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Santos HO. Intermittent fasting in the management of diabetes: a review of glycemic control and safety. Nutr Rev 2024; 82:1437-1443. [PMID: 37837312 DOI: 10.1093/nutrit/nuad132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2023] Open
Abstract
Intermittent fasting (IF) regimens have emerged as a dietary tool to improve the glycemic profile, but a critical appraisal of clinical studies assessing the effects of IF regimens in patients with diabetes is needed. Thus, this review encompasses clinical studies examining the impact of different IF regimens on markers of glycemic control in patients with diabetes. Furthermore, clinical nuances relative to pharmacological treatment are also addressed, mainly insulin therapy, to discuss the risk of hypoglycemic events. Only a handful of clinical studies have investigated the effects of IF on patients with diabetes. Overall, IF regimens may elicit modest benefits on glycemic parameters in patients with diabetes, but their effects are not necessarily greater than those of control diets. Last, although IF regimens may be considered safe for patients receiving insulin therapy within interventional and observational research, markers of glycemic control must be constantly monitored in clinical practice to reduce the risk of hypoglycemia and its related complications.
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Affiliation(s)
- Heitor O Santos
- School of Medicine, Federal University of Uberlandia, Uberlandia, Minas Gerais, Brazil
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2
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Paul S, Kaushik R, Chawla P, Upadhyay S, Rawat D, Akhtar A. Vitamin-D as a multifunctional molecule for overall well-being: An integrative review. Clin Nutr ESPEN 2024; 62:10-21. [PMID: 38901929 DOI: 10.1016/j.clnesp.2024.04.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 03/19/2024] [Accepted: 04/19/2024] [Indexed: 06/22/2024]
Abstract
Vitamin D is amongst the most important biomolecules to regularize and help in sustainable health, however, based on the studies, deficiency of this multifunctional vitamin is common. Vitamin D, besides playing a role in the form of vitamins, also acts as a multifunctional hormone (steroid). Vitamin D is synthesized inside the body through various steps starting from ultraviolet radiation exposure and comes from limited food sources, however, vitamin D-fortified food products are still among the major sources of vitamin D. Current review, focused on how vitamin D acts as a multifunctional molecule by effecting different functions in the body in normal or specific conditions and how it is important in fortification and how it can be managed from the available literature till date. During the Covid pandemic, people were aware of vitamin D and took supplementation, fortified foods, and sat under sunlight. As COVID prevalence decreases, people start forgetting about vitamin D. Vitamin D is very crucial for overall well-being as it has protective effects against a broad range of diseases as it can reduce inflammation, cancer cell growth and helps in controlling infection, increase metabolism, muscle, and bone strength, neurotransmitter expression, etc. Therefore, the present review is to provoke the population, and fulfillment of the vitamin D recommended dietary allowance daily must be confirmed.
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Affiliation(s)
- Snigdha Paul
- UPES, Bidholi, Dehradun 248007, Uttarakhand, India
| | | | - Prince Chawla
- Lovely Professional University, Phagwara 144411, Punjab, India
| | | | - Divya Rawat
- UPES, Bidholi, Dehradun 248007, Uttarakhand, India
| | - Ansab Akhtar
- Louisiana State University, School of Medicine, New Orleans, USA
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3
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Giourga C, Papadopoulou SK, Voulgaridou G, Karastogiannidou C, Giaginis C, Pritsa A. Vitamin D Deficiency as a Risk Factor of Preeclampsia during Pregnancy. Diseases 2023; 11:158. [PMID: 37987269 PMCID: PMC10660864 DOI: 10.3390/diseases11040158] [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: 09/30/2023] [Revised: 10/25/2023] [Accepted: 10/30/2023] [Indexed: 11/22/2023] Open
Abstract
A balanced diet is achieved not only via the consumption of a variety of food products but also by ensuring that we take in sufficient quantities the micronutrients necessary for the adequate functioning of the human body, such as vitamins, an important one of which is vitamin D. Vitamin D has been closely linked to bone health. Vitamin D deficiency has often been associated with negative effects concerning several pregnancy adverse outcomes, the most important of which are the birth of SGA newborns, premature birth, and, finally, preeclampsia, which are discussed in this work. The aim of this review is to critically summarize and scrutinize whether the concentration of vitamin D in the blood serum of pregnant women in all its forms may be correlated with the risk of preeclampsia during pregnancy and whether vitamin D levels could act both as a protective agent or as a risk factor or even a prognostic measure of the disease. The association of vitamin D levels with the onset of preeclampsia was examined by searching the PubMed and Google Scholar databases. A total of 31 clinical trials were identified and included in this review, with the aim of summarizing the recent data concerning vitamin D levels and the risk of preeclampsia. Among them, 16 were published in the last five years, and 13 were published within the last a decade. Most studies showed a significant association between vitamin D deficiency and preeclampsia risk. It was also found that the higher the dose, the lower the risk of disease. Of the 31 articles, only 7 of them did not show a significant difference between vitamin D levels and preeclampsia regardless of comorbidity. The results of this review suggest that there is indeed an association between the concentration of vitamin D during pregnancy and the risk of preeclampsia; however, further studies are strongly recommended to derive conclusive evidence.
