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Dragomir RE, Gheoca Mutu DE, Sima RM, Toader OD, Stănculescu RV. The Impact of Vitamin D Deficiency on Gestational Diabetes Mellitus Risk: A Retrospective Study. Cureus 2024; 16:e65037. [PMID: 39035594 PMCID: PMC11260427 DOI: 10.7759/cureus.65037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/21/2024] [Indexed: 07/23/2024] Open
Abstract
Background Nowadays, there has been growing attention to vitamin D deficiency's impact on women of reproductive age, both during pregnancy and the preconception period. Because of its possible impact on female reproductive ability, vitamin D deficiency may have multiple implications for maternal and fetal health. Currently, the correlation between vitamin D deficiency and gestational diabetes mellitus (GDM) is gaining attention, mainly due to contradictory findings in the literature. Methods We conducted a single-center, retrospective study involving data from 106 pregnant women to establish a possible link between vitamin D deficiency and GDM risk. We analyzed variables such as vitamin D status, the occurrence of gestational diabetes, and body mass index to identify significant statistical correlations among them. Results Within our study group, the average vitamin D level was 19.5 ± 7.8 ng/mL. Regarding vitamin D status, 59 (55.7%) pregnant women had vitamin D deficiency, 36 (34%) had vitamin D insufficiency, and 11 (10.4%) had optimal vitamin D levels. GDM was diagnosed in 18 cases, representing 17%. After the statistical analysis, we found a positive correlation between gestational diabetes and vitamin D deficiency (chi-square = 4.472, p = 0.049). However, we did not find a significant correlation between gestational diabetes and optimal vitamin D status. Conclusions Pregnant women with vitamin D deficiency are at an increased risk of developing GDM and may benefit from vitamin D supplementation. We believe that further research is necessary to have a comprehensive understanding of vitamin D's effects on pregnancy.
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Affiliation(s)
- Ramona E Dragomir
- Doctoral School, Carol Davila University of Medicine and Pharmacy, Bucharest, ROU
| | - Daniela E Gheoca Mutu
- Department of Anatomy, Carol Davila University of Medicine and Pharmacy, Bucharest, ROU
- Clinical Department of Plastic and Aesthetic Surgery and Reconstructive Microsurgery, Prof. Dr. Agrippa Ionescu Clinical Emergency Hospital, Bucharest, ROU
| | - Romina M Sima
- Department of Obstetrics and Gynecology, Carol Davila University of Medicine and Pharmacy, Bucharest, ROU
| | - Oana D Toader
- Department of Obstetrics and Gynecology, Alessandrescu-Rusescu National Institute for Mother and Child Health, Polizu Hospital, Bucharest, ROU
- Department of Obstetrics and Gynecology, Carol Davila University of Medicine and Pharmacy, Bucharest, ROU
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Li J, Li M, Li Y, Zhao X, Guan Y, Zhang Y, Zhang W, Zheng W, Zhang M, Wu S. Do serum vitamin D levels affect assisted reproductive outcomes and perinatal outcomes in young non-PCOS patients? A retrospective study. Arch Gynecol Obstet 2024; 309:2099-2106. [PMID: 38429582 DOI: 10.1007/s00404-024-07410-8] [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: 11/09/2023] [Accepted: 02/01/2024] [Indexed: 03/03/2024]
Abstract
PURPOSE This study aimed to determine the influence of serum vitamin D levels on assisted reproductive and perinatal outcomes in young non-polycystic ovary syndrome (PCOS) patients. METHODS A total of 3397 non-PCOS women under 35 years who underwent their first IVF/ICSI cycle at the Reproductive Medicine Center of the Third Affiliated Hospital of Zhengzhou University, from 2018 to 2019, were included. The women were categorized into two groups based on their serum 25(OH)D concentrations: deficient group [25(OH)D < 50 nmol/L] and non-deficient group [25(OH)D ≥ 50 nmol/L]. Ovulation induction results, clinical pregnancy rate, cumulative live birth rate (CLBR), and perinatal outcomes of both groups were compared. RESULTS A total of 1113 non-PCOS women had successful pregnancies in their first completed IVF cycle. Comparison of laboratory results between the two groups revealed a significantly higher number of oocytes retrieved in the vitamin D-non-deficient group (15.2 ± 6.8 vs. 14.5 ± 6.7, p = 0.015). After controlling for confounding factors, there was no significant difference in the CLBR between the vitamin D-deficient group and the non-deficient group (71.0%, 1,973/2,778 vs. 69.0%, 427/619, p = 0.314, unadjusted). The prevalence of gestational diabetes mellitus (GDM) was higher in the vitamin D-deficient group than in the vitamin D-non-deficient group in both fresh-cycle singleton live births (3.8% vs. 1.2%) and twin live births (2.3% vs. 1.5%). CONCLUSION This study demonstrated that vitamin D-deficient group had a lower number of oocytes retrieved than the non-deficient group and a higher prevalence of GDM, suggesting that vitamin D deficiency impacts assisted pregnancies and perinatal outcomes in infertile non-PCOS women. However, further studies are required to confirm these findings.
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Affiliation(s)
- Jiaheng Li
- Reproduction Center, The Third Affiliated Hospital of ZhengZhou University, Henan, 450000, China.
| | - Mengnuo Li
- Reproduction Center, The Third Affiliated Hospital of ZhengZhou University, Henan, 450000, China
| | - Yijiang Li
- Reproduction Center, The Third Affiliated Hospital of ZhengZhou University, Henan, 450000, China
| | - Xianling Zhao
- Reproduction Center, The Third Affiliated Hospital of ZhengZhou University, Henan, 450000, China
| | - Yichun Guan
- Reproduction Center, The Third Affiliated Hospital of ZhengZhou University, Henan, 450000, China
| | - Yuchao Zhang
- Reproduction Center, The Third Affiliated Hospital of ZhengZhou University, Henan, 450000, China
| | - Wenjuan Zhang
- Reproduction Center, The Third Affiliated Hospital of ZhengZhou University, Henan, 450000, China
| | - Wei Zheng
- Reproduction Center, The Third Affiliated Hospital of ZhengZhou University, Henan, 450000, China
| | - Meng Zhang
- Reproduction Center, The Third Affiliated Hospital of ZhengZhou University, Henan, 450000, China
| | - Sheling Wu
- Reproduction Center, The Third Affiliated Hospital of ZhengZhou University, Henan, 450000, China
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Di Gesù CM, Buffington SA. The early life exposome and autism risk: a role for the maternal microbiome? Gut Microbes 2024; 16:2385117. [PMID: 39120056 PMCID: PMC11318715 DOI: 10.1080/19490976.2024.2385117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Revised: 07/22/2024] [Accepted: 07/23/2024] [Indexed: 08/10/2024] Open
Abstract
Autism spectrum disorders (ASD) are highly heritable, heterogeneous neurodevelopmental disorders characterized by clinical presentation of atypical social, communicative, and repetitive behaviors. Over the past 25 years, hundreds of ASD risk genes have been identified. Many converge on key molecular pathways, from translational control to those regulating synaptic structure and function. Despite these advances, therapeutic approaches remain elusive. Emerging data unearthing the relationship between genetics, microbes, and immunity in ASD suggest an integrative physiology approach could be paramount to delivering therapeutic breakthroughs. Indeed, the advent of large-scale multi-OMIC data acquisition, analysis, and interpretation is yielding an increasingly mechanistic understanding of ASD and underlying risk factors, revealing how genetic susceptibility interacts with microbial genetics, metabolism, epigenetic (re)programming, and immunity to influence neurodevelopment and behavioral outcomes. It is now possible to foresee exciting advancements in the treatment of some forms of ASD that could markedly improve quality of life and productivity for autistic individuals. Here, we highlight recent work revealing how gene X maternal exposome interactions influence risk for ASD, with emphasis on the intrauterine environment and fetal neurodevelopment, host-microbe interactions, and the evolving therapeutic landscape for ASD.
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Affiliation(s)
- Claudia M. Di Gesù
- Center for Precision Environmental Health, Baylor College of Medicine, Houston, TX, USA
| | - Shelly A. Buffington
- Center for Precision Environmental Health, Baylor College of Medicine, Houston, TX, USA
- Department of Neuroscience, Baylor College of Medicine, Houston, TX, USA
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Liu Y, Hocher JG, Chen H, Hu L, Zhang X, Cai S, Tang S, Gong F, Krämer BK, Lin G, Hocher B. The Degree of Prepregnancy Vitamin D Deficiency Is Not Associated With Gestational Diabetes in Women Undergoing ART. J Endocr Soc 2023; 7:bvad140. [PMID: 38024652 PMCID: PMC10681737 DOI: 10.1210/jendso/bvad140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Indexed: 12/01/2023] Open
Abstract
Context Gestational diabetes mellitus (GDM) is a common pregnancy complication, particularly in women undergoing assisted reproductive technology (ART). An association of GDM with vitamin D in women conceiving naturally has been described; however, studies have yielded heterogeneous results. Objective To analyze the association between prepregnancy total and free vitamin D and GDM incidence in women undergoing ART. Methods Post hoc analysis of a prospective study at the Reproductive and Genetic Hospital of CITIC-Xiangya in Changsha, China. Total and free vitamin D were measured 1 day before embryo transfer. The patients were screened for GDM using the oral glucose tolerance test. Results A total of 1593 women were included in the study, among whom 256 (16.1%) developed GDM. According to international guidelines for total 25-hydroxyvitamin D [25(OH)D], 47 (2.9%) patients had sufficient (≥30 ng/mL) levels, while 696 (43.7%) were insufficient (20 to <30 ng/mL) and 850 (54.4%) were deficient (<20 ng/mL). Comparing GDM and non-GDM patients, there was no significant difference in total nor free vitamin D levels (P = .340 and .849). Similarly, analysis of GDM rates by quintiles of total and free 25(OH)D showed no significant association in one-way ANOVA (P = .831 and .799). Multivariate logistic regression, considering age, BMI, and fasting glucose, also did not show a significant influence of the 2 vitamin D forms on GDM incidence (P = .266 and .123 respectively). Conclusion In this relatively vitamin D deficient/insufficient ART cohort, the degree of neither total nor free vitamin D deficiency before pregnancy was associated with the occurrence of GDM.
