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Dragomir RE, Toader DO, Gheoca Mutu DE, Dogaru IA, Răducu L, Tomescu LC, Moleriu LC, Bordianu A, Petre I, Stănculescu R. Consequences of Maternal Vitamin D Deficiency on Newborn Health. Life (Basel) 2024; 14:714. [PMID: 38929697 PMCID: PMC11204719 DOI: 10.3390/life14060714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Revised: 05/27/2024] [Accepted: 05/29/2024] [Indexed: 06/28/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Maternal-fetal gestational pathology is one of the biggest challenges in the field of health at this moment. The current study is designed to determine the effects of vitamin D on pregnancy, starting with the idea that impairment of vitamin D status is thought to be correlated with impairment of the newborn's health. MATERIALS AND METHODS In this retrospective study, we tried to establish the link between vitamin D deficiency and maternal characteristics and also how it impacted the clinical status of the newborn. We analyzed a group of 260 patients: 130 pregnant women and 130 newborns, in whom vitamin D status was detected using the serum levels of 25-hydroxyvitamin D (25-(OH)D). RESULTS The results showed that vitamin D deficiency has a high incidence among pregnant women, as was presented in many important international studies. Our study also showed a positive, direct correlation between the mother's and newborn's vitamin D status. CONCLUSIONS Taking into consideration that vitamin D deficiency has been correlated with many complications, both in maternal and newborn health, a serum level determination of 25-(OH)D is necessary in the first trimester of pregnancy, and after that, adequate supplementation is necessary in order to prevent any negative effects.
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Affiliation(s)
- Ramona Elena Dragomir
- Doctoral School, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (R.E.D.); (I.A.D.); (R.S.)
| | - Daniela Oana Toader
- Department of Obstetrics and Gynecology, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania;
| | - Daniela Elena Gheoca Mutu
- Discipline of Anatomy, Department 2—Morphological Sciences, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Iulian Alexandru Dogaru
- Doctoral School, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (R.E.D.); (I.A.D.); (R.S.)
- Discipline of Anatomy, Department 2—Morphological Sciences, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Laura Răducu
- Discipline of Plastic Surgery, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania;
| | - Laurențiu Cezar Tomescu
- Department of Obstetrics and Gynecology, “Ovidius” University of Constanța, 900527 Constanța, Romania;
| | - Lavinia Cristina Moleriu
- Discipline of Medical Informatics and Biostatistics, Department 3—Functional Sciences, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (L.C.M.); (I.P.)
| | - Anca Bordianu
- Discipline of Plastic Surgery, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania;
| | - Ion Petre
- Discipline of Medical Informatics and Biostatistics, Department 3—Functional Sciences, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (L.C.M.); (I.P.)
| | - Ruxandra Stănculescu
- Doctoral School, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (R.E.D.); (I.A.D.); (R.S.)
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Li DY, Wang L, Li L, Zhou S, Tan J, Tang C, Liao Q, Liu T, Wen L, Qi HB. Maternal vitamin D status and risk of gestational diabetes mellitus in twin pregnancies: a longitudinal twin pregnancies birth cohort study. Nutr J 2024; 23:41. [PMID: 38594739 PMCID: PMC11005156 DOI: 10.1186/s12937-024-00944-2] [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: 12/12/2023] [Accepted: 03/21/2024] [Indexed: 04/11/2024] Open
Abstract
BACKGROUND Gestational diabetes mellitus (GDM) is a common complication of pregnancy, with significant short-term and long-term implications for both mothers and their offspring. Previous studies have indicated the potential benefits of vitamin D in reducing the risk of GDM, yet little is known about this association in twin pregnancies. This study aimed to investigate maternal vitamin D status in the second trimester and examine its association with the risk of GDM in twin pregnancies. METHODS We conducted a prospective cohort study based on data from the Chongqing Longitudinal Twin Study (LoTiS). Peripheral blood serum was collected from the mothers in the second trimester to measure 25(OH)D concentrations. GDM was diagnosed at 23-26 weeks of gestation using a 75-g 2-h oral glucose tolerance test. We used multivariable logistic regression analyses to examine the correlations between vitamin D status and the risk of GDM. RESULTS Of the total participants, 93 (29.9%) women were diagnosed with GDM. The mean serum 25(OH)D concentration in the second trimester was 31.1 ± 11.2 ng/mL, and the rate of vitamin D insufficiency and deficiency were 23.5% and 18.7%, respectively. Compared to women with a 25(OH)D concentration < 30 ng/mL, those with a 25(OH)D concentration ≥ 30 ng/mL had a significantly lower risk of GDM (RR 0.61; 95% CI: 0.43, 0.86), especially those who were overweight before pregnancy (RR 0.32; 95% CI: 0.16, 0.64). The restricted cubic splines model showed an inverted J-shaped relationship between vitamin D concentrations and GDM risk. CONCLUSIONS The risk of GDM was significantly reduced in twin pregnant women with vitamin D concentrations ≥ 30 ng/mL in the second trimester. TRIAL REGISTRATION ChiCTR-OOC-16,008,203. Retrospectively registered on 1 April 2016.