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Affiliation(s)
- Chrysoula Giourga
- Department of Nutritional Sciences and Dietetics, School of Health Sciences, International Hellenic University, 57400 Thessaloniki, Greece; (C.G.); (S.K.P.); (G.V.); (C.K.)
| | - Sousana K. Papadopoulou
- Department of Nutritional Sciences and Dietetics, School of Health Sciences, International Hellenic University, 57400 Thessaloniki, Greece; (C.G.); (S.K.P.); (G.V.); (C.K.)
| | - Gavriela Voulgaridou
- Department of Nutritional Sciences and Dietetics, School of Health Sciences, International Hellenic University, 57400 Thessaloniki, Greece; (C.G.); (S.K.P.); (G.V.); (C.K.)
| | - Calliope Karastogiannidou
- Department of Nutritional Sciences and Dietetics, School of Health Sciences, International Hellenic University, 57400 Thessaloniki, Greece; (C.G.); (S.K.P.); (G.V.); (C.K.)
| | - Constantinos Giaginis
- Department of Food Science and Nutrition, School of Environment, University of the Aegean, 81400 Myrina, Greece;
| | - Agathi Pritsa
- Department of Nutritional Sciences and Dietetics, School of Health Sciences, International Hellenic University, 57400 Thessaloniki, Greece; (C.G.); (S.K.P.); (G.V.); (C.K.)
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4
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Iordache O, Anastasiu DM, Kakarla M, Ali A, Bratosin F, Neamtu R, Dumitru C, Olaru F, Erdelean I, Gherman A, Avram CR, Stelea L. Influence of Antiphospholipid Antibody-Associated Thrombophilia on the Risk of Preterm Birth: A Systematic Review. J Clin Med 2023; 12:5316. [PMID: 37629357 PMCID: PMC10456069 DOI: 10.3390/jcm12165316] [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: 07/10/2023] [Revised: 08/08/2023] [Accepted: 08/14/2023] [Indexed: 08/27/2023] Open
Abstract
Antiphospholipid antibody (aPL)-associated thrombophilia has been implicated in various adverse pregnancy outcomes, including preterm birth and impaired fetal development. This systematic review aimed to elucidate the relationship between aPL-associated thrombophilia and these outcomes, as well as to identify potential modifiers of this relationship such as maternal age, coexisting maternal medical conditions, type of aPL antibodies involved, and the timing of thrombophilia diagnosis during gestation. We conducted a comprehensive literature search in PubMed, Web of Science, Cochrane, and Scopus in May 2023, covering literature published within the last 10 years. Eight articles, involving 2935 patients, were eligible for inclusion in the review. Single aCL was the most common type of aPL found in patients, with rates up to 61.0% in some studies, followed by single LA and single ab2GPI. Multiple aPL antibody positivity was found to be associated with a higher risk of preterm birth, with odds ratios ranging from 1.29 to 9.61. Patient characteristics and previous pregnancy history varied significantly across the studies. Risk factors such as diabetes mellitus, thrombosis, and systemic lupus erythematosus were also variable across the studies, but presence of these risk factors did not consistently affect the risk of preterm birth. Furthermore, although a triple positive aPL test was the most important risk factor for preterm birth, it was observed that thrombophilia treatment during pregnancy significantly reduced the risk by 2.44 times (95% CI = 1.18-6.20). This review supports the evidence for aPL-associated thrombophilia being a significant contributor to preterm birth and fetal developmental abnormalities. Further research is required to investigate the exact mechanisms and to determine the best clinical management for patients with aPL-associated thrombophilia during pregnancy.