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Affiliation(s)
- Yvonne Liu
- Fifth Department of Medicine (Nephrology/Endocrinology/Rheumatology/Pneumology), University Medical Centre Mannheim, University of Heidelberg, 68167 Mannheim, Germany
- Medical Faculty of Charité Universitätsmedizin Berlin, 10117 Berlin, Germany
| | - Johann-Georg Hocher
- Fifth Department of Medicine (Nephrology/Endocrinology/Rheumatology/Pneumology), University Medical Centre Mannheim, University of Heidelberg, 68167 Mannheim, Germany
- Second Faculty of Medicine, Charles University, 150 06 Prague, Czech Republic
| | - Huijun Chen
- Fifth Department of Medicine (Nephrology/Endocrinology/Rheumatology/Pneumology), University Medical Centre Mannheim, University of Heidelberg, 68167 Mannheim, Germany
- Medical Faculty of Charité Universitätsmedizin Berlin, 10117 Berlin, Germany
- Department of Clinical Science, Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha 410008, China
| | - Liang Hu
- Department of Clinical Science, Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha 410008, China
- School of Basic Medical Science, Institute of Reproductive and Stem Cell Engineering, Central South University, Changsha 410017, China
- Key Laboratory of Stem Cells and Reproductive Engineering, Ministry of Health, Changsha 410017, China
| | - Xiaoli Zhang
- Fifth Department of Medicine (Nephrology/Endocrinology/Rheumatology/Pneumology), University Medical Centre Mannheim, University of Heidelberg, 68167 Mannheim, Germany
- Institute of Pharmacy, Freie Universität Berlin, 14195 Berlin, Germany
| | - Sufen Cai
- Department of Clinical Science, Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha 410008, China
- School of Basic Medical Science, Institute of Reproductive and Stem Cell Engineering, Central South University, Changsha 410017, China
| | - Sha Tang
- Department of Clinical Science, Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha 410008, China
| | - Fei Gong
- Department of Clinical Science, Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha 410008, China
- School of Basic Medical Science, Institute of Reproductive and Stem Cell Engineering, Central South University, Changsha 410017, China
- Key Laboratory of Stem Cells and Reproductive Engineering, Ministry of Health, Changsha 410017, China
| | - Bernhard K Krämer
- Fifth Department of Medicine (Nephrology/Endocrinology/Rheumatology/Pneumology), University Medical Centre Mannheim, University of Heidelberg, 68167 Mannheim, Germany
- Key Laboratory of Stem Cells and Reproductive Engineering, Ministry of Health, Changsha 410017, China
| | - Ge Lin
- Department of Clinical Science, Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha 410008, China
- School of Basic Medical Science, Institute of Reproductive and Stem Cell Engineering, Central South University, Changsha 410017, China
- Key Laboratory of Stem Cells and Reproductive Engineering, Ministry of Health, Changsha 410017, China
| | - Berthold Hocher
- Fifth Department of Medicine (Nephrology/Endocrinology/Rheumatology/Pneumology), University Medical Centre Mannheim, University of Heidelberg, 68167 Mannheim, Germany
- Department of Clinical Science, Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha 410008, China
- School of Basic Medical Science, Institute of Reproductive and Stem Cell Engineering, Central South University, Changsha 410017, China
- Institute of Medical Diagnostics, IMD, 12247 Berlin, Germany
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Das BP, Das SK, Bhuyan AK, Nandakumar A. Relationship Between Vitamin D Level and Gestational Diabetes Mellitus: A Cross-Sectional Study. J Obstet Gynaecol India 2023; 73:83-87. [PMID: 37916002 PMCID: PMC10616051 DOI: 10.1007/s13224-023-01832-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Accepted: 08/16/2023] [Indexed: 11/03/2023] Open
Abstract
Aim To determine the correlation between vitamin D levels and gestational diabetes mellitus. Materials and Methods Cross-sectional observational study, conducted in Gauhati Medical College and Hospital, over a period of 1 year, on 350 antenatal patients, with gestational age beyond 24 weeks, keeping in mind the inclusion and exclusion criteria. Age, obstetric score, religion, BMI were noted for all patients. They underwent screening for gestational diabetes mellitus using DIPSI (Diabetes in Pregnancy Study Group of India) guidelines and were divided into two groups. Vitamin D estimation by CLIA method (chemiluminescence method) was done in both groups and results were compared. Association between vitamin D levels and gestational diabetes mellitus was studied using Chi Square Test. Results The prevalence of vitamin D deficiency in antenatal patients was found to be 63.7%. 73% of gestational diabetes mellitus patients were deficient in vitamin D. There was a statistically significant association seen between vitamin D level and Gestational diabetes mellitus (p value-0.046). There was 1.34 times increased risk of developing gestational diabetes mellitus when the vitamin D levels were deficient as compared to when the vitamin levels were within the normal range. Conclusion There was a high level of vitamin D deficiency in the pregnant women of North East. Due to lack of screening of vitamin D levels, many pregnant women suffer from adverse feto-maternal outcomes. There is a need to identify them early in pregnancy, provide vitamin D supplementation and to decrease the likelihood of them developing complications.
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Affiliation(s)
- Bishnu Prasad Das
- Department of Obstetrics and Gynaecology, Gauhati Medical College and Hospital, Guwahati, Kamrup Metro, Assam 781032 India
| | - Sasindra Kumar Das
- Department of Obstetrics and Gynaecology, Gauhati Medical College and Hospital, Guwahati, Kamrup Metro, Assam 781032 India
| | - Ashok Krishna Bhuyan
- Department of Endocrinology, Gauhati Medical College and Hospital, Guwahati, Kamrup Metro, Assam 781032 India
| | - Aishwarya Nandakumar
- Department of Obstetrics and Gynaecology, Gauhati Medical College and Hospital, Guwahati, Kamrup Metro, Assam 781032 India
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Dos Santos SDF, Dos Reis Costa PN, Gouvêa TG, de Almeida NFA, Cardoso FDS. Influence of hypovitaminosis D during pregnancy on glycemic and lipid profile, inflammatory indicators and anthropometry of pregnant and newborn. Clin Nutr ESPEN 2023; 54:81-93. [PMID: 36963902 DOI: 10.1016/j.clnesp.2023.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 12/22/2022] [Accepted: 01/04/2023] [Indexed: 01/13/2023]
Abstract
BACKGROUND & AIMS Hypovitaminosis D currently represents a public health problem and is related to the emergence of chronic diseases. Furthermore, this vitamin deficiency has been associated with pregnancy complications, and it can also influence newborn's growth and development. The purpose of this review is to understand the effects of vitamin D nutritional status on women during pregnancy, as well as its impact on newborn's health. METHODS Review of observational studies, published between 2020 and 2021. The research was carried out in the following databases: Pubmed and SciELO. The search terms used to select the articles were: vitamin D, 25(OH)D, serum levels, pregnancy, lactation, gene expression, maternal results, complications, pre-eclampsia, obesity, gestational diabetes, and children. As inclusion criteria, were considered observational studies that addressed the topic and answered the review aims. RESULTS 52 articles were identified and at the end of the selection process, 19 articles were considered, in which they met all the established eligibility criteria. According to the findings in this review, hypovitaminosis D is related to gestational diabetes, pre-eclampsia and gestational weight gain, changes in laboratory parameters as well as outcomes in newborns. CONCLUSIONS Hypovitaminosis D can adversely influence pregnancy and newborn's health, evidencing the need to assess the nutritional status of vitamin D, as well as the existence, or not, of a clinic during pregnancy. It is important that new scientific evidence is published to support this hypothesis.
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Affiliation(s)
- Sara de Figueiredo Dos Santos
- Centro Universitário Arthur De Sá EARP NETO/ Faculdade De Medicina De Petrópolis, Av. Barão Do Rio Branco, 1003 - Centro, 25680-120, Petrópolis, RJ, Brazil.
| | - Paula Normando Dos Reis Costa
- Centro Universitário Arthur De Sá EARP NETO/ Faculdade De Medicina De Petrópolis, Av. Barão Do Rio Branco, 1003 - Centro, 25680-120, Petrópolis, RJ, Brazil.
| | - Thaise Gasser Gouvêa
- Centro Universitário Arthur De Sá EARP NETO/ Faculdade De Medicina De Petrópolis, Av. Barão Do Rio Branco, 1003 - Centro, 25680-120, Petrópolis, RJ, Brazil.
| | - Nathalia Ferreira Antunes de Almeida
- Centro Universitário Arthur De Sá EARP NETO/ Faculdade De Medicina De Petrópolis, Av. Barão Do Rio Branco, 1003 - Centro, 25680-120, Petrópolis, RJ, Brazil.
| | - Felipe de Souza Cardoso
- Centro Universitário Arthur De Sá EARP NETO/ Faculdade De Medicina De Petrópolis, Av. Barão Do Rio Branco, 1003 - Centro, 25680-120, Petrópolis, RJ, Brazil.
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Wang X, Lu K, Shen J, Xu S, Wang Q, Gong Y, Xia Y, Wang X, Chen L, Yan S, Tang Z, Li C. Correlation between meteorological factors and vitamin D status under different season. Sci Rep 2023; 13:4762. [PMID: 36959344 PMCID: PMC10036626 DOI: 10.1038/s41598-023-31698-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 03/16/2023] [Indexed: 03/25/2023] Open
Abstract
Pregnant women with low vitamin D levels tend to have poor clinical outcomes. Meteorological factors were associated with vitamin D. Here, we aimed to study the current status of 25-Hydroxy vitamin D (25(OH)D) concentrations in pregnant women in Kunshan city and investigate the meteorological factors associated with 25(OH)D levels under different seasons. The correlation between meteorological factors and 25(OH)D levels was estimated by cross-correlation analysis and multivariate logistic regression. A restrictive cubic spline method was used to estimate the non-linear relationship. From 2015 to 2020, a total of 22,090 pregnant women were enrolled in this study. Pregnant women with 25(OH)D concentrations below 50 nmol/l represent 65.85% of the total study population. There is a positive correlation between temperature and 25(OH)D. And there is a protective effect of the higher temperature on vitamin D deficiency. However, in the subgroup analysis, we found that in autumn, high temperatures above 30 °C may lead to a decrease in 25(OH)D levels. This study shows that vitamin D deficiency in pregnant women may widespread in eastern China. There is a potential inverted U-shaped relationship between temperature and 25(OH)D levels, which has implications for understanding of vitamin D changes under different seasons.
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Affiliation(s)
- Xichao Wang
- Department of Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, 215123, China
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, 215123, China
| | - Ke Lu
- Department of Orthopedics, Affiliated Kunshan Hospital of Jiangsu University, No. 91 West of Qianjin Road, Suzhou, 215300, Jiangsu, China
| | - Junjie Shen
- Department of Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, 215123, China
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, 215123, China
| | - Shihan Xu
- Department of Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, 215123, China
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, 215123, China
| | - Qi Wang
- Department of Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, 215123, China
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, 215123, China
| | - Yaqin Gong
- Information Department, Affiliated Kunshan Hospital of Jiangsu University, Suzhou, 215300, Jiangsu, China
| | - Yunyu Xia
- Meteorological Bureau of Kunshan City, Suzhou, 215337, Jiangsu, China
| | - Xiaochun Wang
- Meteorological Bureau of Kunshan City, Suzhou, 215337, Jiangsu, China
| | - Lin Chen
- Ecology and Environment Bureau of Kunshan City, Suzhou, 215330, Jiangsu, China
| | - Shanjun Yan
- Ecology and Environment Bureau of Kunshan City, Suzhou, 215330, Jiangsu, China
| | - Zaixiang Tang
- Department of Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, 215123, China.
