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Mondon C, Tan PY, Chan CL, Tran TN, Gong YY. Prevalence, determinants, intervention strategies and current gaps in addressing childhood malnutrition in Vietnam: a systematic review. BMC Public Health 2024; 24:960. [PMID: 38575928 PMCID: PMC10996139 DOI: 10.1186/s12889-024-18419-8] [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: 08/02/2023] [Accepted: 03/22/2024] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND Childhood malnutrition in all forms is a major public health issue worldwide. This review systematically examined the prevalence and determinants and identify the potential interventions and current gap in addressing malnutrition including undernutrition, overnutrition and micronutrient deficiencies (MNDs) in Vietnamese children aged 0-18 years old. METHODS Embase, Scopus, PubMed, and Web of Science were systematically searched through June 2022 to identify relevant articles published within the past 25 years. Study selection and data extraction were performed by one reviewer and checked for accuracy by the other two reviewers in accordance with PRISMA guideline. Risk of publication bias was assessed using American Dietetic Association Quality Criteria Checklist. RESULTS Seventy-two studies that met the inclusion criteria were included. Undernutrition has decreased over time but still 22.4%, 5.2% and 12.2% of children under 5 were stunted, wasted and underweight, respectively. Anaemia, iron, zinc, and vitamin D deficiencies were the more common forms of MNDs, the prevalence varied by age, region, and socioeconomic group. Population-based surveys reported that 11% and 48% of children aged 0-11 years old were iron and vitamin D deficient, respectively. Zinc deficiency affected almost one-quarter of the children and adolescents. Retinol deficiency was of less concern (< 20%). However, more evidence on MNDs prevalence is needed. Overweight and obesity is now on the rise, affecting one-third of school-aged children. The key determinants of undernutrition included living in rural areas, children with low birth weight, and poor socio-economic status, whereas living in urban and affluent areas, having an inactive lifestyle and being a boy were associated with increased risk of overweight and obesity. Nutrition specific intervention studies including supplementation and food fortification consistently showed improvements in anthropometric indices and micronutrient biomarkers. National nutrition-sensitive programmes also provided nutritional benefits for children's growth and eating behaviours, but there is a lack of data on childhood obesity. CONCLUSION This finding highlights the need for effective double duty actions to simultaneously address different forms of childhood malnutrition in Vietnam. However, evidence on the potential intervention strategies, especially on MNDs and overnutrition are still limited to inform policy decision, thus future research is warranted.
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Affiliation(s)
- Charlotte Mondon
- School of Food Science and Nutrition, Faculty of Environment, University of Leeds, Leeds, LS2 9JT, UK
| | - Pui Yee Tan
- School of Food Science and Nutrition, Faculty of Environment, University of Leeds, Leeds, LS2 9JT, UK.
| | - Chong Ling Chan
- School of Food Science and Nutrition, Faculty of Environment, University of Leeds, Leeds, LS2 9JT, UK
| | - Thuy Nga Tran
- Department of Micronutrient, National Institution of Nutrition, 48B Tang Ba Ho, Hai Ba Trung District, Ha Noi, Vietnam
| | - Yun Yun Gong
- School of Food Science and Nutrition, Faculty of Environment, University of Leeds, Leeds, LS2 9JT, UK.
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Phuc TT, Duc TQ, Quynh Chi VT, Quang PN. The prevalence of excess weight among Vietnamese adults: A pooled analysis of 58 studies with more 430 thousand participants over the last three decades. Nutr Health 2023; 29:443-452. [PMID: 36285514 DOI: 10.1177/02601060221129440] [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: 06/16/2023]
Abstract
BACKGROUND Chronic noncommunicable diseases (NCDs) associated with excess weight as a significant risk factor, but few studies have been sufficient enough to examine the magnitude of excess weight of Vietnamese adults. This review aimed to provide a generalized estimate of the prevalence of excess weight among Vietnamese adults. METHODS PubMed, Scopus and national database were used to identify articles published up to May 2022. The Newcastle-Ottawa Quality Assessment Scale was used to rate the study quality. The data was analyzed using RStudio software, and the combined effects were estimated using random-effects meta-analysis. The Cochran's Q-test and the I2 test were employed to examine heterogeneity, and subgroups were conducted. Egger's test and visual inspection of the symmetry in funnel plots were used to determine publication bias. RESULTS 58 studies with 432,585 participants from 1998 to 2020 were suitable for inclusion in the final model after meeting the prerequisites. Over the last three decades, the combined pooled prevalence of excess weight among adults in Vietnam was 20.3% (95% CI: 15.2-26.6). Notably, this proportion has a tendency to go up between 1998 and 2020. Moreover, rates of excess weight were found to be substantially higher in non-national studies (23.1%, 17.3-30.1) compared to national studies (8.4%, 3.6-18.3) and significantly higher when Asian and Pacific cut-offs (27.6%, 20.0-36.7) were used rather than WHO classification (11.2%, 6.7-18.0). CONCLUSION The findings suggest healthcare professionals and policymakers should focus more on designing and implementing preventive initiatives to lower the rising prevalence of excess weight adults in Vietnam.
