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Rayhill M. Headache in Pregnancy and Lactation. Continuum (Minneap Minn) 2022; 28:72-92. [DOI: 10.1212/con.0000000000001070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Munger RG, Kuppuswamy R, Murthy J, Balakrishnan K, Thangavel G, Sambandam S, Kurpad AV, Molloy AM, Ueland PM, Mossey PA. Maternal Vitamin B 12 Status and Risk of Cleft Lip and Cleft Palate Birth Defects in Tamil Nadu State, India. Cleft Palate Craniofac J 2021; 58:567-576. [PMID: 33686867 DOI: 10.1177/1055665621998394] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND AND OBJECTIVE The causal role of maternal nutrition in orofacial clefts is uncertain. We tested hypotheses that low maternal vitamin B12 and low folate status are each associated with an increased risk of isolated cleft lip with or without cleft palate (CL±P) in a case-control study in Tamil Nadu state, India. METHODS Case-mothers of CL±P children (n = 47) and control-mothers of unaffected children (n = 50) were recruited an average of 1.4 years after birth of the index child and plasma vitamin B12, methylmalonic acid (MMA), total homocysteine (tHcy), and folate were measured at that time. Logistic regression analyses estimated associations between nutrient biomarkers and case-control status. RESULTS Odds ratios (ORs) contrasting biomarker levels showed associations between case-mothers and low versus high plasma vitamin B12 (OR = 2.48, 95% CI, 1.02-6.01) and high versus low plasma MMA, an indicator of poor B12 status (OR = 3.65 95% CI, 1.21-11.05). Case-control status was not consistently associated with folate or tHcy levels. Low vitamin B12 status, when defined by a combination of both plasma vitamin B12 and MMA levels, had an even stronger association with case-mothers (OR = 6.54, 95% CI, 1.33-32.09). CONCLUSIONS Mothers of CL±P children in southern India were 6.5 times more likely to have poor vitamin B12 status, defined by multiple biomarkers, compared to control-mothers. Further studies in populations with diverse nutritional backgrounds are required to determine whether poor maternal vitamin B12 or folate levels or their interactions are causally related to CL±P.
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Affiliation(s)
- Ronald G Munger
- Department of Nutrition, Dietetics, and Food Sciences, 4606Utah State University, Logan, Utah, the United States
| | - Rajarajeswari Kuppuswamy
- Department of Environmental Health Engineering, 29875Sri Ramachandra Medical College and Research Institute, Chennai, Tamil Nadu, India
| | - Jyotsna Murthy
- Department of Plastic and Reconstructive Surgery, 29875Sri Ramachandra Medical College and Research Institute, Chennai, Tamil Nadu, India
| | - Kalpana Balakrishnan
- Department of Environmental Health Engineering, 29875Sri Ramachandra Medical College and Research Institute, Chennai, Tamil Nadu, India
| | - Gurusamy Thangavel
- Department of Environmental Health Engineering, 29875Sri Ramachandra Medical College and Research Institute, Chennai, Tamil Nadu, India
| | - Sankar Sambandam
- Department of Environmental Health Engineering, 29875Sri Ramachandra Medical College and Research Institute, Chennai, Tamil Nadu, India
| | - Anura V Kurpad
- Division of Nutrition, 246827St. John's Research Institute, Bangalore, India
| | - Anne M Molloy
- Biomedical Sciences Institute, 214057Trinity College, Dublin, Ireland
| | - Per M Ueland
- Department of Clinical Science, 1658University of Bergen, Bergen, Norway
| | - Peter A Mossey
- School Dentistry, 3042University of Dundee, Dundee, Scotland, UK
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Zhou Y, Sinnathamby V, Yu Y, Sikora L, Johnson CY, Mossey P, Little J. Folate intake, markers of folate status and oral clefts: An updated set of systematic reviews and meta-analyses. Birth Defects Res 2020; 112:1699-1719. [PMID: 33118705 DOI: 10.1002/bdr2.1827] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 10/04/2020] [Accepted: 10/11/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND There has been a longstanding debate about the role of folate in the etiology of orofacial clefts (OFCs). Studies of different measures of nutritional intake or folate status have been done to investigate the possible role of folate in the prevention of OFC. Only one knowledge synthesis has attempted to bring together different types of evidence. The aim of the present work was to update it. METHODS Evidence