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, 215123, China.
| | - Chong Li
- Department of Orthopedics, Affiliated Kunshan Hospital of Jiangsu University, No. 91 West of Qianjin Road, Suzhou, 215300, Jiangsu, China.
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[Correlation analysis of vitamin D level and anti-Müllerian hormone in infertile female and the role in predicting pregnancy outcome]. BEIJING DA XUE XUE BAO. YI XUE BAN = JOURNAL OF PEKING UNIVERSITY. HEALTH SCIENCES 2023; 55:167-173. [PMID: 36718707 PMCID: PMC9894808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
OBJECTIVE To investigate the relationship between serum 25(OH)D and anti-Müllerian hormone (AMH) among infertile females and their predictive impacts on in vitro fertilization and embryo transfer pregnancy outcome. METHODS Totally 756 infertile females treated with assisted reproductive technology were enrolled and divided into three groups according to their vitamin D levels (group A with serum 25(OH)D≤10 μg/L, group B with serum (10-20) μg/L, and group C with serum ≥20 μg/L). The serum AMH levels were detected. The differences among the groups were analyzed, as well as the correlation between vitamin D levels and serum AMH levels in various infertility types (fallopian tube/male factor, polycystic ovary syndrome (PCOS), ovulation disorders excluded PCOS, endometriosis, unexplained infertility, and others). Also, the predictive roles of vitamin D and AMH in pregnancy outcome in all the infertile females were discussed. RESULTS (1) 87.7% of the enrolled females were insufficient or deficient in vitamin D. (2) The serum AMH levels in the three groups with different vitamin D levels were 1.960 (1.155, 3.655) μg/L, 2.455 (1.370, 4.403) μg/L, 2.360 (1.430, 4.780) μg/L and there was no significant difference in serum AMH levels among the three groups (P>0.05). (3) Serum 25(OH)D and AMH levels presented seasonal variations (P < 0.05). (4) There was no prominent correlation between the serum AMH level and serum 25(OH)D level in females of various infertility types after adjusting potential confounding factors [age, body mass index (BMI), antral follicle count (AFC), vitamin D blood collection season, etc.] by multiple linear regression analysis (P>0.05). (5) After adjusting for confounding factors, such as age, BMI, number of transplanted embryos and AFC, the results of binary Logistics regression model showed that in all the infertile females, the serum AMH level was an independent predictor of biochemical pregnancy outcome (P < 0.05) while the serum 25(OH)D level might not act as a prediction factor alone (P>0.05). In the meanwhile, the serum 25(OH)D level and serum AMH level were synergistic predictors of biochemical or clinical pregnancy outcome (P < 0.05). CONCLUSION Based on the current diagnostic criteria, most infertile females had vitamin D insufficiency or deficiency, but there was not significant correlation between serum 25(OH)D and ovarian reserve. While vitamin D could not be used as an independent predictor of pregnancy outcome in infertile females, the serum AMH level could predict biochemical pregnancy outcome independently or jointly with vitamin D.
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Balbi G, Schiattarella A, Fasulo D, Cafiero A, Mastrogiacomo A, Musone R, Carucci A, Cobellis L. Vertical transmission of Human papillomavirus: experience from a center of southern Italy. Minerva Obstet Gynecol 2023; 75:45-54. [PMID: 35107233 DOI: 10.23736/s2724-606x.22.04956-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Human papillomavirus (HPV) represents a group of DNA viruses, sexually transmitted, and widely accepted as a cause of invasive squamous cell carcinomas. The virus prevalence is critical worldwide. However, the possibility of perinatal transmission during pregnancy is not well understood as well as the risks for the newborn. METHODS Our study analyzed pregnant women referred to the obstetric outpatient room of the Department of Gynecology and Obstetrics of Sant'Anna and San Sebastiano University Hospital in Caserta, Italy. Cervicovaginal samples were achieved from patients during the first trimester and tested for HPV. The specimen was repeated during the third trimester for HPV-positive patients. After the birth, we took a placenta sample and an eye, pharyngeal, mouth, and genital samples in children from HPV positive mothers, at 36-48 hours after birth and three and six months. RESULTS We found out a high prevalence of HPV infections in the recruited patients: 71 participants were positive at the HPV test in the first trimester (45%), and 17 (14%) showed a positivity in the placental samples. However, there was a low prevalence of viral infection in newborns, and six newborns were positive for HPV at birth (9%). CONCLUSIONS HPV vertical transmission represents a critical obstetric topic, and the transplacental passage of the virus represents a possible cause. However, further studies are necessary to deepen the pathological mechanism and assess the risks for the newborn.
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Affiliation(s)
- Giancarlo Balbi
- Unit of Obstetrics and Gynecology, Sant'Anna e San Sebastiano Hospital, Caserta, Italy.,Department of Woman, Child and General and Specialized Surgery, Luigi Vanvitelli University of Campania, Naples, Italy
| | - Antonio Schiattarella
- Department of Woman, Child and General and Specialized Surgery, Luigi Vanvitelli University of Campania, Naples, Italy -
| | - Diego Fasulo
- Department of Woman, Child and General and Specialized Surgery, Luigi Vanvitelli University of Campania, Naples, Italy
| | - Angela Cafiero
- Unit of Obstetrics and Gynecology, Sant'Anna e San Sebastiano Hospital, Caserta, Italy
| | | | - Rosalia Musone
- Unit of Obstetrics and Gynecology, Sant'Anna e San Sebastiano Hospital, Caserta, Italy
| | - Antonio Carucci
- Unit of Obstetrics and Gynecology, Sant'Anna e San Sebastiano Hospital, Caserta, Italy
| | - Luigi Cobellis
- Unit of Obstetrics and Gynecology, Sant'Anna e San Sebastiano Hospital, Caserta, Italy.,Department of Woman, Child and General and Specialized Surgery, Luigi Vanvitelli University of Campania, Naples, Italy
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Fatima K, Asif M, Nihal K, Hussain HU, Hasan AW, Zahid M, Burney MH, Asad F, Fatima S, Saleem MB, Khalid MA. Association between vitamin D levels in early pregnancy and gestational diabetes mellitus: A systematic review and meta-analysis. J Family Med Prim Care 2022; 11:5569-5580. [PMID: 36505566 PMCID: PMC9731084 DOI: 10.4103/jfmpc.jfmpc_107_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 04/09/2022] [Accepted: 05/17/2022] [Indexed: 11/06/2022] Open
Abstract
Background This meta-analysis aimed to pool all the available data to provide a well-powered assessment of the role of maternal Vitamin D levels in developing gestational diabetes mellitus (GDM) because already published studies evaluating this association are small in sample size and yielded conflicting findings. Material and Methods A systematic review and meta-analysis of observational studies was performed. We searched electronic databases (PubMed and Cochrane Central) from inception to April 2021 for published and unpublished observational studies that determined the association between the reduction of Vitamin D levels and the risk of developing GDM in pregnant women. Results from studies were pooled as mean ± standard deviation (SD) and odds ratios (OR) using the random-effects model. Results Forty-four studies, consisting of 37,838 pregnant women were included in this meta-analysis. Dichotomous studies showed a significant association between maternal Vitamin D deficiency and increased risk of GDM (OR = 1.38; 95% confidence interval [CI] = 1.21-1.57; P < 0.00001). Studies with continuous data also showed a significant association between maternal Vitamin D deficiency and the risk of developing GDM (weighted mean difference (WMD): -5.14 nmol/L, 95% CI = -6.28 to -4.00; P < 0.00001). Moderate heterogeneity was also detected. Conclusion In conclusion, all studies demonstrated that lower levels of maternal serum Vitamin D were associated with a higher risk of developing GDM in pregnancy.
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Affiliation(s)
- Kaneez Fatima
- Department of Medicine, Dow University of Health Sciences, Baba-e-Urdu Road, Saddar, Karachi, Pakistan
| | - Muqaddus Asif
- Department of Medicine, Dow University of Health Sciences, Baba-e-Urdu Road, Saddar, Karachi, Pakistan,Address for correspondence: Dr. Muqaddus Asif, Dow Medical College, Baba-e-Urdu Road, Saddar, Karachi, Pakistan. E-mail:
| | - Kanwal Nihal
- Department of Medicine, Dow University of Health Sciences, Baba-e-Urdu Road, Saddar, Karachi, Pakistan
| | - Hassan Ul Hussain
- Department of Medicine, Dow University of Health Sciences, Baba-e-Urdu Road, Saddar, Karachi, Pakistan
| | - Ayeza Waseem Hasan
- Department of Medicine, Dow University of Health Sciences, Baba-e-Urdu Road, Saddar, Karachi, Pakistan
| | - Marium Zahid
- Karachi Medical and Dental College, Karachi, Pakistan
| | | | - Fatima Asad
- Department of Medicine, Dow University of Health Sciences, Baba-e-Urdu Road, Saddar, Karachi, Pakistan
| | - Sarah Fatima
- Department of Medicine, Dow University of Health Sciences, Baba-e-Urdu Road, Saddar, Karachi, Pakistan
| | - Minahil Binte Saleem
- Department of Medicine, Dow University of Health Sciences, Baba-e-Urdu Road, Saddar, Karachi, Pakistan
| | - Muhammad Abdullah Khalid
- Department of Medicine, Dow University of Health Sciences, Baba-e-Urdu Road, Saddar, Karachi, Pakistan
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11
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Wang L, Yu T, Jiao R, Fan X, Wang Y, Liu W, Wang S, Xie J, Zhao C. The association between vitamin D levels in the second trimester of pregnancy and gestational diabetes mellitus. J Obstet Gynaecol Res 2022; 48:2748-2755. [DOI: 10.1111/jog.15394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 07/03/2022] [Accepted: 07/28/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Lingli Wang
- Research Center for Clinical Medical Sciences The Fourth Hospital of Shijiazhuang (The Affiliated Obstetrics and Gynecology Hospital of Hebei Medical University) Shijiazhuang China
| | - Tianxiao Yu
- Research Center for Clinical Medical Sciences The Fourth Hospital of Shijiazhuang (The Affiliated Obstetrics and Gynecology Hospital of Hebei Medical University) Shijiazhuang China
| | - Ruifen Jiao
- Department of Obstetrics The Fourth Hospital of Shijiazhuang (The affiliated obstetrics and Gynecology Hospital of Hebei medical university) Shijiazhuang China
| | - Xizhenzi Fan
- Research Center for Clinical Medical Sciences The Fourth Hospital of Shijiazhuang (The Affiliated Obstetrics and Gynecology Hospital of Hebei Medical University) Shijiazhuang China
| | - Yafang Wang
- Department of Clinical Laboratory The Fourth Hospital of Shijiazhuang (The Affiliated Obstetrics and Gynecology Hospital of Hebei Medical University) Shijiazhuang China
| | - Wei Liu
- Research Center for Clinical Medical Sciences The Fourth Hospital of Shijiazhuang (The Affiliated Obstetrics and Gynecology Hospital of Hebei Medical University) Shijiazhuang China
| | - Shaoxiong Wang
- Department of Clinical Laboratory The Fourth Hospital of Shijiazhuang (The Affiliated Obstetrics and Gynecology Hospital of Hebei Medical University) Shijiazhuang China
| | - Jialiang Xie
- Department of Clinical Laboratory The Fourth Hospital of Shijiazhuang (The Affiliated Obstetrics and Gynecology Hospital of Hebei Medical University) Shijiazhuang China
| | - Chuan Zhao
- Research Center for Clinical Medical Sciences The Fourth Hospital of Shijiazhuang (The Affiliated Obstetrics and Gynecology Hospital of Hebei Medical University) Shijiazhuang China
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Calagna G, Catinella V, Polito S, Schiattarella A, De Franciscis P, D’Antonio F, Calì G, Perino A, Cucinella G. Vitamin D and Male Reproduction: Updated Evidence Based on Literature Review. Nutrients 2022; 14:nu14163278. [PMID: 36014783 PMCID: PMC9412569 DOI: 10.3390/nu14163278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Revised: 08/04/2022] [Accepted: 08/07/2022] [Indexed: 11/16/2022] Open
Abstract
The purpose of this study was to clarify the vitamin D (VD) effect on male infertility. Our research was conducted using the following electronic databases: MEDLINE, Embase, Web of Science, Scopus, ClinicalTrials.gov, and Cochrane Library. Selection criteria included all published randomized controlled trials and non-randomized studies, focusing on vitamin D and male reproductive function. The results showed that the effects of VD on male reproduction has been investigated in three different topics: the molecular mechanism underlying VD effects on semen quality (SQ), the relationship between VD levels and SQ, and the effect of VD supplementation on SQ. Results supported the hypothesis of a relevant interrelation between concentrations of male VD and semen parameters, with particular reference to sperm motility; on the contrary, evidence on the effect of VD on male sex steroid hormone levels was inconclusive. The results of this review hold up the thesis that VD plays a role in male reproduction. Most of the data highlighted a positive effect on semen quality, particularly in sperm motility, both in fertile and infertile men. Additional dedicated studies are required to elucidate the still controversial aspects of this topic.
