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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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Mata-Greenwood E, Westenburg HCA, Zamudio S, Illsley NP, Zhang L. Decreased Vitamin D Levels and Altered Placental Vitamin D Gene Expression at High Altitude: Role of Genetic Ancestry. Int J Mol Sci 2023; 24:3389. [PMID: 36834800 PMCID: PMC9967090 DOI: 10.3390/ijms24043389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 01/14/2023] [Accepted: 01/24/2023] [Indexed: 02/10/2023] Open
Abstract
High-altitude hypoxia challenges reproduction; particularly in non-native populations. Although high-altitude residence is associated with vitamin D deficiency, the homeostasis and metabolism of vitamin D in natives and migrants remain unknown. We report that high altitude (3600 m residence) negatively impacted vitamin D levels, with the high-altitude Andeans having the lowest 25-OH-D levels and the high-altitude Europeans having the lowest 1α,25-(OH)2-D levels. There was a significant interaction of genetic ancestry with altitude in the ratio of 1α,25-(OH)2-D to 25-OH-D; with the ratio being significantly lower in Europeans compared to Andeans living at high altitude. Placental gene expression accounted for as much as 50% of circulating vitamin D levels, with CYP2R1 (25-hydroxylase), CYP27B1 (1α-hydroxylase), CYP24A1 (24-hydroxylase), and LRP2 (megalin) as the major determinants of vitamin D levels. High-altitude residents had a greater correlation between circulating vitamin D levels and placental gene expression than low-altitude residents. Placental 7-dehydrocholesterol reductase and vitamin D receptor were upregulated at high altitude in both genetic-ancestry groups, while megalin and 24-hydroxylase were upregulated only in Europeans. Given that vitamin D deficiency and decreased 1α,25-(OH)2-D to 25-OH-D ratios are associated with pregnancy complications, our data support a role for high-altitude-induced vitamin D dysregulation impacting reproductive outcomes, particularly in migrants.
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Affiliation(s)
- Eugenia Mata-Greenwood
- Lawrence D. Longo Center for Perinatal Biology, School of Medicine, Loma Linda University, Loma Linda, CA 92350, USA
| | - Hans C. A. Westenburg
- Lawrence D. Longo Center for Perinatal Biology, School of Medicine, Loma Linda University, Loma Linda, CA 92350, USA
| | - Stacy Zamudio
- Placental Research Group LLC, Maplewood, NJ 07040, USA
| | | | - Lubo Zhang
- Lawrence D. Longo Center for Perinatal Biology, School of Medicine, Loma Linda University, Loma Linda, CA 92350, USA
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Luo C, Li Z, Lu Y, Wei F, Suo D, Lan S, Ren Z, Jiang R, Huang F, Chen A, Jiang L, Huang H, Guo X. Association of serum vitamin D status with gestational diabetes mellitus and other laboratory parameters in early pregnant women. BMC Pregnancy Childbirth 2022; 22:400. [PMID: 35545756 PMCID: PMC9097231 DOI: 10.1186/s12884-022-04725-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 04/29/2022] [Indexed: 12/02/2022] Open
Abstract
Background The association between serum 25-hydroxy vitamin D (25(OH)D) status and gestational diabetes mellitus (GDM) gained attention in recent years, however the conclusion is still controversial due to many interfering factors, such as region of living, environment, lifestyle, and food supplements. Other metabolites (laboratory parameters) are also important in reflecting gestational states. This study aimed to investigate the association of serum 25(OH)D status in early pregnancy with GDM and other laboratory parameters in pregnant women. Methods A total of 1516 pregnant women whose blood glucose were normal before pregnancy in the city of Foshan in Guangdong, China were enrolled in this study. GDM was diagnosed between 24 to 28 weeks of pregnancy following the guidelines from the American Diabetes Association. Maternal serum 25(OH)D and other laboratory parameters—including hematology, coagulation, chemistry, and bone density—were measured utilizing various analytical methods in clinical laboratory at gestational weeks 11 to 14. Results The average 25(OH)D concentration was 59.1 ± 12.6 nmol/L. None of the study subjects had 25(OH)D < 25 nmol/L; 434 (28.6%) women had 25(OH)D deficiency (< 50 nmol/L), 882 women (58.2%) had 25(OH)D insufficiency (50–74 mmol/L) and 200 women (13.2%) had 25(OH)D sufficiency (≥ 75 nmol/L). There were 264 (17.4%) women diagnosed with GDM. There was not, however, an association between serum 25(OH)D in early pregnancy and GDM. Interestingly, women with more parity and high serum alkaline phosphatase levels had higher serum 25(OH)D levels. There was a possible positive association between serum 25(OH)D and pre-albumin, and a possible negative association between serum 25(OH)D, creatinine, and thrombin time. This study did not find an association between serum 25(OH)D and bone density. Conclusions There were no associations between maternal serum 25(OH)D concentration in early pregnancy and the risk of GDM or bone density. There were, however, correlations between serum 25(OH)D and parity, seasoning at sampling, serum alkaline phosphatase, creatinine, pre-albumin, and coagulation factor thrombin time, which need further study to explain their pathophysiology and clinical significance.