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Affiliation(s)
- Da-Yan Li
- Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
- Department of Obstetrics and Gynecology, Banan Hospital of Chongqing Medical University, Chongqing, 401320, China
- Department of Obstetrics and Gynecology, Women and Children's Hospital of Chongqing Medical University, Longshan Road 120, Yubei District, Chongqing, 401147, China
| | - Lan Wang
- Department of Obstetrics and Gynecology, Women and Children's Hospital of Chongqing Medical University, Longshan Road 120, Yubei District, Chongqing, 401147, China
- Department of Obstetrics and Gynecology, Chongqing Health Center for Women and Children, Chongqing, 401147, China
| | - Li Li
- Department of Obstetrics and Gynecology, Women and Children's Hospital of Chongqing Medical University, Longshan Road 120, Yubei District, Chongqing, 401147, China
- Department of Obstetrics and Gynecology, Chongqing Health Center for Women and Children, Chongqing, 401147, China
| | - Shuwei Zhou
- Department of Obstetrics and Gynecology, Women and Children's Hospital of Chongqing Medical University, Longshan Road 120, Yubei District, Chongqing, 401147, China
- Department of Obstetrics and Gynecology, Chongqing Health Center for Women and Children, Chongqing, 401147, China
| | - Jiangyun Tan
- Department of Obstetrics and Gynecology, Women and Children's Hospital of Chongqing Medical University, Longshan Road 120, Yubei District, Chongqing, 401147, China
- Department of Obstetrics and Gynecology, Chongqing Health Center for Women and Children, Chongqing, 401147, China
| | - Chunyan Tang
- Department of Obstetrics and Gynecology, Women and Children's Hospital of Chongqing Medical University, Longshan Road 120, Yubei District, Chongqing, 401147, China
- Department of Obstetrics and Gynecology, Chongqing Health Center for Women and Children, Chongqing, 401147, China
| | - Qianqian Liao
- Department of Obstetrics and Gynecology, Women and Children's Hospital of Chongqing Medical University, Longshan Road 120, Yubei District, Chongqing, 401147, China
- Department of Obstetrics and Gynecology, Chongqing Health Center for Women and Children, Chongqing, 401147, China
| | - Ting Liu
- Department of Obstetrics and Gynecology, Women and Children's Hospital of Chongqing Medical University, Longshan Road 120, Yubei District, Chongqing, 401147, China
- Department of Obstetrics and Gynecology, Chongqing Health Center for Women and Children, Chongqing, 401147, China
| | - Li Wen
- Department of Obstetrics and Gynecology, Women and Children's Hospital of Chongqing Medical University, Longshan Road 120, Yubei District, Chongqing, 401147, China.
- Department of Obstetrics and Gynecology, Chongqing Health Center for Women and Children, Chongqing, 401147, China.
| | - Hong-Bo Qi
- Department of Obstetrics and Gynecology, Women and Children's Hospital of Chongqing Medical University, Longshan Road 120, Yubei District, Chongqing, 401147, China.
- Department of Obstetrics and Gynecology, Chongqing Health Center for Women and Children, Chongqing, 401147, China.
