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Aagaard K, Møllegaard Jepsen JR, Sevelsted A, Horner D, Vinding R, Rosenberg JB, Brustad N, Eliasen A, Mohammadzadeh P, Følsgaard N, Hernández-Lorca M, Fagerlund B, Glenthøj BY, Rasmussen MA, Bilenberg N, Stokholm J, Bønnelykke K, Ebdrup BH, Chawes B. High-dose vitamin D3 supplementation in pregnancy and risk of neurodevelopmental disorders in the children at age 10: A randomized clinical trial. Am J Clin Nutr 2024; 119:362-370. [PMID: 38072183 DOI: 10.1016/j.ajcnut.2023.12.002] [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: 07/02/2023] [Revised: 11/28/2023] [Accepted: 12/04/2023] [Indexed: 12/28/2023] Open
Abstract
BACKGROUND Vitamin D deficiency in pregnancy may increase the risk of autism and attention deficit hyperactivity disorder (ADHD). OBJECTIVE The objective of this study was to estimate the effect of vitamin D3 supplementation in pregnancy on risk of autism and ADHD. DESIGN This randomized clinical trial was part of the COpenhagen Prospective Study on Neuro-PSYCHiatric Development (COPYCH) project nested within the Copenhagen Prospective Studies on Asthma in Childhood 2010 (COPSAC2010) cohort comprising a population-based sample of 700 healthy mother-child pairs enrolled at week 24 of pregnancy. Maternal 25-hydroxy-vitamin D (25(OH)D) was measured at inclusion and 623 mothers were randomized 1:1 to either high-dose (2800 IU/d) or standard dose (400 IU/d) vitamin D3 until 1 wk postpartum (315 received high-dose, 308 standard dose). At age 10, diagnoses and symptom load of autism and ADHD, respectively, were established using the Kiddie-Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version. RESULTS The psychopathologic evaluation was completed by 591 children aged 10 y, and 16 children (2.7%) were diagnosed with autism and 65 (11.0%) with ADHD. Hereof, 496 children participated in the vitamin D3 trial (246 received high-dose, 250 standard dose). Of these, 12 children (2.4%) were diagnosed with autism and 58 (11.7%) with ADHD. Higher maternal preintervention 25(OH)D levels were associated with a decreased risk of autism [odd ratio (OR) per 10 nmol/L: 0.76 (0.59,0.97); P = 0.034], lower autistic symptom load [β per 10 nmol/L: -0.03 (-0.05,0.00); P = 0.024), and decreased risk of ADHD diagnosis (OR per 10 nmol/L: 0.88 (0.78,0.99); P = 0.033]. High-dose vitamin D3 supplementation was not associated with risk of autism or ADHD. CONCLUSIONS Higher maternal preintervention 25(OH)D was associated with a decreased risk of autism, lower autistic symptom load, and decreased risk of ADHD diagnosis, but high-dose vitamin D3 supplementation in pregnancy had no effect on risk of autism and ADHD. This trial was registered at clinicaltrials.gov as NCT00856947.
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Affiliation(s)
- Kristina Aagaard
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Gentofte, Denmark
| | - Jens Richardt Møllegaard Jepsen
- Child and Adolescent Mental Health Center, Copenhagen University Hospital - Mental Health Services CPH, Copenhagen, Denmark; Center for Neuropsychiatric Schizophrenia Research & Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark
| | - Astrid Sevelsted
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Gentofte, Denmark
| | - David Horner
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Gentofte, Denmark
| | - Rebecca Vinding
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Gentofte, Denmark
| | - Julie Bøjstrup Rosenberg
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Gentofte, Denmark; Center for Neuropsychiatric Schizophrenia Research & Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark
| | - Nicklas Brustad
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Gentofte, Denmark
| | - Anders Eliasen
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Gentofte, Denmark; Department of Health Technology, Section for Bioinformatics, Technical University of Denmark
| | - Parisa Mohammadzadeh
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Gentofte, Denmark; Center for Neuropsychiatric Schizophrenia Research & Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark
| | - Nilofar Følsgaard
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Gentofte, Denmark
| | - María Hernández-Lorca
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Gentofte, Denmark
| | - Birgitte Fagerlund
- Child and Adolescent Mental Health Center, Copenhagen University Hospital - Mental Health Services CPH, Copenhagen, Denmark; Center for Neuropsychiatric Schizophrenia Research & Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark; Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Birte Y Glenthøj
- Center for Neuropsychiatric Schizophrenia Research & Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Morten Arendt Rasmussen
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Gentofte, Denmark; Section of Food, Microbiology and Fermentation, Department of Food Science, University of Copenhagen
| | - Niels Bilenberg
- Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark; Department of Child and Adolescent Mental Health Odense, Mental Health Services in the Region of Southern Denmark, University of Southern Denmark, Odense, Denmark
| | - Jakob Stokholm
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Gentofte, Denmark; Section of Food, Microbiology and Fermentation, Department of Food Science, University of Copenhagen
| | - Klaus Bønnelykke
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Gentofte, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Bjørn H Ebdrup
- Center for Neuropsychiatric Schizophrenia Research & Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Bo Chawes
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Gentofte, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
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Tamang MK, Ali A, Pertile RN, Cui X, Alexander S, Nitert MD, Palmieri C, Eyles D. Developmental vitamin D-deficiency produces autism-relevant behaviours and gut-health associated alterations in a rat model. Transl Psychiatry 2023; 13:204. [PMID: 37316481 PMCID: PMC10267107 DOI: 10.1038/s41398-023-02513-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 05/21/2023] [Accepted: 06/05/2023] [Indexed: 06/16/2023] Open
Abstract
Developmental vitamin D (DVD)-deficiency is an epidemiologically established risk factor for autism. Emerging studies also highlight the involvement of gut microbiome/gut physiology in autism. The current study aims to examine the effect of DVD-deficiency on a broad range of autism-relevant behavioural phenotypes and gut health. Vitamin D deficient rat dams exhibited altered maternal care, DVD-deficient pups showed increased ultrasonic vocalizations and as adolescents, social behaviour impairments and increased repetitive self-grooming behaviour. There were significant impacts of DVD-deficiency on gut health demonstrated by alterations to the microbiome, decreased villi length and increased ileal propionate levels. Overall, our animal model of this epidemiologically validated risk exposure for autism shows an expanded range of autism-related behavioural phenotypes and now alterations in gut microbiome that correlate with social behavioural deficits raising the possibility that DVD-deficiency induced ASD-like behaviours are due to alterations in gut health.
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Affiliation(s)
- Man Kumar Tamang
- Queensland Brain Institute, The University of Queensland, Brisbane, Australia
| | - Asad Ali
- Queensland Brain Institute, The University of Queensland, Brisbane, Australia
| | | | - Xiaoying Cui
- Queensland Brain Institute, The University of Queensland, Brisbane, Australia
- Queensland Centre for Mental Health Research, Wacol, Australia
| | - Suzy Alexander
- Queensland Brain Institute, The University of Queensland, Brisbane, Australia
- Queensland Centre for Mental Health Research, Wacol, Australia
| | - Marloes Dekker Nitert
- School of Chemistry and Molecular Bioscience, The University of Queensland, Brisbane, Australia
| | - Chiara Palmieri
- School of Veterinary Science, The University of Queensland, Gatton, Australia
| | - Darryl Eyles
- Queensland Brain Institute, The University of Queensland, Brisbane, Australia.
- Queensland Centre for Mental Health Research, Wacol, Australia.
