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Shi Y, Zhong H, Pang L. Maternal micronutrient disturbance as risks of offspring metabolic syndrome. J Trace Elem Med Biol 2023; 75:127097. [PMID: 36272194 DOI: 10.1016/j.jtemb.2022.127097] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 10/08/2022] [Accepted: 10/13/2022] [Indexed: 11/06/2022]
Abstract
Metabolic syndrome (MetS) is defined as a constellation of individual metabolic disturbances, including central obesity, hypertension, dyslipidemia, and insulin resistance. The established pathogenesis of MetS varies extensively with gender, age, ethnic background, and nutritional status. In terms of nutritional status, micronutrients are more likely to be discounted as essential components of required nutrition than macronutrients due to the small amount required. Numerous observational studies have shown that pregnant women frequently experience malnutrition, especially in developing and low-income countries, resulting in chronic MetS in the offspring due to the urgent and increasing demands for micronutrients during gestation and lactation. Over the past few decades, scientific developments have revolutionized our understanding of the association between balanced maternal micronutrients and MetS in the offspring. Examples of successful individual, dual, or multiple maternal micronutrient interventions on the offspring include iron for hypertension, selenium for type 2 diabetes, and a combination of folate and vitamin D for adiposity. In this review, we aim to elucidate the effects of maternal micronutrient intake on offspring metabolic homeostasis and discuss potential perspectives and challenges in the field of maternal micronutrient interventions.
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Affiliation(s)
- Yujie Shi
- Nanjing Maternal and Child Health Medical Institute, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing 210004, China.
| | - Hong Zhong
- Nanjing Maternal and Child Health Medical Institute, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing 210004, China
| | - Lingxia Pang
- Department of Child Healthcare, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing 210004, China.
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Cheng Y, Chen J, Li T, Pei J, Fan Y, He M, Liu S, Liu J, Zhang Q, Cheng H. Maternal vitamin D status in early pregnancy and its association with gestational diabetes mellitus in Shanghai: a retrospective cohort study. BMC Pregnancy Childbirth 2022; 22:819. [PMID: 36335302 PMCID: PMC9636619 DOI: 10.1186/s12884-022-05149-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 10/25/2022] [Indexed: 11/07/2022] Open
Abstract
Background There is growing interest regarding vitamin D and its potential role in gestational diabetes mellitus (GDM). We aimed to assess maternal vitamin D status in early pregnancy and its relationships with the risk of GDM in a Chinese population in Shanghai. Methods The retrospective cohort study included a total of 7816 pregnant women who underwent a 75-g oral glucose tolerance test (OGTT) during 24–28 weeks of gestation. Participants’ demographic information including maternal age, prepregnancy body mass index (BMI), gestational age, parity, season of blood collection, serum 25-hydroxy vitamin D [25(OH)D] data and other blood biomarker data at 6 to 14 weeks of gestation were retrospectivly extracted from the medical records in the hospital information system. Results In the cohort, the prevalence of GDM was 8.6% and the prevalence of vitamin D deficiency and insufficiency in early pregnancy was 53.1 and 38.5%, respectively. The mean value of the serum 25(OH)D concentration was 19.6±7.5 ng/mL. The restricted cubic splines model showed an inverted J-shaped relationship in which the risk of GDM decreased when the 25(OH)D concentrations were ≥ 20 ng/mL. Logistic model analysis showed that 25(OH)D concentrations ≥ 30 ng/mL significantly decreased the risk of GDM (odds ratio = 0.63, 95% confidence interval: 0.45-0.89; P = 0.010) compared with 25(OH)D concentrations < 20 ng/ml. Conclusions In early pregnancy, vitamin D deficiency and insufficiency were very common, and a high level of vitamin D showed protective effects against the incidence risk of GDM.
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Associations between maternal vitamin D status during three trimesters and cord blood 25(OH)D concentrations in newborns: a prospective Shanghai birth cohort study. Eur J Nutr 2021; 60:3473-3483. [PMID: 33661376 DOI: 10.1007/s00394-021-02528-w] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 02/23/2021] [Indexed: 12/15/2022]
Abstract
PURPOSE Prenatal vitamin D (VitD) deficiency influences children's health in later life. We aimed to test the associations between maternal VitD status in each of the three trimesters of pregnancy and cord blood 25(OH)D concentrations in newborns. METHODS Participants were pregnant women recruited from the Shanghai Birth Cohort (SBC) (n = 1100). Of all the participants, 946 completed the collection of venous blood at early (< 16 weeks, T1), mid- (24-28 weeks, T2), and late (32-34 weeks, T3) pregnancy as well as the corresponding cord blood in the newborns. Maternal serum 25(OH)D concentrations were measured by LC-MS/MS, and the information on confounding factors was obtained through a standardized questionnaire. RESULTS The mean 25(OH)D concentrations at time points T1, T2, T3 in maternal blood and cord blood of the newborns were 26.31 ng/mL, 31.92 ng/mL, 35.62 ng/mL, and 19.77 ng/mL, respectively. Neonatal 25(OH)D level in cord blood was positively correlated with maternal serum 25(OH)D levels at each trimester, and the strongest correlation was found at time point T3. CONCLUSION Maternal 25(OH)D concentrations at each trimester were positively associated with neonatal VitD status in cord blood, and the strongest correlation was found in the late stage of pregnancy, which could be considered as a sensitive time window. Attention should be paid to the nutritional status of VitD during pregnancy to better prevent the VitD deficiency in neonates.
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Jin D, Zhu DM, Hu HL, Yao MN, Yin WJ, Tao RX, Zhu P. Vitamin D status affects the relationship between lipid profile and high-sensitivity C-reactive protein. Nutr Metab (Lond) 2020; 17:57. [PMID: 32684941 PMCID: PMC7359462 DOI: 10.1186/s12986-020-00455-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Accepted: 05/07/2020] [Indexed: 12/18/2022] Open
Abstract
Background The biological pathways through which vitamin D is involved in the regulation of systemic inflammation remain largely unknown. Objective The objective of this study was to evaluate the role of vitamin D status on the relationship between lipid profile and high-sensitivity C-reactive protein (hs-CRP) in pregnant women. Design Serum 25-hydroxyvitamin D (25(OH)D), hs-CRP, and indicators of lipid profiles (total cholesterol, TC; triglyceride, TG; high-density lipoprotein cholesterol, HDL-C; low-density lipoprotein cholesterol, LDL-C), were measured in 2479 pregnant women during the second trimester. Potential confounding including maternal sociodemographic characteristics, perinatal health status, diet, and lifestyle was prospectively collected. Multiple regression models and cubic models were used to evaluate the associations. Results There was a significant non-linear relationship between lipid profile (TC, TG, HDL-C, LDL-C) and hs-CRP (P < 0.05). Increased serum 25(OH)D was significantly associated with decreasing TC, TG, HDL-C, LDL-C, and hs-CRP levels. Compared with medium levels of lipids group, pregnant women with higher levels of TC or TG have higher levels of hs-CRP, and pregnant women with lower levels of TC, HDL-C or LDL-C also have higher levels of hs-CRP in the vitamin D deficient group, and there was a significant correlation between low levels of TG and decreased hs-CRP (adjusted β for TG: -0.063, 95%CI: − 0.120,-0.007) in the non-vitamin D deficient group. Mediators that had appreciable shares of the associations between 25(OH)D and hs-CRP was TG (10.2% of the association; β = − 0.011; total indirect effect: 95% CI: − 0.019, − 0.002). The cubic model suggested that a steep increase in the adjusted regression coefficient of lipid with hs-CRP up to 50 nmol/L of 25(OH)D, and the highest adjusted regression coefficients were observed in pregnant women with 25(OH)D above 50 nmol/L. Conclusion Our findings suggest that high levels of vitamin D during pregnancy may improve lipid profile levels and inhibit elevated hs-CRP induced by high lipid metabolism.
