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Weiler HA, Attar A, Farahnak Z, Sotunde OF, Razaghi M, Gharibeh N, Khamessan A, Vanstone CA. Vitamin D Status of Infants of Mothers with Gestational Diabetes: Status at Birth and a Randomized Controlled Trial of Vitamin D Supplementation across Infancy. J Nutr 2022; 152:2441-2450. [PMID: 36774110 PMCID: PMC9644174 DOI: 10.1093/jn/nxac194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 08/16/2022] [Accepted: 09/01/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Vitamin D status and requirements of infants of women with gestational diabetes mellitus (GDM) are unclear. OBJECTIVES The objectives were to assess vitamin D status in infants of mothers with GDM and compare vitamin D status in response to 400 vs. 1000 IU/d vitamin D supplementation in infants born with serum 25-hydroxyvitamin D [25(OH)D] <50 nmol/L. METHODS Women with GDM delivering full-term infants (n = 98; March 2017-2019, Montreal, Canada) were surveyed for demographic and lifestyle factors. Pregnancy history was obtained from medical records. Newborn serum 25(OH)D was measured (immunoassay) and categorized as <30 (deficient) or ≥40 nmol/L (adequate). Breastfed neonates (n = 16) with serum 25(OH)D <50 nmol/L at birth were randomly assigned to 400 or 1000 IU/d of supplemental cholecalciferol (vitamin D3), and serum 25(OH)D was measured at baseline (≤1 mo) and 3, 6, and 12 mo of age. Groups were compared using a linear mixed-effects model and Tukey-Kramer post hoc tests. RESULTS Mean newborn serum 25(OH)D was 46.4 (95% CI: 43.9, 49.9) nmol/L, with 15.3% (95% CI: 8.2%, 22.4%) <30 nmol/L and 61.2% (95% CI: 51.6%, 70.9%) ≥40 nmol/L. During the trial, most infants were breastfed to 3 mo (400 IU/d: 87.5%; 1000 IU/d: 75.0%). Mean (± SEM) infant serum 25(OH)D was higher in the 1000-IU/d group at 3 mo (79.9 ± 5.9 vs. 111.5 ± 15.2 nmol/L; P = 0.0263), and although not different at 6-12 mo, was maintained at >50 nmol/L. CONCLUSIONS Most infants of women with GDM had adequate vitamin D status in this study. In those born with serum 25(OH)D <50 nmol/L, vitamin D status was corrected by 3 mo of age in response to 400 or 1000 IU/d of supplemental vitamin D. Dietary guidance should continue to recommend that all women who could become pregnant take a multivitamin supplement and that breastfed infants receive 400 IU/d of supplemental vitamin D. This study and ancillary trial were registered at clinicaltrials.gov (https://www. CLINICALTRIALS gov/ct2/show/NCT02563015) as NCT02563015.
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Affiliation(s)
- Hope A Weiler
- Nutrition Research Division, Bureau of Nutritional Sciences, Food Directorate, Health Products and Food Branch, Health Canada, Ottawa, Ontario, Canada; School of Human Nutrition, McGill University, Ste Anne de Bellevue, Quebec, Canada.
