentrations during pregnancy and at birth and eczema, wheezing, and RTIs among infants (1-year-old and younger) published up to 31 March 2019 were identified, screened and retrieved. RESULTS From the initial 2678 articles screened, ten met the inclusion criteria and were included in the final analysis. There were mixed and conflicting results with regards to the relationship between maternal and cord blood vitamin D concentrations and the three health outcomes-eczema, wheezing and RTIs-in infants. CONCLUSION Current findings revealed no robust and consistent associations between vitamin D status in early life and the risk of developing eczema, wheezing and RTIs in infants. PROSPERO registration no. CRD42018093039.
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Affiliation(s)
- Muzaitul Akma Mustapa Kamal Basha
- Department of Social Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- Department of Special Care Nursing, Kulliyyah of Nursing, International Islamic University Malaysia (IIUM), Kuantan Campus, Pahang, Malaysia
| | - Hazreen Abdul Majid
- Department of Social Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- Department of Nutrition, Harvard Chan School of Public Health, Boston, Massachusetts, United States of America
- Department of Nutrition, Faculty of Public Health, University of Airlangga, Surabaya, Indonesia
| | - Nuguelis Razali
- Department of Obstetrics & Gynaecology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Abqariyah Yahya
- Department of Social Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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Abd Aziz NH, Yazid NA, Abd Rahman R, Abd Rashid N, Wong SK, Mohamad NV, Lim PS, Chin KY. Is First Trimester Maternal 25-Hydroxyvitamin D Level Related to Adverse Maternal and Neonatal Pregnancy Outcomes? A Prospective Cohort Study among Malaysian Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17093291. [PMID: 32397276 PMCID: PMC7246875 DOI: 10.3390/ijerph17093291] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 05/01/2020] [Accepted: 05/05/2020] [Indexed: 12/27/2022]
Abstract
Information on the role of 25-hydroxyvitamin D (25(OH)D) in preventing adverse pregnancy/neonatal outcomes is limited in Malaysia. This study aims to determine the relationship between the level of maternal 25(OH)D in the first trimester of pregnant women and their pregnancy/neonatal outcomes. A total of 60 pregnant women in the first trimester were recruited and followed until the end of their pregnancy. The occurrence of any antenatal, delivery, and neonatal complications was recorded. Their blood was collected in the first trimester for total serum 25(OH)D determination using enzyme-linked immunosorbent assay. Overall, 10% of the women had vitamin D deficiency, while 57% had vitamin D insufficiency in their first trimester. No statistically significant difference in 25(OH)D level/status was observed between women with or without antenatal and delivery complications (p > 0.05). No difference in maternal serum 25(OH)D level and vitamin D status was observed between neonates with or without complications (p > 0.05). In conclusion, there is a high prevalence of vitamin D insufficiency among Malaysian pregnant women, but it is not associated with adverse maternal and neonatal outcomes. More comprehensive studies should be planned to verify this relationship.
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Affiliation(s)
- Nor Haslinda Abd Aziz
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Cheras 56000, Malaysia; (N.H.A.A.); (N.A.Y.); (R.A.R.); (N.A.R.); (P.S.L.)
| | - Noor Azyani Yazid
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Cheras 56000, Malaysia; (N.H.A.A.); (N.A.Y.); (R.A.R.); (N.A.R.); (P.S.L.)
| | - Rahana Abd Rahman
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Cheras 56000, Malaysia; (N.H.A.A.); (N.A.Y.); (R.A.R.); (N.A.R.); (P.S.L.)
| | - Norhashima Abd Rashid
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Cheras 56000, Malaysia; (N.H.A.A.); (N.A.Y.); (R.A.R.); (N.A.R.); (P.S.L.)
| | - Sok Kuan Wong
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Cheras 56000, Malaysia; (S.K.W.); (N.V.M.)
| | - Nur Vaizura Mohamad
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Cheras 56000, Malaysia; (S.K.W.); (N.V.M.)
| | - Pei Shan Lim
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Cheras 56000, Malaysia; (N.H.A.A.); (N.A.Y.); (R.A.R.); (N.A.R.); (P.S.L.)
| | - Kok-Yong Chin
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Cheras 56000, Malaysia; (S.K.W.); (N.V.M.)