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Liu Y, Hocher JG, Chen H, Hu L, Zhang X, Cai S, Tang S, Gong F, Krämer BK, Lin G, Hocher B. The Degree of Prepregnancy Vitamin D Deficiency Is Not Associated With Gestational Diabetes in Women Undergoing ART. J Endocr Soc 2023; 7:bvad140. [PMID: 38024652 PMCID: PMC10681737 DOI: 10.1210/jendso/bvad140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Indexed: 12/01/2023] Open
Abstract
Context Gestational diabetes mellitus (GDM) is a common pregnancy complication, particularly in women undergoing assisted reproductive technology (ART). An association of GDM with vitamin D in women conceiving naturally has been described; however, studies have yielded heterogeneous results. Objective To analyze the association between prepregnancy total and free vitamin D and GDM incidence in women undergoing ART. Methods Post hoc analysis of a prospective study at the Reproductive and Genetic Hospital of CITIC-Xiangya in Changsha, China. Total and free vitamin D were measured 1 day before embryo transfer. The patients were screened for GDM using the oral glucose tolerance test. Results A total of 1593 women were included in the study, among whom 256 (16.1%) developed GDM. According to international guidelines for total 25-hydroxyvitamin D [25(OH)D], 47 (2.9%) patients had sufficient (≥30 ng/mL) levels, while 696 (43.7%) were insufficient (20 to <30 ng/mL) and 850 (54.4%) were deficient (<20 ng/mL). Comparing GDM and non-GDM patients, there was no significant difference in total nor free vitamin D levels (P = .340 and .849). Similarly, analysis of GDM rates by quintiles of total and free 25(OH)D showed no significant association in one-way ANOVA (P = .831 and .799). Multivariate logistic regression, considering age, BMI, and fasting glucose, also did not show a significant influence of the 2 vitamin D forms on GDM incidence (P = .266 and .123 respectively). Conclusion In this relatively vitamin D deficient/insufficient ART cohort, the degree of neither total nor free vitamin D deficiency before pregnancy was associated with the occurrence of GDM.
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Affiliation(s)
- Yvonne Liu
- Fifth Department of Medicine (Nephrology/Endocrinology/Rheumatology/Pneumology), University Medical Centre Mannheim, University of Heidelberg, 68167 Mannheim, Germany
- Medical Faculty of Charité Universitätsmedizin Berlin, 10117 Berlin, Germany
| | - Johann-Georg Hocher
- Fifth Department of Medicine (Nephrology/Endocrinology/Rheumatology/Pneumology), University Medical Centre Mannheim, University of Heidelberg, 68167 Mannheim, Germany
- Second Faculty of Medicine, Charles University, 150 06 Prague, Czech Republic
| | - Huijun Chen
- Fifth Department of Medicine (Nephrology/Endocrinology/Rheumatology/Pneumology), University Medical Centre Mannheim, University of Heidelberg, 68167 Mannheim, Germany
- Medical Faculty of Charité Universitätsmedizin Berlin, 10117 Berlin, Germany
- Department of Clinical Science, Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha 410008, China
| | - Liang Hu
- Department of Clinical Science, Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha 410008, China
- School of Basic Medical Science, Institute of Reproductive and Stem Cell Engineering, Central South University, Changsha 410017, China
- Key Laboratory of Stem Cells and Reproductive Engineering, Ministry of Health, Changsha 410017, China
| | - Xiaoli Zhang
- Fifth Department of Medicine (Nephrology/Endocrinology/Rheumatology/Pneumology), University Medical Centre Mannheim, University of Heidelberg, 68167 Mannheim, Germany
- Institute of Pharmacy, Freie Universität Berlin, 14195 Berlin, Germany
| | - Sufen Cai
- Department of Clinical Science, Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha 410008, China
- School of Basic Medical Science, Institute of Reproductive and Stem Cell Engineering, Central South University, Changsha 410017, China
| | - Sha Tang
- Department of Clinical Science, Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha 410008, China
| | - Fei Gong