| | - Atheer Attar
- School of Human Nutrition, McGill University, Ste Anne de Bellevue, Quebec, Canada; Clinical Nutrition Department, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Zahra Farahnak
- School of Human Nutrition, McGill University, Ste Anne de Bellevue, Quebec, Canada; Department of Biochemistry, Memorial University of Newfoundland, St. John's, Newfoundland, Canada
| | - Olusola F Sotunde
- School of Human Nutrition, McGill University, Ste Anne de Bellevue, Quebec, Canada
| | - Maryam Razaghi
- School of Human Nutrition, McGill University, Ste Anne de Bellevue, Quebec, Canada
| | - Nathalie Gharibeh
- School of Human Nutrition, McGill University, Ste Anne de Bellevue, Quebec, Canada
| | - Ali Khamessan
- Europharm International Canada, Inc., Montreal, Quebec, Canada
| | - Catherine A Vanstone
- School of Human Nutrition, McGill University, Ste Anne de Bellevue, Quebec, Canada
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Zhou K, Ji L, Pang S, Tang Y, Liu C. Predictive nomogram of cage nonunion after anterior cervical discectomy and fusion: A retrospective study in a spine surgery center. Medicine (Baltimore) 2022; 101:e30763. [PMID: 36181102 PMCID: PMC9524884 DOI: 10.1097/md.0000000000030763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
The cage nonunion may cause serious consequences, including recurrent pain, radiculopathy, and kyphotic deformity. The risk factors for nonunion following anterior cervical discectomy and fusion (ACDF) are controversial. The aim of the study is to investigate the risk factors for nonunion in cervical spondylotic cases after ACDF. We enrolled 58 and 692 cases in the nonunion and union group respectively and followed up the cases at least 6 months. Patient demographic information, surgical details, cervical sagittal parameters, and the serum vitamin D level were collected. A logistic regression was performed to determine the independent predictors for nonunion, which were used for establishing a nomogram. In order to estimate the reliability and the net benefit of nomogram, we applied a receiver operating characteristic curve analysis, calibration curves and plotted decision curves. Using the multivariate logistic regression, we found that age (odds ratio [OR] = 1.16, P < .001), smoking (OR = 3.41, P = .001), angle of C2 to C7 (OR = 1.53, P < .001), number of operated levels (2 levels, OR = 0.42, P = .04; 3 levels, OR = 1.32, P = .54), and serum vitamin D (OR = 0.81, P < .001) were all significant predictors of nonunion (Table 3). The area under the curve of the model training cohort and validation cohort was 0.89 and 0.87, respectively. The calibration curves showed that the predicted outcome fitted well to the observed outcome in the training cohort (P = .102,) and validation cohort (P = .125). The decision curves showed the nomogram had more benefits than the All or None scheme if the threshold probability is >10% and <100% in training cohort and validation cohort. We found that age, smoking, angle of C2 to C7, number of operated levels, and serum vitamin D were all significant predictors of nonunion.
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Affiliation(s)
- Kai Zhou
- Department of Trauma Surgery, The People’s Hospital of Dongying District, Dongying, Shandong Province, China
| | - Longfei Ji
- Department of Trauma Surgery, The People’s Hospital of Dongying District, Dongying, Shandong Province, China
| | - Shuwei Pang
- Department of Trauma Surgery, The People’s Hospital of Dongying District, Dongying, Shandong Province, China
| | - You Tang
- Department of Orthopaedics and Joint Surgery, Binzhou People’s Hospital, Dongying, Shandong Province, China
| | - Changliang Liu
- Department of Trauma Surgery, The People’s Hospital of Dongying District, Dongying, Shandong Province, China
- *Correspondence: Changliang Liu, Trauma Surgery, The People’s Hospital of Dongying District, No. 333 Jinan Road, Dongying City, Shandong Province, China (e-mail: )
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Li X, Yu J, Wen L, Li Q, Yan J, Tian J, Tong C, Tong Q, Qi H, Saffery R, Kilby MD, Baker PN. Vitamin D status in women with dichorionic twin pregnancies and their neonates: a pilot study in China. BMC Pregnancy Childbirth 2021; 21:279. [PMID: 33832462 PMCID: PMC8034067 DOI: 10.1186/s12884-021-03707-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 03/10/2021] [Indexed: 01/16/2023] Open
Abstract
Background Vitamin D deficiency is a global public health issue in women and children and is associated with adverse impacts on child growth, such as rickets. However, prior studies have mainly focused on measuring vitamin D levels in singleton pregnant women and their offspring, and very limited studies have revealed the prevalence of vitamin D deficiency in twin pregnant women and their offspring. The aim of this study was to investigate vitamin D levels in twin-pregnant women and their neonates. We also explored the correlation of maternal vitamin D levels with neonatal outcomes and infant growth. Methods A prospective subcohort investigation was carried out among 72 dichorionic, diamniotic twin-pregnant mothers and their twin offspring from the Longitudinal Twin Study. Peripheral blood was collected from the mothers in the third trimester, and cord blood was collected from neonates at birth to identify 25[OH]D levels. Data on the characteristics of the mothers and neonates were collected. Infant growth data and food sensitivities were also collected. Results The average maternal 25[OH]D level was 31.78 ng/mL, with 19.4% being deficient and 20.8% insufficient, while the average neonatal 25[OH]D level was 15.37 ng/mL, with 99.3% being deficiency or insufficient. A positive correlation was found between maternal and neonatal 25[OH]D levels (beta-value: 0.43, 95% CI: 0.37, 0.49). Interestingly, the higher the maternal 25[OH]D level was, the smaller the cotwin birthweight discordance (beta-value: -2.67, 95% CI: − 5.11, − 0.23). In addition, the infants of mothers with vitamin D deficiency were more likely to be allergic to foods at 6 months than those of mothers with vitamin D sufficiency. Conclusions Twin neonates were at high risk of vitamin D deficiency, although their mothers’ vitamin D deficiency partially improved. Higher maternal vitamin D levels were associated with smaller discordance of cotwin birthweight. Trial registration Chinese Clinical Trial Registry ChiCTR-OOC-16008203, 1st April 2016. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-021-03707-7.