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Affiliation(s)
- Dan Jin
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China.,MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China.,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Medical University, Hefei, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China
| | - Dao-Min Zhu
- Department of Sleep Disorders, Hefei Fourth People's Hospital, Hefei, China
| | - Hong-Lin Hu
- Department of Endocrinology, the First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Meng-Nan Yao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China.,MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China.,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Medical University, Hefei, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China
| | - Wan-Jun Yin
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China.,MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China.,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Medical University, Hefei, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China
| | - Rui-Xue Tao
- Department of Gynecology and Obstetrics, Hefei First People's Hospital, Hefei, China
| | - Peng Zhu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China.,MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China.,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Medical University, Hefei, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China
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Li H, Ma J, Huang R, Wen Y, Liu G, Xuan M, Yang L, Yang J, Song L. Prevalence of vitamin D deficiency in the pregnant women: an observational study in Shanghai, China. ACTA ACUST UNITED AC 2020; 78:31. [PMID: 32518650 PMCID: PMC7271532 DOI: 10.1186/s13690-020-00414-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Accepted: 03/24/2020] [Indexed: 12/24/2022]
Abstract
Background Maternal vitamin D deficiency has been a worldwide concern in recent years. However the epidemiological data of vitamin D deficiency among large group of Chinese pregnant women is limited. This study is to evaluate the prevalence of vitamin D deficiency among pregnant women in Shanghai, China and to analyze the association of vitamin D status with some pregnancy outcomes (gestational diabetes and low birth weight). Methods A total of 34,417 pregnant women in Shanghai were included in this study from January 2014 to December 2017, and the serum 25-hydroxyvitamin D [25(OH)D] concentrations were measured at 16th week of gestation by electrochemiluminescence assay. Seventy five grams of glucose was used to conduct oral glucose tolerance test during 24-28th week of gestational in all enrolled persons and the birth weight of newborns was recorded. Results The median serum 25(OH) D concentration in the pregnant women during 4 years was 42.87 nmol/L (32.88–51.90 nmol/L). 9.9% of the population were severe vitamin D deficient [25(OH)D < 25 nmol/L], 60.1% were deficient [25 nmol/L ≤ 25(OH)D < 50 nmol/L], 28.4% were insufficient [50 nmol/L ≤ 25(OH)D < 75 nmol/L] and only 1.6% of the enrolled population reached the level of adequate [25(OH)D ≥ 75 nmol/L]. Serum 25(OH) D concentrations showed significant difference among seasons with the highest level in winter and the lowest level in summer. Women with advanced maternal age were more likely to have better vitamin D status compared with younger women. The 25(OH) D levels were significantly different among 2014–2017. The year of 2017 had the highest 25(OH) D level with the median serum concentration reaching 47.80 nmol/L (41.00–55.00 nmol/L), while the lowest appeared in 2016 which has median 25(OH) D concentration at 38.87 nmol/L (28.76–49.97 nmol/L). No relations were found between the 25(OH) D status and the rate of gestational diabetes or low birth weight of newborns. Conclusion Pregnant women in Shanghai were generally deficient in vitamin D status and the level of vitamin D was related to season and age. No evidence showed vitamin D deficiency in pregnant women contributes to the rate of gestational diabetes or low birth weight of newborns in this study. These results suggest that most of the pregnant women may need vitamin D supplementation to achieve adequate vitamin D level.
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Affiliation(s)
- Huijuan Li
- Department of Endocrinology, Tongji Hospital, Tongji University School of Medicine, Shanghai, 200065 China
| | - Jing Ma
- Department of Endocrinology, Tongji Hospital, Tongji University School of Medicine, Shanghai, 200065 China
| | - Runzhi Huang
- Division of Spine, Department of Orthopedics, Tongji Hospital affiliated to Tongji University School of Medicine, Shanghai, 200065 China.,Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration (Tongji University) Ministry of Education, Shanghai, 200065 China
| | - Yuhua Wen
- Department of Endocrinology, Tongji Hospital, Tongji University School of Medicine, Shanghai, 200065 China
| | - Guanghui Liu
- Department of Endocrinology, Tongji Hospital, Tongji University School of Medicine, Shanghai, 200065 China
| | - Miao Xuan
- Department of Endocrinology, Tongji Hospital, Tongji University School of Medicine, Shanghai, 200065 China
| | - Ling Yang
- Shanghai Changning District Maternal and Child Health Hospital, Shanghai, 200065 China
| | - Jun Yang
- Tongji Hospital, Tongji University School of Medicine, Shanghai, 200092 China
| | - Lige Song
- Department of Endocrinology, Tongji Hospital, Tongji University School of Medicine, Shanghai, 200065 China
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Rizzo G, Garzon S, Fichera M, Panella MM, Catena U, Schiattarella A, de Franciscis P, Vilos G, Tesarik J, Török P, Grosso G. Vitamin D and Gestational Diabetes Mellitus: Is There a Link? Antioxidants (Basel) 2019; 8:E511. [PMID: 31731439 PMCID: PMC6912234 DOI: 10.3390/antiox8110511] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Revised: 09/29/2019] [Accepted: 10/21/2019] [Indexed: 12/25/2022] Open
Abstract
Gestational diabetes mellitus (GDM) is a very common condition among pregnant women worldwide with important metabolic implications on the mother and the offspring. Vitamin D status has been suggested to potentially play a role in GDM risk with no documented consequences for the offspring. The purpose of this article was to review currently available evidence on the relationship between vitamin D and GDM. Current evidence shows an association between vitamin D blood levels and risk of GDM, despite heterogeneity of results across studies limit the conclusions. Moreover, data from randomized controlled trials is scarce and resulting in null findings. Among the limitations to be noted, improving the standardization of dosages, the characteristics of individuals in the sample, and the appropriate outcome measurement could provide a more effective approach in understanding the relationship between vitamin D and GDM. In conclusions, despite observational studies may suggest that adequate vitamin D levels may decrease the risk of GDM compared to deficiency status, evidence from clinical trials is inadequate to draft any definitive conclusion regarding its supplementation. Future better designed randomized clinical trials taking into account a more integrated approach could provide clearer and definitive data on the outcomes of such a multifactorial condition.