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Affiliation(s)
- Tran Thai Phuc
- Department of Nursing, Thai Binh University of Medicine and Pharmacy, Thai Binh, Vietnam
| | | | | | - Phan Ngoc Quang
- The Center Service For Technology Science Of Medi-Phar, Thai Binh University of Medicine and Pharmacy, Thai Binh, Vietnam
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Hisbiyah Y, Endaryanto A, Setyoboedi B, Rochmah N, Faizi M. The correlation between vitamin D and levels of IFN-γ, NF-κB, thyroid antibodies in down syndrome: study in Indonesian children. ACTA BIO-MEDICA : ATENEI PARMENSIS 2022; 93:e2022342. [PMID: 36533745 PMCID: PMC9828918 DOI: 10.23750/abm.v93i6.13722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 11/11/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND AND AIM Vitamin D (VD) reduces interferon-gamma (IFN-γ) production and prevents nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) activation, impacting the inhibition of the autoimmunity process such as autoimmune thyroiditis (AITD). Children with Down syndrome (DS) are reported to have a higher risk of autoimmunity and lower VD levels than non-DS. Therefore, this study aimed to evaluate VD levels in Indonesian DS children and their relationship with marker of AITD. METHODS This study was conducted on DS children at Dr Soetomo Hospital between February 2021-June 2022. Socio-demographic status, amount of milk, fish and meat consumption, and duration of sun exposure were obtained using a self-report questionnaire. Thyroid hormone (TSH and FT4), thyroid antibody (TPO-Ab and Tg-Ab), 25 (OH)D, IFN-γ, and NF-κB levels were measured using ELISA. RESULTS Of the 80 participants, 53.75% had sufficient (50.829±17.713 ng/ml) and 46.25% had non-sufficient (20.606±5.974 ng/ml) VD levels. Daily milk consumption, meat and fish consumption were risk factors contributing to VD levels in multivariate analysis [p=0.003, OR=1.007(1.003-1.012); p=0.004, OR=1.816(1.209- 2.728), respectively]. Participants with sufficient VD had significantly higher TPO-Ab (p=0.007) and Tg-Ab (p=0.016). Mean of VD levels were significantly negatively correlated with IFN-γ levels (r =-0.262, p=0.037) and positively correlated with TPO-Ab (r= 0.432, p=1x10-5,) and Tg-Ab (r= 0.375, p=0.001). CONCLUSIONS Majority of subjects had sufficient VD levels. VD suppresses IFN-g, but is unable to affect NF-κB levels, presumably causing high levels of TPO-Ab and Tg-Ab in sufficient VD patient.
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Affiliation(s)
- Yuni Hisbiyah
- Doctoral Program of Medical Science, Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia; Faculty of Medicine, Department of child health, Dr. Soetomo General Hospital, Universitas Airlangga, Surabaya, East Java, Indonesia.
| | - Anang Endaryanto
- Doctoral Program of Medical Science, Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia; Faculty of Medicine, Department of child health, Dr. Soetomo General Hospital, Universitas Airlangga, Surabaya, East Java, Indonesia.
| | - Bagus Setyoboedi
- Doctoral Program of Medical Science, Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia; Faculty of Medicine, Department of child health, Dr. Soetomo General Hospital, Universitas Airlangga, Surabaya, East Java, Indonesia.
| | - Nur Rochmah
- Faculty of Medicine, Department of child health, Dr. Soetomo General Hospital, Universitas Airlangga, Surabaya, East Java, Indonesia.
| | - Muhammad Faizi
- Faculty of Medicine, Department of child health, Dr. Soetomo General Hospital, Universitas Airlangga, Surabaya, East Java, Indonesia.
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Oktaria V, Putri DAD, Ihyauddin Z, Julia M, Sulistyoningrum DC, Koon PB, Danchin M, Murni IK. Vitamin D deficiency in South-East Asian children: a systematic review. Arch Dis Child 2022; 107:980-987. [PMID: 35680405 DOI: 10.1136/archdischild-2021-323765] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 04/29/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To describe the prevalence and determinants of vitamin D deficiency (VDD) among healthy children aged between 0 and 18 years living in South-East Asia (SEA). DESIGN We systematically searched Ovid MEDLINE and Ovid EMBASE for observational studies assessing VDD among healthy children in the SEA region as the primary or secondary outcome from database inception to 6 April 2021. PubMed was used for e-pubs and publications not indexed in Medline. Publications that included abstracts in English were included. We performed a systematic review to describe the prevalence of VDD in SEA children. RESULTS Our initial search identified 550 publications with an additional 2 publications from manual screening. Of those, 21 studies from 5 different countries (Thailand, Indonesia, Vietnam, Malaysia and Cambodia) were summarised and included in forest plots. The prevalence of VDD (<50 nmol/L) ranged from 0.9% to 96.4%, with >50% of newborns having VDD, and severe VDD (<30 nmol/L) ranged from 0% to 55.8%. Female sex and urban living were the most common determinants of VDD. CONCLUSIONS VDD among healthy children living in the SEA region is common. Efforts to detect VDD and the implementation of preventive measures, including education on safe sun exposure and oral vitamin D supplementation or food fortification, should be considered for key target groups, including adolescent females and pregnant and lactating women to improve the vitamin D status of newborns. PROTOCOL REGISTRATION NUMBER This study is registered with PROSPERO (CRD42020181600).