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Affiliation(s)
- Olivera Iordache
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (O.I.); (D.M.A.); (R.N.); (F.O.); (I.E.); (L.S.)
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania;
| | - Doru Mihai Anastasiu
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (O.I.); (D.M.A.); (R.N.); (F.O.); (I.E.); (L.S.)
| | - Manaswini Kakarla
- Kamineni Institute of Medical Sciences, School of Medicine, Hyderabad 500001, Telangana, India;
| | - Ayesha Ali
- Bhaskar Medical College, Amdapur Road 156-162, Hyderabad 500075, Telangana, India;
| | - Felix Bratosin
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania;
- Department of Infectious Diseases, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Radu Neamtu
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (O.I.); (D.M.A.); (R.N.); (F.O.); (I.E.); (L.S.)
| | - Catalin Dumitru
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (O.I.); (D.M.A.); (R.N.); (F.O.); (I.E.); (L.S.)
| | - Flavius Olaru
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (O.I.); (D.M.A.); (R.N.); (F.O.); (I.E.); (L.S.)
| | - Izabella Erdelean
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (O.I.); (D.M.A.); (R.N.); (F.O.); (I.E.); (L.S.)
| | - Angelica Gherman
- Research Center for Medical Communication, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania;
| | - Cecilia Roberta Avram
- Department of Residential Training and Post-University Training, “Vasile Goldis” Western University, Liviu Rebreanu Street 86, 310414 Arad, Romania;
| | - Lavinia Stelea
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (O.I.); (D.M.A.); (R.N.); (F.O.); (I.E.); (L.S.)
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5
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Marusca LM, Reddy G, Blaj M, Prathipati R, Rosca O, Bratosin F, Bogdan I, Horhat RM, Tapos GF, Marti DT, Susan M, Pingilati RA, Horhat FG, Adelina M. The Effects of Vitamin D Supplementation on Respiratory Infections in Children under 6 Years Old: A Systematic Review. Diseases 2023; 11:104. [PMID: 37606475 PMCID: PMC10443358 DOI: 10.3390/diseases11030104] [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: 07/04/2023] [Revised: 07/27/2023] [Accepted: 08/03/2023] [Indexed: 08/23/2023] Open
Abstract
Childhood respiratory tract infections (RTIs) pose a significant health burden, especially in children under six years old. The main objective of this systematic review was to assess the effectiveness of vitamin D supplementation in the prevention of RTI in this population while also exploring potential effect modifiers such as age, baseline vitamin D status, and type of respiratory infection. A systematic review of the literature published up to February 2023 was conducted according to PRISMA guidelines, searching PubMed, Web of Science, Cochrane, and Scopus databases. Eight studies met the inclusion criteria, which investigated the association between vitamin D supplementation and respiratory infections in children between zero and five years old. The included studies were conducted between 2012 and 2021, encompassing a total of 2189 children from five randomized trials, two case-control studies, and one prospective cohort study. The relationship between vitamin D supplementation and the prevention of childhood RTI was not consistently observed across all included studies. Pooled results demonstrated varied effects of vitamin D supplementation on respiratory infection incidence, severity, and symptoms. Three studies reported statistically significant associations between low vitamin D levels and respiratory infections (OR = 4.90, OR = 6.97), while one study found that children who received vitamin D supplementation of 800 UI/day for 3 months during the cold season had fewer episodes of respiratory symptoms (RR = 0.55) and recovered more quickly from acute RTI. Lastly, according to one study, vitamin D intake < 80 IU/kg/day was significantly associated with the risk of acquiring pneumonia (OR 7.9) but not bronchiolitis. The remaining five studies found no statistically significant differences in infection rates or severity (p-value > 0.050). The available evidence on the effectiveness of vitamin D supplementation for preventing and treating respiratory infections in children under six years old is limited, with only a few favorable effects being reported. In some cases, a dose of 80 UI/kg/day was found to provide significant protection for acute respiratory infections, although in the major trials the only benefit was a quicker recovery and fewer respiratory symptoms, with no impact on incidence and severity of respiratory infections. Nevertheless, the study protocol, the supplementation dose, and duration of supplementation had significant variations between studies, leading to inconclusive findings.