- Department of Clinical Science, Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha 410008, China
- School of Basic Medical Science, Institute of Reproductive and Stem Cell Engineering, Central South University, Changsha 410017, China
- Key Laboratory of Stem Cells and Reproductive Engineering, Ministry of Health, Changsha 410017, China
| | - Bernhard K Krämer
- Fifth Department of Medicine (Nephrology/Endocrinology/Rheumatology/Pneumology), University Medical Centre Mannheim, University of Heidelberg, 68167 Mannheim, Germany
- Key Laboratory of Stem Cells and Reproductive Engineering, Ministry of Health, Changsha 410017, China
| | - Ge Lin
- Department of Clinical Science, Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha 410008, China
- School of Basic Medical Science, Institute of Reproductive and Stem Cell Engineering, Central South University, Changsha 410017, China
- Key Laboratory of Stem Cells and Reproductive Engineering, Ministry of Health, Changsha 410017, China
| | - Berthold Hocher
- Fifth Department of Medicine (Nephrology/Endocrinology/Rheumatology/Pneumology), University Medical Centre Mannheim, University of Heidelberg, 68167 Mannheim, Germany
- Department of Clinical Science, Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha 410008, China
- School of Basic Medical Science, Institute of Reproductive and Stem Cell Engineering, Central South University, Changsha 410017, China
- Institute of Medical Diagnostics, IMD, 12247 Berlin, Germany
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Huang YL, Pham TTM, Chen YC, Chang JS, Chao JCJ, Bai CH. Effects of Climate, Sun Exposure, and Dietary Intake on Vitamin D Concentrations in Pregnant Women: A Population-Based Study. Nutrients 2023; 15:nu15051182. [PMID: 36904183 PMCID: PMC10005797 DOI: 10.3390/nu15051182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 02/23/2023] [Accepted: 02/24/2023] [Indexed: 03/02/2023] Open
Abstract
BACKGROUND Vitamin D deficiency (VDD) is a global micronutrient issue that commonly occurs in pregnant women, leading to adverse health outcomes. We examined the role of sunlight-related factors and dietary vitamin D intake on vitamin D concentrations among pregnant women in different climate zones. METHODS We conducted a nationwide cross-sectional survey in Taiwan between June 2017 and February 2019. The data of 1502 pregnant women were collected, including sociodemographic information and characteristics related to pregnancy, diet, and sun exposure. Serum 25-hydroxyvitamin D concentrations were measured, and VDD was assessed as a concentration of less than 20 ng/mL. Logistic regression analyses were used to explore the factors associated with VDD. Furthermore, the area under the receiver operating characteristic (AUROC) curve was used to analyze the contribution of sunlight-related factors and dietary vitamin D intake to vitamin D status stratified by climate zones. RESULTS The prevalence of VDD was 30.1% and was the highest in the north. Sufficient intake of red meat (odds ratio (OR): 0.50, 95% confidence interval (CI): 0.32-0.75; p = 0.002), vitamin D and/or calcium supplements (OR: 0.51, 95% CI: 0.39-0.66; p < 0.001), sun exposure (OR: 0.75, 95% CI: 0.57-0.98; p = 0.034), and blood draw during sunny months (OR: 0.59, 95% CI: 0.46-0.77; p < 0.001) were associated with a lower likelihood of VDD. Additionally, in northern Taiwan, which is characterized by a subtropical climate, dietary vitamin D intake (AUROC: 0.580, 95% CI: 0.528-0.633) had a greater influence on vitamin D status than did sunlight-related factors (AUROC: 0.536, 95% CI: 0.508-0.589) with a z value = 51.98, p < 0.001. By contrast, sunlight-related factors (AUROC: 0.659, 95% CI: 0.618-0.700) were more important than dietary vitamin D intake (AUROC: 0.617, 95% CI, 0.575-0.660) among women living in tropical areas of Taiwan (z value = 54.02, p < 0.001). CONCLUSIONS Dietary vitamin D intake was essential to alleviate VDD in the tropical region, whereas sunlight-related factors played a greater role in subtropical areas. Safe sunlight exposure and adequate dietary vitamin D intake should be promoted appropriately as a strategic healthcare program.