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Affiliation(s)
- Vicka Oktaria
- Department of Biostatistics, Epidemiology and Population Health, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Sleman, Daerah Istimewa Yogyakarta, Indonesia
- Center for Child Health-Pediatric Research Office, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Sleman, Daerah Istimewa Yogyakarta, Indonesia
| | - Dwi Astuti Dharma Putri
- Center for Child Health-Pediatric Research Office, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Sleman, Daerah Istimewa Yogyakarta, Indonesia
| | - Zulfikar Ihyauddin
- Center for Child Health-Pediatric Research Office, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Sleman, Daerah Istimewa Yogyakarta, Indonesia
| | - Madarina Julia
- Child Health Department, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Sleman, Daerah Istimewa Yogyakarta, Indonesia
| | - Dian Caturini Sulistyoningrum
- Department of Nutrition and Health, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Sleman, Daerah Istimewa Yogyakarta, Indonesia
| | - Poh Bee Koon
- Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Selangor, Malaysia
| | - Margaret Danchin
- Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia
- Department of General Medicine, Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Indah Kartika Murni
- Center for Child Health-Pediatric Research Office, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Sleman, Daerah Istimewa Yogyakarta, Indonesia
- Child Health Department, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Sleman, Daerah Istimewa Yogyakarta, Indonesia
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Muacevic A, Adler JR. The Frequency of Vitamin D and Calcium Deficiencies Among Women of Reproductive Age in Wadi Etba, Southern Region of Libya. Cureus 2022; 14:e29832. [PMID: 36285107 PMCID: PMC9583046 DOI: 10.7759/cureus.29832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/02/2022] [Indexed: 11/06/2022] Open
Abstract
Background Vitamin D (VD) is the sunshine vitamin. Its deficiency is widely spread worldwide and is implicated in various health problems that have serious financial, mental, and physical health burdens. In Libya, it also has a high incidence as many studies have been conducted on this issue, but the exact situation of VD deficiency in the southern region of Libya remains unclear. Aim The aim of this study is to investigate the frequency of VD deficiency and calcium status among females of reproductive age in Wadi Etba (located in the southern region of Libya). Material and methods This study included 622 females aged 20-40 years attending the Rural Hospital and Private Clinics in Wadi Etba for various health issues during the last five years. The study population was further subdivided into two age groups; 20-30 years and 31-40 years. VD and calcium were measured to determine the VD status among the study population. Results In general, 489 females had sub-optimal VD (<30 ng/mL), representing 78.6% of the total subjects. Normal VD levels were represented only by 133 subjects (21.4%). VD deficiency was represented by 354 subjects (57%) of the total subjects. A total of 232 (37%) subjects were VD-deficient females (18.3 ± 5.5 ng/ml), 122 subjects (20%) were considered poor (severe deficient, VD <10 ng/ml) represented with a mean serum VD of 8.2 ± 0.6. Furthermore, deficiency cases dominated the older age group. Regarding calcium (Ca+2) levels, 31% had lower than the normal range, 68% had normal range, and only 1% showed high Ca+2 levels. On the other hand, there was no correlation between serum levels of VD and Ca+2 levels. Conclusion VD deficiency has become a widespread condition in the southern region of Libya. Therefore, we recommended making lifestyle changes, including extending the exposure time to the sunlight radiation, fortifying foods and drinks with VD, and taking supplementary doses of VD to reduce the high incidence of VD deficiency.
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Van DTT, Trijsburg L, Do HTP, Kurotani K, Feskens EJM, Talsma EF. Development of the Vietnamese Healthy Eating Index. J Nutr Sci 2022; 11:e45. [PMID: 35754986 PMCID: PMC9201877 DOI: 10.1017/jns.2022.44] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 05/16/2022] [Indexed: 11/17/2022] Open
Abstract
Poor dietary quality is a major contributor to malnutrition and disease burden in Vietnam, necessitating the development of a tool for improving dietary quality. Food-based dietary guidelines (FBDGs) have been proposed to do this by providing specific, culturally appropriate and actionable recommendations. We developed the Vietnamese Healthy Eating Index (VHEI) to assess the adherence to the 2016-2020 Vietnamese FBDGs and the dietary quality of the general Vietnamese population. This VHEI consists of eight component scores, 'grains', 'protein foods', 'vegetables', 'fruits', 'dairy', 'fats and oils', 'sugar and sweets' and 'salt and sauces', representing the recommendations in the FBDGs. Each component score ranges from 0 to 10, resulting in a total VHEI score between 0 (lowest adherence) and 80 (highest adherence). The VHEI was calculated using dietary intake data from the Vietnamese General Nutrition Survey 2009-2010 (n = 8225 households). Associations of the VHEI with socio-demographic characteristics, energy and nutrient intakes and food group consumptions were examined. The results showed that the mean and standard deviation score of the VHEI was 43⋅3 ± 8⋅1. The component 'sugar and sweets' scored the highest (9⋅8 ± 1⋅1), whereas the component 'dairy' scored the lowest (0⋅6 ± 1⋅6). The intake of micronutrients was positively associated with the total VHEI, both before and after adjustment for energy intake. In conclusion, the VHEI is a valuable measure of dietary quality for the Vietnamese population regarding their adherence to the FBDGs.
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Key Words
- A4NH, The CGIAR Research Program on Agriculture for Nutrition and Health
- AFE, Adult Female Equivalent
- AME, Adult Male Equivalent
- Dietary quality
- E %, energy percentage
- FBDG, food-based dietary guidelines
- FCT, Food Composition Table
- Food-based dietary guidelines
- GNS 2009–10, Vietnamese General Nutrition Survey 2009–2010
- Healthy Eating Index
- NCDs, non-communicable diseases
- NIN, National Institute of Nutrition
- RAE, Retinol Activity Equivalent
- T, tertile
- VHEI, Vietnamese Healthy Eating Index
- Vietnamese adults
- sd, standard deviation
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Affiliation(s)
- Duong T. T. Van
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, The Netherlands
- Department of Nutrition and Food Science, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Laura Trijsburg
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, The Netherlands
| | - Ha T. P. Do
- National Institute of Nutrition, Ministry of Health, Hanoi, Vietnam
| | - Kayo Kurotani
- Department of Health Science, Showa Women's University, Tokyo, Japan
- Department of Nutritional Epidemiology and Shokuiku, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
| | - Edith J. M. Feskens
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, The Netherlands
| | - Elise F. Talsma
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, The Netherlands
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Trijsburg L, Talsma EF, Crispim SP, Garrett J, Kennedy G, de Vries JHM, Brouwer ID. Method for the Development of WISH, a Globally Applicable Index for Healthy Diets from Sustainable Food Systems. Nutrients 2020; 13:nu13010093. [PMID: 33396659 PMCID: PMC7824146 DOI: 10.3390/nu13010093] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 12/22/2020] [Accepted: 12/27/2020] [Indexed: 12/14/2022] Open
Abstract
Promoting both a healthy diet and at the same time considering the environmental sustainability aspects of production and consumption of the diet are urgent global issues. We developed the WISH (World Index for Sustainability and Health) to evaluate diets for healthiness and sustainability. The WISH seeks to measure two complex multidimensional concepts, diet quality and environmental sustainability, in one scoring system. The WISH is based on the EAT-Lancet recommendations for a healthy and sustainable diet in the general population with global applicability across multiple settings. Thirteen food groups are scored between 0 and 10, based on their association with disease and impact on environmental indicators. The scoring system was applied using a dataset of duplicate 24 h dietary recalls from 396 urban Vietnamese men and women. Out of a maximum score of 130, the mean total WISH score was 46 (SD 11), and scores for the healthy and high-environmental impact sub-scores were mean 25 (11) (out of 100) and mean 26 (8) (out of 70) respectively. A higher score was observed for the less-healthy (mean 20 (2) out of 30) sub-score. Our initial analysis shows that the WISH is able to differentiate between the healthiness and the environmental sustainability of a Vietnamese diet.