for associations between OFC and dietary folate, supplement use, folic acid fortification, biomarkers of folate status, and variants of MTHFR (C677T and A1298C) were included. Potentially eligible articles were systematically identified from PubMed, Medline, Embase, and Web of Science (2007-2020) and combined using random-effects meta-analysis when appropriate. Quality assessments were conducted using the Newcastle-Ottawa scale and Cochrane's risk of bias tool. RESULTS Sixty-four studies published since the previous knowledge synthesis were identified, with eight of these identified through a supplementary search from October, 2018 to August, 2020. There was an inverse association between folic acid-containing supplement use before or during pregnancy and cleft lip with or without cleft palate (CL/P) (OR 0.60, 95% CI 0.51-0.69), with considerable between-study heterogeneity. The prevalence of CL/P showed a small decline post-folic acid fortification in seven studies (OR 0.94, 95% CI 0.86-1.02). No association was found between OFC and genetic markers of folate status. The coronavirus-19 pandemic has threatened food availability globally and therefore there is a need to maintain and even enhance surveillance concerning maternal intake of folate and related vitamins. CONCLUSIONS The risk of non-syndromic OFC was reduced among pregnant women with folic acid-containing supplements during the etiologically relevant period. However, high heterogeneity between included studies, incomplete reporting of population characteristics and variation in timing of exposure and supplement types mean that conclusions should be drawn with caution.
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Affiliation(s)
- Yulai Zhou
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ontario, Canada
| | | | - Yamei Yu
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ontario, Canada
| | - Lindsey Sikora
- Health Sciences Library, University of Ottawa, Ontario, Canada
| | - Candice Y Johnson
- Department of Family Medicine and Community Health, Duke University, Durham, North Carolina, USA
| | - Peter Mossey
- School of Dentistry, University of Dundee, Dundee, Scotland.,WHO Collaborating Centre for Craniofacial Anomalies, Dundee, Scotland
| | - Julian Little
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ontario, Canada
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Lakkakula BV, Sengupta S, Agrawal J, Singh S, Mendhey P, Jangde P, Sharma A, Pande PA, Krishan P, Shukla P, Momin S, Nagaraju GP, Pattnaik S. Maternal and infant MTHFR gene polymorphisms and non-syndromic oral cleft susceptibility: An updated meta-analysis. Process Biochem 2020. [DOI: 10.1016/j.procbio.2019.10.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Blanco R, Colombo A, Pardo R, Suazo J. Maternal biomarkers of methylation status and non-syndromic orofacial cleft risk: a meta-analysis. Int J Oral Maxillofac Surg 2016; 45:1323-1332. [DOI: 10.1016/j.ijom.2016.06.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Revised: 04/01/2016] [Accepted: 06/14/2016] [Indexed: 11/16/2022]
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Pan X, Wang P, Yin X, Liu X, Li D, Li X, Wang Y, Li H, Yu Z. Association between Maternal MTHFR Polymorphisms and Nonsyndromic Cleft Lip with or without Cleft Palate in Offspring, A Meta-Analysis Based on 15 Case-Control Studies. INTERNATIONAL JOURNAL OF FERTILITY & STERILITY 2015; 8:463-80. [PMID: 25780529 PMCID: PMC4355933 DOI: 10.22074/ijfs.2015.4186] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/09/2013] [Accepted: 11/25/2013] [Indexed: 11/30/2022]
Abstract
Background The methylenetetrahydrofolate reductase (MTHFR) is thought to be
involved in the development of nonsyndromic cleft lip with or without cleft palate
(NSCL/P). However, conflicting results have been obtained when evaluating the association between maternal MTHFR C677T and A1298C polymorphisms and the risk of
NSCL/P. In light of this gap, a meta-analysis of all eligible case-control studies was
conducted in the present study. Materials and Methods A total of 15 case-control studies were ultimately identified
after a comprehensive literature search and Hardy-Weinberg equilibrium (HWE) examination. Cochrane’s Q test and index of heterogeneity (I2) indicated no obvious heterogeneity among studies. Results Fixed or random-effects models were used to calculate the pooled odds ratios