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Affiliation(s)
- Gloria Calagna
- Obstetrics and Gynecology, “Villa Sofia Cervello” Hospital, IVF Unit, University of Palermo, Via Trabucco 180, 90145 Palermo, Italy
| | - Valeria Catinella
- Obstetrics and Gynecology, “Fondazione per gli Studi sulla Riproduzione Umana”–Clinica Candela, Via Valerio Villareale 54, 90141 Palermo, Italy
| | - Salvatore Polito
- Obstetrics and Gynecology, “Villa Sofia Cervello” Hospital, IVF Unit, University of Palermo, Via Trabucco 180, 90145 Palermo, Italy
| | - Antonio Schiattarella
- Department of Woman, Child and General and Specialized Surgery University of Campania “Luigi Vanvitelli”, Largo Madonna delle Grazie, 1, 80138 Naples, Italy
- Correspondence: ; Tel.: +39-39-2165-3275
| | - Pasquale De Franciscis
- Department of Woman, Child and General and Specialized Surgery University of Campania “Luigi Vanvitelli”, Largo Madonna delle Grazie, 1, 80138 Naples, Italy
| | - Francesco D’Antonio
- Center for High-Risk Pregnancy and Fetal Care, Department of Obstetrics and Gynecology, University of Chieti, Via dei Vestini 31, 66100 Chieti, Italy
| | - Giuseppe Calì
- Obstetrics and Gynecology, “Fondazione per gli Studi sulla Riproduzione Umana”–Clinica Candela, Via Valerio Villareale 54, 90141 Palermo, Italy
| | - Antonino Perino
- IVF Unit, Azienda Sanitaria Provinciale di Palermo, Via G. Cusmano 24, 90100 Palermo, Italy
| | - Gaspare Cucinella
- Obstetrics and Gynecology, “Villa Sofia Cervello” Hospital, IVF Unit, University of Palermo, Via Trabucco 180, 90145 Palermo, Italy
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Çin NNA, Yalçin M, Yardimci H. Vitamin D Deficiency During the First Trimester of Pregnancy and the Risk of Developing Gestational Diabetes Mellitus. J Obstet Gynecol Neonatal Nurs 2022; 51:526-535. [PMID: 35932884 DOI: 10.1016/j.jogn.2022.06.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 06/17/2022] [Accepted: 06/23/2022] [Indexed: 10/16/2022] Open
Abstract
OBJECTIVE To investigate the relationships among various factors that affect serum vitamin D levels and vitamin D in the first trimester and the risk of developing gestational diabetes mellitus (GDM). DESIGN A prospective cohort design. SETTING The family health center of Ankara, Turkey. PARTICIPANTS Out of 889 pregnant women who participated in the study in the first trimester (6-13 weeks gestation), 814 participated in GDM screening in the second trimester (24-28 weeks gestation). METHODS We determined serum vitamin D levels, demographic data, various biochemical and anthropometric parameters, and factors that affect vitamin D synthesis of participants in the first trimester and used logistic regression analysis to analyze the effects of the associations among vitamin D deficiency and the other variables on the occurrence of GDM. RESULTS Vitamin D deficiency in the first trimester was present in 425 (82.5%) participants. In the second trimester, 198 participants (24.3%) were diagnosed with GDM through oral glucose tolerance test screening. We detected GDM in the second trimester in 5.7% of participants who had vitamin D deficiency in the first trimester. Even after adjustment for vitamin D intake, clothing style, and duration of exposure to the sun, the risk of GDM was significantly greater in participants who were vitamin D deficient than those who were not deficient. The risk of GDM among women with vitamin D deficiency was sustained or increased significantly after we adjusted for age, parity, prepregnancy body mass index, history of diabetes, triglyceride levels, vitamin D intake, clothing style, and length of sun exposure, OR = 10.60, p < .001, 95% confidence interval [2.82, 39.76]. CONCLUSIONS Our results suggest that vitamin D deficiency in the first trimester may significantly increase the risk of developing GDM.
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Associations of serum vitamin D and Fok I polymorphism of receptor gene with unexplained recurrent spontaneous abortion. REV ROMANA MED LAB 2022. [DOI: 10.2478/rrlm-2022-0024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Abstract
Background: To investigate the associations of serum vitamin D and Fok I polymorphism of its receptor (VDR) with unexplained recurrent spontaneous abortion (URSA).
Methods: Ninety URSA patients and another 104 healthy pregnant women were selected as URSA and control groups, respectively. 25-Hydroxyvitamin D [25-(OH)D] level was detected by chemiluminescence. VDR gene Fok I polymorphism was analyzed by PCR, and the distribution of genotype frequency was calculated by Hardy-Weinberg equilibrium test. Association between Fok I polymorphism and susceptibility to URSA was investigated by logistic regression analysis.
Results: Gestational age, uterine height, waist circumference, 25-(OH)D level and proportions of Fok I FF and Ff genotypes were significantly lower in the URSA group (P<0.05). Compared with ff genotype, risk of URSA reduced for Ff and FF genotypes. Compared with allele f, risk of URSA was lower for allele F. 25-(OH)D level of ff genotype was significantly lower in the URSA group, which was lower than that of FF genotype (P<0.05). Compared with women with 25-(OH)D level >30 ng/mL and F allele (FF+Ff), the risk of URSA increased 2.45-, 2.43- and 5.34-fold for those with 25-(OH)D level >30 ng/mL and ff genotype, with 25-(OH)D level ≤30 ng/mL, and with ff genotype and 25-(OH)D level ≤30 ng/mL, respectively.
Conclusions: The 25-(OH)D level of the URSA group was significantly lower than that of normal pregnant women. Probably, VDR gene Fok I polymorphism is associated with URSA occurrence, and allele F decreases the risk. The risk of URSA dramatically increases in women with ff genotype and 25-(OH)D deficiency.
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15
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Vitamin D Status and Gestational Diabetes in Russian Pregnant Women in the Period between 2012 and 2021: A Nested Case-Control Study. Nutrients 2022; 14:nu14102157. [PMID: 35631298 PMCID: PMC9143366 DOI: 10.3390/nu14102157] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 05/12/2022] [Accepted: 05/17/2022] [Indexed: 11/17/2022] Open
Abstract
Several meta-analyses found an association between low maternal serum 25-hydroxyvitamin D (25(OH)D) level and gestational diabetes mellitus (GDM). However, some of them reported significant heterogeneity. We examined the association of serum 25(OH)D concentration measured in the first and in the second halves of pregnancy with the development of GDM in Russian women surveyed in the periods of 2012−2014 and 2018−2021. We conducted a case−control study (including 318 pregnant women) nested on two previous studies. In 2012−2014, a total of 214 women (83 GDM and 131 controls) were enrolled before 15 weeks of gestation and maternal serum 25(OH)D concentrations were measured twice: at 8th−14th week of gestation and simultaneously with two-hour 75 g oral glucose tolerance test (OGTT) at 24th−32nd week of gestation. In the period of 2018−2021, 104 women (56 GDM and 48 controls) were included after OGTT and 25(OH)D concentrations were measured at 24th−32nd week of gestation. Median 25(OH)D levels were 20.0 [15.1−25.7] vs. 20.5 [14.5−27.5] ng/mL (p = 0.565) in GDM and control group in the first half of pregnancy and 25.3 [19.8−33.0] vs. 26.7 [20.8−36.8] ng/mL (p = 0.471) in the second half of pregnancy, respectively. The prevalence rates for vitamin D deficiency (25(OH)D levels < 20 ng/mL) were 49.4% and 45.8% (p = 0.608) in the first half of pregnancy and 26.2% vs. 22.1% (p = 0.516) in the second half of pregnancy in women who developed GDM and in women without GDM, respectively. The frequency of vitamin D supplements intake during pregnancy increased in 2018−2021 compared to 2012−2014 (p = 0.001). However, the third trimester 25(OH)D levels and prevalence of vitamin D deficiency (25.5 vs. 23.1, p = 0.744) did not differ in women examined in the periods of 2012−2014 and 2018−2021. To conclude, there was no association between gestational diabetes risk and maternal 25(OH)D measured both in the first and in the second halves of pregnancy. The increased prevalence of vitamin D supplements intake during pregnancy by 2018−2021 did not lead to higher levels of 25(OH)D.
