Determinants of Vitamin D Status in Fair-Skinned Women of Childbearing Age at Northern Latitudes

Hedlund, Linnea; Brembeck, Petra; Olausson, Hanna

doi:10.1371/journal.pone.0060864

Cited by 24 publications

(32 citation statements)

References 36 publications

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“…Similarly, mean 25(OH)D concentrations were higher in the third trimester than in early pregnancy during all seasons except winter, perhaps due to the small group sampled in early pregnancy during winter. We have previously showed that use of estrogen contraceptives is associated with higher 25(OH)D concentrations in non-pregnant women of childbearing age [29]. Similar hormonal changes due to pregnancy cannot be ruled out as a cause of the increasing 25(OH)D concentrations.…”

Section: Discussionmentioning

confidence: 99%

Vitamin D Status during Pregnancy in a Multi-Ethnic Population-Representative Swedish Cohort

et al. 2016

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There is currently little information on changes in vitamin D status during pregnancy and its predictors. The aim was to study the determinants of change in vitamin D status during pregnancy and of vitamin D deficiency (<30 nmol/L) in early pregnancy. Blood was drawn in the first (T1) and third trimester (T3). Serum 25-hydroxyvitamin D (25(OH)D) (N = 1985) was analysed by liquid chromatography tandem-mass spectrometry. Season-corrected 25(OH)D was calculated by fitting cosine functions to the data. Mean (standard deviation) 25(OH)D was 64.5(24.5) nmol/L at T1 and 74.6(34.4) at T3. Mean age was 31.3(4.9) years, mean body mass index (BMI) was 24.5(4.2) kg/m2 and 74% of the women were born in Sweden. Vitamin D deficiency was common among women born in Africa (51%) and Asia (46%) and prevalent in 10% of the whole cohort. Determinants of vitamin D deficiency at T1 were of non-North European origin, and had less sun exposure, lower vitamin D intake and lower age. Season-corrected 25(OH)D increased by 11(23) nmol/L from T1 to T3. The determinants of season-corrected change in 25(OH)D were origin, sun-seeking behaviour, clothing style, dietary vitamin D intake, vitamin D supplementation and recent travel <35° N. In conclusion, season-corrected 25(OH)D concentration increased during pregnancy and depended partly on lifestyle factors. The overall prevalence of vitamin D deficiency was low but common among women born in Africa and Asia. Among them, the determinants of both vitamin D deficiency and change in season-corrected vitamin D status were fewer, indicating a smaller effect of sun exposure.

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Section: Discussionmentioning

confidence: 99%

Vitamin D Status during Pregnancy in a Multi-Ethnic Population-Representative Swedish Cohort

et al. 2016

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“…The concentration of serum 25(OH)D was affected by many factors such as season or the extent of exposure to UV-B radiation, use of vitamin D supplements, intake of diets rich in vitamin D and use of estrogen contraceptives as well as the difference between urban and rural areas (Table 3 and Table 4) [30, 33–36]. There was higher serum vitamin D level of lactating women in urban area than in rural area in Beijing, which might be due to the difference of multivitamin supplement uses as well as the intake of food rich in vitamin D [33].…”

Section: Discussionmentioning

confidence: 99%

“…There was higher serum vitamin D level of lactating women in urban area than in rural area in Beijing, which might be due to the difference of multivitamin supplement uses as well as the intake of food rich in vitamin D [33]. Season is an important factor in determining vitamin D status of lactating women which could be related to sunlight exposure.…”

Section: Discussionmentioning

confidence: 99%

“…Season is an important factor in determining vitamin D status of lactating women which could be related to sunlight exposure. Several studies have found that 25(OH)D levels and vitamin D deficiency were significantly associated with the season [33, 34, 36]. Compared with the summer and fall, 25(OH)D levels were generally lower and prevalence of vitamin D deficiency was higher in winter and spring [37].…”

Section: Discussionmentioning

confidence: 99%

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Vitamin D status and the prevalence of deficiency in lactating women from eight provinces and municipalities in China