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Affiliation(s)
| | - Simone Garzon
- Department of Obstetrics and Gynecology, “Filippo del Ponte” Hospital, University of Insubria, 21100 Varese, Italy;
| | - Michele Fichera
- Department of General Surgery and Medical Surgical Specialties, University of Catania, 95124 Catania, Italy; (M.F.); (M.M.P.)
| | - Marco Marzio Panella
- Department of General Surgery and Medical Surgical Specialties, University of Catania, 95124 Catania, Italy; (M.F.); (M.M.P.)
| | - Ursula Catena
- Division of Gynecologic Oncology, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, 00168 Rome, Italy;
| | - Antonio Schiattarella
- Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, 81100 Naples, Italy; (A.S.); (P.d.F.)
| | - Pasquale de Franciscis
- Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, 81100 Naples, Italy; (A.S.); (P.d.F.)
| | - George Vilos
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Western University, London, ON N6H5W9, Canada;
| | | | - Péter Török
- Faculty of Medicine, Institute of Obstetrics and Gynaecology, University of Debrecen, H-4032 Debrecen, Hungary;
| | - Giuseppe Grosso
- Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy
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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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van der Pligt P, Willcox J, Szymlek-Gay EA, Murray E, Worsley A, Daly RM. Associations of Maternal Vitamin D Deficiency with Pregnancy and Neonatal Complications in Developing Countries: A Systematic Review. Nutrients 2018; 10:E640. [PMID: 29783717 PMCID: PMC5986519 DOI: 10.3390/nu10050640] [Citation(s) in RCA: 63] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 04/16/2018] [Accepted: 05/12/2018] [Indexed: 01/01/2023] Open
Abstract
Pregnant women in Asia, the Middle East, Africa and Latin America are at risk of vitamin D deficiency (VDD) and prevalence throughout these regions are among the highest, globally. Maternal VDD has been associated with increased risk of a number of adverse maternal and neonatal health outcomes, yet research from developing countries is limited. We assessed the associations of maternal VDD during pregnancy with adverse health outcomes by synthesizing the literature from observational studies conducted in developing countries. Six electronic databases were searched for English-language studies published between 2000 and 2017. Thirteen studies from seven countries were included in the review. Prevalence of VDD ranged from 51.3% to 100%. Six studies assessed both maternal and neonatal outcomes, four studies assessed only maternal outcomes and three studies assessed only neonatal outcomes. Ten studies showed at least one significant association between VDD and adverse maternal and/or neonatal health outcomes including pre-eclampsia (n = 3), gestational diabetes mellitus (n = 1), postpartum depression (n = 1), emergency cesarean section delivery (n = 1), low birth weight babies (n = 4), small for gestational age (n = 2), stunting (n = 1). However most of these studies (n = 6) also showed no association with multiple health outcomes. Vitamin D assessment methods, criteria applied to define VDD, season and trimester in which studies were conducted varied considerably across studies. In conclusion, this study highlights the need to improve maternal vitamin D status in developing countries in an effort to support best maternal and child health outcomes across these regions. Future research should focus on more unified approaches to vitamin D assessment and preventative approaches that may be embedded into already existing antenatal care settings.
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Affiliation(s)
- Paige van der Pligt
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong 3220, Australia.
| | - Jane Willcox
- School of Exercise and Nutrition Sciences, Deakin University, Burwood 3125, Australia.
- School of Allied Health, College of Science, Health and Engineering, La Trobe University, Bundoora 3083, Australia.
| | - Ewa A Szymlek-Gay
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong 3220, Australia.
| | - Emily Murray
- School of Exercise and Nutrition Sciences, Deakin University, Burwood 3125, Australia.
| | - Anthony Worsley
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong 3220, Australia.
| | - Robin M Daly
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong 3220, Australia.
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The effect of maternal vitamin D deficiency during pregnancy on body fat and adipogenesis in rat offspring. Sci Rep 2018; 8:365. [PMID: 29321608 PMCID: PMC5762667 DOI: 10.1038/s41598-017-18770-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Accepted: 12/18/2017] [Indexed: 12/12/2022] Open
Abstract
To evaluate the effects of maternal vitamin D deficiency on body fat and adipogenesis in offspring rats, and explore the potential mechanism, we constructed a vitamin D deficient rat model and performed metabolic activity evaluation, body fat monitoring, biochemical analysis, adipogenesis assay, methylation microarray and RNA-seq for their offspring rats. We found the weight of vitamin D deficient (VDD) offspring was gradually higher than that of control (CLT) offspring, and the difference was significant since 10 weeks old. When compared with CTL offspring, the 24 h heat production, peak blood glucose, adipose tissue volume and blood lipid indexes were significantly increased in VDD offspring at 14 weeks old. Moreover, a significant increase in proliferation rate and number of lipid droplets for pre-adipocytes was also observed in VDD offspring group. DNA methylation profiling showed that compared to CTL group, 608 promoters and 204 CpG islands were differentially methylated in the VDD group, involving 305 genes. When combined with the results of RNA-seq, 141 genes of the methylated genes were differentially expressed. In conclusion, vitamin D deficiency during pregnancy may promote the proliferation and differentiation of pre-adipocytes, which may be associated with methylation alterations of genes, ultimately leading to offspring obesity.
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Liu C, Chen Z, Li W, Huang L, Zhang Y. Vitamin D Enhances Alveolar Development in Antenatal Lipopolysaccharide-Treated Rats through the Suppression of Interferon-γ Production. Front Immunol 2018; 8:1923. [PMID: 29354129 PMCID: PMC5760506 DOI: 10.3389/fimmu.2017.01923] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Accepted: 12/15/2017] [Indexed: 12/12/2022] Open
Abstract
Bronchopulmonary dysplasia (BPD) is characterized by the premature arrest of alveolar development. Antenatal exposure to inflammation inhibits lung morphogenesis, thereby increasing the risk for the development of BPD. Here, we investigated whether vitamin D (VitD) enhances alveolar development in antenatal lipopolysaccharide (LPS)-treated rats, which is a model for BPD. We used an established animal model of BPD, and random assignment to the control group, LPS group, or LPS with VitD group. Levels of interferon (IFN)-γ and interleukin-4 were detected by real-time polymerase chain reaction (PCR) and enzyme-linked immunosorbent assay. IFN-γ producing CD8+ T cells were assessed by flow cytometry, and the methylation status of the VitD-response element (VDRE) was analyzed by bisulfite sequencing PCR. 25-hydroxyvitamin D levels were measured by liquid chromatography tandem mass spectrometry in maternal serum samples collected from 86 pregnant women in a prospective birth cohort enrolled from 2012 to 2013. Our results showed that VitD effectively alleviated the simplification of the lung alveolar structure in BPD rats and suppressed LPS-induced IFN-γ expression in the lung and spleen tissues. Further investigation revealed that VitD suppressed IFN-γ production in CD8+ T cells. Specifically, VitD increased the methylation percentage of the VDRE in the IFN-γ-promoter region and suppressed LPS-induced expression of IFN-γ. Additionally, we observed an association between maternal VitD exposure during pregnancy and neonatal IFN-γ levels in a prospective birth cohort, with a trend similar to that observed in the animal model. Our data suggested that supplementation of VitD could suppress IFN-γ production, resulting in improved alveolar development in an LPS-induced BPD rat model.