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Maternal Vitamin D Levels during Pregnancy and Offspring Psychiatric Outcomes: A Systematic Review. Int J Mol Sci 2022; 24:ijms24010063. [PMID: 36613505 PMCID: PMC9820292 DOI: 10.3390/ijms24010063] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 12/14/2022] [Accepted: 12/16/2022] [Indexed: 12/24/2022] Open
Abstract
Prenatal exposure to vitamin D may play a significant role in human brain development and function. Previous epidemiological studies investigating the associations between maternal vitamin D status and offspring developmental and psychiatric outcomes in humans have been inconclusive. We aimed to systematically assess the results of previously published studies that examined the associations between maternal vitamin D levels, measured as circulating 25(OH)D levels in pregnancy or at birth, and offspring neuropsychiatric and psychiatric outcomes. Systematic searches were conducted using MEDLINE, Embase, PsychINFO and Web of Science for studies published by 10 August 2022. We included human observational studies that examined associations between prenatal or perinatal vitamin D levels and offspring neuropsychiatric and psychiatric outcomes and were published in English in peer-reviewed journals. Of the 3729 studies identified, 66 studies were screened for full texts and 29 studies published between 2003 and 2022 were included in the final review. There was a small amount of evidence for the association between prenatal vitamin D deficiency and autism spectrum disorder. When studies with larger sample sizes and stricter definitions of vitamin D deficiency were considered, positive associations were also found for attention-deficit/hyperactivity disorder and schizophrenia. Future studies with larger sample sizes, longer follow-up periods and prenatal vitamin D assessed at multiple time points are needed.
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Cui X, Eyles DW. Vitamin D and the Central Nervous System: Causative and Preventative Mechanisms in Brain Disorders. Nutrients 2022; 14:nu14204353. [PMID: 36297037 PMCID: PMC9610817 DOI: 10.3390/nu14204353] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 09/13/2022] [Accepted: 09/13/2022] [Indexed: 11/16/2022] Open
Abstract
Twenty of the last one hundred years of vitamin D research have involved investigations of the brain as a target organ for this hormone. Our group was one of the first to investigate brain outcomes resulting from primarily restricting dietary vitamin D during brain development. With the advent of new molecular and neurochemical techniques in neuroscience, there has been increasing interest in the potential neuroprotective actions of vitamin D in response to a variety of adverse exposures and how this hormone could affect brain development and function. Rather than provide an exhaustive summary of this data and a listing of neurological or psychiatric conditions that vitamin D deficiency has been associated with, here, we provide an update on the actions of this vitamin in the brain and cellular processes vitamin D may be targeting in psychiatry and neurology.
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Affiliation(s)
- Xiaoying Cui
- Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol Q4076, Australia
- Queensland Brain Institute, University of Queensland, St Lucia Q4076, Australia
| | - Darryl W. Eyles
- Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol Q4076, Australia
- Queensland Brain Institute, University of Queensland, St Lucia Q4076, Australia
- Correspondence:
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Vitamin AD Drops are More Effective than Intramuscular Injection of Thymosin in Reducing the Rate of Growth Retardation in Children. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:7799111. [PMID: 35990850 PMCID: PMC9388235 DOI: 10.1155/2022/7799111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 07/18/2022] [Accepted: 07/26/2022] [Indexed: 12/04/2022]
Abstract
Objective To explore the effect of vitamin AD drops on growth retardation in children. Methods From February 2020 to February 2021, 100 children with constipation and recurrent respiratory infections treated in our hospital were assigned to a vitamin AD drops group and intramuscular thymosin group, with 50 cases in each group. Outcome measures included mean height, body mass index (BMI), frequency of respiratory infections, increase in height and BMI, growth retardation, clinical effectiveness, immune function, medication compliance, and adverse responses. Results The vitamin AD drops group showed higher mean height (t = 5.958, P < 0.05), greater body mass (t = 3.997, P < 0.05), and less frequency of respiratory infections than the intramuscular thymosin group (t = 26.564, P < 0.05). The vitamin AD drops group resulted in a lower ratio of height increase of >1 cm and a higher ratio of >2 cm as compared with the intramuscular thymosin group (χ2 = 8.167, P < 0.05). The vitamin AD drops group showed a lower ratio of weight gain of 0 and > 1 kg and a higher ratio of >2 kg versus the intramuscular thymosin group (χ2 = 4.058, P < 0.05). Vitamin AD drops resulted in a significantly lower growth retardation rate than intramuscular thymosin administration (χ2 = 5.530, P < 0.05). The vitamin AD drops group yielded markedly higher treatment efficiency in contrast to the intramuscular thymosin group (Z = 2.111, P < 0.05). The levels of CD3+CD4+, CD3+CD8+, CD4/CD8, IgA, IgG, and IgM in the two groups of patients after medication were higher than those before medication (P < 0.05), with higher levels in the vitamin AD drops group compared with the intramuscular thymosin group (P < 0.05). The vitamin AD drops group showed remarkably higher medication compliance in patients versus the intramuscular thymosin group (Z = 2.239, P < 0.05). The vitamin AD drops group experienced a significantly lower incidence of adverse reactions (χ2 = 4.396, P < 0.05). Conclusion Vitamin AD drops are more effective than the intramuscular injection of thymosin in reducing the incidence of growth retardation in children.
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Guiducci L, Vassalle C, Prosperi M, Santocchi E, Morales MA, Muratori F, Calderoni S. Vitamin D Status in Children with Autism Spectrum Disorders: Determinants and Effects of the Response to Probiotic Supplementation. Metabolites 2022; 12:metabo12070611. [PMID: 35888736 PMCID: PMC9317442 DOI: 10.3390/metabo12070611] [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: 06/01/2022] [Revised: 06/21/2022] [Accepted: 06/23/2022] [Indexed: 02/04/2023] Open
Abstract
A relationship between the presence of clinical symptoms and gastrointestinal (GI) disturbances associated with nutritional deficiencies, including vitamin D (25(OH)D) deficiency, has been observed in autism spectrum disorder (ASD). The aim was to evaluate 25(OH)D levels according to the annual rhythm cycle, gender, the severity of autism, nutritional or clinical status, inflammatory and metabolic biomarkers, GI symptoms, and the clinical response to probiotic/placebo supplementation in preschooler children with ASD. Eighty-one ASD preschoolers (67 males) were assessed with standardized tools for ASD severity (ADOS score) and GI symptoms (by GI-Index at six-items and at nine-items, the latter defined as the Total GI-Index). The 25(OH)D levels were compared among different ASD subgroups according to metabolic and inflammatory biomarkers (leptin, insulin, resistin, PAI-1, MCP-1, TNF-alfa, and IL-6), gender, and the presence or absence of: (i) GI symptoms, (ii) the response to probiotic supplementation (the improvement of GI symptomatology), (iii) the response to probiotic supplementation (improvement of ASD severity). Only 25% of the ASD children presented an adequate 25(OH)D status (≥30 ng/mL according to the Endocrine Society guidelines). All the 25(OH)D levels falling in the severe deficiency range (<10 ng/mL) were observed in the male subgroup. A significant inverse correlation between 25(OH)D and leptin was observed (R = −0.24, p = 0.037). An inverse correlation was found between 25(OH)D levels and the GI Index 6-Items and Total GI-Index (R = −0.25, p = 0.026; −0.27, = 0.009) and a direct relationship with the probiotic response (R = 0.4, p = 0.05). The monitoring of 25(OH)D levels and the co-administration of 25(OH)D and probiotic supplementation could be considered in ASD from early ages.
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Affiliation(s)
- Letizia Guiducci
- Institute of Clinical Physiology, CNR, 56124 Pisa, Italy; (L.G.); (M.A.M.)
| | - Cristina Vassalle
- Fondazione CNR-Regione Toscana G. Monasterio, 56124 Pisa, Italy
- Correspondence:
| | - Margherita Prosperi
- IRCCS Fondazione Stella Maris, Calambrone, 56128 Pisa, Italy; (M.P.); (F.M.); (S.C.)
| | - Elisa Santocchi
- UFSMIA Zona Valle del Serchio, Azienda USL Toscana Nord Ovest, 55032 Castelnuovo di Garfagnana, Italy;
| | | | - Filippo Muratori
- IRCCS Fondazione Stella Maris, Calambrone, 56128 Pisa, Italy; (M.P.); (F.M.); (S.C.)
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
| | - Sara Calderoni
- IRCCS Fondazione Stella Maris, Calambrone, 56128 Pisa, Italy; (M.P.); (F.M.); (S.C.)