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Affiliation(s)
- Ya-Li Huang
- Department of Public Health, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110-31, Taiwan
- School of Public Health, College of Public Health, Taipei Medical University, Taipei 110-31, Taiwan
| | - Thu T. M. Pham
- School of Public Health, College of Public Health, Taipei Medical University, Taipei 110-31, Taiwan
- Faculty of Public Health, Hai Phong University of Medicine and Pharmacy, Hai Phong 042-12, Vietnam
| | - Yi-Chun Chen
- School of Nutrition and Health Sciences, Taipei Medical University, Taipei 110-31, Taiwan
| | - Jung-Su Chang
- School of Nutrition and Health Sciences, Taipei Medical University, Taipei 110-31, Taiwan
- Nutrition Research Center, Taipei Medical University Hospital, Taipei 110-31, Taiwan
- Graduate Institute of Metabolism and Obesity Sciences, College of Nutrition, Taipei Medical University, Taipei 110-31, Taiwan
- Chinese Taipei Society for the Study of Obesity, Taipei 110-31, Taiwan
| | - Jane C.-J. Chao
- School of Nutrition and Health Sciences, Taipei Medical University, Taipei 110-31, Taiwan
- Nutrition Research Center, Taipei Medical University Hospital, Taipei 110-31, Taiwan
- Master Program in Global Health and Development, College of Public Health, Taipei Medical University, Taipei 110-31, Taiwan
| | - Chyi-Huey Bai
- Department of Public Health, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110-31, Taiwan
- School of Public Health, College of Public Health, Taipei Medical University, Taipei 110-31, Taiwan
- Nutrition Research Center, Taipei Medical University Hospital, Taipei 110-31, Taiwan
- Correspondence:
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Lin CH, Lin PS, Lee MS, Lin CY, Sung YH, Li ST, Weng SL, Chang SJ, Lee HC, Lee YJ, Chang HY, Lin CS. Associations between Vitamin D Deficiency and Carbohydrate Intake and Dietary Factors in Taiwanese Pregnant Women. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59010107. [PMID: 36676731 PMCID: PMC9863845 DOI: 10.3390/medicina59010107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 12/20/2022] [Accepted: 12/26/2022] [Indexed: 01/05/2023]
Abstract
This cross-sectional observation study investigated the vitamin D (VD) status in Taiwanese pregnant women and the effects of VD supplementation and macronutrient intake on serum 25-hydroxy-vitamin D (25[OH]D) level. Data on VD intake, daily sunlight exposure, and carbohydrate intake were obtained from 125 pregnant women at 30−37 weeks’ gestation. Serum 25[OH]D level was measured before delivery in all enrolled women; and the mean 25(OH)D level was 43 nmol/L or 17.2 ng/mL. The 25(OH)D level was significantly correlated with total VD intake of pregnant women (r = 0.239; p = 0.007). The severe VD deficiency group (n = 16; mean of 25(OH)D level = 8.5 ng/mL) had significantly lower total VD intake and supplementation than the groups with VD deficiency (n = 69), insufficiency (n = 32), and sufficiency (n = 8). Those with ≥400 IU/day total VD intake (including VD from food and supplementation) had significantly higher 25(OH)D concentration than those with <400 IU/day total VD intake. Those with 400 IU/day VD supplementation could significantly increase serum 25(OH)D concentrations for pregnant women. Among 85 pregnant women with carbohydrate intake of ≥300 g/day, serum 25(OH)D levels were negatively correlated with carbohydrate intake (p = 0.031). In conclusion, VD deficiency was highly prevalent in Taiwanese pregnant women. VD supplementation was the most effective method for increasing 25(OH)D concentration in pregnant women. Higher carbohydrate intake might reduce 25(OH)D levels.
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Affiliation(s)
- Chao-Hsu Lin
- Department of Pediatrics, Hsinchu MacKay Memorial Hospital, Hsinchu 300, Taiwan
- Department of Biological Science and Technology, National Yang Ming Chiao Tung University, Hsinchu 300, Taiwan
- Department of Medicine, MacKay Medical College, New Taipei 252, Taiwan
| | - Pei-Shun Lin