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Affiliation(s)
- Chengbo Liu
- Department of Neonatology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Ze Chen
- Department of Neonatology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Wen Li
- Department of Neonatology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Lisu Huang
- Department of Neonatology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.,MOE and Shanghai Key Laboratory of Children's Environmental Health, Shanghai, China
| | - Yongjun Zhang
- Department of Neonatology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.,MOE and Shanghai Key Laboratory of Children's Environmental Health, Shanghai, China
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Tao RX, Meng DH, Li JJ, Tong SL, Hao JH, Huang K, Tao FB, Zhu P. Current Recommended Vitamin D Prenatal Supplementation and Fetal Growth: Results From the China-Anhui Birth Cohort Study. J Clin Endocrinol Metab 2018; 103:244-252. [PMID: 29096022 DOI: 10.1210/jc.2017-00850] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Accepted: 10/23/2017] [Indexed: 02/13/2023]
Abstract
CONTEXT Maternal vitamin D insufficiency has been associated with fetal growth restriction. However, the effect of maternal vitamin D supplementation on fetal growth has not been confirmed. OBJECTIVE To assess the effect of maternal vitamin D supplementation recommended by the Institute of Medicine (IOM) during pregnancy on the neonatal vitamin D status and the risk of small for gestational age (SGA). DESIGN AND PARTICIPANTS As part of the China-Anhui Birth Cohort study, maternal sociodemographic characteristics, food intake, lifestyle, information on vitamin D supplementation, and birth outcomes were prospectively collected. For participants, 600 IU/d of vitamin D3 was routinely advised to take during pregnancy. Cord blood levels of 25-hydroxyvitamin D [25(OH)D], calcium, and phosphorus were measured in 1491 neonates who were divided into three groups based on the duration of maternal vitamin D supplementation during pregnancy. RESULTS Mean cord blood concentrations of 25(OH)D were 3.5 nmol/L higher [95% confidence interval (CI), 0.8, 6.2] in neonates (median, 37.9 nmol/L) whose mother took vitamin D supplementation for >2 months during pregnancy compared with those (median, 34.3 nmol/L) whose mother did not take any supplement. These significant differences on cord blood concentrations of 25(OH)D occurred regardless of the season of birth. The adjusted risk of SGA in pregnant women with vitamin D supplementation for >2 months was significantly decreased than that in women without any vitamin D supplementation (11.8% vs 6.9%; adjusted odds ratio = 0.53; 95% CI, 0.32, 0.87). CONCLUSIONS The findings from China suggest that maternal vitamin D supplementation recommended by the IOM results in a slight but significantly higher fetal level of 25(OH)D and improves fetal growth.
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Affiliation(s)
- Rui-Xue Tao
- Department of Gynecology and Obstetrics, The Third Affiliated Hospital of Anhui Medical University, Hefei, China
- Hefei First People's Hospital, Hefei, China
| | - Deng-Hon Meng
- Department of Maternal, Child, and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
| | - Jing-Jing Li
- Department of Maternal, Child, and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
| | - Shi-Lu Tong
- Department of Maternal, Child, and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
- School of Public Health and Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia
| | - Jia-Hu Hao
- Department of Maternal, Child, and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
- Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China
| | - Kun Huang
- Department of Maternal, Child, and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
- Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China
| | - Fang-Biao Tao
- Department of Maternal, Child, and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
- Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China
| | - Peng Zhu
- Department of Maternal, Child, and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
- Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China
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Vosoughi A, Aliasgarzadeh A, Bahrami A, Abbasalizadeh F, Niafar M, Najafipour F, Aghamohammadzadeh N, Nikniaz Z. Concentration of Maternal Serum 25-Hydroxy Vitamin D and Gestational 2 Diabetes Mellitus Risk. PHARMACEUTICAL SCIENCES 2017. [DOI: 10.15171/ps.2017.28] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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[Vitamin D level at birth and influencing factors in preterm infants]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2017; 19. [PMID: 28697835 PMCID: PMC7389922 DOI: 10.7499/j.issn.1008-8830.2017.07.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
OBJECTIVE To investigate vitamin D level at birth and possible influencing factors in preterm infants. METHODS A total of 600 preterm infants were enrolled, and venous blood samples were collected within 24 hours after birth to measure the serum level of 25-hydroxyvitamin D [25(OH)D]. The effect of sex, birth weight, birth season, gestational age, mother's age, body mass index (BMI) in early pregnancy, delivery mode, and complications during pregnancy on serum 25(OH)D level was analyzed. RESULTS The rates of vitamin D deficiency, insufficiency, and sufficiency were 42.0%, 38.7%, and 19.3% respectively. The preterm infants born in summer and autumn had a significantly higher serum 25(OH)D level than those born in winter (P<0.05) and a significantly lower incidence rate of vitamin D deficiency than those born in spring and winter (P<0.003). Compared with those whose mothers were aged <30 years, the infants whose mothers were aged ≥30 years had a significantly higher serum 25(OH)D level (P<0.05) and a significantly lower incidence rate of vitamin D deficiency (P<0.017). Compared with those whose mothers were overweight or had normal body weight, the infants whose mothers were obese had a significantly lower serum 25(OH)D level (P<0.05) and a significantly higher incidence rate of vitamin D deficiency (P<0.006). Compared with those whose mothers had no preeclampsia, the infants whose mothers had preeclampsia during pregnancy had a significantly lower serum 25(OH)D level (P<0.05) and a significantly higher incidence rate of vitamin D deficiency (P<0.017). The multivariate analysis showed that birth in winter and spring, mother's age <30 years, and early-pregnancy BMI ≥28 kg/m2 were risk factors for vitamin D deficiency (P<0.05). CONCLUSIONS There is a high prevalence of vitamin D deficiency in preterm infants. Vitamin D supplementation should be given to the preterm infants with high-risk factors for vitamin D deficiency.