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Affiliation(s)
- Laura Trijsburg
- Human Nutrition and Health, Wageningen University and Research, 6700 AA Wageningen, The Netherlands; (E.F.T.); (J.H.M.d.V.); (I.D.B.)
- Correspondence:
| | - Elise F. Talsma
- Human Nutrition and Health, Wageningen University and Research, 6700 AA Wageningen, The Netherlands; (E.F.T.); (J.H.M.d.V.); (I.D.B.)
| | - Sandra P. Crispim
- Department of Nutrition, Federal University of Paraná, Curitiba 80210-170, Brazil;
| | | | - Gina Kennedy
- Advancing Nutrition, USAID, Arlington, VA 22202, USA;
| | - Jeanne H. M. de Vries
- Human Nutrition and Health, Wageningen University and Research, 6700 AA Wageningen, The Netherlands; (E.F.T.); (J.H.M.d.V.); (I.D.B.)
| | - Inge D. Brouwer
- Human Nutrition and Health, Wageningen University and Research, 6700 AA Wageningen, The Netherlands; (E.F.T.); (J.H.M.d.V.); (I.D.B.)
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Ha AN, Pham TD, Vuong LN. Association between Vitamin D Levels and Fertility Outcomes in Patients Undergoing IVF/ICSI. FERTILITY & REPRODUCTION 2020. [DOI: 10.1142/s2661318220500139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background: Several studies have demonstrated that vitamin D (vitD) might play an important role in the reproductive system due to expression of vitD receptor and vitD-metabolizing enzymes in many reproductive tissues. VitD deficiency has been associated with increased risk of obstetric complications. However, the effect of vitD levels on in vitro fertilization (IVF)/ICSI outcomes is not fully understood. Evidence shows that women with adequate vitD levels might have higher pregnancy rates. This study evaluated the association between serum vitD levels and IVF/ICSI outcomes. Methods: This multicenter, retrospective cohort study was conducted at IVFMD, My Duc Hospital and IVFMDPN, My Duc Phu Nhuan Hospital, Ho Chi Minh City, Vietnam between November 2017 and July 2019. Vietnamese patients aged 18–40 years with serum vitD (25(OH)D) samples collected before starting controlled ovarian stimulation and undergoing embryo transfer were eligible. Patients were divided into four groups based on 25(OH)D levels: <10 ng/mL, 10 to <20 ng/mL, 20 to <30 ng/mL, and [Formula: see text]30 ng/mL. The primary outcome was ongoing pregnancy rate. Results: Of 3779 patients recruited, 25(OH)D levels were <10 ng/mL in 564 (14.9%), 10 to <20 ng/mL in 436 (11.5%), 20 to <30 in 1,142 (30.2%), and [Formula: see text]30 ng/mL in 1,637 (43.3%). Ongoing pregnancy rates were similar across the four subgroups (36%, 40%, 36%, and 36%, respectively; p = 0.409). The number of oocytes retrieved, embryos, clinical pregnancy, implantation, and miscarriage rates did not differ significantly between subgroups. Conclusions: In this analysis, serum vitD levels did not appear to be correlated with pregnancy outcomes in patients undergoing IVF/ICSI.
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Affiliation(s)
- Anh N. Ha
- IVFMD, My Duc Hospital, 4 Nui Thanh, Tan Binh District, Ho Chi Minh City, Vietnam
| | - Toan D. Pham
- IVFMD, My Duc Hospital, 4 Nui Thanh, Tan Binh District, Ho Chi Minh City, Vietnam
- HOPE Research Center, 4 Nui Thanh, Tan Binh District, Ho Chi Minh City, Vietnam
| | - Lan N. Vuong
- IVFMD, My Duc Hospital, 4 Nui Thanh, Tan Binh District, Ho Chi Minh City, Vietnam
- HOPE Research Center, 4 Nui Thanh, Tan Binh District, Ho Chi Minh City, Vietnam
- Department of Obstetrics and Gynecology, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
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Aji AS, Yerizel E, Desmawati D, Lipoeto NI. Low Maternal Vitamin D and Calcium Food Intake during Pregnancy Associated with Place of Residence: A Cross-Sectional Study in West Sumatran Women, Indonesia. Open Access Maced J Med Sci 2019; 7:2879-2885. [PMID: 31844453 PMCID: PMC6901836 DOI: 10.3889/oamjms.2019.659] [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] [Received: 05/16/2019] [Revised: 07/01/2019] [Accepted: 07/02/2019] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND There is a high prevalence of vitamin D deficiency in pregnancy worldwide, and variable availability of vitamin D-rich foods may affect the adequacy of vitamin D food intake in different regions. AIM We analysed the relationship between place of residence and maternal food intake of vitamin D and calcium in West Sumatra, Indonesia. METHODS This cross-sectional study was conducted in 203 pregnant women. Data collection was carried out in four districts in West Sumatra - two in coastal locations and two in mountainous locations - with subjects divided into groups based on their place of residence. The dietary intakes of pregnant women were assessed through a semi-quantitative food-frequency questionnaire (SQ-FFQ). RESULTS The means of maternal vitamin D and calcium food intake were 7.92 ± 5.26 µg/day and 784.88 ± 409.77 mg/day, respectively. There were no reports of vitamin D supplement intake during pregnancy. A total of 86.7% and 89.7% of the study subjects had low vitamin D and calcium food intake status, respectively. There was a significant association between maternal vitamin D intake and place of residence (p = 0.02) and significant different mean levels of vitamin D food intake with the place of residence (9.04 vs 6.55 µg/day; p = 0.01). Mothers who had higher education levels had adequate calcium food intake (p = 0.015; OR: 0.295; 0.116-0.751). CONCLUSION Low maternal vitamin D and calcium food intake were found to be common in West Sumatra, Indonesia and their differed between those residents in mountainous and in coastal areas.