(ORs). The results showed that the TT genotype in mothers increased the likelihood of having
NSCL/P offspring 1.25 times (95% CI: 1.047-1.494) more than the CC homozygotes. Meanwhile, maternal TT genotype increased the risk of producing NSCL/P offspring in recessive
model (OR=1.325, 95% CI: 1.124-1.562). However, the CT heterozygote and the CT+TT
dominant models had no association with NSCL/P offspring compared with the CC wild-type
homozygote model. Subgroup analyses based on ethnicity indicated that maternal TT genotype increased the likelihood of having NSCL/P offspring in Whites (OR=1.308, 95% CI:
1.059-1.617) and Asians (OR=1.726, 95% CI: 1.090-2.733) in recessive model. Also, subgroup analyses based on source of control showed that mothers with the 677TT genotype had
a significantly increased susceptibility of having NSCL/P children in hospital based population (HB) when compared with CC homozygotes (OR=1.248, 95% CI: 1.024-1.520) and un-
der the recessive model (OR=1.324, 95% CI: 1.104-1.588). Furthermore, maternal A1298C
polymorphism had no significant association with producing NSCL/P offspring (dominant
model OR=0.952, 95% CI: 0.816-1.111, recessive model OR=0.766, 95% CI: 0.567-1.036). Conclusion MTHFR C677T polymorphism is associated with the risk of generating NSCL/P
offspring, and being a 677TT homozygote is a risk factor. MTHFR A1298C polymorphism
was not associated with generating NSCL/P offspring. However, further work should be performed to confirm these findings.
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Affiliation(s)
- Xinjuan Pan
- College of Public Health, Zhengzhou University, Zhengzhou, China ; Medical College, Henan University of Science and Technology, Luoyang, China
| | - Ping Wang
- Medical College, Henan University of Science and Technology, Luoyang, China
| | - Xinjuan Yin
- College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Xiaozhuan Liu
- College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Di Li
- College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Xing Li
- College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Yongchao Wang
- College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Hongle Li
- College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Zengli Yu
- College of Public Health, Zhengzhou University, Zhengzhou, China
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Heese P, Linnebank M, Semmler A, Muschler MA, Heberlein A, Frieling H, Stoffel-Wagner B, Kornhuber J, Banger M, Bleich S, Hillemacher T. Alterations of Homocysteine Serum Levels during Alcohol Withdrawal Are Influenced by Folate and Riboflavin: Results from the German Investigation on Neurobiology in Alcoholism (GINA). Alcohol Alcohol 2012; 47:497-500. [DOI: 10.1093/alcalc/ags058] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Abstract
Crohn's disease is a chronic relapsing condition that has no certain cure. Both genetic susceptibility and nutrition have key roles, but their level of involvement varies between patients. Interacting gene pathways influence the probability of disease development, but these are affected by stress and various environmental factors, including diet. In addition, the role of the gut microbiome must not be underestimated, as it is substantially altered in patients with Crohn's disease. Although an elemental diet might lead to disease remission, reintroducing real foods and sustainable diets in patients with Crohn's disease is currently difficult, and would benefit from the sensitivity and rapid feedback provided by the field of nutrigenomics. Nutrigenomics utilizes high-throughput genomics technologies to reveal changes in gene and protein expression that are modulated by the patient's nutrition. The most widely used technique thus far is transcriptomics, which permits measurement of changes in the expression of thousands of genes simultaneously in one sample. Given the volume of numbers generated in such studies, data-basing and bioinformatics are essential to ensure the correct application of nutrigenomics at the population level. These methods have been successfully applied to animal models of Crohn's disease, and the time is right to move them to human studies.
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Affiliation(s)
- Lynnette R Ferguson
- Discipline of Nutrition, Faculty of Medical and Health Sciences, The University of Auckland, Private Bag 92019, Auckland, New Zealand.
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