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Affiliation(s)
- Caihong Luo
- Department of Obstetrics, Southern Medical University Affiliated Maternal & Children's Hospital of Foshan, No. 11 Renminxi Road, Foshan, Guangdong, 528000, China.
| | - Zhiju Li
- Department of Epidemiology, School of Public Health, Southern Medical University, No. 1838 North Guangzhou Avenue, Guangzhou, 510515, China
| | - Yunya Lu
- Department of Obstetrics, Southern Medical University Affiliated Maternal & Children's Hospital of Foshan, No. 11 Renminxi Road, Foshan, Guangdong, 528000, China
| | - Fang Wei
- Department of Obstetrics, Southern Medical University Affiliated Maternal & Children's Hospital of Foshan, No. 11 Renminxi Road, Foshan, Guangdong, 528000, China
| | - Dongmei Suo
- Department of Obstetrics, Southern Medical University Affiliated Maternal & Children's Hospital of Foshan, No. 11 Renminxi Road, Foshan, Guangdong, 528000, China
| | - Shiyan Lan
- Department of Obstetrics, Southern Medical University Affiliated Maternal & Children's Hospital of Foshan, No. 11 Renminxi Road, Foshan, Guangdong, 528000, China
| | - Zhengyuan Ren
- Department of Information Technology, Southern Medical University Affiliated Maternal & Children's Hospital of Foshan, No. 11 Renminxi Road, Foshan, Guangdong, 528000, China
| | - Runchang Jiang
- Department of Laboratory Medicine, Southern Medical University Affiliated Maternal & Children's Hospital of Foshan, No. 11 Renminxi Road, Foshan, Guangdong, 528000, China
| | - Fang Huang
- Department of Obstetrics, Southern Medical University Affiliated Maternal & Children's Hospital of Foshan, No. 11 Renminxi Road, Foshan, Guangdong, 528000, China
| | - Aiyue Chen
- Department of Obstetrics, Southern Medical University Affiliated Maternal & Children's Hospital of Foshan, No. 11 Renminxi Road, Foshan, Guangdong, 528000, China
| | - Liejun Jiang
- Department of Laboratory Medicine, The People's Hospital of Guangxi Zhuang Autonomous Region, 6 Taoyuan Road, Nanning, Guangxi, 530021, China
| | - Huayi Huang
- School of Medical Laboratory, Youjiang Medical University for Nationalities, No. 98 Chengxiang Road, Baise, Guangxi, 533000, China. .,Mindray North America, 800 MacArthur Boulevard, Mahwah, New Jersey, 07430, USA. .,Department of Surgical Oncology, Roswell Park Comprehensive Cancer Center, Elm and Carlton Streets, Buffalo, New York, 14263, USA.
| | - Xiaoling Guo
- Department of Obstetrics, Southern Medical University Affiliated Maternal & Children's Hospital of Foshan, No. 11 Renminxi Road, Foshan, Guangdong, 528000, China.
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Ouchi N, Takeshita T, Kasano S, Yokote R, Yonezawa M, Kurashina R, Ichikawa T, Kawabata I, Kuwabara Y. Effects of thrombophilia and antithrombotic therapy on embryonic chromosomal aberration rates in patients with recurrent pregnancy loss. J NIPPON MED SCH 2021; 89:40-46. [PMID: 33867424 DOI: 10.1272/jnms.jnms.2022_89-103] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Miscarriage occurs in 10-15% of pregnancies and recurrent pregnancy loss (RPL) occurs in 1% of couples hoping for a child. Various risk factors, such as thrombophilia, uterine malformation, and embryonic chromosomal aberration cause RPL. We hypothesized that antithrombotic therapy for RPL patients with thrombophilia would reduce miscarriage due to thrombophilia, which would reduce the total miscarriages and result in a relative increase in miscarriage due to embryonic chromosomal aberrations. In this study, we investigated the incidence of chromosomal aberrations in products of conception in RPL patients with and without antithrombotic therapy. METHODS We performed a single-center, retrospective review of cases diagnosed as miscarriage with embryo chromosome analysis between July 1, 2000, and May 31, 2019. Rates of chromosomal aberration were compared between RPL patients with and without thrombophilia or antithrombotic therapy. RESULTS One hundred and-ninety RPL cases were analyzed. The average age was 37.4 ± 4.3 years, and the average number of previous pregnancy losses was 2.2 ± 1.1. The overall chromosomal aberration rate was 67.4% (128/190). There was no difference in the chromosomal aberration rate between the factors for RPL, with or without thrombophilia, and antithrombotic therapy. Only advancing maternal age had significant correlation to increased embryo chromosomal aberration rates. CONCLUSIONS With or without antithrombotic therapy, miscarriage was caused by embryonic chromosome abnormalities at a certain rate. Antithrombotic therapy in RPL patients with thrombophilia may reduce abortions due to thrombophilia, which may also normalize the rate of embryonic chromosome aberrations in the subsequent miscarriages.
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Affiliation(s)
- Nozomi Ouchi
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Nippon Medical School
| | - Toshiyuki Takeshita
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Nippon Medical School
| | - Sayuri Kasano
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Nippon Medical School
| | - Ryoko Yokote
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Nippon Medical School
| | - Mirei Yonezawa
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Nippon Medical School
| | - Ryuhei Kurashina
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Nippon Medical School
| | - Tomoko Ichikawa
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Nippon Medical School
| | - Ikuno Kawabata
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Nippon Medical School
| | - Yoshimitsu Kuwabara
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Nippon Medical School
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