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Kahramanoglu Ö, Schiattarella A, Demirci O, Sisti G, Ammaturo FP, Trotta C, Ferrari F, Rapisarda AMC. Preeclampsia: state of art and future perspectives. A special focus on possible preventions. J OBSTET GYNAECOL 2022; 42:766-777. [PMID: 35469530 DOI: 10.1080/01443615.2022.2048810] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Preeclampsia (PE) is characterised by the new onset of hypertension after the 20th week of pregnancy, with or without proteinuria or hypertension that leads to end-organ dysfunction. Since the only definitive treatment is delivery, PE still represents one of the leading causes of preterm birth and perinatal mobility and mortality. Therefore, any strategies that aim to reduce adverse outcomes are based on early primary prevention, prenatal surveillance and prophylactic interventions. In the last decade, intense research has been focussed on the study of predictive models in order to identify women at higher risk accurately. To date, the most effective screening model is based on the combination of anamnestic, demographic, biophysical and maternal biochemical factors. In this review, we provide a detailed discussion about the current and future perspectives in the field of PE. We will examine pathogenesis, risk factors and clinical features. Moreover, recent developments in screening and prevention strategies, novel therapies and healthcare management strategies will be discussed.
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Affiliation(s)
- Özge Kahramanoglu
- Department of Perinatology, Zeynep Kamil Education and Research Hospital, İstanbul, Turkey
| | - Antonio Schiattarella
- Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Oya Demirci
- Department of Perinatology, Zeynep Kamil Education and Research Hospital, İstanbul, Turkey
| | - Giovanni Sisti
- Department of Obstetrics and Gynecology, New York Health and Hospitals/Lincoln, Bronx, NY, USA
| | - Franco Pietro Ammaturo
- Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Carlo Trotta
- Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Federico Ferrari
- Department of Women's and Reproductive Health, University of Oxford, Oxford, UK
| | - Agnese Maria Chiara Rapisarda
- Department of General Surgery and Medical Surgical Specialties, Obstetrics and Gynecology Unit, University of Catania, Catania, Italy
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de Mendonça ELSS, Fragoso MBT, de Oliveira JM, Xavier JA, Goulart MOF, de Oliveira ACM. Gestational Diabetes Mellitus: The Crosslink among Inflammation, Nitroxidative Stress, Intestinal Microbiota and Alternative Therapies. Antioxidants (Basel) 2022; 11:129. [PMID: 35052633 PMCID: PMC8773111 DOI: 10.3390/antiox11010129] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 12/30/2021] [Accepted: 01/04/2022] [Indexed: 01/09/2023] Open
Abstract
Gestational diabetes mellitus (GDM) is characterized by a set of metabolic complications arising from adaptive failures to the pregnancy period. Estimates point to a prevalence of 3 to 15% of pregnancies. Its etiology includes intrinsic and extrinsic aspects of the progenitress, which may contribute to the pathophysiogenesis of GDM. Recently, researchers have identified that inflammation, oxidative stress, and the gut microbiota participate in the development of the disease, with potentially harmful effects on the health of the maternal-fetal binomial, in the short and long terms. In this context, alternative therapies were investigated from two perspectives: the modulation of the intestinal microbiota, with probiotics and prebiotics, and the use of natural products with antioxidant and anti-inflammatory properties, which may mitigate the endogenous processes of the GDM, favoring the health of the mother and her offspring, and in a future perspective, alleviating this critical public health problem.
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Affiliation(s)
- Elaine Luiza Santos Soares de Mendonça
- Institute of Chemistry and Biotechnology, Federal University of Alagoas, Maceio 57072-970, Alagoas, Brazil; (E.L.S.S.d.M.); (M.B.T.F.); (J.M.d.O.); (J.A.X.)
| | - Marilene Brandão Tenório Fragoso
- Institute of Chemistry and Biotechnology, Federal University of Alagoas, Maceio 57072-970, Alagoas, Brazil; (E.L.S.S.d.M.); (M.B.T.F.); (J.M.d.O.); (J.A.X.)
| | - Jerusa Maria de Oliveira
- Institute of Chemistry and Biotechnology, Federal University of Alagoas, Maceio 57072-970, Alagoas, Brazil; (E.L.S.S.d.M.); (M.B.T.F.); (J.M.d.O.); (J.A.X.)
| | - Jadriane Almeida Xavier
- Institute of Chemistry and Biotechnology, Federal University of Alagoas, Maceio 57072-970, Alagoas, Brazil; (E.L.S.S.d.M.); (M.B.T.F.); (J.M.d.O.); (J.A.X.)
| | - Marília Oliveira Fonseca Goulart
- Institute of Chemistry and Biotechnology, Federal University of Alagoas, Maceio 57072-970, Alagoas, Brazil; (E.L.S.S.d.M.); (M.B.T.F.); (J.M.d.O.); (J.A.X.)
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Akgöl S, Budak MŞ, Oğlak SC, Ölmez F, Dilek ME, Kartal S. Can maternal abdominal fat thickness predict antenatal insulin therapy in patients with gestational diabetes mellitus? J Obstet Gynaecol Res 2021; 48:634-639. [PMID: 34931403 DOI: 10.1111/jog.15128] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 11/13/2021] [Accepted: 12/05/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE This study aimed to investigate the effectiveness of abdominal subcutaneous fat thickness (ASFT) in predicting antenatal insulin therapy (AIT) in patients with gestational diabetes mellitus (GDM). METHODS A prospective study was conducted on patients with regulated blood sugar levels (n = 50) and those with unregulated blood sugar (n = 50) although medical nutrition therapy (MNT) was initiated and then AIT was applied. Using receiver operator characteristic (ROC) curve analysis, appropriate ASFT cut-off point values were found for the prediction of cases that required AIT after MNT in GDM pregnancies. RESULTS Patients with GDM who needed AIT had a significantly higher ASFT value compared to those with GDM who did not need AIT. The optimal ASFT cutoff was 21.7 mm in predicting cases that required AIT after MNT (sensitivity, specificity, negative, and positive predictive values were 68.0%, 64.0%, 65.8%, and 66.6%, respectively). The risk of AIT increased 3.77-fold in those with ASFT > 21.7 mm in GDM pregnancies (p = 0.001). CONCLUSION The ASFT value was significantly higher in cases with GDM, with blood glucose levels not regulated despite MNT and AIT being then needed, compared to patients with blood glucose levels regulated by MNT, and who did not need AIT. Also, patients requiring AIT can be determined with moderate to high sensitivity and specificity using a cut-off value of ASFT > 21.7 mm. The ASFT > 21.7 mm cut-off point was seen to be more effective than BMI ≥ 30 kg/m2 in the determination of cases where AIT is required.
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Affiliation(s)
- Sedat Akgöl
- Department of Obstetrics and Gynecology, Başakşehir Çam and Sakura City Hospital, Istanbul, Turkey
| | - Mehmet Şükrü Budak
- Department of Obstetrics and Gynecology, Private Can Hospital, Izmir, Turkey
| | - Süleyman Cemil Oğlak
- Department of Obstetrics and Gynecology, Health Sciences University, Gazi Yaşargil Training and Research Hospital, Diyarbakır, Turkey
| | - Fatma Ölmez
- Department of Obstetrics and Gynecology, Health Sciences University, Kanuni Sultan Süleyman Training and Research Hospital, Istanbul, Turkey
| | - Mehmet Emin Dilek
- Department of Internal Medicine, Health Sciences University, Gazi Yaşargil Training and Research Hospital, Diyarbakır, Turkey
| | - Serhat Kartal
- Department of Radiology, Health Sciences University, Gazi Yaşargil Training and Research Hospital, Diyarbakır, Turkey
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Rizzo G, Goggi S, Giampieri F, Baroni L. A review of mushrooms in human nutrition and health. Trends Food Sci Technol 2021. [DOI: 10.1016/j.tifs.2020.12.025] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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20
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Somigliana E, Sarais V, Reschini M, Ferrari S, Makieva S, Cermisoni GC, Paffoni A, Papaleo E, Vigano P. Single oral dose of vitamin D 3 supplementation prior to in vitro fertilization and embryo transfer in normal weight women: the SUNDRO randomized controlled trial. Am J Obstet Gynecol 2021; 225:283.e1-283.e10. [PMID: 33894153 DOI: 10.1016/j.ajog.2021.04.234] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 04/12/2021] [Accepted: 04/17/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND Improving in vitro fertilization success is an unmet need. Observational studies have suggested that women with deficient or insufficient vitamin D have lower chances of in vitro fertilization success, but whether supplementation improves clinical pregnancy rate remains unclear. OBJECTIVE This study aimed to determine whether oral vitamin D3 supplementation improves clinical pregnancy in women undergoing an in vitro fertilization cycle. STUDY DESIGN The "supplementation of vitamin D and reproductive outcome" trial is a 2-center randomized superiority double-blind placebo-controlled trial. Subjects were recruited between October 2016 and January 2019. Participants were women aged 18 to 39 years with low vitamin D (peripheral 25-hydroxyvitamin D of <30 ng/mL), serum calcium of ≥10.6 mg/dL, body mass index of 18 to 25 kg/m2, and antimüllerian hormone levels of >0.5 ng/mL and starting their first, second, or third treatment cycle of conventional in vitro fertilization or intracytoplasmic sperm injection. The primary outcome was the cumulative clinical pregnancy rate per cycle. Pregnancies obtained with both fresh or frozen embryo transfers were included. Clinical pregnancy was defined as an intrauterine gestational sac with a viable fetus. The primary analysis was performed according to the intention-to-treat principle and could also include natural conceptions. Secondary outcomes included total dose of gonadotropins used, embryologic variables (number of oocytes retrieved, number of suitable oocytes retrieved, fertilization rate, and rate of top-quality embryos), and clinical outcomes (miscarriage rate and live birth rate). RESULTS Overall, 630 women were randomized 2 to 12 weeks before the initiation of the in vitro fertilization cycle to receive either a single dose of 600,000 IU of vitamin D3 (n=308) or placebo (n=322). Interestingly, 113 (37%) and 130 (40%) women achieved a clinical pregnancy in the treatment and placebo groups, respectively (P=.37). The risk ratio of clinical pregnancy in women receiving vitamin D3 was 0.91 (95% confidence interval, 0.75-1.11). Compared with the placebo, vitamin D3 supplementation did not improve the rate of clinical pregnancy. Exploratory subgroup analyses for body mass index, age, indication to in vitro fertilization, ovarian reserve, interval between drug administration and initiation of the cycle, and basal levels of 25-hydroxyvitamin D failed to highlight any clinical situation that could benefit from the supplementation. CONCLUSION In women with normal weight with preserved ovarian reserve and low vitamin D levels undergoing in vitro fertilization cycles, a single oral dose of 600,000 IU of vitamin D3 did not improve the rate of clinical pregnancy. Although the findings do not support the use of vitamin D3 supplementation to improve in vitro fertilization success rates, further studies are required to rule out milder but potentially interesting benefits and explore the effectiveness of alternative modalities of supplementation.