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Zhou P, Hu J, Xi P, Zhang N, Yang B, Zheng J, Wang X. Survey on the levels of 25-hydroxy vitamin D and bone metabolic markers and evaluation of their correlations with osteoporosis in perimenopausal woman in Xi'an region. PLoS One 2017; 12:e0180366. [PMID: 28686649 PMCID: PMC5501542 DOI: 10.1371/journal.pone.0180366] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2016] [Accepted: 06/14/2017] [Indexed: 12/30/2022] Open
Abstract
It has been accepted that vitamin D (VD) plays an important role in bone metabolism. However, the levels of VD in people of different regions are quite different and there is still no final conclusion on the significant correlation between VD and osteoporosis. 245 cases of peri-menopausal women were collected to study the relationship between VD and osteoporosis in western China. The mean value of 25-hydroxyvitamin D for the participants was 14.39 ng/mL. The average values of parathyroid hormone (PTH), calcium (Ca) and phosphorus (P) were 47.62 pg/mL, 2.26 mmol/L and 1.18 mmol/L, respectively. The average value of bone mineral density (BMD) in lumbar vertebrae was -1.20 SD and that in femoral neck was -0.04 SD. Compared with normal group, PTH of VD deficiency group was significantly increased (P < 0.05), Ca was remarkably decreased (P < 0.01) while the BMD between these two groups showed no significant difference (P > 0.05). VD was in positive correlation with the age (P < 0.01) and Ca (< 0.01) of the participants, negative correlation with PTH (P < 0.01) while no significant correlation with the BMD of lumbar vertebrae and femoral neck (P > 0.05). The risk factors resulting in the occurrence of osteoporosis in the lumbar vertebrae of the participants covered Ca increase (OR = 66.247, P<0.05), age growth (OR = 1.194, P<0.01) and menopause (OR = 2.285, P<0.05). This study has found that the status of VD deficiency showed no significant correlation with the level of BMD, which hinted that independent measurement of the bone metabolic markers, including Ca, P, VD and PTH, was difficult to accurately reflect the status of BMD in peri-menopausal women of this region. It's necessary to combine multi-site bone scanning to diagnose the patients' status of osteoporosis so as to provide reasonable guidance for early clinical prevention and treatment.
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Affiliation(s)
- Ping Zhou
- The Laboratory Department of Xi'an Jiaotong University Medical College First Affiliated Hospital, Xi'an, Shaanxi, China
| | - Jian Hu
- The Laboratory Department of Xi'an Jiaotong University Medical College First Affiliated Hospital, Xi'an, Shaanxi, China
| | - Ping Xi
- The Endocrinology Department of Xi'an Jiaotong University Medical College First Affiliated Hospital, Xi'an, Shaanxi, China
| | - Ning Zhang
- The Laboratory Department of Xi'an Jiaotong University Medical College First Affiliated Hospital, Xi'an, Shaanxi, China
| | - Bo Yang
- The Laboratory Department of Xi'an Jiaotong University Medical College First Affiliated Hospital, Xi'an, Shaanxi, China
| | - Jie Zheng
- The Clinical Research Center of Xi'an Jiaotong University Medical College First Affiliated Hospital, Xi'an, Shaanxi, China
| | - Xiaoqin Wang
- The Laboratory Department of Xi'an Jiaotong University Medical College First Affiliated Hospital, Xi'an, Shaanxi, China
- * E-mail:
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Loudyi FM, Kassouati J, Kabiri M, Chahid N, Kharbach A, Aguenaou H, Barkat A. Vitamin D status in Moroccan pregnant women and newborns: reports of 102 cases. Pan Afr Med J 2016; 24:170. [PMID: 27795767 PMCID: PMC5072868 DOI: 10.11604/pamj.2016.24.170.4782] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2014] [Accepted: 01/08/2016] [Indexed: 01/08/2023] Open
Abstract
Introduction Vitamin D insufficiency to pregnant women has been associated with a number of adverse consequences, and has been recognized as a public health concern. The aim of this study was to evaluate vitamin D status of Morrocan pregnant women and their newborns. Our study is being the first of its kind in Morocco, as it supports the program of systematic supplementation of pregnant women in the third quarter. Its results have established a new program for the fight against the deficit of various nutrients, thereby intake of vitamin D has become routine. So this work is a true example of action research. Methods It’s an observational and a cross sectional study. The data was collected prospectively from the 1st January to 31 December 2012 in the labor room of the Souissi maternity hospital, at the Ibn Sina university center of Rabat in Morocco. Women included were consented to participate in the study. Data on epidemiological, sociodemographic and clinical characteristics was recolted by interview, physical exam and biochemistry parameters. Hypovitaminosis D is defined as serum level of vitamin D ≤ 50 nmol/l (20 ng/ml). Results Our study included 102 cases of mother-newborn pairs. The average age of mothers was 28.3 +/- 6.7 years (range 17-43 years), 90.1% of women enrolled had a hypovitaminosis D, the average weight of newborns was 3377.9 +/- 509g (2270 - 4880g). Hypovitaminosis D is not correlated with the origin, season, body mass index, birth interval and birth weight. It was positively correlated with maternal serum calcium (p=0.000). Conclusion The maternal hypovitaminosis D is real public health problem. The prevention is necessary, by the systematic vitamin D supplementation for pregnant women.
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Affiliation(s)
- Fouzia Mnebhi Loudyi
- Research unit for mother & Child Health and Nutrition, Faculty of Medicine and Pharmacy, University of Mohammed V, Rabat, Morocco; National Referral Center of Neonatology and Nutrition, Ibn Sina University Hospital, Rabat, Morocco
| | - Jalal Kassouati
- Laboratory of Biostatistics and Epidemiological Research, Rabat, Morocco
| | - Meryem Kabiri
- Laboratory of Biostatistics and Epidemiological Research, Rabat, Morocco
| | - Naima Chahid
- Laboratory of Biostatistics and Epidemiological Research, Rabat, Morocco
| | - Aicha Kharbach
- Maternity of Rabat, Rabat, Morocco; Unité Mixte de Recherche en Nutrition et Alimentation URAC 39, Université Ibn Tofail-CNESTEN, RDC-Nutrition AFRA/AIEA, Morocco
| | - Hassan Aguenaou
- Maternity of Rabat, Rabat, Morocco; Unité Mixte de Recherche en Nutrition et Alimentation URAC 39, Université Ibn Tofail-CNESTEN, RDC-Nutrition AFRA/AIEA, Morocco
| | - Amina Barkat
- Laboratory of Biostatistics and Epidemiological Research, Rabat, Morocco
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El-Sagheer GM, Kasem A, Shawky IM, Abdel-Fadeel A. Vitamin D Deficiency and Gestational Diabetes Mellitus in Egyptian Women. ACTA ACUST UNITED AC 2016. [DOI: 10.4236/ojemd.2016.62015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Abstract
OBJECTIVE To evaluate vitamin D deficiency prevalence and risk factors among pregnant Chinese women. DESIGN A descriptive cross-sectional analysis. SETTING China National Nutrition and Health Survey (CNNHS) 2010-2013. SUBJECTS A total of 1985 healthy pregnant women participated. Possible predictors of vitamin D deficiency were evaluated via multiple logistic regression analyses. RESULTS The median serum 25-hydroxyvitamin D level was 15·5 (interquartile range 11·9-20·0, range 3·0-51·5) ng/ml, with 74·9 (95 % CI 73·0, 76·7) % of participants being vitamin D deficient (25-hydroxyvitamin D <20 ng/ml). According to the multivariate logistic regression analyses, vitamin D deficiency was positively correlated with Hui ethnicity (P=0·016), lack of vitamin D supplement use (P=0·021) and low ambient UVB level (P<0·001). In the autumn months, vitamin D deficiency was related to Hui ethnicity (P=0·012) and low ambient UVB level (P<0·001). In the winter months, vitamin D deficiency was correlated with younger age (P=0·050), later gestational age (P=0·035), higher pre-pregnancy BMI (P=0·019), low ambient UVB level (P<0·001) and lack of vitamin D supplement use (P=0·007). CONCLUSIONS Vitamin D deficiency is prevalent among pregnant Chinese women. Residing in areas with low ambient UVB levels increases the risk of vitamin D deficiency, especially for women experiencing advanced stages of gestation, for younger pregnant women and for women of Hui ethnicity; therefore, vitamin D supplementation and sensible sun exposure should be encouraged, especially in the winter months. Further studies must determine optimal vitamin D intake and sun exposure levels for maintaining sufficient vitamin D levels in pregnant Chinese women.
