Prevalence of vitamin D deficiency in pregnant mothers in Tehran and investigating its association with serum glucose and insulin

Naseh, Ali; Ashrafzadeh, Sahar; Rassi, Sepehr

doi:10.1080/14767058.2017.1342796

Cited by 12 publications

(12 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Consistent predictors of low 25(OH)D levels across the lifecycle included increasing age, female gender, high weight or body mass index (BMI), low physical activity, low intake of calcium or vitamin D supplements, concealed clothing, low sun exposure duration, winter season, lower education or socio-economic status, and urban residence ( Hoteit et al, 2014 ; Al-Mahroos et al, 2013 ; Khalesi et al, 2012 ; Khuri-Bulos et al, 2013 ; Fouda et al, 2017 ; Mohamed and Al-Shehri, 2013 ; Djennane et al, 2014 ; Shady et al, 2015 ; Ebrahimi et al, 2014 ; Kelishadi et al, 2014 ; Nikooyeh et al, 2017 ; Nichols et al, 2012 ; Al-Daghri et al, 2015 ; Al-Daghri et al, 2016 ; Al Shaikh et al, 2016 ; Kaddam et al, 2017 ; Sulimani et al, 2016 ; Korchia et al, 2013 ; Bezrati et al, 2016 ; Narchi et al, 2015 ; Rajah et al, 2012 ; Al-Sahlawi et al, 2014 ; Botros et al, 2015 ; Khalessi et al, 2015 ; Naseh et al, 2017 ; Al-Ajlan et al, 2015 ; Golbahar et al, 2013 ; Ardeshir Larijani et al, 2014 ; Esteghamati et al, 2014 ; Jaddou et al, 2012 ; Alfawaz et al, 2014 ; Ardawi et al, 2012 ; Tuffaha et al, 2015 ; Zhang et al, 2016 ; El Maghraoui et al, 2012 ; Saliba et al, 2012a ; El-Menyar et al, 2012 ; Sayed-Hassan et al, 2014 ; Sridhar et al, 2016 ; Hosseini et al, 2014 ; Saliba et al, 2012b ). Added to that is smoking status in adults and maternal weight at delivery ( Appendix II ) ( Hoteit et al, 2014 ).…”

Section: Prevalence Of Low 25(oh)d Concentrations By Age Category Andmentioning

confidence: 99%

Vitamin D in the Middle East and North Africa

et al. 2018

View full text Add to dashboard Cite

PurposeThe Middle East and North Africa (MENA) region registers some of the lowest serum 25‑hydroxyvitamin D [25(OH)D] concentrations, worldwide. We describe the prevalence and the risk factors for hypovitaminosis D, completed and ongoing clinical trials, and available guidelines for vitamin D supplementation in this region.MethodsThis review is an update of previous reviews published by our group in 2013 for observational studies, and in 2015 for randomized controlled trials (RCTs) from the region. We conducted a comprehensive search in Medline, PubMed, and Embase, and the Cochrane Library, using MeSH terms and keywords relevant to vitamin D, vitamin D deficiency, and the MENA region, for the period 2012–2017 for observational studies, and 2015–2017 for RCTs. We included large cross-sectional studies with at least 100 subjects/study, and RCTs with at least 50 participants per arm.ResultsWe identified 41 observational studies. The prevalence of hypovitaminosis D, defined as a 25‑hydroxyvitamin D [25(OH)D] level below the desirable level of 20 ng/ml, ranged between 12–96% in children and adolescents, and 54–90% in pregnant women. In adults, it ranged between 44 and 96%, and the mean 25(OH)D varied between 11 and 20 ng/ml. In general, significant predictors of low 25(OH)D levels were female gender, increasing age and body mass index, veiling, winter season, use of sun screens, lower socioeconomic status, and higher latitude.We retrieved 14 RCTs comparing supplementation to control or placebo, published during the period 2015-2017: 2 in children, 8 in adults, and 4 in pregnant women. In children and adolescents, a vitamin D dose of 1000–2000 IU/d was needed to maintain serum 25(OH)D level at target. In adults and pregnant women, the increment in 25(OH)D level was inversely proportional to the dose, ranging between 0.9 and 3 ng/ml per 100 IU/d for doses ≤2000 IU/d, and between 0.1 and 0.6 ng/ml per 100 IU/d for doses ≥3000 IU/d. While the effect of vitamin D supplementation on glycemic indices is still controversial in adults, vitamin D supplementation may be protective against gestational diabetes mellitus in pregnant women. In the only identified study in the elderly, there was no significant difference between 600 IU/day and 3750 IU/day doses on bone mineral density. We did not identify any fracture studies.The available vitamin D guidelines in the region are based on expert opinion, with recommended doses between 400 and 2000 IU/d, depending on the age category, and country.ConclusionHypovitaminosis D is prevalent in the MENA region, and doses of 1000–2000 IU/d may be necessary to reach a desirable 25(OH)D level of 20 ng/ml. Studies assessing the effect of such doses of vitamin D on major outcomes, and confirming their long term safety, are needed.