Zhao

Yan

et al. 2017

PLoS ONE

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BackgroundVitamin D deficiency has become prevalent worldwide in recent years. However, less evidence was available for lactating women.ObjectiveThe purpose of the study was to understand vitamin D status and prevalence of deficiency in lactating women and associated risk factors for vitamin D deficiency from eight provinces and municipalities in China.MethodsLactating women within 1–10 months postpartum were recruited in 2011–2013 from eight provinces and municipalities in China. Radioimmunoassay was used to measure serum 25-hydroxyvitamin D [25(OH)D] concentration. Standardized questionnaire was used to collect information on season, living site, ethnicity and socio-demographic characteristics.ResultsTotally 2004 lactating women were recruited. The median (p25, p75) of 25(OH)D was 15.8 (10.5, 24.0) nmol/L. The prevalence of vitamin D deficiency was 85.3% as 25(OH)D <30nmol/L. Serum 25(OH)D levels of lactating women were significantly lower during October-January (14.0nmol/L) than during February-May (18.0nmol/L) (P<0.001), and were significantly higher in Dai ethnicity (22.5nmol/L) than in Hui ethnicity (Chinese Muslims) (9.0nmol/L) (P<0.001). For every 10,000 CNY annual income per capita increasing, serum 25(OH)D levels significantly increased 1.04 times (P<0.001). The odds of vitamin D deficiency in winter were 2.56 times higher than that in spring (OR 2.56, 95%CI: 1.91–3.43).ConclusionsVitamin D deficiency of lactating women was highly prevalent in the eight provinces and municipalities in China. It is urgent to study the strategy and intervention ways for improving vitamin D status of lactating women, especially for certain population groups during low sunlight exposure season.

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“…In Danish adults in general, 52% have a 25(OH)D below 50 nmol/l . In two smaller Scandinavian studies of young women, however, only 16–23% had 25(OH)D below 50 nmol/l …”

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confidence: 96%

Reply to: ‘Vitamin D deficiency during pregnancy: confronting the issues’

Christesen

Andersen

2013

Clinical Endocrinology

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Dear Editor, Thank you for the opportunity to respond to the comments of Karras et al. on our study of a cohort of Danish women in early pregnancy. 1 The authors raise several important questions regarding the analysis method of serum 25(OH)D and the prevalence of vitamin D insufficiency.We measured serum 25(OH)D 2+3 by the LC-MS/MS method validated according to the American National Institute of Standards and Technology (NIST). We chose to report the combined 25(OH)D 2 + 25(OH)D 3 values only. In the vast majority of participants (n = 1319), the level of 25(OH)D 2 was below the detection threshold (<6Á5 nmol/l). Detectable, but low, levels of D 2 were seen in 29 women (2Á2%), and for these women, the level of the reported 25(OH)D was the sum of D 2 and D 3 .Vitamin D 3 is of animal origin and known to have a higher biological activity than the plant-derived vitamin D 2 . In Denmark, vitamin D supplementation during pregnancy is recommended at a dose of 10 lg daily, and most products consist of D 3 . Further dietary vitamin D sources in pregnant Danish women are predominantly of animal origin, especially fish, sea food, low-fat dairy products and eggs. 2 We agree that in other settings with a higher vitamin D 2 intake, or specific vitamin D 2 supplementation, separate 25(OH)D 2 and 25(OH)D 3 data could be potentially useful.We did not report on the less active C3-and C2-epimers, which in the relatively small (n = 60) study from Karras et al. 3 represented almost 25% of the total 25(OH)D in pregnant women at term and 22% in their offspring. In our study, the C2-epimer was expected to be negligible given the low 25(OH) D 2 levels. Our laboratory has separately examined the concentration of 3-epi-25(OH)D in serum from 400 randomly selected patients who needed assessment of serum 25(OH)D. In these samples, none had a content of C3-epimer above the detection limit (1Á5 nmol/l), despite full detection rate for the C3-epimer in the set-up (unpublished data). This lack of C3-detection may be due to selection of patients with low total 25(OH)D levels. Engelman recently reported a mean C3-epimer concentration of 0Á5 ng/ml (1Á25 nmol/l; below our detection limit) in adults with a total level of 25(OH)D below 62Á5 nmol/l. 4 In various studies, the C3-epimer represented 3Á9-6% of the total 25(OH)D in children and adults, but 11-21% in neonates and infants. 4-6 It could be hypothesized that the C3-epimer percentage is especially high in late pregnancy and neonates, in keeping with other alterations during pregnancy including the oestrogen-induced rise in vitamin D binding globulin, a twofold increase in 1,25 (OH) 2 D and a rise in the free fraction of 1,25(OH) 2 D. In early pregnancy, as in our study, a much lower C3-epimer fraction compared with late pregnancy could be expected. More data during early and late pregnancy including a higher number of pregnant women should be published, before conclusions on a substantially high C3-epimer fraction during late pregnancy eventually can be drawn. Future studies should, furtherm...

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Determinants of Vitamin D Status in Fair-Skinned Women of Childbearing Age at Northern Latitudes

Cited by 24 publications

References 36 publications

Vitamin D Status during Pregnancy in a Multi-Ethnic Population-Representative Swedish Cohort

Vitamin D Status during Pregnancy in a Multi-Ethnic Population-Representative Swedish Cohort

Vitamin D status and the prevalence of deficiency in lactating women from eight provinces and municipalities in China

Reply to: ‘Vitamin D deficiency during pregnancy: confronting the issues’

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