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Vitamin D Deficiency Increases the Risk of Gestational Diabetes Mellitus: A Meta-Analysis of Observational Studies. Nutrients 2015; 7:8366-75. [PMID: 26437429 PMCID: PMC4632418 DOI: 10.3390/nu7105398] [Citation(s) in RCA: 98] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Revised: 09/20/2015] [Accepted: 09/23/2015] [Indexed: 02/07/2023] Open
Abstract
The results investigating the relationship between vitamin D levels and gestational diabetes mellitus (GDM) are inconsistent. Thus, we focused on evaluating the association of vitamin D deficiency with GDM by conducting a meta-analysis of observed studies. A systematic literature search was conducted via PubMed, MEDLINE, and Cochrane library to identify eligible studies before August 2015. The meta-analysis of 20 studies including 9209 participants showed that women with vitamin D deficiency experienced a significantly increased risk for developing GDM (odds ratio (OR) = 1.53; 95% confidence intervals (CI), 1.33, 1.75) with a little heterogeneity (I2 = 16.20%, p = 0.252). A noteworthy decrease of 4.93 nmol/L (95% CI, −6.73, −3.14) in serum 25(OH)D was demonstrated in the participants with GDM, and moderate heterogeneity was observed (I2 = 61.40%, p = 0.001). Subgroup analysis with study design showed that there were obvious heterogeneities in nested case–control studies (I2 > 52.5%, p < 0.07). Sensitivity analysis showed that exclusion of any single study did not materially alter the overall combined effect. In summary, the evidence from this meta-analysis indicates a consistent association between vitamin D deficiency and an increased risk of GDM. However, well-designed randomized controlled trials are needed to elicit the clear effect of vitamin D supplementation on prevention of GDM.
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Yang N, Wang L, Li Z, Chen S, Li N, Ye R. Effects of vitamin D supplementation during pregnancy on neonatal vitamin D and calcium concentrations: a systematic review and meta-analysis. Nutr Res 2015; 35:547-56. [DOI: 10.1016/j.nutres.2015.04.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Revised: 04/08/2015] [Accepted: 04/14/2015] [Indexed: 12/11/2022]
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Xiao JP, Zang J, Pei JJ, Xu F, Zhu Y, Liao XP. Low maternal vitamin D status during the second trimester of pregnancy: a cross-sectional study in Wuxi, China. PLoS One 2015; 10:e0117748. [PMID: 25659105 PMCID: PMC4320063 DOI: 10.1371/journal.pone.0117748] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Accepted: 12/30/2014] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Vitamin D deficiency is common in pregnant women, but an optimal serum vitamin D level during pregnancy has not been determined and remains an area of active research. Vitamin D data from large populations of pregnant Chinese women are still limited. OBJECTIVE To evaluate the vitamin D status of women in Eastern China during the second trimester of pregnancy. METHODS A hospital-based, cross-sectional, observational study. Serum 25-hydroxyvitamin D [25(OH)D] concentration was measured in samples from 5823 pregnant women in Wuxi City, China (latitude: 31.5o N), from January 2011 to June 2012. RESULTS The median serum 25(OH)D concentration was 34.0 nmol/L [2.5 nmol/L 25(OH)D = 1 ng/mL 25(OH)D]. Vitamin D deficiency [defined as 25(OH)D < 30 nmol/L according to the Institute of Medicine (National Academy of Sciences, Washington, D.C., USA)] or inadequacy [25(OH)D of 30-49.9 nmol/L] was identified in 40.7% and 38.0% of the women, respectively. Only 0.9% had a 25(OH)D level ≥ 80.0 nmol/L, which is the concentration recommended as adequate by the Endocrine Society (Washington, D.C., USA). Compared with older women, younger women were more likely to be deficient in vitamin D. There were significant differences in the 25(OH)D levels according to season. The 25(OH)D levels reached peak values in September and were correlated with (r = 0.337, P < 0.001), and fluctuated with, average monthly air temperatures. CONCLUSIONS There is a high prevalence of Vitamin D deficiency among pregnant Chinese women, and 25(OH)D levels varied according to season and air temperature. The results of this study also suggest that currently there is a big gap between the levels of Vitamin D detected in pregnant Chinese women and the levels recommended by the Endocrine Society.
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Affiliation(s)
- Jian-Ping Xiao
- Department of Obstetrics, Wuxi Maternity and Child Health Hospital, Nanjing Medical University, Jiangsu, China
- Perinatal Biology Center, Soochow University School of Medicine, Jiangsu, China
| | - Jia Zang
- Central Laboratory, Wuxi Maternity and Child Health Hospital, Nanjing Medical University, Jiangsu, China
| | - Jing-Jing Pei
- Department of Health Care, Wuxi Maternity and Child Health Hospital, Nanjing Medical University, Jiangsu, China
| | - Fei Xu
- Central Laboratory, Wuxi Maternity and Child Health Hospital, Nanjing Medical University, Jiangsu, China
| | - Yan Zhu
- Department of Obstetrics, Wuxi Maternity and Child Health Hospital, Nanjing Medical University, Jiangsu, China
| | - Xiang-Peng Liao
- Department of Newborn, Wuxi Maternity and Child Health Hospital, Nanjing Medical University, Jiangsu, China
- Department of Obstetrics and Gynecology, Sherbrooke University Hospital Center, Sherbrooke, Canada
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Vitamin D status and related factors in newborns in Shanghai, China. Nutrients 2014; 6:5600-10. [PMID: 25486368 PMCID: PMC4276986 DOI: 10.3390/nu6125600] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2014] [Revised: 11/11/2014] [Accepted: 11/20/2014] [Indexed: 11/17/2022] Open
Abstract
With the increasing recognition of the importance of the non-skeletal effects of vitamin D (VitD), more and more attention has been drawn to VitD status in early life. However, the VitD status of newborns and factors that influence VitD levels in Shanghai, China, remain unclear. A total of 1030 pregnant women were selected from two hospitals in Shanghai, one of the largest cities in China located at 31 degrees north latitude. Umbilical cord serum concentrations of 25-hydroxy vitamin D [25(OH)D] were measured by LC-MS-MS, and questionnaires were used to collect information. The median cord serum 25(OH)D concentration was 22.4 ng/mL; the concentration lower than 20 ng/mL accounted for 36.3% of the participants, and the concentration lower than 30 ng/mL for 84.1%. A multivariable logistic regression model showed that the determinants of low 25(OH)D status were being born during autumn or winter months and a lack of VitD-related multivitamin supplementation. The relative risk was 1.7 for both autumn (95% CI, 1.1-2.6) and winter (95% CI, 1.1-2.5) births (p < 0.05). VitD-related multivitamin supplementation more than once a day during pregnancy reduced the risk of VitD deficiency [adjusted OR (aOR) = 0.6, 95% CI (0.45-1.0) for VitD supplementation] (p < 0.05). VitD deficiency and insufficiency are common in newborns in Shanghai, China, and are independently associated with season and VitD supplementation. Our findings may assist future efforts to correct low levels of 25(OH)D in Shanghai mothers and their newborn children.