- Department of Nutrition, Hsinchu MacKay Memorial Hospital, Hsinchu 300, Taiwan
- Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei 112, Taiwan
| | - Meei-Shyuan Lee
- School of Public Health, National Defense Medical Center, Taipei 114, Taiwan
| | - Chien-Yu Lin
- Department of Pediatrics, Hsinchu MacKay Memorial Hospital, Hsinchu 300, Taiwan
- Department of Medicine, MacKay Medical College, New Taipei 252, Taiwan
| | - Yi-Hsiang Sung
- Department of Pediatrics, Hsinchu MacKay Memorial Hospital, Hsinchu 300, Taiwan
| | - Sung-Tse Li
- Department of Pediatrics, Hsinchu MacKay Memorial Hospital, Hsinchu 300, Taiwan
| | - Shun-Long Weng
- Department of Obstetrics and Gynecology, Hsinchu MacKay Memorial Hospital, Hsinchu 300, Taiwan
| | - Shing-Jyh Chang
- Department of Obstetrics and Gynecology, Hsinchu MacKay Memorial Hospital, Hsinchu 300, Taiwan
| | - Hung-Chang Lee
- Department of Pediatrics, MacKay Children’s Hospital, Taipei 104, Taiwan
| | - Yann-Jinn Lee
- Department of Medicine, MacKay Medical College, New Taipei 252, Taiwan
- Department of Pediatrics, MacKay Children’s Hospital, Taipei 104, Taiwan
- Department of Medical Research, Tamshui MacKay Memorial Hospital, New Taipei 251, Taiwan
- Department of Pediatrics, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan
- Institute of Biomedical Sciences, MacKay Medical College, New Taipei 252, Taiwan
| | - Hung-Yang Chang
- Department of Medicine, MacKay Medical College, New Taipei 252, Taiwan
- Department of Pediatrics, MacKay Children’s Hospital, Taipei 104, Taiwan
| | - Chih-Sheng Lin
- Department of Biological Science and Technology, National Yang Ming Chiao Tung University, Hsinchu 300, Taiwan
- Center for Intelligent Drug Systems and Smart Bio-Devices (IDS2B), National Yang Ming Chiao Tung University, Hsinchu 300, Taiwan
- Correspondence: ; Tel.: +886-3-5131338
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Wu C, Song Y, Wang X. Vitamin D Supplementation for the Outcomes of Patients with Gestational Diabetes Mellitus and Neonates: A Meta-Analysis and Systematic Review. Int J Clin Pract 2023; 2023:1907222. [PMID: 36713951 PMCID: PMC9867594 DOI: 10.1155/2023/1907222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 08/29/2022] [Accepted: 09/07/2022] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Prevention and timely treatment of gestational diabetes mellitus (GDM) are important to the prognosis of pregnant women and neonates. We aimed to conduct a meta-analysis to evaluate the effects and safety of vitamin D supplementation on GDM patients and neonates, to provide insights into clinical GDM treatment. METHODS Two authors searched the Medline, PubMed, Cochrane Library, Web of Science, Embase, CNKI, and Wanfang databases for randomized controlled trials (RCTs) on the effects and safety of vitamin D supplementation in GDM patients. The quality of the included RCTs was evaluated according to Cochrane handbook. RevMan 5.3 software was used for statistical analysis. RESULTS A total of 20 RCTs involving 1682 GDM patients were finally included, of whom 837 received vitamin D supplementation. Vitamin D supplementation in GDM patients increased the serum 25(OH)D level (SMD = 4.07, 95% CI: (2.73, 5.41)) and HDL level (SMD = 0.41, 95% CI: (0.23, 0.58)) and reduced serum LDL (SMD = -0.49, 95% CI: (-0.68, -0.29)), TG (SMD = -0.59, 95% CI: (-1.01, -0.17)), and TC (SMD = -0.67, 95% CI: (-1.19, -0.14)) levels in GDM patients (all P < 0.05). Besides, vitamin D supplementation reduced the risk of premature birth (OR = 0.37, 95% CI: (0.22, 0.62)), hyperbilirubinemia (OR = 0.38, 95% CI: (0.25, 0.58)), and neonatal hospitalization (OR = 0.38, 95% CI: (0.25, 0.58)) of neonates (all P < 0.05). No significant publication bias in synthesized results was found (all P > 0.05). CONCLUSIONS Vitamin D supplementation improves the blood lipid level in GDM patients and reduces adverse neonatal outcomes. The dose and duration of vitamin D supplementation for safety need to be further investigated in future high-quality studies.