show abstract

Section: Prevalence Of Low 25(oh)d Concentrations By Age Category Andmentioning

confidence: 99%

Vitamin D in the Middle East and North Africa

et al. 2018

View full text Add to dashboard Cite

show abstract

“…Moreover, Karras et al [35] out of literature systemic review found the prevalence of VD insufficiency among pregnant Greece women ranged from 9.3 to 41.4%, whereas that of VD deficiency from 22.7 to 90.3%. Furthermore, Naseh et al [36] and Kilicaslan et al [37] detected VD deficiency rates of 27% and 53% and insufficiency rates of 73% and 47%, respectively, in their series of pregnant women. Moreover, Wierzejska et al [38] detected higher VD levels in maternal and umbilical cord blood in summer than in winter, but only 16% of studied pregnant women had the optimal VD level during summer.…”

Section: Discussionmentioning

confidence: 92%

Insulin resistance, obesity and hypovitaminosis D adversely affect pregnancy utcome: Can Supplemental vitamin D cut this risk?

Barakat

Edris

Al-Kholy

2018

Evidence Based Women's Health Journal

View full text Add to dashboard Cite

Aim of work:To estimate serum 25-hydroxy vitamin D (25OH-VD) and insulin, and fasting blood glucose (FBG) early in pregnancy, determine the frequency and severity of insulin resistance (IR), gestational diabetes mellitus (GDM) and pre-eclampsia (PE) during pregnancy and the impact of VD supplemental therapy (VD-ST) on these effects. Patients and Methods: 494 pregnant women fulfilling the inclusion criteria were randomly divided into two equal groups: Study group received VD-ST as a daily oral dose of 1000 IU soft gels with meal since 6th week till delivery, while control group did not receive VD-ST. All women gave blood samples for colorimetric estimation of FBG and ELISA estimation of serum insulin and 25-OH-VD levels. Evaluated parameters included body mass index (BMI), VD sufficiency status and homeostasis model assessment IR (HOMA-IR) score. Oral glucose tolerance test for diagnosis of GDM was performed at the 20th, 28th and 36th week GA and blood pressure was measured regularly at follow-up visits for diagnosis of PE. Results: At time of enrolment, 405 women (81.9%) were overweight-obese, 86 women (17.4%) had IR and only 63 women (12.8%) had sufficient serum 25OH-VD level. At 3rd trimester, 68 women (13.8%) developed GDM, 71 women (14.4%) developed PE and 23 women (4.7%) developed both with significantly lower incidence in women who received VD-ST. Frequency of GDM and PE showed positive significant correlation with BMI and HOMA-IR score, while showed negative significant correlation with serum 25OH-VD. ROC curve analysis defined low 25OH-VD level and high HOMA-IR score as significant sensitive predictors for development of both GDM and PE ; while receiving VD-ST was the significant specific predictor for possibility of amelioration of such event. Kaplan-Meier regression curve defined a cumulative hazard for developing both GDM and PE of <20% with and 60% without VD-ST. Conclusion: VD deficiency-insufficiency is a problem that requires national evaluation for predisposition and progress. The triad of maternal hypovitaminosis D, obesity and IR is associated with development of GDM and/or PE. The proposed VD supplementation regimen effectively reduced the frequencies of pregnancy-associated or induced complications; so it is effective to break that triad.

show abstract

“…In line with these data, Karras et al 12 detected a prevalence of VD insufficiency and deficiency among pregnant women in Mediterranean region in ranges of 9.3-41.4% and 22.7-90.3%, respectively. Thereafter, Naseh et al 11 reported VD deficiency in 27% and insufficiency in 73% of their sample of Iranian pregnant women. Moreover, Chakhtoura et al 26 found the prevalence of HVD, defined as a 25-hydroxyvitamin D level <50 nmol/L, ranged between 44 and 96% in adults and 54-90% in pregnant women.…”