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Affiliation(s)
- Larisa Mihaela Marusca
- Laboratory Medicine, “Louis Turcanu” Emergency Hospital for Children, Doctor Iosif Nemoianu Street, 300011 Timisoara, Romania;
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (F.B.); (I.B.)
| | - Gowry Reddy
- New York Medical College at St. Mary’s and St. Clare’s Hospital, Denville, NJ 07834, USA;
| | - Mihaela Blaj
- Department of Anesthesiology and Intensive Care, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, University Street, 700115 Iasi, Romania
| | | | - Ovidiu Rosca
- Department of Infectious Diseases, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania;
| | - Felix Bratosin
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (F.B.); (I.B.)
- Department of Infectious Diseases, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania;
| | - Iulia Bogdan
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (F.B.); (I.B.)
- Department of Infectious Diseases, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania;
| | - Razvan Mihai Horhat
- Department of Conservative Dentistry and Endodontics, Faculty of Dental Medicine, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania;
| | - Gabriela-Florentina Tapos
- Department of Emergency Medicine, Arad County Emergency Clinical Hospital, Calea Victoriei, 310037 Arad, Romania;
| | - Daniela-Teodora Marti
- Department of Biology and Life Sciences, Faculty of Medicine, “Vasile Goldis” Western University of Arad, Revolutiei Square 94, 310025 Arad, Romania;
| | - Monica Susan
- Department of Internal Medicine, Discipline of Medical Semiology I, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania;
| | - Raja Akshay Pingilati
- Malla Reddy Institute of Medical Sciences, Suraram Main Road 138, Hyderabad 500055, India;
| | - Florin George Horhat
- Multidisciplinary Research Center on Antimicrobial Resistance (MULTI-REZ), Microbiology Department, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
| | - Mavrea Adelina
- Department of Internal Medicine I, Cardiology Clinic, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania;
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6
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Sakowicz A, Bralewska M, Rybak-Krzyszkowska M, Grzesiak M, Pietrucha T. New Ideas for the Prevention and Treatment of Preeclampsia and Their Molecular Inspirations. Int J Mol Sci 2023; 24:12100. [PMID: 37569476 PMCID: PMC10418829 DOI: 10.3390/ijms241512100] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 07/25/2023] [Accepted: 07/26/2023] [Indexed: 08/13/2023] Open
Abstract
Preeclampsia (PE) is a pregnancy-specific disorder affecting 4-10% of all expectant women. It greatly increases the risk of maternal and foetal death. Although the main symptoms generally appear after week 20 of gestation, scientific studies indicate that the mechanism underpinning PE is initiated at the beginning of gestation. It is known that the pathomechanism of preeclampsia is strongly related to inflammation and oxidative stress, which influence placentation and provoke endothelial dysfunction in the mother. However, as of yet, no "key players" regulating all these processes have been discovered. This might be why current therapeutic strategies intended for prevention or treatment are not fully effective, and the only effective method to stop the disease is the premature induction of delivery, mostly by caesarean section. Therefore, there is a need for further research into new pharmacological strategies for the treatment and prevention of preeclampsia. This review presents new preventive methods and therapies for PE not yet recommended by obstetrical and gynaecological societies. As many of these therapies are in preclinical studies or under evaluation in clinical trials, this paper reports the molecular targets of the tested agents or methods.