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
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Alanazi M, Nabil Aboushady RM, Kamel AD. Association between Different Levels of Maternal Vitamin-D Status during Pregnancy and Maternal Outcomes. Clin Nutr ESPEN 2022; 50:307-313. [DOI: 10.1016/j.clnesp.2022.04.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 04/16/2022] [Accepted: 04/19/2022] [Indexed: 10/18/2022]
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Sammallahti S, Holmlund-Suila E, Zou R, Valkama S, Rosendahl J, Enlund-Cerullo M, Hauta-Alus H, Lahti-Pulkkinen M, El Marroun H, Tiemeier H, Mäkitie O, Andersson S, Räikkönen K, Heinonen K. Prenatal maternal and cord blood vitamin D concentrations and negative affectivity in infancy. Eur Child Adolesc Psychiatry 2021; 32:601-609. [PMID: 34657965 PMCID: PMC10115713 DOI: 10.1007/s00787-021-01894-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 10/06/2021] [Indexed: 11/29/2022]
Abstract
Higher maternal vitamin D concentration during pregnancy is associated with better child mental health. Negative affectivity, an early-emerging temperamental trait, indicates an increased risk of psychopathology. We investigated if maternal early/mid-pregnancy 25-hydroxyvitamin D (25(OH)D) and neonatal cord blood 25(OH)D concentrations are associated with Negative affectivity in infancy. We studied term-born infants from the vitamin D Intervention in Infants study (VIDI, n = 777, follow-up rate 80%, Finland), and the Generation R Study (n = 1505, follow-up rate 40%, Netherlands). We measured maternal serum 25(OH)D at 6-27 weeks (VIDI) or 18-25 weeks (Generation R) of pregnancy, and cord blood 25(OH)D at birth (both cohorts). Caregivers rated infant Negative affectivity at 11.7 months (VIDI) or 6.5 months (Generation R) using the Revised Infant Behavior Questionnaire. Using linear regression, we tested associations between 25(OH)D and Negative affectivity adjusted for infant age, sex, season of 25(OH)D measurement, maternal age, education, smoking, and body-mass-index. Per 10 nmol/l increase in maternal early/mid-pregnancy 25(OH)D, infant Negative affectivity decreased by 0.02 standard deviations (95% confidence interval [CI] - 0.06, - 0.004) in VIDI, and 0.03 standard deviations (95% CI - 0.03, - 0.01) in Generation R. Cord blood 25(OH)D was associated with Negative affectivity in Generation R (- 0.03, 95% CI - 0.05, - 0.01), but not VIDI (0.00, 95% CI - 0.02, 0.02). Lower maternal 25(OH)D concentrations were consistently associated with higher infant Negative affectivity, while associations between cord blood 25(OH)D concentrations and Negative affectivity were less clear. Maternal vitamin D status during early- and mid-pregnancy may be linked with early-emerging differences in offspring behavior.
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Affiliation(s)
- Sara Sammallahti
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, Sophia Children's Hospital, Rotterdam, The Netherlands.,Department of Social and Behavioral Science, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Elisa Holmlund-Suila
- Pediatric Research Center, Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Runyu Zou
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Saara Valkama
- Pediatric Research Center, Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Jenni Rosendahl
- Pediatric Research Center, Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Maria Enlund-Cerullo
- Pediatric Research Center, Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Folkhälsan Research Center, Helsinki, Finland
| | - Helena Hauta-Alus
- Pediatric Research Center, Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,National Institute for Health and Welfare (THL), Helsinki, Finland.,PEDEGO Research Unit, MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Marius Lahti-Pulkkinen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Hanan El Marroun
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, Sophia Children's Hospital, Rotterdam, The Netherlands.,Department of Psychology, Education and Child Studies, Erasmus School of Social and Behavioural Sciences, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Henning Tiemeier
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, Sophia Children's Hospital, Rotterdam, The Netherlands.,Department of Social and Behavioral Science, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Outi Mäkitie
- Pediatric Research Center, Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Folkhälsan Research Center, Helsinki, Finland
| | - Sture Andersson
- Pediatric Research Center, Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Katri Räikkönen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Kati Heinonen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland. .,Psychology/Welfare Sciences, Faculty of Social Sciences, Tampere University, 33014, Tampere, Finland.
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Juwita F, Gumilang L, Risan NA, Dhamayanti M. The Association of Vitamin D and Neurodevelopmental Status Among 2 Years Old Infants. Glob Pediatr Health 2021; 8:2333794X211034075. [PMID: 34350310 PMCID: PMC8295950 DOI: 10.1177/2333794x211034075] [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: 06/01/2021] [Accepted: 07/01/2021] [Indexed: 01/05/2023] Open
Abstract
The previous studies about association of vitamin D and neurodevelopmental status in the first 1000 days of life showed inconsistent results. This study aimed to investigate correlation between vitamin D deficiency and neurodevelopmental in 2 years old infants. A cross-sectional study was conducted in Sukabumi and Waled, West Java involving 2 years old infants born from the mothers participated in previous cohort. Total 109 infants met the criteria. Vitamin D was measured and neurodevelopmental status was assessed using ASQ-3 in each subject. Statistical analysis using Spearman's Rank correlation and multiple regression model. 50.4% infants had vitamin D deficiency (<50 nmol/L). Neurodevelopmental status showed appropriate for age. No significant association between vitamin D level and neurodevelopmental in 2 years old infants. However, there was an association between some developmental domains and vitamin D level at birth. No correlation between vitamin D and neurodevelopmental in 2 years old infants.
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Affiliation(s)
- Feby Juwita
- Department of Child Health, Hasan Sadikin General Hospital, Faculty of Medicine, Universitas Padjadjaran, Bandung, West Java, Indonesia
| | - Lani Gumilang
- Department of Public Health, Faculty of Medicine, Universitas Padjadjaran, Bandung, West Java, Indonesia
| | - Nelly Amalia Risan
- Department of Child Health, Hasan Sadikin General Hospital, Faculty of Medicine, Universitas Padjadjaran, Bandung, West Java, Indonesia
| | - Meita Dhamayanti
- Department of Child Health, Hasan Sadikin General Hospital, Faculty of Medicine, Universitas Padjadjaran, Bandung, West Java, Indonesia
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Lyall K, Ames JL, Pearl M, Traglia M, Weiss LA, Windham GC, Kharrazi M, Yoshida CK, Yolken R, Volk HE, Ashwood P, Van de Water J, Croen LA. A profile and review of findings from the Early Markers for Autism study: unique contributions from a population-based case-control study in California. Mol Autism 2021; 12:24. [PMID: 33736683 PMCID: PMC7977191 DOI: 10.1186/s13229-021-00429-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 02/23/2021] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND The Early Markers for Autism (EMA) study is a population-based case-control study designed to learn more about early biologic processes involved in ASD. METHODS Participants were drawn from Southern California births from 2000 to 2003 with archived prenatal and neonatal screening specimens. Across two phases, children with ASD (n = 629) and intellectual disability without ASD (ID, n = 230) were ascertained from the California Department of Developmental Services (DDS), with diagnoses confirmed according to DSM-IV-TR criteria based on expert clinical review of abstracted records. General population controls (GP, n = 599) were randomly sampled from birth certificate files and matched to ASD cases by sex, birth month and year after excluding individuals with DDS records. EMA has published over 20 papers examining immune markers, endogenous hormones, environmental chemicals, and genetic factors in association with ASD and ID. This review summarizes the results across these studies, as well as the EMA study design and future directions. RESULTS EMA enabled several key contributions to the literature, including the examination of biomarker levels in biospecimens prospectively collected during critical windows of neurodevelopment. Key findings from EMA include demonstration of elevated cytokine and chemokine levels in maternal mid-pregnancy serum samples in association with ASD, as well as aberrations in other immune marker levels; suggestions of increased odds of ASD with prenatal exposure to certain endocrine disrupting chemicals, though not in mixture analyses; and demonstration of maternal and fetal genetic influence on prenatal chemical, and maternal and neonatal immune marker and vitamin D levels. We also observed an overall lack of association with ASD and measured maternal and neonatal vitamin D, mercury, and brain-derived neurotrophic factor (BDNF) levels. LIMITATIONS Covariate and outcome data were limited to information in Vital Statistics and DDS records. As a study based in Southern California, generalizability for certain environmental exposures may be reduced. CONCLUSIONS Results across EMA studies support the importance of the prenatal and neonatal periods in ASD etiology, and provide evidence for the role of the maternal immune response during pregnancy. Future directions for EMA, and the field of ASD in general, include interrogation of mechanistic pathways and examination of combined effects of exposures.