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Affiliation(s)
- Arif Sabta Aji
- Biomedical Science Department, Andalas University, Padang, Indonesia
| | - Eti Yerizel
- Biochemistry Department, Andalas University, Padang, Indonesia
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Wieringa F, Roos N, Greffeuille V, Dijkhuizen M, Berger J. Improving Micronutrient Status of Vulnerable Groups in South-East Asia: The SMILING Experience. Matern Child Health J 2019; 23:1-3. [PMID: 30607670 DOI: 10.1007/s10995-018-02700-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Affiliation(s)
- Frank Wieringa
- Institute of Research for Development (IRD), UMR Nutripass IRD, UM/SupAgro, Montpellier, France.
| | - Nanna Roos
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Valerie Greffeuille
- Institute of Research for Development (IRD), UMR Nutripass IRD, UM/SupAgro, Montpellier, France
| | - Marjoleine Dijkhuizen
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Jacques Berger
- Institute of Research for Development (IRD), UMR Nutripass IRD, UM/SupAgro, Montpellier, France
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Loeb M, Dang AD, Thiem VD, Thanabalan V, Wang B, Nguyen NB, Tran HTM, Luong TM, Singh P, Smieja M, Maguire J, Pullenayegum E. Effect of Vitamin D supplementation to reduce respiratory infections in children and adolescents in Vietnam: A randomized controlled trial. Influenza Other Respir Viruses 2019; 13:176-183. [PMID: 30328294 PMCID: PMC6379634 DOI: 10.1111/irv.12615] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2018] [Revised: 09/11/2018] [Accepted: 10/15/2018] [Indexed: 11/28/2022] Open
Abstract
Background It is uncertain whether vitamin D can reduce respiratory infection. Objective To determine whether vitamin D supplementation reduces influenza and other upper viral respiratory tract infections. Methods A total of 1300 healthy children and adolescents between the ages of 3 and 17 years were randomized to vitamin D (14 000 U weekly) or placebo for 8 months in Vietnam. The primary outcome was reverse transcriptase (RT)‐PCR–confirmed influenza infection, and the coprimary outcome was multiplex PCR–confirmed non‐influenza respiratory viruses. Participants, caregivers, and those assessing outcomes were blinded to group assignment. Results A total of 650 children and adolescents were randomly assigned to vitamin D and 650 to placebo. The mean baseline serum 25‐hydroxyvitamin D levels were 65.7 nmol/L and 65.2 nmol/L in the intervention and placebo groups, respectively, with an increase to 91.8 nmol/L in the vitamin D group and no increase, 64.5 nmol/L, in the placebo group. All 1300 participants randomized contributed to the analysis. We observed RT‐PCR–confirmed influenza A or B occurred in 50 children (7.7%) in the vitamin D group and in 43 (6.6%) in the placebo group (hazard ratio [HR]: 1.18, 95% CI: 0.79‐1.78). RT‐PCR–confirmed non‐influenza respiratory virus infection occurred in 146 (22.5%) in the vitamin D group and in 185 (28.5%) in the placebo group (hazard ratio [HR]: 0.76, 95% CI: 0.61‐0.94). When considering all respiratory viruses, including influenza, the effect of vitamin D in reducing infection was significant, HR: 0.81, 95% CI: 0.66‐0.99. Conclusion Vitamin D supplementation did not reduce the incidence of influenza but moderately reduced non‐influenza respiratory viral infection.
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Affiliation(s)
- Mark Loeb
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Anh Duc Dang
- National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | - Vu Dinh Thiem
- Department of Epidemiology, National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | - Vitheya Thanabalan
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Biao Wang
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Nguyen Binh Nguyen
- Department of Epidemiology, National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | - Hung Thi Mai Tran
- Department of International Cooperation, National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | - Tan Minh Luong
- National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | - Pardeep Singh
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Marek Smieja
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Jonathon Maguire
- St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
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Roos N, Ponce MC, Doak CM, Dijkhuizen M, Polman K, Chamnan C, Khov K, Chea M, Prak S, Kounnavong S, Akkhavong K, Mai LB, Lua TT, Muslimatun S, Famida U, Wasantwisut E, Winichagoon P, Doets E, Greffeuille V, Wieringa FT, Berger J. Micronutrient status of populations and preventive nutrition interventions in South East Asia. Matern Child Health J 2018; 23:29-45. [DOI: 10.1007/s10995-018-2639-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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13
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Is vitamin D deficiency a public health concern for low middle income countries? A systematic literature review. Eur J Nutr 2018; 58:433-453. [PMID: 29344677 DOI: 10.1007/s00394-018-1607-3] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Accepted: 01/03/2018] [Indexed: 12/18/2022]
Abstract
PURPOSE Vitamin D deficiency has been receiving increasing attention as a potential public health concern in low and lower-middle income countries (LMICs), of which there are currently 83. We aimed to conduct a comprehensive systematic literature review (SLR) of available data on vitamin D status and prevalence of vitamin D deficiency in all 83 LMICs. METHODS We followed the general methodology for SLRs in the area of serum 25-hydroxyvitamin D. Highest priority was placed on identifying relevant population-based studies, followed by cross-sectional studies, and to a lesser extent case-control studies. We adopted the public health convention that a prevalence of vitamin D deficiency (serum 25-hydroxyvitamin D < 25/30 nmol/L) at > 20% in the entire population and/or at-risk population subgroups (infants, children, women of child-bearing age, pregnancy) constitutes a public health issue that may warrant intervention. RESULTS Our SLR revealed that of the 83 LMICs, 65% (n = 54 countries) had no published studies with vitamin D data suitable for inclusion. Using data from the remaining third, a number of LMICs had evidence of excess burden of vitamin D deficiency in one or more population subgroup(s) using the above convention (Afghanistan, Pakistan, India, Tunisia and Mongolia) as well as possibly other LMICs, albeit with much more limited data. Several LMICs had no evidence of excess burden. CONCLUSION Vitamin D deficiency is a public health issue in some, but certainly not all, LMICs. There is a clear need for targeting public health strategies for prevention of vitamin D deficiency in those LMICs with excess burden.