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Palacios C, Gonzalez L. Is vitamin D deficiency a major global public health problem? J Steroid Biochem Mol Biol 2014; 144 Pt A:138-45. [PMID: 24239505 PMCID: PMC4018438 DOI: 10.1016/j.jsbmb.2013.11.003] [Citation(s) in RCA: 721] [Impact Index Per Article: 72.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Revised: 09/17/2013] [Accepted: 11/05/2013] [Indexed: 12/26/2022]
Abstract
Vitamin D deficiency is a major public health problem worldwide in all age groups, even in those residing in countries with low latitude, where it was generally assumed that UV radiation was adequate enough to prevent this deficiency, and in industrialized countries, where vitamin D fortification has been implemented now for years. However, most countries are still lacking data, particularly population representative data, with very limited information in infants, children, adolescents and pregnant women. Since the number of recent publications is escalating, with a broadening of the geographic diversity, the objective of the present report was to conduct a more recent systematic review of global vitamin D status, with particular emphasis in at risk groups. A systematic review was conducted in PubMed/Medline in April-June 2013 to identify articles on vitamin D status worldwide published in the last 10 years in apparently healthy individuals. Only studies with vitamin D status prevalence were included. If available, the first source selected was population-based or representative samples studies. Clinical trials, case-control studies, case reports or series, reviews, validation studies, letters, editorials, or qualitative studies were excluded. A total of 103 articles were eligible and included in the present report. Maps were created for each age group, providing an updated overview of global vitamin D status. In areas with available data, the prevalence of low vitamin D status is a global problem in all age groups, in particular in girls and women from the Middle East. These maps also evidenced the regions with missing data for each specific population groups. There is striking lack of data in infants, children and adolescents worldwide, and in most countries of South America and Africa. In conclusion, vitamin D deficiency is a global public health problem in all age groups, particularly in those from the Middle East. This article is part of a Special Issue entitled '16th Vitamin D Workshop'.
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Affiliation(s)
- Cristina Palacios
- Nutrition Program, School of Public Health, Medical Sciences Campus, University of Puerto Rico, San Juan 00935, Puerto Rico.
| | - Lilliana Gonzalez
- Nutrition Program, School of Public Health, Medical Sciences Campus, University of Puerto Rico, San Juan 00935, Puerto Rico
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Associations between 25-hydroxyvitamin D levels and pregnancy outcomes: a prospective observational study in southern China. Eur J Clin Nutr 2014; 68:925-30. [PMID: 24865483 DOI: 10.1038/ejcn.2014.99] [Citation(s) in RCA: 100] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2013] [Revised: 04/10/2014] [Accepted: 04/13/2014] [Indexed: 01/18/2023]
Abstract
BACKGROUND/OBJECTIVES Observational studies relating 25-hydroxyvitamin D (25(OH)D) and pregnancy outcomes have reported conflicting results. The aim was to assess maternal 25(OH)D status and its association with pregnancy outcomes. A prospective observational study was carried out in Guangzhou city (23 ºN), China. SUBJECTS/METHODS Pregnant women (n=2960) and healthy controls (n=100) were recruited at a teaching hospital. Maternal 25(OH)D levels were measured at 16-20-week gestation. The pregnant women, if met inclusion and exclusion criteria, were enrolled in further analysis for pregnancy outcomes (n=1953). RESULTS Mean serum 25(OH)D in pregnant women was 27.03±7.92 ng/ml. In total, 18.9 and 48.6% of pregnant women had low (25(OH)D less than or equal to 20 ng/ml) and medium level (25(OH)D 21-29 ng/ml) of vitamin D, respectively. 25(OH)D was highest in summer and lowest in winter, which showed a positive correlation with temperature (R=0.942) and calcium (R=0.074). Most maternal outcomes (premature rupture of membranes break, polyhydramnios, oligohydramnios, pre-eclampsia, cesarean section), fetal outcomes (spontaneous abortions, medically induced labor, fetal death, fetal distress, fetal growth restriction) and neonatal outcomes (malformations, birth weight and height, low birth weight, macrosomia, small-for-gestational age, score of Apgar 1',5', asphyxia of newborn) were not significantly different between groups, but prevalence of gestational diabetes (adjusted odds ratio (OR) 1.017; 95% confidence interval (CI) 1.002-1.033) and preterm delivery (adjusted OR 1.038; 95% CI 1.018-1.059) in high level group (25(OH)D ⩾30 ng/ml) was higher than that in low and medium level groups. CONCLUSIONS The prevalence of low level of vitamin D (serum 25OHD ⩽20 ng/ml) was 18.9% among pregnant women in southern China. There were no significant differences in most adverse pregnancy outcomes among pregnant women with different levels of vitamin D at 16-20-week gestation except for higher prevalence of gestational diabetes and preterm delivery in women with high level of vitamin D, possibly related to the older age and higher body mass index of this group.
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Grant CC, Stewart AW, Scragg R, Milne T, Rowden J, Ekeroma A, Wall C, Mitchell EA, Crengle S, Trenholme A, Crane J, Camargo CA. Vitamin D during pregnancy and infancy and infant serum 25-hydroxyvitamin D concentration. Pediatrics 2014; 133:e143-53. [PMID: 24344104 DOI: 10.1542/peds.2013-2602] [Citation(s) in RCA: 120] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To determine the vitamin D dose necessary to achieve serum 25-hydroxyvitamin D (25(OH)D) concentration ≥ 20 ng/mL during infancy. METHODS A randomized, double-blind, placebo-controlled trial in New Zealand. Pregnant mothers, from 27 weeks' gestation to birth, and then their infants, from birth to age 6 months, were randomly assigned to 1 of 3 mother/infant groups: placebo/placebo, vitamin D3 1000/400 IU, or vitamin D3 2000/800 IU. Serum 25(OH)D and calcium concentrations were measured at enrollment, 36 weeks' gestation, in cord blood, and in infants at 2, 4, and 6 months of age. RESULTS Two-hundred-and-sixty pregnant women were randomized. At enrollment, the proportions with serum 25(OH)D ≥ 20 ng/mL for placebo, lower-dose, and higher-dose groups were 54%, 64%, and 55%, respectively. The proportion with 25(OH)D ≥ 20 ng/mL was larger in both intervention groups at 36 weeks' gestation (50%, 91%, 89%, P < .001). In comparison with placebo, the proportion of infants with 25(OH)D ≥ 20 ng/mL was larger in both intervention groups to age 4 months: cord blood (22%, 72%, 71%, P < .001), 2 months (50%, 82%, 92%, P < .001), and 4 months (66%, 87%, 87%, P = .004), but only in the higher-dose group at age 6 months (74%, 82%, 89%, P = .07; higher dose versus placebo P = .03, lower dose versus placebo P = .21). CONCLUSIONS Daily vitamin D supplementation during pregnancy and then infancy with 1000/400 IU or 2000/800 IU increases the proportion of infants with 25(OH)D ≥ 20 ng/mL, with the higher dose sustaining this increase for longer.