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Affiliation(s)
- Kristen Lyall
- A.J. Drexel Autism Institute, Drexel University, Suite 560, 3020 Market St, Philadelphia, PA, 19104, USA.
| | - Jennifer L Ames
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Michelle Pearl
- Environmental Health Investigations Branch, California Department of Public Health, Richmond, CA, USA
| | - Michela Traglia
- University of California, San Francisco, San Francisco, CA, USA
| | - Lauren A Weiss
- University of California, San Francisco, San Francisco, CA, USA
| | - Gayle C Windham
- Environmental Health Investigations Branch, California Department of Public Health, Richmond, CA, USA
| | - Martin Kharrazi
- Environmental Health Investigations Branch, California Department of Public Health, Richmond, CA, USA
| | - Cathleen K Yoshida
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Robert Yolken
- School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Heather E Volk
- Department of Mental Health, Johns Hopkins University, Baltimore, MD, USA
| | - Paul Ashwood
- UC Davis MIND Institute, University of California, Davis, Davis, CA, USA
| | - Judy Van de Water
- UC Davis MIND Institute, University of California, Davis, Davis, CA, USA
| | - Lisa A Croen
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
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11
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Lee BK, Eyles DW, Magnusson C, Newschaffer CJ, McGrath JJ, Kvaskoff D, Ko P, Dalman C, Karlsson H, Gardner RM. Developmental vitamin D and autism spectrum disorders: findings from the Stockholm Youth Cohort. Mol Psychiatry 2021; 26:1578-1588. [PMID: 31695167 PMCID: PMC7200274 DOI: 10.1038/s41380-019-0578-y] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 10/07/2019] [Accepted: 10/23/2019] [Indexed: 12/18/2022]
Abstract
Animal studies indicate that early life vitamin D is crucial for proper neurodevelopment. Few studies have examined whether maternal and neonatal vitamin D concentrations influence risk of autism spectrum disorders (ASD). Participants were sampled from the Stockholm Youth Cohort, a register-based cohort in Sweden. Concentrations of total 25-hydroxyvitamin D (25OHD) were assessed from maternal and neonatal biosamples using a highly sensitive liquid chromatography tandem mass spectrometry method. The maternal sample consisted of 449 ASD cases and 574 controls, the neonatal sample: 1399 ASD cases and 1607 controls; and the paired maternal-neonatal sample: 340 ASD cases and 426 controls. Maternal 25OHD was not associated with child ASD in the overall sample. However, in Nordic-born mothers, maternal 25OHD insufficiency (25 - <50 nmol/L) at ~11 weeks gestation was associated with 1.58 times higher odds of ASD (95% CI: 1.00, 2.49) as compared with 25OHD sufficiency (≥50 nmol/L). Neonatal 25OHD < 25 nmol/L was associated with 1.33 times higher odds of ASD (95% CI: 1.02, 1.75) as compared with 25OHD ≥ 50 nmol/L. Sibling-matched control analyses indicated these associations were not likely due to familial confounding. Children with both maternal 25OHD and neonatal 25OHD below the median had 1.75 (95% CI: 1.08, 2.86) times the odds of ASD compared with children with maternal and neonatal 25OHD both below the median. Our results are consistent with an increasing body of evidence suggesting that vitamin D concentrations in early life may be associated with increased risk of neurodevelopmental disorders including ASD.
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Affiliation(s)
- Brian K. Lee
- grid.166341.70000 0001 2181 3113Department of Epidemiology and Biostatistics, Drexel University School of Public Health, Philadelphia, PA USA ,A.J. Drexel Autism Institute, Philadelphia, PA USA ,grid.4714.60000 0004 1937 0626Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Darryl W. Eyles
- grid.1003.20000 0000 9320 7537Queensland Brain Institute, University of Queensland, St. Lucia, QLD Australia ,grid.417162.70000 0004 0606 3563Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, QLD Australia
| | - Cecilia Magnusson
- grid.4714.60000 0004 1937 0626Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Craig J. Newschaffer
- grid.166341.70000 0001 2181 3113Department of Epidemiology and Biostatistics, Drexel University School of Public Health, Philadelphia, PA USA ,A.J. Drexel Autism Institute, Philadelphia, PA USA
| | - John J. McGrath
- grid.1003.20000 0000 9320 7537Queensland Brain Institute, University of Queensland, St. Lucia, QLD Australia ,grid.417162.70000 0004 0606 3563Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, QLD Australia ,grid.7048.b0000 0001 1956 2722National Centre for Register-based Research, Aarhus BSS, Aarhus University, Aarhus, Denmark
| | - David Kvaskoff
- grid.1003.20000 0000 9320 7537Queensland Brain Institute, University of Queensland, St. Lucia, QLD Australia
| | - Pauline Ko
- grid.1003.20000 0000 9320 7537Queensland Brain Institute, University of Queensland, St. Lucia, QLD Australia ,grid.417162.70000 0004 0606 3563Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, QLD Australia
| | - Christina Dalman
- grid.4714.60000 0004 1937 0626Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Håkan Karlsson
- grid.4714.60000 0004 1937 0626Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Renee M. Gardner
- grid.4714.60000 0004 1937 0626Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
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12
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Wang Z, Ding R, Wang J. The Association between Vitamin D Status and Autism Spectrum Disorder (ASD): A Systematic Review and Meta-Analysis. Nutrients 2020; 13:E86. [PMID: 33383952 PMCID: PMC7824115 DOI: 10.3390/nu13010086] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 12/21/2020] [Accepted: 12/25/2020] [Indexed: 12/22/2022] Open
Abstract
The association between vitamin D status and autism spectrum disorder (ASD) is well-investigated but remains to be elucidated. We quantitatively combined relevant studies to estimate whether vitamin D status was related to ASD in this work. PubMed, EMBASE, Web of Science, and the Cochrane Library were searched to include eligible studies. A random-effects model was applied to pool overall estimates of vitamin D concentration or odds ratio (OR) for ASD. In total, 34 publications involving 20,580 participants were identified in this present study. Meta-analysis of 24 case-control studies demonstrated that children and adolescents with ASD had significantly lower vitamin D concentration than that of the control group (mean difference (MD): -7.46 ng/mL, 95% confidence interval (CI): -10.26; -4.66 ng/mL, p < 0.0001, I2 = 98%). Quantitative integration of 10 case-control studies reporting OR revealed that lower vitamin D was associated with higher risk of ASD (OR: 5.23, 95% CI: 3.13; 8.73, p < 0.0001, I2 = 78.2%). Analysis of 15 case-control studies barring data from previous meta-analysis reached a similar result with that of the meta-analysis of 24 case-control studies (MD: -6.2, 95% CI: -9.62; -2.78, p = 0.0004, I2 = 96.8%), which confirmed the association. Furthermore, meta-analysis of maternal and neonatal vitamin D showed a trend of decreased early-life vitamin D concentration in the ASD group (MD: -3.15, 95% CI: -6.57; 0.26, p = 0.07, I2 = 99%). Meta-analysis of prospective studies suggested that children with reduced maternal or neonatal vitamin D had 54% higher likelihood of developing ASD (OR: 1.54, 95% CI: 1.12; 2.10, p = 0.0071, I2 = 81.2%). These analyses indicated that vitamin D status was related to the risk of ASD. The detection and appropriate intervention of vitamin D deficiency in ASD patients and pregnant and lactating women have clinical and public significance.
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Affiliation(s)
- Zuqun Wang
- Department of Biomedical Informatics, School of Basic Medical Sciences, Peking University, Beijing 100191, China; (Z.W.); (R.D.)
- Autism Research Center, Peking University Health Science Center, Beijing 100191, China
| | - Rui Ding
- Department of Biomedical Informatics, School of Basic Medical Sciences, Peking University, Beijing 100191, China; (Z.W.); (R.D.)
- Autism Research Center, Peking University Health Science Center, Beijing 100191, China
| | - Juan Wang
- Department of Biomedical Informatics, School of Basic Medical Sciences, Peking University, Beijing 100191, China; (Z.W.); (R.D.)