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Abstract
Vitamin D deficiency occurs all over the world, mainly in the Middle East, China, Mongolia, and India. This article focuses on the vitamin D status in adults. Risk groups include older persons, pregnant women, and non-Western immigrants. Adequate vitamin D status, defined as serum 25-hydroxyvitamin D greater than 50 nmol/L, is present in less than 50% of the world population, at least in winter. Preventative strategies, such as increasing fish consumption, fortification of foods, use of vitamin D supplements, and advice for moderate sunlight exposure, are warranted.
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Affiliation(s)
- Natasja van Schoor
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, Van der Boechorststraat 7, Amsterdam 1081 BT, The Netherlands.
| | - Paul Lips
- Department of Internal Medicine, Endocrine Section, VU University Medical Center, PO Box 7057, Amsterdam 1007 MB, The Netherlands
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15
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Michalski ES, Nguyen PH, Gonzalez-Casanova I, Nguyen SV, Martorell R, Tangpricha V, Ramakrishnan U. Serum 25-hydroxyvitamin D but not dietary vitamin D intake is associated with hemoglobin in women of reproductive age in rural northern Vietnam. J Clin Transl Endocrinol 2017; 8:41-48. [PMID: 29067258 PMCID: PMC5651337 DOI: 10.1016/j.jcte.2017.05.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Revised: 05/02/2017] [Accepted: 05/02/2017] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Hypovitaminosis D and anemia are both prevalent in Vietnam, and low vitamin D status may be a risk factor for anemia. This study aimed to 1) describe vitamin D intake and its determinants, and 2) examine the associations of vitamin D intake and serum 25(OH)D concentrations with hemoglobin and anemia. METHODS AND STUDY DESIGN We used data from the baseline survey of a pre-conceptual micronutrient supplementation trial in women of reproductive age (WRA) in Thai Nguyen, Vietnam (N = 4961). Vitamin D intake was estimated using a semi-quantitative food frequency questionnaire (FFQ). Multivariable regression models were used for the analyses. RESULTS Median vitamin D intake was 0.2 µg/d (8.0 IU) [IQR: 0.4]. Age, being a farmer, food insecurity, and body mass index (BMI) were inversely associated with vitamin D intake, while socioeconomic status (SES), total energy intake, and education were positively associated with vitamin D intake. Vitamin D intake was not associated with hemoglobin concentration or anemia after adjusting for age, BMI, total energy intake, transferrin receptor, C-reactive protein, α1-acid glycoprotein, SES, occupation, education, ethnicity, and food insecurity (P = 0.56 and P = 0.65 for hemoglobin and anemia, respectively). Controlling for the same covariates, 25(OH)D <50 nmol/L (vs. ≥50 nmol/L) was associated with decreased hemoglobin concentrations (β = -0.91 (SE:0.42), P = 0.03), but not with anemia (P = 0.11). CONCLUSIONS Low vitamin D status may be linked to reduced hemoglobin concentrations, but the role of diet in this association was not evident in this population of WRA in Vietnam where dietary vitamin D intake was very low.
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Key Words
- 25(OH)D, 25-hydroxyvitamin D
- AGP, α1-acid glycoprotein
- AMDR, acceptable macronutrient distribution range
- Anemia
- CRP, C-reactive protein
- Dietary intake
- EAR, estimated average requirement
- Hemoglobin
- IOM, Institute of Medicine
- IQR, interquartile range
- RBP, retinol binding protein
- SD, standard deviation
- SE, standard error
- SES, socioeconomic status
- Vietnam
- Vitamin D
- WHO, World Health Organization
- WRA, women of reproductive age
- sTfR, soluble transferrin receptor
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Affiliation(s)
- Ellen S. Michalski
- Nutrition and Health Sciences Program, Laney Graduate School, Emory University, Atlanta, GA 30322, USA
| | - Phuong H. Nguyen
- Thai Nguyen University of Pharmacy and Medicine, Thai Nguyen, Viet Nam
- International Food Policy Research Institute, Washington, DC 20006, USA
| | | | - Son V. Nguyen
- Thai Nguyen University of Pharmacy and Medicine, Thai Nguyen, Viet Nam
| | - Reynaldo Martorell
- Nutrition and Health Sciences Program, Laney Graduate School, Emory University, Atlanta, GA 30322, USA
- Hubert Department of Global Health, Emory University, Atlanta GA 30322, USA
| | - Vin Tangpricha
- Nutrition and Health Sciences Program, Laney Graduate School, Emory University, Atlanta, GA 30322, USA
- Division of Endocrinology, Metabolism & Lipids, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Usha Ramakrishnan
- Nutrition and Health Sciences Program, Laney Graduate School, Emory University, Atlanta, GA 30322, USA
- Hubert Department of Global Health, Emory University, Atlanta GA 30322, USA
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16
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Smith G, Wimalawansa SJ, Laillou A, Sophonneary P, Un S, Hong R, Poirot E, Kuong K, Chamnan C, De Los Reyes FN, Wieringa FT. High Prevalence of Vitamin D Deficiency in Cambodian Women: A Common Deficiency in a Sunny Country. Nutrients 2016; 8:nu8050290. [PMID: 27187456 PMCID: PMC4882703 DOI: 10.3390/nu8050290] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Revised: 04/08/2016] [Accepted: 04/21/2016] [Indexed: 12/31/2022] Open
Abstract
Recent studies have shown that in spite of being generally close to the equator; vitamin D deficiency is common in South East Asian countries. In order to quantify micronutrient status for women and children in Cambodia; a nationally-representative survey was conducted in 2014 linked to the Cambodian Demographic Health Survey. The countrywide median of 25(OH)D was, respectively, 64.9 and 91.1 nmol/L for mothers and children. Based on The Endocrine Society cutoffs (>50<75 nmol/L = insufficiency; ≤50 nmol/L = deficiency); 64.6% of mothers and 34.8% of their children had plasma vitamin D concentrations indicating insufficiency or deficiency. For deficiency alone, 29% of the mothers were found to be vitamin D deficient, but only 13.4% of children. Children who live in urban areas had a 43% higher rate of vitamin D insufficiency versus those who live in rural areas (OR; 1.434; 95% CI: 1.007; 2.041). However, such differences were not observed in their mothers. The high prevalence of vitamin D deficiency is likely in part due to lifestyle choices, including sun avoidance, increasingly predominant indoor work, and covered transport. These survey findings support the need for a broader national Cambodian study incorporating testing of adult men, adolescents and the elderly, and encompassing other parameters such as skeletal health. However, the data presented in this study already show significant deficiencies which need to be addressed and we discuss the benefit of establishing nationally-mandated food fortification programs to enhance the intake of vitamin D.