- Correspondence: ; Tel.: +603-9145-9573
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Associations of Serum 25-Hydroxyvitamin D with Adiposity and At-Risk Lipid Profile Differ for Indigenous (Orang Asli) Male and Female Adults of Peninsular Malaysia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17082855. [PMID: 32326217 PMCID: PMC7215365 DOI: 10.3390/ijerph17082855] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 04/17/2020] [Accepted: 04/17/2020] [Indexed: 01/07/2023]
Abstract
BACKGROUND Low vitamin D status, adiposity, and at-risk lipid profile are associated with adverse health consequences. This study aimed to assess serum 25(OH)D concentration of Indigenous (Orang Asli) adults and to determine the associations between serum 25(OH)D with adiposity and lipid profile, respectively. METHODS This cross-sectional study was conducted among 555 (164 men, 391 women) Orang Asli adults aged 18-65 years of Jah Hut sub-tribe in Krau Wildlife Reserve (KWR), Peninsular Malaysia. Demographic and socio-economic information were obtained using interviewer-administered questionnaire. Participants were also assessed for serum 25-hydroxyvitamin D (25(OH)D) concentration, adiposity indices (BMI, WC, WHtR, WHR, %BF) and lipid parameters (TC, LDL-C, HDL-C, TG). Data were analyzed using binary logistic regression via SPSS. RESULTS The prevalence of suboptimal 25(OH)D concentration was 26.3%, comprising 24.9% insufficiency (50 to <75 nmol/L) and 1.4% deficiency (<50 nmol/L). While men (14-30.5%) were associated with a more proatherogenic lipid profile than women (6.1-14.3%), more women were with central obesity (M: 19.5-46.3%; F: 34.5-49.1%) and suboptimal (<75 nmol/L) vitamin D status (M: 11.6%; F: 32.4%). While suboptimal 25(OH)D concentration was significantly associated with higher odds of at-risk LDL-C (p < 0.01) and obesity (WC, WHtR) (p < 0.05) in men, no significant association was observed for women. Nonetheless, it should be noted that there were only 19 men with suboptimal (<75 nmol/L) vitamin D status. CONCLUSIONS While suboptimal vitamin D status was relatively low in Orang Asli adults, the prevalence of obesity and undesirable serum lipids were relatively high. The sex-specific associations between vitamin D status with adiposity indices and serum lipids warrant further investigation.
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Tran NT, Nguyen LT, Berde Y, Low YL, Tey SL, Huynh DTT. Maternal nutritional adequacy and gestational weight gain and their associations with birth outcomes among Vietnamese women. BMC Pregnancy Childbirth 2019; 19:468. [PMID: 31801514 PMCID: PMC6894140 DOI: 10.1186/s12884-019-2643-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2018] [Accepted: 11/27/2019] [Indexed: 01/08/2023] Open
Abstract
Background During pregnancy, a mother’s nutritional needs increase to meet the added nutrient demands for fetal growth and development. An enhanced understanding of adequate nutrition and sufficient weight gain during pregnancy can guide development of policies and strategies for maternal nutrition care, actions that will ultimately promote better pregnancy outcomes. In a sample of pregnant women in Vietnam, this study characterized maternal nutrition status and gestational weight gain at a mid-pregnancy baseline, then examined the association of these variables with specific birth outcomes. Methods The study used baseline data from a randomized, controlled trial that compared pregnant Vietnamese women who received a nutritional intervention group with those who received only standard dietary counseling (control group). At baseline (26–29 weeks gestation), mothers’ dietary reports were collected, and intake of 10 macro- and micronutrients was estimated; data for baseline gestational weight gain was collected for all pregnant women enrolled into the study (n = 228). This analysis also used weights, lengths, and head circumferences at birth for infants of mothers in the control group. Results At baseline, 95% of the pregnant women had concurrent inadequacies for more than five nutrients, and nearly half had concurrent inadequacies for more than ten nutrients. Almost two-thirds of the pregnant women did not meet recommendations for gestational weight gain. We found a significant, inverse association between the number of nutrient inadequacies and gestational weight gain (overall p ≤ 0.045). After adjusting for potential confounders, gestational weight gain was positively associated with birth weight, length at birth, birth weight-for-age z-score and length-for-age z-score (all p ≤ 0.006). Conclusions Our findings raise concern over the high proportion of pregnant women in Vietnam who have multiple concurrent nutrient inadequacies and who fall short of meeting recommended gestational weight gain standards. To ensure better birth outcomes in this population, policies and strategies to improve the status of maternal nutrition are greatly needed. Trial registration The trial was retrospectively registered at clinicaltrials.gov on December 20, 2013, registration identifier: NCT02016586.
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Affiliation(s)
- Nga Thuy Tran
- Micronutrient Research and Application, National Institution of Nutrition, 48B Tang Ba Ho, Hai Ba Trung District, Ha Noi, Vietnam
| | - Lam Thi Nguyen
- Clinical Nutrition, National Institution of Nutrition, 48B Tang Ba Ho, Hai Ba Trung District, Ha Noi, Vietnam
| | - Yatin Berde
- Statistical Services, Cognizant Technologies Solution Pvt. Ltd, Hiranandani Business Park, Mumbai, 400076, India
| | - Yen Ling Low
- Abbott Nutrition Research and Development Asia-Pacific Center, 20 Biopolis Way, Unit 09-01/02 Centros Building, Singapore, 138668, Singapore
| | - Siew Ling Tey
- Abbott Nutrition Research and Development Asia-Pacific Center, 20 Biopolis Way, Unit 09-01/02 Centros Building, Singapore, 138668, Singapore
| | - Dieu Thi Thu Huynh
- Abbott Nutrition Research and Development Asia-Pacific Center, 20 Biopolis Way, Unit 09-01/02 Centros Building, Singapore, 138668, Singapore.