- Autism Research Center, Peking University Health Science Center, Beijing 100191, China
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13
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Ali AA, Cui X, Pertile RAN, Li X, Medley G, Alexander SA, Whitehouse AJO, McGrath JJ, Eyles DW. Developmental vitamin D deficiency increases foetal exposure to testosterone. Mol Autism 2020; 11:96. [PMID: 33298169 PMCID: PMC7727109 DOI: 10.1186/s13229-020-00399-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 11/06/2020] [Indexed: 12/18/2022] Open
Abstract
Background Autism spectrum disorder (ASD) is a group of neurodevelopmental disorders which are more common in males. The ‘prenatal sex steroid’ hypothesis links excessive sex-steroid exposure during foetal life with the behavioural differences observed in ASD. However, the reason why sex steroid exposure may be excessive remains unclear. Epidemiological studies have identified several environmental risk factors associated with ASD, including developmental vitamin D (DVD) deficiency. We have demonstrated in an animal model that DVD-deficiency is associated with a hyper-inflammatory response in placentas from male but not female foetuses. Vitamin D also regulates the expression of several steroidogenic enzymes in vitro. Therefore using this animal model, we have examined whether DVD-deficiency leads to increased sex-steroid levels in both the maternal and foetal compartments. Methods Female rats are fed a vitamin D deficient diet from 6 weeks before mating until tissue collection at embryonic day 18. We examined the levels of testosterone, androstenedione and corticosterone in maternal plasma, foetal brains and amniotic fluid. We further examined gene expressions of steroidogenic enzymes and DNA methylation of aromatase promoters in foetal brains as a potential molecular mechanism regulating testosterone expression. Results We show that DVD-deficiency increases testosterone levels in maternal blood. We also show elevated levels of testosterone and androstenedione in the amniotic fluid of female but not male DVD-deficient foetuses. Testosterone levels were also elevated in DVD-deficient male brains. Vitamin D, like other steroid-related hormones, regulates gene expression via methylation. Therefore we examined whether the significant elevation in testosterone in male brains was due to such a potential gene-silencing mechanism. We show that the promoter of aromatase was hyper-methylated compared to male controls. Limitations A reduction in aromatase, in addition to causing excessive testosterone, could also lead to a reduction in estradiol which was not examined here. Conclusions This study is the first to show how an epidemiologically established environmental risk factor for ASD may selectively elevate testosterone in male embryonic brains. These findings provide further mechanistic support for the prenatal sex steroid theory of ASD.
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Affiliation(s)
- Asad Amanat Ali
- Queensland Brain Institute, The University of Queensland, St Lucia, QLD, Australia
| | - Xiaoying Cui
- Queensland Brain Institute, The University of Queensland, St Lucia, QLD, Australia.,Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, QLD, Australia
| | | | - Xiang Li
- Queensland Brain Institute, The University of Queensland, St Lucia, QLD, Australia
| | - Gregory Medley
- Queensland Brain Institute, The University of Queensland, St Lucia, QLD, Australia
| | - Suzanne Adele Alexander
- Queensland Brain Institute, The University of Queensland, St Lucia, QLD, Australia.,Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, QLD, Australia
| | - Andrew J O Whitehouse
- Telethon Kids Institute, The University of Western Australia, Perth, WA, 6009, Australia
| | - John Joseph McGrath
- Queensland Brain Institute, The University of Queensland, St Lucia, QLD, Australia.,Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, QLD, Australia.,NCRR-National Centre for Register-Based Research, Department of Economics and Business Economics, Aarhus University, Aarhus C, Denmark
| | - Darryl Walter Eyles
- Queensland Brain Institute, The University of Queensland, St Lucia, QLD, Australia. .,Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, QLD, Australia.
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14
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Windham GC, Pearl M, Poon V, Berger K, Soriano JW, Eyles D, Lyall K, Kharrazi M, Croen LA. Maternal Vitamin D Levels During Pregnancy in Association With Autism Spectrum Disorders (ASD) or Intellectual Disability (ID) in Offspring; Exploring Non-linear Patterns and Demographic Sub-groups. Autism Res 2020; 13:2216-2229. [PMID: 33135392 PMCID: PMC11068065 DOI: 10.1002/aur.2424] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 08/21/2020] [Accepted: 09/27/2020] [Indexed: 12/20/2022]
Abstract
Increasing vitamin D deficiency and evidence for vitamin D's role in brain and immune function have recently led to studies of neurodevelopment; however, few are specific to autism spectrum disorder (ASD) and vitamin D in pregnancy, a likely susceptibility period. We examined this in a case-control study of 2000-2003 Southern Californian births; ASD and intellectual disability (ID) were identified through the Department of Developmental Services and controls from birth certificates (N = 534, 181, and 421, respectively, in this analysis). Total 25-Hydroxyvitamin D (25(OH)D) was measured in mid-pregnancy serum, categorized as deficient (<50 nmol/L), insufficient (50-74 nmol/L), or sufficient (≥75 nmol/L, referent category), and examined continuously (per 25 nmol/L). Crude and adjusted odds ratios (AORs) and 95% confidence intervals (95% CI) were calculated. Non-linearity was examined with cubic splines. AORs (95% CI) for ASD were 0.79 (0.49-1.3) for maternal deficiency (9.5%), 0.93 (0.68-1.3) for insufficiency (25.6%), and 0.95 (0.86, 1.05) for linear continuous 25(OH)D. Results were similarly null for ASD with or without ID, and ID only. Interactions were observed; non-Hispanic whites (NHW) (AOR = 0.82, 95% CI = 0.69-0.98) and males (AOR = 0.89, 95% CI = 0.80-0.99) had protective associations for ASD with continuous 25(OH)D. A positive association with ASD was observed in females (AOR = 1.40, 95% CI = 1.06-1.85). With splines, a non-linear inverted j-shaped pattern was seen overall (P = 0.009 for non-linearity), with the peak around 100 nmol/L; a non-linear pattern was not observed among NHW, females, nor for ID. Our findings from a large study of ASD and prenatal vitamin D levels indicate that further research is needed to investigate non-linear patterns and potentially vulnerable sub-groups. LAY SUMMARY: We studied whether mothers' vitamin D levels during pregnancy were related to their children having autism (or low IQ) later. Low vitamin D levels were not related to greater risk of autism or low IQ in children overall. With higher levels of mothers' vitamin D, risk of autism went down in boys, but went up in girls. Risk of autism also went down in children of non-Hispanic white mothers with higher vitamin D levels, but we did not find a relation in other race/ethnic groups.
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Affiliation(s)
- Gayle C Windham
- Environmental Health Investigations Branch, California Department of Public Health, Richmond, California, USA
| | - Michelle Pearl
- Environmental Health Investigations Branch, California Department of Public Health, Richmond, California, USA
| | - Victor Poon
- Sequoia Foundation, La Jolla, California, USA
| | | | | | - Darryl Eyles
- Queensland Brain Institute, University of Queensland, Brisbane, Queensland, Australia
| | - Kristen Lyall
- A.J. Drexel Autism Institute, Drexel University, Philadelphia, Pennsylvania, USA
| | - Martin Kharrazi
- Environmental Health Investigations Branch, California Department of Public Health, Richmond, California, USA
| | - Lisa A Croen
- Kaiser Permanente Division of Research, Oakland, California, USA
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15
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Abstract
It has been 20 years since we first proposed vitamin D as a "possible" neurosteroid.( 1 ) Our work over the last two decades, particularly results from our cellular and animal models, has confirmed the numerous ways in which vitamin D differentiates the developing brain. As a result, vitamin D can now confidently take its place among all other steroids known to regulate brain development.( 2 ) Others have concentrated on the possible neuroprotective functions of vitamin D in adult brains. Here these data are integrated, and possible mechanisms outlined for the various roles vitamin D appears to play in both developing and mature brains and how such actions shape behavior. There is now also good evidence linking gestational and/or neonatal vitamin D deficiency with an increased risk of neurodevelopmental disorders, such as schizophrenia and autism, and adult vitamin D deficiency with certain degenerative conditions. In this mini-review, the focus is on what we have learned over these past 20 years regarding the genomic and nongenomic actions of vitamin D in shaping brain development, neurophysiology, and behavior in animal models. © 2020 The Author. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.