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Affiliation(s)
- Geoffry Smith
- International Life Sciences Institute, South East Asia Region, 9 Mohamed Sultan Road #02-01, Singapore 238959, Singapore.
- Essential Micronutrients Foundation, 3 Pickering Street, #02-36 Nankin Row, China Square Central, Singapore 048660, Singapore.
| | - Sunil J Wimalawansa
- Cardio Metabolic Institute, Medicine, Endocrinology & Nutrition, 661 Darmody Avenue, North Brunswick, NJ 08902, USA.
| | - Arnaud Laillou
- United Nations Children's Fund (UNICEF), Maternal, Newborn and Child Health and Nutrition Section, No. 11 street 75, Phnom Penh 12202, Cambodia.
| | - Prak Sophonneary
- National Nutrition Program, Maternal and Child Health Center, No. 31A, Rue de France (St. 47), Phnom Penh 12202, Cambodia.
| | - Samoeurn Un
- United Nations Children's Fund (UNICEF), Maternal, Newborn and Child Health and Nutrition Section, No. 11 street 75, Phnom Penh 12202, Cambodia.
| | - Rathavuth Hong
- ICF International, 530 Gaither Road, Suite 500, Rockville, MD 20850, USA.
| | - Etienne Poirot
- United Nations Children's Fund (UNICEF), Maternal, Newborn and Child Health and Nutrition Section, No. 11 street 75, Phnom Penh 12202, Cambodia.
| | - Khov Kuong
- Department of Fisheries Post-harvest Technologies and Quality control (DFPTQ), Fisheries Administration, Ministry of Agriculture, Forestry and Fisheries (MAFF), 186 Preah Norodom Boulevard, Phnom Penh 12000, Cambodia.
- Nutrition, Exercise and Sports, University of Copenhagen, Bülowsvej 17, Frederiksberg C DK-1870, Denmark.
| | - Chhoun Chamnan
- Department of Fisheries Post-harvest Technologies and Quality control (DFPTQ), Fisheries Administration, Ministry of Agriculture, Forestry and Fisheries (MAFF), 186 Preah Norodom Boulevard, Phnom Penh 12000, Cambodia.
| | | | - Frank T Wieringa
- Institute of Research for Development (IRD), UMR Nutripass IRD-UM2-UM1, Montpellier 3400, France.
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Hemery YM, Fontan L, Moench-Pfanner R, Laillou A, Berger J, Renaud C, Avallone S. Influence of light exposure and oxidative status on the stability of vitamins A and D₃ during the storage of fortified soybean oil. Food Chem 2015; 184:90-8. [PMID: 25872430 DOI: 10.1016/j.foodchem.2015.03.096] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Revised: 02/10/2015] [Accepted: 03/16/2015] [Indexed: 02/06/2023]
Abstract
Food fortification is implemented to address vitamins A and D deficiencies in numerous countries. The stability of vitamins A and D3 was assessed during a two-month period reproducing the usual oil storage conditions before sale to consumers. Soybean oils with different oxidative status and vitamin E contents were stored in the dark, semi-dark, or exposed to natural light. Lipid peroxidation took place after 3 weeks of storage in dark conditions. After 2 months, the vitamin A and D3 losses reached 60-68% and 61-68%, respectively, for oils exposed to natural light, and 32-39% and 24-44% in semi-dark conditions. The determining factors of vitamin A and D3 losses were (in decreasing order) the storage time, the exposure to light and the oxidative status of the oil, whereas vitamin E content had a protective role. Improving these parameters is thus essential to make vitamins A and D fortification in oils more efficient.
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Affiliation(s)
- Youna M Hemery
- Institute of Research for Development (IRD), UMR 204 Prevention of Malnutrition and Associated Pathologies (NUTRIPASS), IRD/Univ. Montpellier 1/Univ. Montpellier 2/SupAgro, Montpellier, France
| | - Laura Fontan
- Institute of Research for Development (IRD), UMR 204 Prevention of Malnutrition and Associated Pathologies (NUTRIPASS), IRD/Univ. Montpellier 1/Univ. Montpellier 2/SupAgro, Montpellier, France
| | | | - Arnaud Laillou
- UNICEF, Maternal Child Health and Nutrition Section, Phnom Penh, Cambodia
| | - Jacques Berger
- Institute of Research for Development (IRD), UMR 204 Prevention of Malnutrition and Associated Pathologies (NUTRIPASS), IRD/Univ. Montpellier 1/Univ. Montpellier 2/SupAgro, Montpellier, France
| | - Cécile Renaud
- Institute of Research for Development (IRD), UMR 204 Prevention of Malnutrition and Associated Pathologies (NUTRIPASS), IRD/Univ. Montpellier 1/Univ. Montpellier 2/SupAgro, Montpellier, France
| | - Sylvie Avallone
- Montpellier SupAgro, UMR 204 Prevention of Malnutrition and Associated Pathologies (NUTRIPASS), IRD/Univ. Montpellier 1/Univ. Montpellier 2/SupAgro, Montpellier, France.