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Woon FC, Chin YS, Ismail IH, Batterham M, Abdul Latiff AH, Gan WY, Appannah G, Mohammed Hussien SH, Edi M, Tan ML, Chan YM. Vitamin D deficiency during pregnancy and its associated factors among third trimester Malaysian pregnant women. PLoS One 2019; 14:e0216439. [PMID: 31233513 PMCID: PMC6590777 DOI: 10.1371/journal.pone.0216439] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 06/12/2019] [Indexed: 01/09/2023] Open
Abstract
Background Despite perennial sunshine, vitamin D deficiency is prevalent among Malaysians especially pregnant women. This study determines the vitamin D status and its associated factors among third trimester pregnant women attending government health clinics in Selangor and Kuala Lumpur, Malaysia. Methods Information on socio-demographic characteristics, obstetrical history, and sun exposure were obtained through face-to-face interviews. Vitamin D intake was assessed using a semi-quantitative food frequency questionnaire (FFQ). Serum 25-hydroxyvitamin D concentration was measured and classified as deficient (< 30 nmol/L), insufficient (30–50 nmol/L), and sufficient (≥ 50 nmol/L). Results Of the 535 pregnant women recruited, 42.6% were vitamin D deficient. They consumed an average of 8.7 ± 6.7 μg of vitamin D daily. A total of 80.4% of the vitamin D were obtained from the food sources, while 19.6% were from dietary supplements. Fish and fish products showed the highest contribution to vitamin D intake (35.8%). The multivariable generalized linear mixed models, with clinic as a random effect, indicates that higher intake of vitamin D is associated with lower odds of vitamin D deficiency among pregnant women (OR = 0.96; 95% CI = 0.93–0.99). The odds of having vitamin D deficiency was reduced by 87% in non-Malays (OR = 0.14; 95% CI = 0.05–0.41) compared to Malays. No associations were found between age, educational level, monthly household income, work status, gravidity, parity, pre-pregnancy body mass index, total hours of sun exposure, total percentage of body surface area, and sun exposure index per day with vitamin D deficiency. Conclusion Vitamin D deficiency is prevalent among Malaysian pregnant women. Considering the possible adverse obstetric and fetal outcomes of vitamin D deficiency during pregnancy, future nutrition education should emphasise on vitamin D-fortified foods consumption among pregnant women by taking into consideration ethnic differences.
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Affiliation(s)
- Fui Chee Woon
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Yit Siew Chin
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
- Research Centre of Excellence, Nutrition and Non-communicable Diseases, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
- * E-mail:
| | - Intan Hakimah Ismail
- Department of Paediatrics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Marijka Batterham
- National Institute for Applied Statistics Research Australia, University of Wollongong, Northfields Ave Wollongong, NSW Australia
| | | | - Wan Ying Gan
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Geeta Appannah
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Siti Huzaifah Mohammed Hussien
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Muliana Edi
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Meng Lee Tan
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Yoke Mun Chan
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
- Research Centre of Excellence, Nutrition and Non-communicable Diseases, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
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Vitamin D deficiency status and its related risk factors during early pregnancy: a cross-sectional study of pregnant Minangkabau women, Indonesia. BMC Pregnancy Childbirth 2019; 19:183. [PMID: 31117971 PMCID: PMC6532131 DOI: 10.1186/s12884-019-2341-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 05/14/2019] [Indexed: 12/16/2022] Open
Abstract
Background Vitamin D deficiency (VDD) is a common problem in reproductive-aged women and has become a major public health problem worldwide. The effect of VDD in pregnancy has been associated with several adverse pregnancy outcomes. This study aims to assess the serum levels of 25-hydroxyvitamin D (25(OH)D) in the first trimester and its associated factors (socio-demographics, pregnancy profiles, dietary intake, and maternal anthropometry measurements) for the determination of vitamin D deficiency status in early pregnancy. Methods A cross-sectional study of 239 pregnant mothers in West Sumatra, Indonesia was conducted. We measured lifestyle, socio-demographics and pregnancy profile through a structured questionnaire and interview process. A semi quantitative-food frequency questionnaire (SQ-FFQ) was used to analyse the dietary intake of the pregnant women. Serum 25(OH)D concentrations were measured at < 13 weeks gestation using ELISA and logistic regression models were employed to identify the predictors of low vitamin D status. Results The prevalence of first-trimester maternal VDD and sufficiency were 82.8 and 17.2% respectively. The median 25(OH)D was 13.15 ng/mL (3.00–49.29 ng/mL). The significant independent predictors were no working status (OR: 0.029;0.001–0.708) (p = 0.030); nulliparous parity status (OR: 7.634;1.550–37.608) (p = 0.012); length of outdoor activity status of less than an hour (OR: 9.659;1.883–49.550) (p = 0.007); and no consumption of supplements before pregnancy (OR: 4.49;1.081–18.563) (p = 0.039). Conclusions The prevalence of VDD is common in early pregnancy among Minangkabau women. Recommendations and policies to detect and prevent such insufficiency during pregnancy should be developed by considering the associated factors.