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Affiliation(s)
- Darryl Walter Eyles
- Queensland Centre for Mental Health Research The Park Centre for Mental Health Wacol Australia.,Queensland Brain Institute University of Queensland St. Lucia Queensland Australia
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16
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Zhong C, Tessing J, Lee BK, Lyall K. Maternal Dietary Factors and the Risk of Autism Spectrum Disorders: A Systematic Review of Existing Evidence. Autism Res 2020; 13:1634-1658. [PMID: 33015977 PMCID: PMC9234972 DOI: 10.1002/aur.2402] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 08/07/2020] [Accepted: 09/12/2020] [Indexed: 01/15/2023]
Abstract
Prenatal maternal diet is a critical factor in offspring neurodevelopment. Emerging evidence suggests that prenatal diet may also play a role in the etiology autism spectrum disorder (ASD). This review summarizes studies published in English that examined prenatal nutrients or maternal diet in association with ASD from PubMed as of July 2020. Thiry-six studies from nine countries were included in this systematic review; these focused on multivitamin (n = 5), prenatal vitamin (n = 3), folic acid (FA; n = 14), Vitamin D (n = 11), polyunsaturated fatty acid or fish/supplement intake (n = 7), iron (n = 3), Vitamin B12 (n = 1), calcium (n = 1), magnesium (n = 1), and broad maternal dietary habits (n = 3). Overall, higher or moderate intake of prenatal/multivitamin, FA, and Vitamin D was associated with reductions in odds of ASD, though results have not been uniform and there is a need to clarify differences in findings based on biomarkers versus reported intake. Evidence was inconclusive or insufficient for other nutrients. Differences in the timing and measurement of these dietary factors, as well as potential residual confounding, may contribute to existing discrepancies. Key areas for future research to better understand the role of maternal diet in ASD include the need to address potential critical windows, examine the combined effect of multiple nutrients, and consider interactions with genetic or environmental factors. LAY SUMMARY: Maternal diet during pregnancy is important for child neurodevelopment. We reviewed 36 studies examining maternal diet and autism spectrum disorder (ASD) and found that prenatal vitamin/multivitamin use and adequate intake of folic acid and Vitamin D were each associated with lower likelihood of having a child with ASD. Future studies on these and other dietary factors are needed to better understand the role of maternal diet in the development of ASD. Autism Res 2020, 13: 1634-1658. © 2020 International Society for Autism Research and Wiley Periodicals LLC.
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Affiliation(s)
- Caichen Zhong
- Department of Epidemiology and Biostatistics, Drexel University School of Public Health, Philadelphia, Pennsylvania, USA
| | | | - Brian K Lee
- Department of Epidemiology and Biostatistics, Drexel University School of Public Health, Philadelphia, Pennsylvania, USA
| | - Kristen Lyall
- A.J. Drexel Autism Institute, Philadelphia, Pennsylvania, USA
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17
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Li B, Xu Y, Zhang X, Zhang L, Wu Y, Wang X, Zhu C. The effect of vitamin D supplementation in treatment of children with autism spectrum disorder: a systematic review and meta-analysis of randomized controlled trials. Nutr Neurosci 2020; 25:835-845. [PMID: 32893747 DOI: 10.1080/1028415x.2020.1815332] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Bingbing Li
- Henan Key Laboratory of Child Brain Injury, Third Affiliated Hospital and Institute of Neuroscience of Zhengzhou University, Zhengzhou, People’s Republic of China
| | - Yiran Xu
- Henan Key Laboratory of Child Brain Injury, Third Affiliated Hospital and Institute of Neuroscience of Zhengzhou University, Zhengzhou, People’s Republic of China
| | - Xiaoli Zhang
- Henan Key Laboratory of Child Brain Injury, Third Affiliated Hospital and Institute of Neuroscience of Zhengzhou University, Zhengzhou, People’s Republic of China
| | - Lingling Zhang
- Henan Key Laboratory of Child Brain Injury, Third Affiliated Hospital and Institute of Neuroscience of Zhengzhou University, Zhengzhou, People’s Republic of China
| | - Yanan Wu
- Henan Key Laboratory of Child Brain Injury, Third Affiliated Hospital and Institute of Neuroscience of Zhengzhou University, Zhengzhou, People’s Republic of China
| | - Xiaoyang Wang
- Henan Key Laboratory of Child Brain Injury, Third Affiliated Hospital and Institute of Neuroscience of Zhengzhou University, Zhengzhou, People’s Republic of China
- Center of Perinatal Medicine and Health, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Changlian Zhu
- Henan Key Laboratory of Child Brain Injury, Third Affiliated Hospital and Institute of Neuroscience of Zhengzhou University, Zhengzhou, People’s Republic of China
- Center for Brain Repair and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden
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18
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Pacheva I, Ivanov I. Targeted Biomedical Treatment for Autism Spectrum Disorders. Curr Pharm Des 2020; 25:4430-4453. [PMID: 31801452 DOI: 10.2174/1381612825666191205091312] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 12/02/2019] [Indexed: 12/29/2022]
Abstract
BACKGROUND A diagnosis of autism spectrum disorders (ASD) represents presentations with impairment in communication and behaviour that vary considerably in their clinical manifestations and etiology as well as in their likely pathophysiology. A growing body of data indicates that the deleterious effect of oxidative stress, mitochondrial dysfunction, immune dysregulation and neuroinflammation, as well as their interconnections are important aspects of the pathophysiology of ASD. Glutathione deficiency decreases the mitochondrial protection against oxidants and tumor necrosis factor (TNF)-α; immune dysregulation and inflammation inhibit mitochondrial function through TNF-α; autoantibodies against the folate receptors underpin cerebral folate deficiency, resulting in disturbed methylation, and mitochondrial dysfunction. Such pathophysiological processes can arise from environmental and epigenetic factors as well as their combined interactions, such as environmental toxicant exposures in individuals with (epi)genetically impaired detoxification. The emerging evidence on biochemical alterations in ASD is forming the basis for treatments aimed to target its biological underpinnings, which is of some importance, given the uncertain and slow effects of the various educational interventions most commonly used. METHODS Literature-based review of the biomedical treatment options for ASD that are derived from established pathophysiological processes. RESULTS Most proposed biomedical treatments show significant clinical utility only in ASD subgroups, with specified pre-treatment biomarkers that are ameliorated by the specified treatment. For example, folinic acid supplementation has positive effects in ASD patients with identified folate receptor autoantibodies, whilst the clinical utility of methylcobalamine is apparent in ASD patients with impaired methylation capacity. Mitochondrial modulating cofactors should be considered when mitochondrial dysfunction is evident, although further research is required to identify the most appropriate single or combined treatment. Multivitamins/multiminerals formulas, as well as biotin, seem appropriate following the identification of metabolic abnormalities, with doses tapered to individual requirements. A promising area, requiring further investigations, is the utilization of antipurinergic therapies, such as low dose suramin. CONCLUSION The assessment and identification of relevant physiological alterations and targeted intervention are more likely to produce positive treatment outcomes. As such, current evidence indicates the utility of an approach based on personalized and evidence-based medicine, rather than treatment targeted to all that may not always be beneficial (primum non nocere).