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Salem AM. Variation of Leptin During Menstrual Cycle and Its Relation to the Hypothalamic-Pituitary-Gonadal (HPG) Axis: A Systematic Review. Int J Womens Health 2021; 13:445-458. [PMID: 34007218 PMCID: PMC8121381 DOI: 10.2147/ijwh.s309299] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 04/19/2021] [Indexed: 12/23/2022] Open
Abstract
Recently, adipose tissue has been identified as endocrine organ in addition to its action as energy store; it produces a large number of biologically active mediators known as adipocytokines. Significantly, adipocytokines were found to be involved in the physiology of many body functions, including reproduction. The role of body weight, body fat compositions, and nutrition has been largely investigated using animal models and human studies. Malnutrition and/or abnormal body weight may induce disturbances in fertility, puberty, pregnancy, and menstrual cycles. Leptin was the first discovered adipocytokine, and a large body of data over the last 25 years has shown that leptin is not only a molecule that reflects energy stores in the body, but is also an important cytokine involved in many physiological functions, such as inflammatory response, insulin sensitivity, bone metabolism, immunity, and most importantly, reproductive function. Leptin controls the normal physiology of the female reproductive system; it interacts with the hypothalamic–pituitary–gonadal (HPG) axis by a complex mechanism that connects energy homeostasis with reproduction. However, observational studies have demonstrated inconsistent results about leptin variation during normal menstrual cycle, and the mechanisms involved in the interplay between leptin and the hormones of the HPG axis are largely unknown. This review focuses on leptin variation during normal menstrual cycles and its relation to the hypothalamic–pituitary–gonadal axis, and the effect of overweight/obesity on leptin during menstrual cycle is further reviewed.
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Affiliation(s)
- Ayad Mohammed Salem
- Department of Physiology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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Zhao X, Li N, Jia R, Chen S, Wang L. The factors affecting the physical development of neonates in pregnant women with or without gestational diabetes mellitus. PLoS One 2021; 16:e0251024. [PMID: 33930086 PMCID: PMC8087091 DOI: 10.1371/journal.pone.0251024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Accepted: 04/19/2021] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES To explore the factors affecting neonatal physical development in pregnant women with or without gestational diabetes mellitus (GDM). METHODS The subjects were selected from the pregnant woman giving birth in 2nd Affiliated Hospital of Zhengzhou University, from November 2015 to May 2016. The age, occupation, education level, gestational age, body weight before pregnancy, body weight at delivery, body height, delivery pattern, GDM status of pregnant women and neonatal gender, birth weight (BW), chest circumference (CC), head circumference (HC) and birth length (BL) were collected through medical records and questionnaires. The clinical data were retrospectively analyzed and studied. RESULTS The significant differences were found between women with GDM and without GDM in following neonatal variables (P<0.05): BW, CC, and HC. GDM status increased the incidence of macrosomia (OR = 2.241, 95% CI: 1.406-3.573), large CC (OR = 2.470, 95% CI: 1.687-3.6153). Gestational weight gain (GWG) above IOM guideline was risk factor for macrosomia (OR = 1.763, 95% CI:1.098-2.833), large HC (OR = 1,584, 95% CI: 1.093-2.296) and large CC (OR = 1.707, 95% CI:1.163-2.506). Underweight was risk factor for short BL (OR = 2.543, 95% CI:1.161-5.571) and small CC (OR = 1.901, 95% CI:1.064-3.394). Female neonate was prone to appear short BL(OR = 2.831, 95% CI: 1.478-5.422) and small HC (OR = 2.750, 95% CI: 1.413-5.350), and not likely to macrosomia (OR = 0.538, 95% CI: 0.343-0.843), longer BL (OR = 0.584, 95% CI: 0.401-0.850), large HC (OR = 0.501, 95% CI: 0.352-0.713), and (OR = 0.640, 95% CI: 0.446-0.917). For women with GDM, gestational age was an risk factor of neonatal BW (low BW: OR = 0.207, 95% CI: 0.085-0.503; macrosomia: OR = 1.637, 95% CI: 1.177-2.276), BL (short BL: OR = 0.376, 95% CI: 0.241-0.585; long BL: OR = 1.422, 95% CI: 1.054-1.919), HC (small HC: OR = 0.343, 95% CI: 0.202-0.583; large HC: OR = 1.399, 95% CI: 1.063-1.842) and CC (small CC: OR = 0.524, 95% CI: 0.374-0.733; large CC: OR = 1.485, 95% CI: 1.138-1.936). CONCLUSIONS In our study, gestational age, GDM status, neonatal gender, GWG and pre-pregnancy body mass index (BMI) are associated the abnormal physical development of neonates. In women with GDM, gestational age was correlate with neonatal abnormal physical developments.
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Affiliation(s)
- Xiaodi Zhao
- College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Nana Li
- Zhengzhou Central Hospital, Zhengzhou, Henan, China
| | - Runping Jia
- 2 Affiliated Hospital of Zhengzhou University, Henan, China
| | - Shumin Chen
- College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Ling Wang
- College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
- Faculty of Medicine, Macau University of Science and Technology, Macau, China
- * E-mail: ,
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Mosavat M, Mirsanjari M, Lwaleed BA, Kamarudin M, Omar SZ. Adipocyte-Specific Fatty Acid-Binding Protein (AFABP) and Chemerin in Association with Gestational Diabetes: A Case-Control Study. J Diabetes Res 2021; 2021:5533802. [PMID: 34007846 PMCID: PMC8100411 DOI: 10.1155/2021/5533802] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 04/21/2021] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Adipocytokines participate in regulating the inflammatory response in glucose homeostasis and type 2 diabetes. However, among these peptides, the role of adipocyte-specific fatty-acid-binding protein (AFABP), chemerin, and secreted protein acidic and rich in cysteine (SPARC) in gestational diabetes (GDM) has not been fully investigated. METHOD The maternal fasting level of adipocytokines of 53 subjects with GDM and 43 normal pregnant (NGDM) was measured using multiplex immunoassay at 24-28 weeks, before delivery, immediate postpartum, and 2-6 months postpuerperium. RESULTS Higher levels of AFABP were associated with a 3.7-fold higher risk of GDM. Low chemerin levels were associated with a 3.6-fold higher risk of GDM. Interleukin-10 (IL-10) was inversely associated with the risk of GDM. SPARC had no association with GDM. AFABP was directly correlated to interleukin-6 (r = 0.50), insulin resistance index (r = 0.26), and body mass index (r = 0.28) and inversely correlated to C-reactive protein (r = -0.27). Chemerin levels were directly and strongly correlated with IL-10 (r = 0.41) and interleukin-4 (r = 0.50) and inversely correlated to insulin resistance index (r = -0.23) in GDM but not NGDM. In the longitudinal assessment, there were no significant differences in AFABP and chemerin concentrations of both studied groups. CONCLUSION AFABP and chemerin were associated with a higher risk of GDM. These adipocytokines were related to insulin resistance, body mass index, and inflammation in pregnant women diagnosed with GDM.
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Affiliation(s)
- Maryam Mosavat
- Department of Obstetrics & Gynecology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Mitra Mirsanjari
- Mazandaran University of Medical Sciences, Emam Khomeini Hospital, Fereidonkenar, Mazandaran, Iran
| | | | - Maherah Kamarudin
- Department of Obstetrics & Gynecology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Siti Zawiah Omar
- Department of Obstetrics & Gynecology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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Schiattarella A, Lombardo M, Morlando M, Rizzo G. The Impact of a Plant-Based Diet on Gestational Diabetes: A Review. Antioxidants (Basel) 2021; 10:antiox10040557. [PMID: 33918528 PMCID: PMC8065523 DOI: 10.3390/antiox10040557] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 03/30/2021] [Accepted: 03/31/2021] [Indexed: 12/13/2022] Open
Abstract
Gestational diabetes mellitus (GDM) represents a challenging pregnancy complication in which women present a state of glucose intolerance. GDM has been associated with various obstetric complications, such as polyhydramnios, preterm delivery, and increased cesarean delivery rate. Moreover, the fetus could suffer from congenital malformation, macrosomia, neonatal respiratory distress syndrome, and intrauterine death. It has been speculated that inflammatory markers such as tumor necrosis factor-alpha (TNF-α), interleukin (IL) 6, and C-reactive protein (CRP) impact on endothelium dysfunction and insulin resistance and contribute to the pathogenesis of GDM. Nutritional patterns enriched with plant-derived foods, such as a low glycemic or Mediterranean diet, might favorably impact on the incidence of GDM. A high intake of vegetables, fibers, and fruits seems to decrease inflammation by enhancing antioxidant compounds. This aspect contributes to improving insulin efficacy and metabolic control and could provide maternal and neonatal health benefits. Our review aims to deepen the understanding of the impact of a plant-based diet on oxidative stress in GDM.
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Affiliation(s)
- Antonio Schiattarella
- Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (A.S.); (M.M.)
| | - Mauro Lombardo
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, 00166 Rome, Italy;
| | - Maddalena Morlando
- Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (A.S.); (M.M.)
| | - Gianluca Rizzo
- Independent Researcher, Via Venezuela 66, 98121 Messina, Italy
- Correspondence: ; Tel.: +39-320-897-6687
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Association of pre- and early-pregnancy factors with the risk for gestational diabetes mellitus in a large Chinese population. Sci Rep 2021; 11:7335. [PMID: 33795771 PMCID: PMC8016847 DOI: 10.1038/s41598-021-86818-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 03/19/2021] [Indexed: 02/07/2023] Open
Abstract
Gestational diabetes mellitus (GDM) has aroused wide public concern, as it affects approximately 1.8-25.1% of pregnancies worldwide. This study aimed to examine the association of pre-pregnancy demographic parameters and early-pregnancy laboratory biomarkers with later GDM risk, and further to establish a nomogram prediction model. This study is based on the big obstetric data from 10 "AAA" hospitals in Xiamen. GDM was diagnosed according to the International Association of Diabetes and Pregnancy Study Group (IADPSG) criteria. Data are analyzed using Stata (v14.1) and R (v3.5.2). Total 187,432 gestational women free of pre-pregnancy diabetes mellitus were eligible for analysis, including 49,611 women with GDM and 137,821 women without GDM. Irrespective of confounding adjustment, eight independent factors were consistently and significantly associated with GDM, including pre-pregnancy body mass index (BMI), pre-pregnancy intake of folic acid, white cell count, platelet count, alanine transaminase, albumin, direct bilirubin, and creatinine (p < 0.001). Notably, per 3 kg/m2 increment in pre-pregnancy BMI was associated with 22% increased risk [adjusted odds ratio (OR) 1.22, 95% confidence interval (CI) 1.21-1.24, p < 0.001], and pre-pregnancy intake of folic acid can reduce GDM risk by 27% (adjusted OR 0.73, 95% CI 0.69-0.79, p < 0.001). The eight significant factors exhibited decent prediction performance as reflected by calibration and discrimination statistics and decision curve analysis. To enhance clinical application, a nomogram model was established by incorporating age and above eight factors, and importantly this model had a prediction accuracy of 87%. Taken together, eight independent pre-/early-pregnancy predictors were identified in significant association with later GDM risk, and importantly a nomogram modeling these predictors has over 85% accuracy in early detecting pregnant women who will progress to GDM later.