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Affiliation(s)
- Agata Sakowicz
- Department of Medical Biotechnology, Medical University of Lodz, Zeligowskiego 7/9, 90-752 Lodz, Poland; (M.B.); (T.P.)
| | - Michalina Bralewska
- Department of Medical Biotechnology, Medical University of Lodz, Zeligowskiego 7/9, 90-752 Lodz, Poland; (M.B.); (T.P.)
| | - Magda Rybak-Krzyszkowska
- Department of Obstetrics and Perinatology, University Hospital in Krakow, 31-501 Krakow, Poland;
| | - Mariusz Grzesiak
- Department of Perinatology, Obstetrics and Gynecology, Polish Mother’s Memorial Hospital-Research Institute in Lodz, 93-338 Lodz, Poland;
- Department of Gynecology and Obstetrics, Medical University of Lodz, 93-338 Lodz, Poland
| | - Tadeusz Pietrucha
- Department of Medical Biotechnology, Medical University of Lodz, Zeligowskiego 7/9, 90-752 Lodz, Poland; (M.B.); (T.P.)
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7
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Dahma G, Reddy G, Craina M, Dumitru C, Popescu A, Stelea L, Neamtu R, Gluhovschi A, Nitu R, Maghiari AL, Tapalaga G, Arnautu DA, Nelluri A, Maganti RK, Bernad E. The Effects of Vitamin D Supplementation before 20 Weeks of Gestation on Preeclampsia: A Systematic Review. J Pers Med 2023; 13:996. [PMID: 37373985 DOI: 10.3390/jpm13060996] [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: 04/27/2023] [Revised: 06/07/2023] [Accepted: 06/12/2023] [Indexed: 06/29/2023] Open
Abstract
Preeclampsia is a leading cause of maternal and fetal morbidity and mortality worldwide. The role of vitamin D supplementation during early pregnancy in the prevention of preeclampsia remains unclear. Our objective was to synthesize and critically appraise the available evidence from observational and interventional studies to determine the effects of early pregnancy vitamin D supplementation on the risk of preeclampsia. A systematic review was conducted in March 2023 using PubMed, Web of Science, Cochrane, and Scopus databases, including literature published up to February 2023. In adherence to PRISMA guidelines, a structured and systematic search strategy was employed. A total of five studies were included in the review, encompassing 1474 patients. Overall, vitamin D supplementation during early pregnancy was associated with a reduced incidence of preeclampsia in all studies (ORs ranging from 0.26 to 0.31), while others showed an increased risk of preeclampsia with low vitamin D levels during the first trimester (ORs of 4.60, 1.94, and 2.52). However, other studies found no significant protective effect but good overall safety for various vitamin D dosages administered during the first trimester. Nevertheless, variations in vitamin D dosage, the timing of supplementation, and definitions of vitamin D insufficiency may have contributed to the inconsistencies in the observed outcomes. Some studies reported significant secondary outcomes, such as a reduction in blood pressure, preterm labor, and improved neonatal outcomes, such as birth weight. The evidence from this systematic review suggests that early pregnancy vitamin D supplementation may have a role in reducing the risk of preeclampsia. However, inconsistencies in the timing of supplementation, dosages, and methodological differences between studies highlight the need for further research to determine the optimal supplementation strategy and to clarify the relationship between vitamin D and preeclampsia risk.