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Affiliation(s)
- Chunfeng Wu
- Department of Obstetrics, Shenzhen Longhua Maternity and Child Healthcare Hospital, Shenzhen 51800, China
| | - Yang Song
- Department of Obstetrics, Shenzhen Longhua Maternity and Child Healthcare Hospital, Shenzhen 51800, China
| | - Xueying Wang
- Department of Obstetrics, Shenzhen Longhua Maternity and Child Healthcare Hospital, Shenzhen 51800, China
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Cheng Y, Chen J, Li T, Pei J, Fan Y, He M, Liu S, Liu J, Zhang Q, Cheng H. Maternal vitamin D status in early pregnancy and its association with gestational diabetes mellitus in Shanghai: a retrospective cohort study. BMC Pregnancy Childbirth 2022; 22:819. [PMID: 36335302 PMCID: PMC9636619 DOI: 10.1186/s12884-022-05149-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 10/25/2022] [Indexed: 11/07/2022] Open
Abstract
Background There is growing interest regarding vitamin D and its potential role in gestational diabetes mellitus (GDM). We aimed to assess maternal vitamin D status in early pregnancy and its relationships with the risk of GDM in a Chinese population in Shanghai. Methods The retrospective cohort study included a total of 7816 pregnant women who underwent a 75-g oral glucose tolerance test (OGTT) during 24–28 weeks of gestation. Participants’ demographic information including maternal age, prepregnancy body mass index (BMI), gestational age, parity, season of blood collection, serum 25-hydroxy vitamin D [25(OH)D] data and other blood biomarker data at 6 to 14 weeks of gestation were retrospectivly extracted from the medical records in the hospital information system. Results In the cohort, the prevalence of GDM was 8.6% and the prevalence of vitamin D deficiency and insufficiency in early pregnancy was 53.1 and 38.5%, respectively. The mean value of the serum 25(OH)D concentration was 19.6±7.5 ng/mL. The restricted cubic splines model showed an inverted J-shaped relationship in which the risk of GDM decreased when the 25(OH)D concentrations were ≥ 20 ng/mL. Logistic model analysis showed that 25(OH)D concentrations ≥ 30 ng/mL significantly decreased the risk of GDM (odds ratio = 0.63, 95% confidence interval: 0.45-0.89; P = 0.010) compared with 25(OH)D concentrations < 20 ng/ml. Conclusions In early pregnancy, vitamin D deficiency and insufficiency were very common, and a high level of vitamin D showed protective effects against the incidence risk of GDM.
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Zhu Y, Li L, Li P. Vitamin D in gestational diabetes: a broadened frontier. Clin Chim Acta 2022; 537:51-59. [PMID: 36191611 DOI: 10.1016/j.cca.2022.09.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 09/25/2022] [Accepted: 09/27/2022] [Indexed: 11/03/2022]
Abstract
Vitamin D deficiency is very common among women of reproductive age, even during pregnancy. Different studies have yielded vastly different results regarding whether vitamin D deficiency during pregnancy affects the development and progression of gestational diabetes mellitus (GDM), glycemic control in patients with hyperglycemia, and maternal-fetal outcomes. In addition, concerns, such as the mechanisms underlying the effect of vitamin D deficiency on glucose metabolism during pregnancy, efficacy of vitamin D supplementation in reducing the risk of developing GDM, and recommended supplemental dose of vitamin D, are yet to be elucidated. This article reviewed the latest domestic and international studies in this field, with a focus on the relationship between vitamin D deficiency and GDM, their underlying pathophysiological mechanisms, and the role of vitamin D intervention in the prevention and treatment of GDM. We recommend vitamin D supplementation as soon as possible for all pregnant women with vitamin D deficiency, especially those with GDM.
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Affiliation(s)
- Yu Zhu
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, People's Republic of China
| | - Ling Li
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, People's Republic of China
| | - Ping Li
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, People's Republic of China.
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Vitamin D Status and Gestational Diabetes in Russian Pregnant Women in the Period between 2012 and 2021: A Nested Case-Control Study. Nutrients 2022; 14:nu14102157. [PMID: 35631298 PMCID: PMC9143366 DOI: 10.3390/nu14102157] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 05/12/2022] [Accepted: 05/17/2022] [Indexed: 11/17/2022] Open
Abstract
Several meta-analyses found an association between low maternal serum 25-hydroxyvitamin D (25(OH)D) level and gestational diabetes mellitus (GDM). However, some of them reported significant heterogeneity. We examined the association of serum 25(OH)D concentration measured in the first and in the second halves of pregnancy with the development of GDM in Russian women surveyed in the periods of 2012−2014 and 2018−2021. We conducted a case−control study (including 318 pregnant women) nested on two previous studies. In 2012−2014, a total of 214 women (83 GDM and 131 controls) were enrolled before 15 weeks of gestation and maternal serum 25(OH)D concentrations were measured twice: at 8th−14th week of gestation and simultaneously with two-hour 75 g oral glucose tolerance test (OGTT) at 24th−32nd week of gestation. In the period of 2018−2021, 104 women (56 GDM and 48 controls) were included after OGTT and 25(OH)D concentrations were measured at 24th−32nd week of gestation. Median 25(OH)D levels were 20.0 [15.1−25.7] vs. 20.5 [14.5−27.5] ng/mL (p = 0.565) in GDM and control group in the first half of pregnancy and 25.3 [19.8−33.0] vs. 26.7 [20.8−36.8] ng/mL (p = 0.471) in the second half of pregnancy, respectively. The prevalence rates for vitamin D deficiency (25(OH)D levels < 20 ng/mL) were 49.4% and 45.8% (p = 0.608) in the first half of pregnancy and 26.2% vs. 22.1% (p = 0.516) in the second half of pregnancy in women who developed GDM and in women without GDM, respectively. The frequency of vitamin D supplements intake during pregnancy increased in 2018−2021 compared to 2012−2014 (p = 0.001). However, the third trimester 25(OH)D levels and prevalence of vitamin D deficiency (25.5 vs. 23.1, p = 0.744) did not differ in women examined in the periods of 2012−2014 and 2018−2021. To conclude, there was no association between gestational diabetes risk and maternal 25(OH)D measured both in the first and in the second halves of pregnancy. The increased prevalence of vitamin D supplements intake during pregnancy by 2018−2021 did not lead to higher levels of 25(OH)D.