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Risk assessment of shoulder dystocia via the difference between transverse abdominal and biparietal diameters: A retrospective observational cohort study. PLoS One 2021; 16:e0247077. [PMID: 33577577 PMCID: PMC7880486 DOI: 10.1371/journal.pone.0247077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 01/31/2021] [Indexed: 11/19/2022] Open
Abstract
Shoulder dystocia is defined as vaginal cephalic delivery that requires additional obstetric maneuvers to deliver the fetus after the head has been delivered and gentle traction has failed. A bigger difference between the transverse abdominal diameter (TAD) (abdominal circumference [AC]/π) and biparietal diameter (BPD) (TAD-BPD) has been reported as a risk factor for shoulder dystocia in different countries; however, it remains unclear if this relationship is relevant in Japan. This study aimed to clarify the association between TAD-BPD and shoulder dystocia after adjusting for potential confounding factors in a Japanese cohort. We retrospectively examined 1,866 Japanese women who delivered vaginally between 37+0 and 41+6 weeks of gestation at the University of Yamanashi Hospital between June 2012 and November 2018. The cutoff value of TAD-BPD associated with shoulder dystocia and the association between TAD-BPD and shoulder dystocia were evaluated. The mean maternal age was 32.5±5.3 years; the patients included 1,053 nulliparous women (57.5%), 915 male infants (49.0%), 154 women with gestational diabetes mellitus (GDM) (8.3%), and 5 infants with macrosomia (0.3%). The mean TAD-BPD was 9.03±4.7 mm. The overall incidence of shoulder dystocia was 2.4% (44/1866). The cutoff value to predict shoulder dystocia was 12.0 mm (sensitivity, 61.4%; specificity, 73.8%; likelihood ratio, 2.34; positive predictive value, 5.4%; negative predictive value, 98.8%). We then used a multivariable logistic regression analysis to examine the association between TAD-BPD and shoulder dystocia while controlling for the potential confounding factors. In multivariate analyses, TAD-BPD ≥12.0 mm (adjusted odds ratio [OR], 4.39; 95% confidence interval [CI], 2.35-8.18) and GDM (adjusted OR, 3.59; 95% CI, 1.71-7.52) were associated with shoulder dystocia. Although TAD-BPD appears to be a relevant risk factor for shoulder dystocia, sonographic fetal anthropometric measures do not appear to be useful in screening for shoulder dystocia due to a low positive predictive value.
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Fedullo AL, Schiattarella A, Morlando M, Raguzzini A, Toti E, De Franciscis P, Peluso I. Mediterranean Diet for the Prevention of Gestational Diabetes in the Covid-19 Era: Implications of Il-6 In Diabesity. Int J Mol Sci 2021; 22:1213. [PMID: 33530554 PMCID: PMC7866163 DOI: 10.3390/ijms22031213] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 01/21/2021] [Accepted: 01/22/2021] [Indexed: 02/07/2023] Open
Abstract
The aim of this review is to highlight the influence of the Mediterranean Diet (MedDiet) on Gestational Diabetes Mellitus (GDM) and Gestational Weight Gain (GWG) during the COVID-19 pandemic era and the specific role of interleukin (IL)-6 in diabesity. It is known that diabetes, high body mass index, high glycated hemoglobin and raised serum IL-6 levels are predictive of poor outcomes in coronavirus disease 2019 (COVID-19). The immunopathological mechanisms of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection include rising levels of several cytokines and in particular IL-6. The latter is associated with hyperglycemia and insulin resistance and could be useful for predicting the development of GDM. Rich in omega-3 polyunsaturated fatty acids, vitamins, and minerals, MedDiet improves the immune system and could modulate IL-6, C reactive protein and Nuclear Factor (NF)-κB. Moreover, polyphenols could modulate microbiota composition, inhibit the NF-κB pathway, lower IL-6, and upregulate antioxidant enzymes. Finally, adhering to the MedDiet prior to and during pregnancy could have a protective effect, reducing GWG and the risk of GDM, as well as improving the immune response to viral infections such as COVID-19.
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Affiliation(s)
- Anna Lucia Fedullo
- Research Centre for Food and Nutrition, Council for Agricultural Research and Economics (CREA-AN), 00178 Rome, Italy; (A.L.F.); (A.R.); (E.T.)
| | - Antonio Schiattarella
- Department of Woman, Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, 80138 Naples, Italy; (A.S.); (M.M.); (P.D.F.)
| | - Maddalena Morlando
- Department of Woman, Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, 80138 Naples, Italy; (A.S.); (M.M.); (P.D.F.)
| | - Anna Raguzzini
- Research Centre for Food and Nutrition, Council for Agricultural Research and Economics (CREA-AN), 00178 Rome, Italy; (A.L.F.); (A.R.); (E.T.)
| | - Elisabetta Toti
- Research Centre for Food and Nutrition, Council for Agricultural Research and Economics (CREA-AN), 00178 Rome, Italy; (A.L.F.); (A.R.); (E.T.)
| | - Pasquale De Franciscis
- Department of Woman, Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, 80138 Naples, Italy; (A.S.); (M.M.); (P.D.F.)
| | - Ilaria Peluso
- Research Centre for Food and Nutrition, Council for Agricultural Research and Economics (CREA-AN), 00178 Rome, Italy; (A.L.F.); (A.R.); (E.T.)
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Alhabeeb H, Kord-Varkaneh H, Tan SC, Găman MA, Otayf BY, Qadri AA, Alomar O, Salem H, Al-Badawi IA, Abu-Zaid A. The influence of omega-3 supplementation on vitamin D levels in humans: a systematic review and dose-response meta-analysis of randomized controlled trials. Crit Rev Food Sci Nutr 2020; 62:3116-3123. [PMID: 33356450 DOI: 10.1080/10408398.2020.1863905] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Inconsistencies exist with regard to the influence of omega-3 supplementation on 25-hydroxyvitamin D (25(OH)D) levels, which could be attributed to many factors, such as the duration and dose of omega-3 supplementation, and individuals' baseline 25(OH)D levels. Therefore, to address the inconsistencies, we conducted a systematic review and dose-response meta-analysis to accurately determine the effect of omega-3 supplementation on 25(OH)D levels in humans. METHODS We performed a comprehensive literature search in Web of Science, PubMed/Medline, Scopus, and Embase databases from inception up to January 2020. We included only randomized controlled trials (RCTs). We used weighted mean difference (WMD) with 95% confidence interval (CI) to assess the influence of omega-3 supplementation on serum 25(OH)D levels using the random-effects model. RESULTS Our pooled results of 10 RCTs demonstrated an overall significant increase in 25(OH)D levels following omega-3 intake (WMD = 3.77 ng/ml, 95% CI: 1.29, 6.25). In addition, 25(OH)D levels were significantly increased when the intervention duration lasted >8 weeks and when the baseline serum 25(OH)D level was ˂20 ng/ml. Moreover, omega-3 intake ≤1000 mg/day resulted in higher 25(OH)D levels compared to omega-3 intake >1000 mg/day. CONCLUSION In conclusion, omega-3 supplementation increased 25(OH)D concentrations, particularly with dosages ≤1000 mg/day and intervention durations >8 weeks.
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Affiliation(s)
- Habeeb Alhabeeb
- Clinical Research, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Hamed Kord-Varkaneh
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, Student Research Committee, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shing Cheng Tan
- UKM Medical Molecular Biology Institute, University Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | | | | | | | - Osama Alomar
- Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Hany Salem
- Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Ismail A Al-Badawi
- Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Ahmed Abu-Zaid
- Department of Pharmacology, College of Graduate Health Sciences, University of Tennessee Health Science Center, Memphis, Tennessee, USA.,College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
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Baroni L, Rizzo G, Goggi S, Giampieri F, Battino M. Vegetarian diets during pregnancy: effects on the mother's health. A systematic review. Food Funct 2020; 12:466-493. [PMID: 33306085 DOI: 10.1039/d0fo01991g] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
While interest in vegetarian nutrition has been steadily increasing, some aspects have not yet been consistently investigated. One topic requiring evidence-based confirmation is the adoption of a vegetarian diet during pregnancy and lactation. Maternal diet is not only correlated with the fetus's and infant's health, but appears relevant for that of the mother as well. Not only is an adequate delivery of nutrients to the fetus and infant mandatory, but the increased physiological needs of the maternal body require an adequate supply of nutrients and can represent harmful stress events that may lead to well-defined pathological conditions. In this review, we aim to systematically investigate state-of-the-art of vegetarian diets during pregnancy and lactation, focusing on maternal nutritional status and pregnancy outcomes. Data are scarce, often inconsistent and not homogeneous for many of the topics we considered, mainly because only a few studies have been performed in developed countries, whereas other studies have derived from developing countries, where vegetarianism can be a proxy indicator of malnutrition. For this reason, we did not find sufficient data to provide evidence-based information and recommendations. To date, the available literature does not clearly support a negative impact on the mother's health and pregnancy outcomes, but, analogously with the findings in the vegetarian adult population, an improvement in the quality of studies might facilitate finding more information on the possible positive impact of well-planned vegetarian diets during pregnancy and lactation. More epidemiological and interventional studies are warranted, in order to address the question as to whether vegetarian nutrition represents an advantage for the mother or poses nutritional issues that need further attention.
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Affiliation(s)
- Luciana Baroni
- Scientific Society for Vegetarian Nutrition, Venice, Italy
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Role of Vitamin-D Receptor (VDR) single nucleotide polymorphisms in gestational hypertension development: A case-control study. PLoS One 2020; 15:e0239407. [PMID: 33186385 PMCID: PMC7665745 DOI: 10.1371/journal.pone.0239407] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 09/05/2020] [Indexed: 01/01/2023] Open
Abstract
Background Recent literature data have highlighted the important role of hypovitaminosis D in pregnancy complications and prenatal/perinatal health. Vitamin D action takes place through vitamin D receptor (VDR) activation. Two single nucleotide polymorphisms of VDR gene, FokI and BsmI, have been reported to affect VDR molecular signaling and be associated with several disorders, including hypertension. Methods We carried out a case-control study aimed to assess vitamin D serum levels together with the distribution of VDR FokI and BsmI in a population of 116 pregnant women with gestational hypertension (GH) and 69 normotensive pregnant women (CTR). Results Hypovitaminosis D was largely prevalent both in GH (81%) and CTR (69%) pregnant women. Vitamin D insufficiency (10–30 ng/ml) had a similar frequency in both cohorts (GH 60% vs CTR 58%), while vitamin D deficiency (<10 ng/ml) was more frequent in GH cohort than in CTR one (21% vs 11%). Regression analysis showed that GH was significantly (p = 0.031) linked to vitamin D status. Vitamin D deficiency was associated with a threefold-increased risk of developing GH, while a normal vitamin D status was protective against this pregnancy disorder. The VDR FF/bB haplotype was the most frequent in GH cohort, and resulted to increase by two folds the risk for GH. Notably, hypovitaminosis D was found in 92% of FF/bB GH pregnant women, 27% of which had deficient vitamin D levels compared with 11% of their normotensive counterparts. Conclusions Despite being preliminary, these findings suggest that genotyping of pregnant women for VDR polymorphisms may be useful for a tailored vitamin D supplementation strategy.