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Affiliation(s)
- George Dahma
- Department of Obstetrics and Gynecology, Faculty of General Medicine, "Victor Babes" University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania
- Doctoral School, Faculty of General Medicine, "Victor Babes" University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania
| | - Gowry Reddy
- New York Medical College at St. Mary's and St. Clare's Hospital, Denville, NJ 07834, USA
| | - Marius Craina
- Department of Obstetrics and Gynecology, Faculty of General Medicine, "Victor Babes" University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania
- Clinic of Obstetrics and Gynecology, "Pius Brinzeu" County Clinical Emergency Hospital, 300723 Timisoara, Romania
- Center for Laparoscopy, Laparoscopic Surgery and In Vitro Fertilization, "Victor Babes" University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania
| | - Catalin Dumitru
- Department of Obstetrics and Gynecology, Faculty of General Medicine, "Victor Babes" University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania
| | - Alin Popescu
- Department of Obstetrics and Gynecology, Faculty of General Medicine, "Victor Babes" University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania
| | - Lavinia Stelea
- Department of Obstetrics and Gynecology, Faculty of General Medicine, "Victor Babes" University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania
| | - Radu Neamtu
- Department of Obstetrics and Gynecology, Faculty of General Medicine, "Victor Babes" University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania
| | - Adrian Gluhovschi
- Department of Obstetrics and Gynecology, Faculty of General Medicine, "Victor Babes" University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania
| | - Razvan Nitu
- Department of Obstetrics and Gynecology, Faculty of General Medicine, "Victor Babes" University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania
| | - Anca Laura Maghiari
- Department of Anatomy and Embryology, "Victor Babes" University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania
| | - Gianina Tapalaga
- Department of Odontotherapy and Endodontics, Faculty of Dental Medicine, "Victor Babes" University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania
| | - Diana Aurora Arnautu
- Department of Cardiology, "Victor Babes" University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania
| | - Aditya Nelluri
- School of General Medicine, Sri Siddhartha Medical College, Tumakuru 572107, India
| | - Ram Kiran Maganti
- School of General Medicine, Sri Devaraj Urs Academy of Higher Education and Research, Tamaka, Kolar 563101, India
| | - Elena Bernad
- Department of Obstetrics and Gynecology, Faculty of General Medicine, "Victor Babes" University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania
- Clinic of Obstetrics and Gynecology, "Pius Brinzeu" County Clinical Emergency Hospital, 300723 Timisoara, Romania
- Center for Laparoscopy, Laparoscopic Surgery and In Vitro Fertilization, "Victor Babes" University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania
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8
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Santos HO, Forbes SC, Găman MA. Editorial: Functional foods, supplements, and dietary approaches in sports and clinical nutrition. Front Nutr 2023; 10:1203477. [PMID: 37215222 PMCID: PMC10196615 DOI: 10.3389/fnut.2023.1203477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 04/19/2023] [Indexed: 05/24/2023] Open
Affiliation(s)
- Heitor O. Santos
- School of Medicine, Federal University of Uberlandia (UFU), Uberlandia, Minas Gerais, Brazil
| | - Scott C. Forbes
- Faculty of Education, Department of Physical Education Studies, Brandon University, Brandon, MB, Canada
| | - Mihnea-Alexandru Găman
- Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
- Department of Hematology, Center of Hematology and Bone Marrow Transplantation, Fundeni Clinical Institute, Bucharest, Romania
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9
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Man AWC, Zhou Y, Xia N, Li H. Dietary supplements and vascular function in hypertensive disorders of pregnancy. Pflugers Arch 2023:10.1007/s00424-023-02810-2. [PMID: 37043045 DOI: 10.1007/s00424-023-02810-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 03/29/2023] [Accepted: 03/29/2023] [Indexed: 04/13/2023]
Abstract
Hypertensive disorders of pregnancy are complications that can lead to maternal and infant mortality and morbidity. Hypertensive disorders of pregnancy are generally defined as hypertension and may be accompanied by other end organ damages including proteinuria, maternal organ disturbances including renal insufficiency, neurological complications, thrombocytopenia, impaired liver function, or uteroplacental dysfunction such as fetal growth restriction and stillbirth. Although the causes of these hypertensive disorders of pregnancy are multifactorial and elusive, they seem to share some common vascular-related mechanisms, including diseased spiral arteries, placental ischemia, and endothelial dysfunction. Recently, preeclampsia is being considered as a vascular disorder. Unfortunately, due to the complex etiology of preeclampsia and safety concerns on drug usage during pregnancy, there is still no effective pharmacological treatments available for preeclampsia yet. An emerging area of interest in this research field is the potential beneficial effects of dietary intervention on reducing the risk of preeclampsia. Recent studies have been focused on the association between deficiencies or excesses of some nutrients and complications during pregnancy, fetal growth and development, and later risk of cardiovascular and metabolic diseases in the offspring. In this review, we discuss the involvement of placental vascular dysfunction in preeclampsia. We summarize the current understanding of the association between abnormal placentation and preeclampsia in a vascular perspective. Finally, we evaluate several studied dietary supplementations to prevent and reduce the risk of preeclampsia, targeting placental vascular development and function, leading to improved pregnancy and postnatal outcomes.