Section: Discussionmentioning

confidence: 99%

“…VD-ST was found to specific significant (p=0.010) predictor for decreased incidence of PAM with AUC=0.595. In line with the beneficial effect of VD-ST on pregnancy outcome, Naseh et al 11 suggested promoting consumption of VD-fortified foods and supplements among pregnant women to improve maternal and neonatal outcomes. Also, Krieger et al 37 suggested that VD-ST during pregnancy should receive more attention in clinical practice as it was the most actionable determinant of VD status at the 3 rd trimester and in neonatal cord blood and Wheeler et al 38 recommended 1 st trimester maternal VD screening and targeted supplementation for those "at risk".…”

Section: Discussionmentioning

confidence: 99%

“…8 Vitamin D deficiency is a common problem among Egyptian adolescent girls, for whom contributing factors include inadequate sun exposure possibly related to cultural/social factors, and insufficient dietary calcium. 9 Due to; lack of sun exposure, presence of seasonal variations, dark skin pigmentation, clothing style, obesity and low intake of vitamin D. 10 VD deficiency/insufficiency is prevalent among pregnant women 11 and epidemiological studies had linked VD deficiency to adverse maternal and neonatal outcomes. 5 Thus, screening for HVD in the first trimester of pregnancy is important to determine the necessary preventive action.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Vitamin D supplemental therapy can explore the interplay circuit between hypovitaminosis D, high serum IL-6 and pregnancy-associated morbidities

Helal

2019

OGIJ

View full text Add to dashboard Cite

Objectives: To evaluate the relation between baseline vitamin D (VD) serum levels and incidence and severity of pregnancy-associated morbidities (PAM). Patients & methods: The study included 386 pregnant women attended at the 6th gestational week and after full clinical and obstetric examination, gave fasting blood samples for estimation of fasting blood glucose (FBG) and ELISA estimation of serum VD, insulin and interleukin-6 (IL-6). Insulin resistance (IR) was determined according to homeostasis model assessment IR (HOMA-IR) score that was considered abnormal at score of ≥2. Enrolled women were categorized according to at booking VD level as sufficient (Group A), insufficient (Group B) and deficient (Group C). Women of group C received daily oral VD (1000 IU) supplemental therapy (VD-ST) till delivery. Study outcomes included incidence of PAM and its relation to serum VD levels, and the effect of VD-ST on incidence and severity of PAM. Results: Groups A-C included 86, 130 and 170 women, respectively and 263 women developed 424 PAM. PAM incidence and serum IL-6 levels were significantly higher in group B than other groups. PAM incidence and serum IL-6 levels showed negative significant correlations with serum VD levels. Moreover, PAM incidence showed positive significant correlation with serum IL-6 level. ROC curve analysis defined at booking serum VD as significant specific and serum IL-6 as significant sensitive predictors for PAM development. VD-ST allowed significant reduction of PAM with significant reduction of serum IL-6 and FBG levels and IR. Incidence of PAM was negatively correlated with receiving VD-ST that was found to be significant predictor for decreased PAM incidence. Conclusion: Hypovitaminosis D and high IL-6 serum levels may underlie PAM development. VD-ST improved pregnancy outcome in women with VD deficiency to a level better than in women with insufficient VD levels; thus it is recommended as empirical therapy for pregnant women.

show abstract

Prevalence of vitamin D deficiency in pregnant mothers in Tehran and investigating its association with serum glucose and insulin

Abstract: Vitamin D deficiency/insufficiency is prevalent among pregnant women. Factors causing this epidemic need investigation. Promoting consumption of vitamin D-fortified foods and supplements among pregnant women is suggested.

Cited by 12 publications

References 27 publications

Vitamin D in the Middle East and North Africa

Vitamin D in the Middle East and North Africa

Insulin resistance, obesity and hypovitaminosis D adversely affect pregnancy utcome: Can Supplemental vitamin D cut this risk?

Vitamin D supplemental therapy can explore the interplay circuit between hypovitaminosis D, high serum IL-6 and pregnancy-associated morbidities

Contact Info

Product

Resources

About