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Yue CY, Ying CM. Sufficience serum vitamin D before 20 weeks of pregnancy reduces the risk of gestational diabetes mellitus. Nutr Metab (Lond) 2020; 17:89. [PMID: 33088335 PMCID: PMC7574245 DOI: 10.1186/s12986-020-00509-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 10/08/2020] [Indexed: 12/12/2022] Open
Abstract
Objective Our aim was to evaluate the relationship between serum vitamin D levels before 20 weeks of pregnancy and the risk of gestational diabetes mellitus. Methods This study is a retrospective study. We analyzed the relationship between serum 25 (OH) D level before 20 weeks of pregnancy (first antenatal examination) and the risk of gestational diabetes mellitus. Age, parity and pre-pregnancy body mass index were used as confounding factors. 8468 pregnant women were enrolled in this study between January 2018 and March 2020 at the Obstetrics and Gynecology Hospital of Fudan University. Adjusted smoothing splinespline plots, subgroup analysis and multivariate logistic regression analysis was conducted to estimate the relative risk between 25(OH)D and gestational diabetes mellitus. Results After fully adjusting the confounding factors, serum vitamin D is a protective factor in gestational diabetes mellitus (OR = 0.90). Compared with vitamin D deficiency, vitamin D insufficiency (OR = 0.78), sufficience (OR = 0.82) are a protective factor for gestational diabetes mellitus. Conclusion Sufficience vitamin D before 20 weeks of pregnancy is a protective factor for gestational diabetes mellitus. Vitamin D > 20 ng/mL can reduce the risk of GDM, which is not much different from the effect of > 30 ng/mL. The protective effect of vitamin D is more significant in obese pregnant women.
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Affiliation(s)
- Chao-Yan Yue
- Department of Laboratory Medicine, Obstetrics and Gynecology Hospital of Fudan University, Fang Xie Road, No 419, Shanghai, China
| | - Chun-Mei Ying
- Department of Laboratory Medicine, Obstetrics and Gynecology Hospital of Fudan University, Fang Xie Road, No 419, Shanghai, China
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Mainini G, Passaro M, Schiattarella A, Franciscis PD, Donna MCD, Trezza G. Prevention and treatment of cystitis during menopause: efficacy of a nutraceutical containing D-mannose, inulin, cranberry, bearberry, Olea europaea, Orthosiphon and Lactobacillus acidophilus. PRZEGLAD MENOPAUZALNY = MENOPAUSE REVIEW 2020; 19:130-134. [PMID: 33100948 PMCID: PMC7573332 DOI: 10.5114/pm.2020.99567] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 06/23/2020] [Indexed: 11/17/2022]
Abstract
AIM OF THE STUDY To evaluate the efficacy of a nutraceutical compound containing Uticlin® (D-mannose, cranberry, bearberry, Olea europaea), inulin, Orthosiphon and Lactobacillus acidophilus, in preventing recurrent urinary tract infections (UTIs) in menopausal women. MATERIAL AND METHODS This was a prospective cohort study of menopausal women recruited with a history of recurrent UTIs in the previous twelve months and who intended to treat their bladder problem without the use of antibiotics and/or anti-inflammatories. Women were proposed the use of an oral nutraceutical compound. The drug was taken for ten days, every month. Women were assigned to two parallel cohorts: patients using (group 1) or not using (group 2) this nutraceutical compound. The primary objective of the study was to evaluate the number of women with less than two infective episodes in the 6-month follow-up and less than three episodes in the 12-month follow-up. The secondary endpoints were to evaluate the reduction of related symptoms at 12-month follow-up, according to the Visual Analog Scale (VAS). RESULTS At 6 months of therapy, the reduction in the number of patients with ≥ 2 UTIs was statistically significant (p < 0.05) compared to baseline only in group 1. At 12 months, the number of patients who were disease-free was significantly higher (p < 0.05) in group 1 compared to group 2. Moreover, the improvement of related symptoms was statistically significant (p < 0.05) in group 1, as shown by the reduction in the VAS scale value. CONCLUSIONS In menopausal women, the combination of D-mannose, inulin, cranberry, bearberry, Olea europaea, Orthosiphon and Lactobacillus acidophilus SGL 11 per os represents a useful therapy for recurrent UTIs in women wanting a natural approach.
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Affiliation(s)
- Giampaolo Mainini
- Menopausal Center, San Leonardo Hospital, ASL NA3 SUD, Castellammare di Stabia, Naples, Italy
| | | | - Antonio Schiattarella
- Unit of Gynecology and Obstetrics, Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Pasquale De Franciscis
- Unit of Gynecology and Obstetrics, Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Mariano C. Di Donna
- Department of Gynecologic Oncology, Arnas Civico, University of Palermo, Palermo, Italy
| | - Gennaro Trezza
- Unit of Gynecology and Obstetrics, Rummo Hospital, Benevento, Italy
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Aljanahi A, Hadhiah H, Al-Nasr W, Abuzaid O, Al Qahtani N, Sebastian T, Metwally R. The Effect of Dietary Intake of Vitamin D on Gestational Diabetes Mellitus. Nutr Metab Insights 2020; 13:1178638820932164. [PMID: 32843841 PMCID: PMC7418234 DOI: 10.1177/1178638820932164] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Accepted: 05/12/2020] [Indexed: 11/16/2022] Open
Abstract
Diabetes mellitus (DM) is a growing health issue that has been reaching epidemic proportions in the recent years. Low intake of some nutrients like vitamin D may increase the risk of gestational diabetes mellitus (GDM). This study was to investigate the association between the dietary intake of Vitamin D and GDM among women in the Eastern Region of Saudi Arabia. A case-control study was conducted in a sample of 121 women, among those 72 were with GDM and 49 were controls. Vitamin D was estimated using food frequency questionnaire. Also, the 24-h’s dietary recall was carried out for 3 days to determine the nutrient intake as well as biochemical analysis for blood glucose level. In this study, GDM subjects were consuming significantly more eggs (P = .040). Vitamin D and vitamin C intakes in GDM and control pregnant women were lower than recommended dietary allowances (RDA). It was also found that low-fat milk, full-fat milk, fortified yogurt, and fortified orange juice were significantly associated with GDM (P < 0.05). Saudi women with GDM need a well-organized dietary counseling before, during pregnancy, and after delivery especially for vitamin D sources.
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Affiliation(s)
- Alanood Aljanahi
- Clinical Nutrition Department, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Huda Hadhiah
- Department of Clinical Nutrition Services, Johns Hopkins Aramco Healthcare Hospital, Dhahran, Saudi Arabia
| | - Wejdan Al-Nasr
- Dietary Department, Mouwasat Hospital Khobar, Saudi Arabia
| | - Omar Abuzaid
- Clinical Nutrition Department, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Nourah Al Qahtani
- Obstetrics and Gynecology Department, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Tunny Sebastian
- Clinical Nutrition Department, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Reham Metwally
- Clinical Nutrition Department, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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Martínez-Olcina M, Rubio-Arias JA, Reche-García C, Leyva-Vela B, Hernández-García M, Hernández-Morante JJ, Martínez-Rodríguez A. Eating Disorders in Pregnant and Breastfeeding Women: A Systematic Review. MEDICINA (KAUNAS, LITHUANIA) 2020; 56:E352. [PMID: 32679923 PMCID: PMC7404459 DOI: 10.3390/medicina56070352] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 07/09/2020] [Accepted: 07/09/2020] [Indexed: 11/16/2022]
Abstract
Background: Pregnancy is a stage associated with various biopsychosocial changes. These changes, along with concerns about keeping an adequate weight, can modulate an individual's risk for psychological disorders, especially eating disorders (EDs). The aim of this review was to investigate the prevalence, associated risks, and consequences of eating disorders in pregnancy and in breastfeeding mothers. Materials and Methods: A systematic review was carried out following the PRISMA guidelines in the scientific databases: PubMed, Web of Science, Scopus, and PsycINFO. Search terms related to EDs, pregnancy, and breastfeeding were used. The evaluation of the methodological quality of the studies was carried out using different scales; CASP (Checklist for Cohort Study), NICE (Methodology Checklist for Cohort Study), ARHQ (Methodology Checklist for Cross-Sectional), and NOS (Newcastle-Ottawa Scale for Cohort). Results: From 2920 studies, 16 were selected to study EDs in pregnant women and 2 studies in nursing mothers. Most of the studies used questionnaires and scales as tools for the diagnosis of EDs. Binge eating, anxiety, and depression were the most common comorbidities of EDs, accompanied in most cases by excessive concern about weight gain. The consequences of EDs are diverse. The prevalence of EDs in this population is estimated to be 1 out of 20. Conclusions: Eating disorders are related to anxiety and depression and have negative consequences for both mothers and fetuses (cesarean, miscarriages, premature births). More research on the field to determine the risk factors for EDs in the population of pregnant and lactating women is needed.
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Affiliation(s)
- María Martínez-Olcina
- Faculty of Health Sciences, University of Alicante, 03690 Alicante, Spain; (M.M.-O.); (M.H.-G.)
| | - Jacobo A. Rubio-Arias
- LFE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Science-INEF, Polytechnic University of Madrid, 28040 Madrid, Spain;
| | | | - Belén Leyva-Vela
- Department of Health, Vinalopó University Hospital, 03293 Elche, Spain;
| | - María Hernández-García
- Faculty of Health Sciences, University of Alicante, 03690 Alicante, Spain; (M.M.-O.); (M.H.-G.)
| | | | - Alejandro Martínez-Rodríguez
- Department of Analytical Chemistry, Nutrition and Food Science, Faculty of Sciences, University of Alicante, 03690 Alicante, Spain;
- Alicante Institute for Health and Biomedical Research (ISABIAL Foundation), 03010 Alicante, Spain
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Peluso I. Dietary Antioxidants: Micronutrients and Antinutrients in Physiology and Pathology. Antioxidants (Basel) 2019; 8:E642. [PMID: 31847116 PMCID: PMC6943734 DOI: 10.3390/antiox8120642] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Accepted: 12/11/2019] [Indexed: 02/06/2023] Open
Abstract
This Special Issue aimed to clarify the distinction between micronutrients and antinutrients and their different roles in physiology and pathology, considering the European Food Safety Authority (EFSA) criteria for health claims [...].
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Affiliation(s)
- Ilaria Peluso
- Council for Agricultural Research and Economics (CREA-AN), Research Centre for Food and Nutrition, 00178 Rome, Italy
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