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Affiliation(s)
- Iliyana Pacheva
- Department of Pediatrics and Medical Genetics, Medical University - Plovdiv, Plovdiv 4002, Bulgaria
| | - Ivan Ivanov
- Department of Pediatrics and Medical Genetics, Medical University - Plovdiv, Plovdiv 4002, Bulgaria
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19
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Mutua AM, Mogire RM, Elliott AM, Williams TN, Webb EL, Abubakar A, Atkinson SH. Effects of vitamin D deficiency on neurobehavioural outcomes in children: a systematic review. Wellcome Open Res 2020; 5:28. [PMID: 32399499 PMCID: PMC7194460 DOI: 10.12688/wellcomeopenres.15730.2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/04/2020] [Indexed: 01/14/2023] Open
Abstract
Introduction: Vitamin D plays an important role in brain development in experimental studies; however, the effect of vitamin D deficiency on child development remains inadequately characterized. We aimed to estimate the effects of vitamin D deficiency on neurobehavioural outcomes in children up to 18 years of age. Methods: We searched PubMed, EMBASE, PsycINFO, Scopus, Cochrane Library, Web of Science and Open Grey for published studies up to 10th January 2020. We included all studies that assessed the effects of maternal or child vitamin D status or vitamin D supplementation on neurobehavioural outcomes in children. Study findings were synthesized qualitatively as the high level of heterogeneity in study populations and methodologies precluded a quantitative meta-analysis. Results: Our search identified 5,633 studies, of which 31 studies with 31,375 participants from 18 countries were included in the systematic review. Of the studies identified, one was a randomised controlled trial (RCT) of vitamin D supplementation in children, while 30 were observational. The RCT (n=55) reported a beneficial effect of supplementation with lower doses compared to higher doses of vitamin D on motor development. Twelve mother-child studies (n=17,136) and five studies in children (n=1,091) reported an association between low maternal or child 25-hydroxyvitamin D levels and impaired neurobehavioural outcomes in children, while 15 mother-child studies (n=20,778) and eight studies in children (n=7,496) reported no association. Conclusions: Although animal studies point to an effect of vitamin D deficiency on brain development, there are few studies on the effects of vitamin D deficiency on neurobehavioural outcomes in children and their findings are inconsistent. There is a need for well-conducted, adequately powered studies to further determine these effects in children. Registration: PROSPERO ID CRD42018087619; registered on 15 February 2018.
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Affiliation(s)
- Agnes M. Mutua
- KEMRI-Wellcome Trust Research Programme, Kilifi, 80108, Kenya
- Department of Public Health, School of Human and Health Sciences, Pwani University, Kilifi, 80108, Kenya
| | - Reagan M. Mogire
- KEMRI-Wellcome Trust Research Programme, Kilifi, 80108, Kenya
- Open University, KEMRI-Wellcome Trust Research Programme - Accredited Research Centre, Kilifi, 80108, Kenya
| | - Alison M. Elliott
- Medical Research Council / Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK
| | - Thomas N. Williams
- KEMRI-Wellcome Trust Research Programme, Kilifi, 80108, Kenya
- Department of Medicine, Imperial College London, London, W21N, UK
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, OX3 7FZ, UK
| | - Emily L. Webb
- MRC Tropical Epidemiology Group, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK
| | - Amina Abubakar
- KEMRI-Wellcome Trust Research Programme, Kilifi, 80108, Kenya
- Department of Public Health, School of Human and Health Sciences, Pwani University, Kilifi, 80108, Kenya
- Department of Psychiatry, University of Oxford, Oxford, OX3 7JX, UK
- Institute for Human Development, Aga Khan University, Nairobi, 00100, Kenya
| | - Sarah H. Atkinson
- KEMRI-Wellcome Trust Research Programme, Kilifi, 80108, Kenya
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, OX3 7FZ, UK
- Department of Paediatrics, University of Oxford, Oxford, OX3 9DU, UK
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Mutua AM, Nampijja M, Elliott AM, Pettifor JM, Williams TN, Abubakar A, Webb EL, Atkinson SH. Vitamin D Status Is Not Associated with Cognitive or Motor Function in Pre-School Ugandan Children. Nutrients 2020; 12:nu12061662. [PMID: 32503251 PMCID: PMC7352320 DOI: 10.3390/nu12061662] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 05/26/2020] [Accepted: 05/27/2020] [Indexed: 12/24/2022] Open
Abstract
Vitamin D deficiency is common worldwide and young children are among the most affected groups. Animal studies suggest a key role for vitamin D in brain development. However, studies investigating the effects of vitamin D on neurobehavioural outcomes in children are inconclusive and evidence is limited in sub-Saharan Africa. We evaluated the effect of vitamin D status on cognitive and motor outcomes using prospective data from the Entebbe Mother and Baby Study birth cohort. We analysed data from 302 Ugandan children with 25-hydroxyvitamin D (25(OH)D) measurements below five years and developmental measures at five years of age. We used multivariable linear regression, adjusted for potential confounders, to estimate the effect of 25(OH)D on cognitive and motor outcomes. Of 302 children, eight (2.7%) had 25(OH)D levels <50 nmol/L, 105 (35.8%) had levels 50-75 nmol/L and 189 (62.6%) had levels >75 nmol/L. There was no evidence that earlier vitamin D status was associated with cognitive and motor outcomes in five-year-old Ugandan children. This study adds to the sparse literature and highlights the need for further longitudinal studies on vitamin D and neurobehavioural outcomes in children living in sub-Saharan Africa.
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Affiliation(s)
- Agnes M. Mutua
- Kenya Medical Research Institute (KEMRI), Centre for Geographic Medicine Research-Coast, KEMRI Wellcome Trust Research Programme, P.O. BOX 230-80108 Kilifi, Kenya; (T.N.W.); (A.A.)
- Correspondence: (A.M.M.); (S.H.A.); Tel.: +254-709983677/76 (A.M.M.)
| | - Margaret Nampijja
- Maternal and Child Wellbeing (MCW) Unit, African Population and Health Research Center, P.O. Box 10787-00100 Nairobi, Kenya;
- Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, P.O. Box 49, Entebbe, Uganda;
| | - Alison M. Elliott
- Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, P.O. Box 49, Entebbe, Uganda;
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
| | - John M. Pettifor
- South African Medical Research Council and Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, University of the Witwatersrand, 26 Chris Hani Road, Soweto 6201, Johannesburg, South Africa;
| | - Thomas N. Williams
- Kenya Medical Research Institute (KEMRI), Centre for Geographic Medicine Research-Coast, KEMRI Wellcome Trust Research Programme, P.O. BOX 230-80108 Kilifi, Kenya; (T.N.W.); (A.A.)
- Department of Medicine, Imperial College of Science Technology and Medicine, St Mary’s Hospital, London W2 1NY, UK
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford OX3 7FZ, UK
| | - Amina Abubakar
- Kenya Medical Research Institute (KEMRI), Centre for Geographic Medicine Research-Coast, KEMRI Wellcome Trust Research Programme, P.O. BOX 230-80108 Kilifi, Kenya; (T.N.W.); (A.A.)
- Department of Public Health, School of Human and Health Sciences, Pwani University, P.O. BOX 195-80108 Kilifi, Kenya
- Department of Psychiatry, University of Oxford, Oxford OX3 7JX, UK
- Institute for Human Development, Aga Khan University, 2nd Parklands Avenue, P.O. BOX 30270-00100 Nairobi, Kenya
| | - Emily L. Webb
- MRC Tropical Epidemiology Group, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK;
| | - Sarah H. Atkinson
- Kenya Medical Research Institute (KEMRI), Centre for Geographic Medicine Research-Coast, KEMRI Wellcome Trust Research Programme, P.O. BOX 230-80108 Kilifi, Kenya; (T.N.W.); (A.A.)
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford OX3 7FZ, UK
- Department of Paediatrics, University of Oxford, Oxford OX3 9DU, UK
- Correspondence: (A.M.M.); (S.H.A.); Tel.: +254-709983677/76 (A.M.M.)
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Siracusano M, Riccioni A, Abate R, Benvenuto A, Curatolo P, Mazzone L. Vitamin D Deficiency and Autism Spectrum Disorder. Curr Pharm Des 2020; 26:2460-2474. [PMID: 32294031 DOI: 10.2174/1381612826666200415174311] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 04/08/2020] [Indexed: 12/24/2022]
Abstract
Vitamin D is a neurosteroid hormone crucially involved in neurodevelopment. Neural cell proliferation, neurotransmission, oxidative stress and immune function represent the main mechanisms mediated by vitamin D in the Central Nervous System. Therefore, its deficiency during pregnancy and early childhood may significantly impact on a developing brain, leading to possible adverse neuropsychological outcomes including Autism Spectrum Disorder (ASD). Significant vitamin D deficiency is described within children affected by ASD and in pregnant mothers whose offspring will later develop ASD, suggesting a possible role of the hormone as a contributing risk factor in the etiopathogenesis of ASD. We reviewed the actual literature on the potential contributing role of prenatal and early postnatal vitamin D deficiency in ASD etiopathogenesis, at both genetic and environmental levels, and the possible effect of vitamin D supplementation in autistic children. Conflicting but promising results emerged on the topic. Further Randomized Controlled Trials studies carried out during pregnancy and early infancy are necessary for better understanding the possible contribution of vitamin D deficiency in the etiopathogenesis of autism and the potential efficacy of the hormone supplementation in the improvement of ASD core symptoms.