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Agüero-Domenech N, Jover S, Sarrión A, Baranda J, Quesada-Rico JA, Pereira-Expósito A, Gil-Guillén V, Cortés-Castell E, García-Teruel MJ. Vitamin D Deficiency and Gestational Diabetes Mellitus in Relation to Body Mass Index. Nutrients 2021; 14:102. [PMID: 35010982 PMCID: PMC8746839 DOI: 10.3390/nu14010102] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 12/20/2021] [Accepted: 12/24/2021] [Indexed: 01/08/2023] Open
Abstract
A relationship between vitamin D deficiency (VDD) and gestational diabetes mellitus (GDM) has been described. Considering that GDM prevalence depends on body mass index (BMI), our main objective was to determine if VDD is associated with GDM, independent of BMI. A cross-sectional study with 886 pregnant women was conducted in Elda (Spain) from September 2019 to June 2020. To assess the association, Poisson regression models with robust variance were used to estimate the prevalence ratio (PR). The observed GDM prevalence was 10.5%, while the VDD prevalence was 55.5%. In the crude model, both VDD and obesity were associated with GDM, but in the adjusted model, only VDD was statistically significant (PR = 1.635, p = 0.038). A secondary event analysis did not detect differences in VDD, but BMI yielded a higher frequency of births by cesarean section and newborns with a >90 percentile weight in the obesity group. In conclusion, VDD is associated with GDM, independent of BMI. Future longitudinal studies could provide information on causality.
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Affiliation(s)
- Nuria Agüero-Domenech
- Department of Gynaecology and Obstetrics, Hospital General Universitario Elda, 03600 Elda, Spain; (N.A.-D.); (S.J.); (A.S.); (J.B.); (M.J.G.-T.)
- Department of Public Health, History of Science and Gynaecology, Miguel Hernández University, 03550 San Juan, Spain
| | - Silvia Jover
- Department of Gynaecology and Obstetrics, Hospital General Universitario Elda, 03600 Elda, Spain; (N.A.-D.); (S.J.); (A.S.); (J.B.); (M.J.G.-T.)
| | - Ana Sarrión
- Department of Gynaecology and Obstetrics, Hospital General Universitario Elda, 03600 Elda, Spain; (N.A.-D.); (S.J.); (A.S.); (J.B.); (M.J.G.-T.)
| | - Javier Baranda
- Department of Gynaecology and Obstetrics, Hospital General Universitario Elda, 03600 Elda, Spain; (N.A.-D.); (S.J.); (A.S.); (J.B.); (M.J.G.-T.)
| | - José A. Quesada-Rico
- Department of Clinical Medicine, Miguel Hernández University, 03550 San Juan, Spain;
| | | | - Vicente Gil-Guillén
- Department of Clinical Medicine, Miguel Hernández University, 03550 San Juan, Spain;
- Research Unit, Hospital General Universitario Elda, 03600 Elda, Spain;
| | - Ernesto Cortés-Castell
- Department of Pharmacology, Pediatrics and Organic Chemistry, Miguel Hernández University, 03550 San Juan, Spain;
| | - María J. García-Teruel
- Department of Gynaecology and Obstetrics, Hospital General Universitario Elda, 03600 Elda, Spain; (N.A.-D.); (S.J.); (A.S.); (J.B.); (M.J.G.-T.)
- Department of Public Health, History of Science and Gynaecology, Miguel Hernández University, 03550 San Juan, Spain
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