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Affiliation(s)
- Andy W C Man
- Department of Pharmacology, Johannes Gutenberg University Medical Center, Langenbeckstr. 1, 55131, Mainz, Germany
| | - Yawen Zhou
- Department of Pharmacology, Johannes Gutenberg University Medical Center, Langenbeckstr. 1, 55131, Mainz, Germany
| | - Ning Xia
- Department of Pharmacology, Johannes Gutenberg University Medical Center, Langenbeckstr. 1, 55131, Mainz, Germany
| | - Huige Li
- Department of Pharmacology, Johannes Gutenberg University Medical Center, Langenbeckstr. 1, 55131, Mainz, Germany.
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Plotnikoff GA, Dobberstein L, Raatz S. Nutritional Assessment of the Symptomatic Patient on a Plant-Based Diet: Seven Key Questions. Nutrients 2023; 15:1387. [PMID: 36986117 PMCID: PMC10056340 DOI: 10.3390/nu15061387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 03/01/2023] [Accepted: 03/10/2023] [Indexed: 03/15/2023] Open
Abstract
Plant-based diets, both vegan and vegetarian, which emphasize grains, vegetables, fruits, legumes, nuts, and seeds are increasingly popular for health as well as financial, ethical, and religious reasons. The medical literature clearly demonstrates that whole food plant-based diets can be both nutritionally sufficient and medically beneficial. However, any person on an intentionally restrictive, but poorly-designed diet may predispose themselves to clinically-relevant nutritional deficiencies. For persons on a poorly-designed plant-based diet, deficiencies are possible in both macronutrients (protein, essential fatty acids) and micronutrients (vitamin B12, iron, calcium, zinc, and vitamin D). Practitioner evaluation of symptomatic patients on a plant-based diet requires special consideration of seven key nutrient concerns for plant-based diets. This article translates these concerns into seven practical questions that all practitioners can introduce into their patient assessments and clinical reasoning. Ideally, persons on plant-based diets should be able to answer these seven questions. Each serves as a heuristic prompt for both clinician and patient attentiveness to a complete diet. As such, these seven questions support increased patient nutrition knowledge and practitioner capacity to counsel, refer, and appropriately focus clinical resources.
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Affiliation(s)
| | | | - Susan Raatz
- Department of Food Science and Nutrition, University of Minnesota, Minneapolis, MN 55455, USA
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Hrubaru I, Motoc A, Moise ML, Miutescu B, Citu IM, Pingilati RA, Popescu DE, Dumitru C, Gorun F, Olaru F, Erdelean I, Forga M, Nicolae N, Citu C. The Predictive Role of Maternal Biological Markers and Inflammatory Scores NLR, PLR, MLR, SII, and SIRI for the Risk of Preterm Delivery. J Clin Med 2022; 11:jcm11236982. [PMID: 36498555 PMCID: PMC9738289 DOI: 10.3390/jcm11236982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 11/23/2022] [Accepted: 11/25/2022] [Indexed: 11/29/2022] Open
Abstract
In many countries, preterm birth, defined as birth before 37 completed weeks of gestation, is the primary cause of infant death and morbidity. An increasing body of research suggests that inflammation (both clinical and subclinical) plays a significant role in inducing preterm labor or developing pregnancy problems that lead to premature birth. Consequently, the purpose of this research was to determine the predictive value of the Neutrophil-Lymphocyte Ratio (NLR), derived Neutrophil-Lymphocyte Ratio (dNLR), Monocytes-to-Lymphocyte Ratio (MLR), Platelets-to-Lymphocyte Ratio (PLR), Systemic immune-inflammation index (SII), and systemic inflammatory response index (SIRI), for premature delivery. A retrospective study analyzed a total of 243 eligible pregnancies that resulted in a preterm birth during 2020 and 2021. A control group without a history of preterm birth was matched by age and trimester of laboratory analysis at a 1:1 ratio. Although the number of comorbidities was similar among study groups, the body-mass index estimated for the week of gestation was significantly higher among the patients from the prematurity group, as well as the prevalence of urinary tract infections and smoking. Laboratory data showed that patients with a preterm birth had significantly higher white blood cell count and monocytes, but significantly lower lymphocytes, platelets, and hemoglobin. The NLR, dNLR, PLR, and MLR scores showed to be significantly higher among patients from the prematurity group, but SII and SIRI were not significantly different between the study groups. It was observed that the AUC values of NLR, dNLR, PLR, and MLR were higher than 0.600, respectively NLR had the highest value among the tested scores (AUC = 0.694) and the highest sensitivity in this study (71%). The highest sensibility was achieved by dNLR, with 70%, and an AUC value of 0.655 (p-value = 0.022). PLR had the second-highest AUC value (0.682) and the best score in terms of sensitivity (70%) and sensibility (69%) (p-value = 0.015). Lastly, MLR had the lowest significant AUC score (0.607) and lowest sensitivity/sensibility. The significant cut-off values for the inflammatory scores were 9.0 for NLR, 9.8 for dNLR, 250 for PLR, and 4.07 for MLR. After evaluating the importance of these inflammatory scores, further clinical applications should be conducted to confirm the results and improve therapy and care to reduce the burden of premature deliveries.