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Affiliation(s)
- Martina Siracusano
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy.,PHD Student in Experimental Medicine- Neuroscience, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila AQ, Italy
| | - Assia Riccioni
- Child Neurology and Psychiatry Unit, System Medicine Department, Tor Vergata University Hospital of Rome, Rome, Italy
| | - Roberta Abate
- Child Neurology and Psychiatry Unit, System Medicine Department, Tor Vergata University Hospital of Rome, Rome, Italy
| | - Arianna Benvenuto
- Child Neurology and Psychiatry Unit, System Medicine Department, Tor Vergata University Hospital of Rome, Rome, Italy
| | - Paolo Curatolo
- Child Neurology and Psychiatry Unit, System Medicine Department, Tor Vergata University Hospital of Rome, Rome, Italy
| | - Luigi Mazzone
- Child Neurology and Psychiatry Unit, System Medicine Department, Tor Vergata University Hospital of Rome, Rome, Italy
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22
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Mutua AM, Mogire RM, Elliott AM, Williams TN, Webb EL, Abubakar A, Atkinson SH. Effects of vitamin D deficiency on neurobehavioural outcomes in children: a systematic review. Wellcome Open Res 2020; 5:28. [PMID: 32399499 PMCID: PMC7194460 DOI: 10.12688/wellcomeopenres.15730.1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/07/2020] [Indexed: 12/14/2022] Open
Abstract
Introduction: Vitamin D plays an important role in brain development in experimental studies; however, the effect of vitamin D deficiency on child development remains inadequately characterized. We aimed to estimate the effects of vitamin D deficiency on neurobehavioural outcomes in children up to 18 years of age. Methods: We searched PubMed, EMBASE, PsycINFO, Scopus, Cochrane Library, Web of Science and Open Grey for published studies up to 10th January 2020. We included all studies that assessed the effects of maternal or child vitamin D status or vitamin D supplementation on neurobehavioural outcomes in children. Study findings were synthesized qualitatively as the high level of heterogeneity in study populations and methodologies precluded a quantitative meta-analysis. Results: Our search identified 5,633 studies, of which 32 studies with 31,445 participants from 18 countries were included in the systematic review. Of the studies identified, two were randomized controlled trials (RCTs) of vitamin D supplementation in children, while 30 were observational. One RCT (n=55) reported a beneficial effect of supplementation with lower doses compared to higher doses of vitamin D on motor development while the other RCT (n=70) found no beneficial effect of vitamin D supplementation on cognition in extremely preterm infants. Twelve mother-child studies (n=17,136) and five studies in children (n=1,091) reported an association between low maternal or child 25-hydroxyvitamin D levels and impaired neurobehavioural outcomes in children, while 15 mother-child studies (n=20,778) and eight studies in children (n=7,496) reported no association. Conclusions: Although animal studies point to an effect of vitamin D deficiency on brain development, there are few studies on the effects of vitamin D deficiency on neurobehavioural outcomes in children and their findings are inconsistent. There is a need for well-conducted, adequately powered studies to further determine these effects in children. Registration: PROSPERO ID CRD42018087619; registered on 15 February 2018.
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Affiliation(s)
- Agnes M. Mutua
- KEMRI-Wellcome Trust Research Programme, Kilifi, 80108, Kenya
- Department of Public Health, School of Human and Health Sciences, Pwani University, Kilifi, 80108, Kenya
| | - Reagan M. Mogire
- KEMRI-Wellcome Trust Research Programme, Kilifi, 80108, Kenya
- Open University, KEMRI-Wellcome Trust Research Programme - Accredited Research Centre, Kilifi, 80108, Kenya
| | - Alison M. Elliott
- Medical Research Council / Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK
| | - Thomas N. Williams
- KEMRI-Wellcome Trust Research Programme, Kilifi, 80108, Kenya
- Department of Medicine, Imperial College London, London, W21N, UK
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, OX3 7FZ, UK
| | - Emily L. Webb
- MRC Tropical Epidemiology Group, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK
| | - Amina Abubakar
- KEMRI-Wellcome Trust Research Programme, Kilifi, 80108, Kenya
- Department of Public Health, School of Human and Health Sciences, Pwani University, Kilifi, 80108, Kenya
- Department of Psychiatry, University of Oxford, Oxford, OX3 7JX, UK
- Institute for Human Development, Aga Khan University, Nairobi, 00100, Kenya
| | - Sarah H. Atkinson
- KEMRI-Wellcome Trust Research Programme, Kilifi, 80108, Kenya
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, OX3 7FZ, UK
- Department of Paediatrics, University of Oxford, Oxford, OX3 9DU, UK
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López-Vicente M, Sunyer J, Lertxundi N, González L, Rodríguez-Dehli C, Espada Sáenz-Torre M, Vrijheid M, Tardón A, Llop S, Torrent M, Ibarluzea J, Guxens M. Maternal circulating Vitamin D 3 levels during pregnancy and behaviour across childhood. Sci Rep 2019; 9:14792. [PMID: 31616023 PMCID: PMC6794315 DOI: 10.1038/s41598-019-51325-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Accepted: 09/27/2019] [Indexed: 11/12/2022] Open
Abstract
Vitamin D deficiency during critical periods of development could lead to persistent brain alterations. We aimed to assess the association between maternal vitamin D3, the major circulatory form of vitamin D, at pregnancy and neurodevelopmental outcomes during childhood, namely: behavioural problems, Attention Deficit and Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD) symptoms, and social competence. This study included 2,107 mother-child pairs of a Spanish population-based birth cohort. Maternal plasma vitamin D3 was measured in pregnancy. The outcomes were measured through questionnaires at 5, 8, 14, and 18 years old. We ran multivariate regression models adjusted for potential confounding variables. We found that per each 10 ng/mL increment of maternal vitamin D3, children obtained higher social competence scores (coefficient = 0.77; 95% CI = 0.19, 1.35) at 5 years old. However, we observed null associations between maternal vitamin D3 and total behavioural problems and ADHD and ASD symptoms in children from 5 to 18 years old. Further studies carried out in countries where the population is exposed to lower vitamin D levels are needed.
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Affiliation(s)
- Mónica López-Vicente
- ISGlobal, Barcelona, Spain.,CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain.,Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - Jordi Sunyer
- ISGlobal, Barcelona, Spain.,CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain.,Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - Nerea Lertxundi
- BIODONOSTIA, Donostia-San Sebastian, Spain.,University of the Basque Country (UPV/EHU), Donostia-San Sebastian, Spain
| | - Llúcia González
- Unidad Predepartamental de Medicina, UJI, Valencia, Spain.,Unidad Mixta de Investigación en Epidemiología y Salud Ambiental FISABIO-UV-UJI, Valencia, Spain
| | | | | | - Martine Vrijheid
- ISGlobal, Barcelona, Spain.,CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Adonina Tardón
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,IUOPA-Preventive Medicine and Public Health Area, University of Oviedo and ISPA, Oviedo, Spain
| | - Sabrina Llop
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Unidad Mixta de Investigación en Epidemiología y Salud Ambiental FISABIO-UV-UJI, Valencia, Spain
| | | | - Jesús Ibarluzea
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,BIODONOSTIA, Donostia-San Sebastian, Spain.,University of the Basque Country (UPV/EHU), Donostia-San Sebastian, Spain.,Departamento de Salud del Gobierno Vasco, Gipuzkoa, Spain
| | - Mònica Guxens
- ISGlobal, Barcelona, Spain. .,CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain. .,Universitat Pompeu Fabra (UPF), Barcelona, Spain. .,Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Centre-Sophia Children's Hospital, Rotterdam, The Netherlands.
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