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Affiliation(s)
- Cameron C Grant
- MBChB, Department of Paediatrics: Child and Youth Health, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Wellesley St, Auckland 1142, New Zealand.
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Vitamin D Deficiency in Early Life and the Potential Programming of Cardiovascular Disease in Adulthood. J Cardiovasc Transl Res 2013; 6:588-603. [DOI: 10.1007/s12265-013-9475-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2013] [Accepted: 05/14/2013] [Indexed: 01/17/2023]
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Zhang W, Stoecklin E, Eggersdorfer M. A glimpse of vitamin D status in Mainland China. Nutrition 2013; 29:953-7. [PMID: 23594582 DOI: 10.1016/j.nut.2013.01.010] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2012] [Revised: 01/07/2013] [Accepted: 01/11/2013] [Indexed: 12/27/2022]
Abstract
As an essential dietary micronutrient, vitamin D plays a pivotal role in promoting calcium absorption in the intestine and maintaining a healthy skeletal system throughout life. Beyond bone health, an emerging volume of scientific studies shows that vitamin D also may provide cardiovascular, metabolic, and immunologic benefits and reduce mortality. To our knowledge, in mainland China no national surveys have been conducted to date to depict the overall vitamin D status in the population. Therefore, the purpose of this contribution was to provide the best possible evaluation of vitamin D deficiency/insufficiency in China by reviewing publications that measured plasma/serum 25-hydroxyvitamin-D (25[OH]D) levels in various age groups and in different areas of China from January 2000 to June 2012. From these investigations conducted throughout the country and from newborns to adults to the elderly, it has been found that vitamin D deficiency/insufficiency is prevalent in the Chinese population in almost all age groups and areas if individuals are not taking vitamin D-fortified products/supplements or are lacking sufficient sunshine exposure. Some studies showed severe deficiency (25[OH]D <25 nmol/L) in Nanjing (north latitude 31) during the winter months and in Beijing (north latitude 40) in the fall. This unoptimistic situation represents a significant but modifiable public health risk that deserves greater attention and more efficient and timely management.
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Affiliation(s)
- Weiguo Zhang
- DSM Nutritional Products, Human Nutrition and Health, Beijing, China and Kaiseraugst, Switzerland.
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27
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Abstract
PURPOSE OF REVIEW Vitamin D has received global attention because of its many health benefits. Although there is general agreement about the importance of vitamin D for bone health, there remains skepticism about the nonskeletal health benefits of vitamin D. This review will not only focus on the vitamin D deficiency pandemic and ways to treat and prevent vitamin D deficiency but will also explore the epigenetic mechanisms of vitamin D that could help explain many of the nonskeletal benefits of enhancing vitamin D status. RECENT FINDINGS The Institute of Medicine and the Endocrine Society have made new recommendations for vitamin D intake to prevent vitamin D deficiency. Vitamin D deficiency is defined as a 25-hydroxyvitamin D level below 20 ng/ml and vitamin D insufficiency is defined as 21-29 ng/ml. Recent observations have suggested that vitamin D can influence epigenetics which may help explain the nonskeletal health benefits that have been reported for vitamin D. SUMMARY There is general agreement that vitamin D deficiency is a worldwide health problem. This is due in part to the lack of appreciation that sunlight is an important source of vitamin D. There is no downside to increasing vitamin D intake and recent observations suggesting that vitamin D influences epigenetics provide a new insight for the importance of vitamin D in utero in reducing risk of chronic diseases later in life.
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Affiliation(s)
- Arash Hossein-nezhad
- Department of Medicine, Section of Endocrinology, Nutrition, and Diabetes, Vitamin D, Skin and Bone Research Laboratory, Boston University Medical Center, Boston, Massachusetts 02118, USA
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Shao H, Tao M, Fan Y, Jing J, Lu J. Vitamin D levels and other factors related to bone mineral density during pregnancy. Aust N Z J Obstet Gynaecol 2012; 52:571-5. [PMID: 23003672 DOI: 10.1111/j.1479-828x.2012.01477.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2012] [Accepted: 07/14/2012] [Indexed: 12/01/2022]
Affiliation(s)
- Hongfang Shao
- Department of Obstetrics and Gynecology; Affiliated Sixth People's Hospital; Shanghai Jiaotong University; Shanghai; China
| | - Minfang Tao
- Department of Obstetrics and Gynecology; Affiliated Sixth People's Hospital; Shanghai Jiaotong University; Shanghai; China
| | - Yajing Fan
- Department of Obstetrics and Gynecology; Affiliated Sixth People's Hospital; Shanghai Jiaotong University; Shanghai; China
| | - Jianling Jing
- Department of Obstetrics and Gynecology; Affiliated Sixth People's Hospital; Shanghai Jiaotong University; Shanghai; China
| | - Jianping Lu
- Department of Obstetrics and Gynecology; Affiliated Sixth People's Hospital; Shanghai Jiaotong University; Shanghai; China
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29
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Abstract
PURPOSE OF REVIEW Vitamin D is part of a complex steroid hormone system long known to be involved in bone metabolism. Recently, vitamin D has been implicated in physiologic processes as diverse as vascular health, immune function, metabolism and placental function. This review summarizes the current evidence for the role of vitamin D in pregnancy and perinatal outcomes A systematic review of articles published in PubMed between May 2010 and October 2011 was undertaken using key words for vitamin D and pregnancy. Seventy-eight studies were reviewed. RECENT FINDINGS The biologic evidence regarding a role for vitamin D in reproductive outcomes is strong, and rates of vitamin D deficiency may be high among pregnant women. However, no consensus exists regarding optimum vitamin D levels in pregnancy or standard measurement of vitamin D deficiency. Clinical studies establishing an association between vitamin D levels and adverse pregnancy outcomes such as preeclampsia, gestational diabetes, low birthweight, preterm labor, cesarean delivery and infectious diseases have conflicting results. This is likely due to a paucity of randomized trials, heterogeneity of populations studied and low sample size with poor adjustment for confounding among observational studies. SUMMARY Further research should focus on defining optimum 25-hydroxy vitamin D levels in pregnancy as well as among various subgroups of the population. Randomized trials are needed to determine whether vitamin D supplementation can improve pregnancy outcomes. Currently, the American College of Obstetrics and Gynecology and the Institute of Medicine recommend 600 IU of daily vitamin D supplementation during pregnancy to support maternal and fetal bone metabolism.
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Affiliation(s)
- Rachel P Urrutia
- Division of Women's Primary Care, Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, North Carolina, USA.
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