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Affiliation(s)
- Ingrid Hrubaru
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Andrei Motoc
- Department of Anatomy and Embryology, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Marius Liviu Moise
- Department of Radiology, “Premiere” Hospital—“Regina Maria”, Calea Aradului 113, 300643 Timisoara, Romania
- Correspondence:
| | - Bogdan Miutescu
- Department of Gastroenterology and Hepatology, “Premiere” Hospital—“Regina Maria”, Calea Aradului 113, 300643 Timisoara, Romania
| | - Ioana Mihaela Citu
- Department of Internal Medicine I, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Raja Akshay Pingilati
- Malla Reddy Institute of Medical Sciences, Suraram Main Road 138, Hyderabad 500055, India
| | - Daniela-Eugenia Popescu
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
- Department of Neonatology, Premiere Hospital, Regina Maria Health Network, 300645 Timisoara, Romania
| | - Catalin Dumitru
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Florin Gorun
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Flavius Olaru
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Izabella Erdelean
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Marius Forga
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Nicoleta Nicolae
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Cosmin Citu
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
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Results of a Five-Year Experience in First Trimester Preeclampsia Screening. J Clin Med 2022; 11:jcm11154555. [PMID: 35956169 PMCID: PMC9369645 DOI: 10.3390/jcm11154555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 07/30/2022] [Accepted: 08/02/2022] [Indexed: 11/22/2022] Open
Abstract
Background and Objectives: The study aimed to evaluate the ability defining the risk of developing preeclampsia by a screening test carried out in the first trimester (between 11 + 0 and 13 + 6 weeks of gestational age), in order to identify high-risk women requiring more intensive health surveillance. The secondary objective was to evaluate the ability of this test to predict the risk of adverse obstetric outcomes such as fetal growth restriction, intrauterine fetal death, gestational hypertension, HELLP syndrome, placental abruption, and preterm birth. Materials and Methods: This was a single-center study, conducted at the Operative Unit of Obstetrics of the State Hospital of the Republic of San Marino. Medical history was collected at the time of enrolment in writing. Subsequently, obstetric outcomes were collected for each enrolled woman, through the analysis of medical records. Results: From October 2014 to May 2019, 589 pregnant women were recruited, of whom, 474 (80.5%) were included in the “low-risk” group, and 115 (19.5%) in the “high-risk” group. At the time of analysis of this population, the obstetric outcomes were available for 498 women (84.5%), while 91 cases (15.5%) were current pregnancies. The PI of the uterine arteries was not significantly different between the two study groups. Otherwise, a significant difference was highlighted for MAP, which is higher in the case of pregnancies at high risk based on the risk factors only, and for PAPP-A, higher in the case of low-risk pregnancies. Regarding the percentage of fetal DNA, according to the most recent literature data, in our series, we report a statistically significant difference of the average between the low and high-risk groups. Conclusions: In our study, we demonstrate that the multiparametric screening test for early PE performed well in identifying women at high risk of early PE, which certainly has the most severe maternal–fetal outcomes. The data reported that ASA intake at low doses is significantly higher in the population with high-risk tests for both early PE and late PE suggest once again that anamnestic evaluation plays an essential role in women’s screening.
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