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18
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Houghton LA, Gray AR, Harper MJ, Winichagoon P, Pongcharoen T, Gowachirapant S, Gibson RS. Vitamin D status among Thai school children and the association with 1,25-Dihydroxyvitamin D and parathyroid hormone levels. PLoS One 2014; 9:e104825. [PMID: 25111832 PMCID: PMC4128742 DOI: 10.1371/journal.pone.0104825] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2014] [Accepted: 07/09/2014] [Indexed: 01/10/2023] Open
Abstract
In several low latitude countries, vitamin D deficiency is emerging as a public health issue. Adequate vitamin D is essential for bone health in rapidly growing children. In the Thai population, little is known about serum 25-hydroxyvitamin D [25(OH)D] status of infants and children. Moreover, the association between 25(OH)D and the biological active form of 1,25-dihydroxyvitamin D [1,25(OH)]2D is not clear. The specific aims of this study were to characterize circulating serum 25(OH)D, 1,25(OH)2D and their determinants including parathyroid hormone (PTH), age, sex, height and body mass index (BMI) in 529 school-aged Thai children aged 6–14 y. Adjusted linear regression analysis was performed to examine the impact of age and BMI, and its interaction with sex, on serum 25(OH)D concentrations and 1,25(OH)2D concentrations. Serum 25(OH)D, 1,25(OH)2D and PTH concentrations (geometric mean ± geometric SD) were 72.7±1.2 nmol/L, 199.1±1.3 pmol/L and 35.0±1.5 ng/L, respectively. Only 4% (21 of 529) participants had a serum 25(OH)D level below 50 nmol/L. There was statistically significant evidence for an interaction between sex and age with regard to 25(OH)D concentrations. Specifically, 25(OH)D concentrations were 19% higher in males. Moreover, females experienced a statistically significant 4% decline in serum 25(OH)D levels for each increasing year of age (P = 0.001); no decline was seen in male participants with increasing age (P = 0.93). When BMI, age, sex, height and serum 25(OH)D were individually regressed on 1,25(OH)2D, height and sex were associated with 1,25(OH)2D with females exhibiting statistically significantly higher serum 1,25(OH)2D levels compared with males (P<0.001). Serum 1,25(OH)2D among our sample of children exhibiting fairly sufficient vitamin D status were higher than previous reports suggesting an adaptive mechanism to maximize calcium absorption.
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Affiliation(s)
- Lisa A. Houghton
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand
- * E-mail:
| | - Andrew R. Gray
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Michelle J. Harper
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand
| | | | | | | | - Rosalind S. Gibson
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand
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Zhang Z, Xu X, Ni H, Deng H. Predictive value of ionized calcium in critically ill patients: an analysis of a large clinical database MIMIC II. PLoS One 2014; 9:e95204. [PMID: 24736693 PMCID: PMC3988144 DOI: 10.1371/journal.pone.0095204] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2014] [Accepted: 03/24/2014] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND AND OBJECTIVE Ionized calcium (iCa) has been investigated for its association with mortality in intensive care unit (ICU) patients in many studies. However, these studies are small in sample size and the results are conflicting. The present study aimed to establish the association of iCa with mortality by using a large clinical database. METHODS Multiparameter Intelligent Monitoring in Intensive Care II (MIMIC II) database was used for analysis. Patients older than 15 years were eligible, and patients without iCa measured during their ICU stay were excluded. Demographic data and clinical characteristics were extracted and compared between survivors and non-survivors. iCa measure on ICU admission was defined as Ca0; Camax was the maximum iCa during ICU stay; Camin was the minimum value of iCa during the ICU stay; Camean was the arithmetic mean iCa during ICU stay. MAIN RESULTS A total of 15409 ICU admissions satisfied our inclusion criteria and were included in our analysis. The prevalence of hypocalcemia on ICU entry was 62.06%. Ca0 was significantly lower in non-survivors than in survivors (1.11 ± 0.14 vs 1.13 ± 0.10 mmol/l, p<0.001). In multivariate analysis, moderate hypocalcemia in Ca0 was significantly associated with increased risk of death (OR: 1.943; 95% CI: 1.340-2.817), and mild hypercalcemia was associated with lower mortality (OR: 0.553, 95% CI: 0.400-0.767). While moderate and mild hypocalcemia in Camean is associated with increased risk of death (OR: 1.153, 95% CI: 1.006-1.322 and OR: 2.520, 95% CI: 1.485-4.278), hypercalcemia in Camean is not significantly associated with ICU mortality. CONCLUSION The relationship between Ca0 and clinical outcome follows an "U" shaped curve with the nadir at the normal range, extending slightly to hypercalcemia. Mild hypercalcemia in Ca0 is protective, whereas moderate and mild hypocalcemia in Camean is associated with increased risk of death.
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Affiliation(s)
- Zhongheng Zhang
- Department of Critical Care Medicine, Jinhua Municipal Central Hospital, Jinhua Hospital of Zhejiang University, Zhejiang, P.R. China
- * E-mail:
| | - Xiao Xu
- Department of Critical Care Medicine, Jinhua Municipal Central Hospital, Jinhua Hospital of Zhejiang University, Zhejiang, P.R. China
| | - Hongying Ni
- Department of Critical Care Medicine, Jinhua Municipal Central Hospital, Jinhua Hospital of Zhejiang University, Zhejiang, P.R. China
| | - Hongsheng Deng
- Department of Critical Care Medicine, Jinhua Municipal Central Hospital, Jinhua Hospital of Zhejiang University, Zhejiang, P.R. China
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