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Savard C, Gagnon C, Morisset AS. Disparities in the timing and measurement methods to assess vitamin D status during pregnancy: A Narrative Review. INT J VITAM NUTR RES 2019; 88:176-189. [PMID: 30747608 DOI: 10.1024/0300-9831/a000507] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Studies that examined associations between low circulating 25-hydroxyvitamin D (25(OH)D) and adverse pregnancy outcomes used various designs, assay methods and time points for measurement of 25(OH)D concentrations, which creates some confusion in the current literature. We aimed to investigate the variability in the timing and measurement methods used to evaluate vitamin D status during pregnancy. Analysis of 198 studies published between 1976 and 2017 showed an important variability in the choice of 1) threshold values for 25(OH)D insufficiency or deficiency, 2) 25(OH)D measurement methods, and 3) trimester in which 25(OH)D concentrations were measured. Blood samples were taken once during pregnancy in a large majority of studies, which may not be representative of vitamin D status throughout pregnancy. Most studies reported adjustment for confounding factors including season of blood sampling, but very few studies used the 25(OH)D gold standard assay, the LC-MS/MS. Prospective studies assessing maternal 25(OH)D concentrations 1) by standardized and validated methods, 2) at various time points during pregnancy, and 3) after considering potential confounding factors, are needed.
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Affiliation(s)
- Claudia Savard
- 1 School of Nutrition, Laval University.,2 Endocrinology and Nephrology Unit, CHU of Québec-Université Laval Research Center, Québec, Canada.,3 Institute of Nutrition and Functional Foods, Laval University Quebec City, Québec, Canada
| | - Claudia Gagnon
- 2 Endocrinology and Nephrology Unit, CHU of Québec-Université Laval Research Center, Québec, Canada.,3 Institute of Nutrition and Functional Foods, Laval University Quebec City, Québec, Canada.,4 Department of Medicine, Laval University, Quebec City, Québec, Canada
| | - Anne-Sophie Morisset
- 1 School of Nutrition, Laval University.,2 Endocrinology and Nephrology Unit, CHU of Québec-Université Laval Research Center, Québec, Canada.,3 Institute of Nutrition and Functional Foods, Laval University Quebec City, Québec, Canada
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Lee CL, Ng BK, Wu LL, Cheah FC, Othman H, Ismail NAM. Vitamin D deficiency in pregnancy at term: risk factors and pregnancy outcomes. Horm Mol Biol Clin Investig 2017; 31:/j/hmbci.ahead-of-print/hmbci-2017-0005/hmbci-2017-0005.xml. [PMID: 28593917 DOI: 10.1515/hmbci-2017-0005] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Accepted: 03/22/2017] [Indexed: 01/08/2023]
Abstract
Background Vitamin D deficiency during pregnancy is a worldwide epidemic. The aim of this study was to determine the prevalence of vitamin D deficiency, its predictive factors and the association with pregnancy outcomes. Materials and methods This was a prospective observational study in a tertiary teaching hospital over 2-years' duration from August 2013 to August 2015. A total of 680 women who completed 37 weeks of pregnancy were recruited. Results Five hundred and seventy-five patients were enrolled in the final analysis for pregnancy outcomes (response rate of 84.6%). There were 71.7% patients who exhibited vitamin D deficiency, 21.0% vitamin D insufficiency and only 7.3% who had adequate levels of 25-hydroxyvitamin D (25-OH-vit D) of more than 30 ng/mL. There was no statistically significant association between vitamin D status with maternal (parity, gestational diabetes mellitus, hypertension, preeclampsia, intrauterine growth restriction, preterm labor, antenatal infection, bacterial vaginosis and anemia) and neonatal outcomes (low birth weight baby and neonatal intensive care unit admission) among the three groups. Conclusion A high prevalence of low vitamin D level among pregnant women at term was seen in this study, however, there was no significant finding observed between vitamin D status and both maternal and neonatal outcomes.
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