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Affiliation(s)
- Xin Li
- Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, 1 Youyi Road, Yuzhong District, Chongqing, 400016, China.,State Key Laboratory of Maternal and Fetal Medicine of Chongqing Municipality, Chongqing Medical University, Chongqing, 400016, China.,International Collaborative Laboratory of Reproduction and Development of Chinese Ministry of Education, Chongqing Medical University, Chongqing, 400016, China
| | - Jiaxiao Yu
- Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, 1 Youyi Road, Yuzhong District, Chongqing, 400016, China.,State Key Laboratory of Maternal and Fetal Medicine of Chongqing Municipality, Chongqing Medical University, Chongqing, 400016, China.,International Collaborative Laboratory of Reproduction and Development of Chinese Ministry of Education, Chongqing Medical University, Chongqing, 400016, China
| | - Li Wen
- Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, 1 Youyi Road, Yuzhong District, Chongqing, 400016, China.,State Key Laboratory of Maternal and Fetal Medicine of Chongqing Municipality, Chongqing Medical University, Chongqing, 400016, China.,International Collaborative Laboratory of Reproduction and Development of Chinese Ministry of Education, Chongqing Medical University, Chongqing, 400016, China
| | - Qingshu Li
- State Key Laboratory of Maternal and Fetal Medicine of Chongqing Municipality, Chongqing Medical University, Chongqing, 400016, China.,International Collaborative Laboratory of Reproduction and Development of Chinese Ministry of Education, Chongqing Medical University, Chongqing, 400016, China.,Department of Pathology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Jianying Yan
- Fujian Provincial Maternity and Children's Hospital, affiliated hospital of Fujian Medical University, Fuzhou, 350001, Fujian, China
| | - Jing Tian
- Department of Obstetrics and Gynecology, University-Town Hospital of Chongqing Medical University, Chongqing, 401331, China
| | - Chao Tong
- Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, 1 Youyi Road, Yuzhong District, Chongqing, 400016, China. .,State Key Laboratory of Maternal and Fetal Medicine of Chongqing Municipality, Chongqing Medical University, Chongqing, 400016, China. .,International Collaborative Laboratory of Reproduction and Development of Chinese Ministry of Education, Chongqing Medical University, Chongqing, 400016, China. .,Chongqing Population and Family Planning Science and Technology Research Institute, 18 Honghuang Rd, Jiangbei District, Chongqing, 400020, China.
| | - Qi Tong
- Chongqing Population and Family Planning Science and Technology Research Institute, 18 Honghuang Rd, Jiangbei District, Chongqing, 400020, China.
| | - Hongbo Qi
- Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, 1 Youyi Road, Yuzhong District, Chongqing, 400016, China. .,State Key Laboratory of Maternal and Fetal Medicine of Chongqing Municipality, Chongqing Medical University, Chongqing, 400016, China. .,International Collaborative Laboratory of Reproduction and Development of Chinese Ministry of Education, Chongqing Medical University, Chongqing, 400016, China. .,Department of Pathology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.
| | - Richard Saffery
- International Collaborative Laboratory of Reproduction and Development of Chinese Ministry of Education, Chongqing Medical University, Chongqing, 400016, China.,Cancer, Disease and Developmental Epigenetics, Murdoch Children's Research Institute, Parkville, Victoria, 3052, Australia
| | - Mark D Kilby
- Centre for Women's and Newborn Health, Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, B15 2TT, UK.,Fetal Medicine Centre, Birmingham Women's & Children's Foundation Trust, Edgbaston, Birmingham, B15 2TG, UK
| | - Philip N Baker
- International Collaborative Laboratory of Reproduction and Development of Chinese Ministry of Education, Chongqing Medical University, Chongqing, 400016, China.,College of Life Sciences, University of Leicester, Leicester, LE1 7RH, UK
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