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Maternal Vitamin D Status among Different Ethnic Groups and Its Potential Contribution to Adverse Pregnancy and Child Outcomes 不同种族孕妇维生素D状况及其对不良妊娠和儿童结局的潜在影响
Pub Date : 2020-01-07 DOI: 10.5772/intechopen.90766
Pardis Keshavarz, Parisa Jandaghi, Mojtaba Shafiee, Naorin Islam, H. Vatanparast
Maternal vitamin D deficiency in pregnancy is a widespread public health concern. Race and ethnicity as biological and cultural factors, respectively, can affect vitamin D status through differences in skin color, sunlight exposure, and dietary intake. Low maternal vitamin D status in pregnancy may affect both mother and fetus adversely. Vitamin D deficiency and insufficiency are linked to a wide variety of adverse pregnancy outcomes such as gestational diabetes, preeclampsia, and preterm delivery. Furthermore, maternal vitamin D deficiency has been linked to several adverse health outcomes in infants and children. The examples include, but not limited to, impaired growth, skeletal problems, and autoimmune diseases such as type 1 diabetes and asthma. This chapter reviews the vitamin D status during pregnancy across different ethnic groups, looking into the adverse pregnancy and child outcomes, followed by a discussion on the association between maternal and child vitamin D status and successful interventions. Strong evidence exists about the association between vitamin D and some health outcomes during pregnancy, while more studies are needed to confirm the other claim. The existing body of evidence justifies the need for well-designed policies and systematic interventions to ensure optimal vitamin D status of pregnant women and their offsprings across different ethnic and racial groups.
孕妇孕期维生素D缺乏是一个广泛关注的公共卫生问题。种族和民族分别作为生物和文化因素,可以通过肤色、阳光照射和饮食摄入量的差异来影响维生素D的状态。孕妇维生素D水平低可能对母亲和胎儿都有不利影响。维生素D缺乏和不足与多种不良妊娠结局有关,如妊娠糖尿病、先兆子痫和早产。此外,母亲缺乏维生素D与婴儿和儿童的一些不良健康结果有关。这些例子包括但不限于生长障碍、骨骼问题和自身免疫性疾病,如1型糖尿病和哮喘。本章回顾了不同种族怀孕期间的维生素D状况,研究了不利的怀孕和儿童结局,随后讨论了孕产妇和儿童维生素D状况与成功干预之间的关系。有强有力的证据表明维生素D与怀孕期间的一些健康状况之间存在关联,但需要更多的研究来证实另一种说法。现有的大量证据证明,需要制定精心设计的政策和系统的干预措施,以确保不同民族和种族群体的孕妇及其后代的最佳维生素D水平。
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引用次数: 3
Association of Vitamin D Deficiency and Mood Disorders: A Systematic Review 维生素D缺乏与情绪障碍的关系:一项系统综述
Pub Date : 2019-12-24 DOI: 10.5772/intechopen.90617
J. Shah, Sakshi Gurbani
The cells of our body comprise calcitriol (1,25(OH) vitamin D 2 ), the active form of vitamin D, an integral biological substance that has an impact on a large number of biological processes. While high prevalence of vitamin D deficiency is detected in population worldwide, the reports from sun-soaked countries like India are also alarming to note that the deficiency of vitamin D as high as 70 to 90% is observed leading to several chronic diseases in the majority of people. Deficiency of vitamin D is observed not only because of low levels of vitamin D in the diet, less exposure to sunlight, reduced cutaneous vitamin D synthesis, but also due to consumption of particular medicines, undue alcohol intake, and tobacco smoking. Vitamin D is known to affect estradiol, dopamine, and pro-inflammatory cytokine levels, besides being involved in the regulation of mechanisms pertaining to hormones like glucocorticoids. When vitamin D binds to vitamin D receptors (VDR) present in the central nervous system, it is noted to be responsible for the regulation of brain neuronal functions. Low 25-hydroxy vitamin D levels are found to have a higher incidence of various mood disorders. This review focusses on vitamin D receptors, VDR gene mutations, and pathophysiology causing vitamin D deficiency disorders.
我们身体的细胞由骨化三醇(1,25(OH)维生素d2)组成,它是维生素D的活性形式,是一种对许多生物过程有影响的完整的生物物质。虽然维生素D缺乏症在全球人口中普遍存在,但来自印度等阳光普照的国家的报告也令人震惊地注意到,维生素D缺乏症高达70%至90%,导致大多数人患上几种慢性疾病。观察到维生素D缺乏不仅是因为饮食中维生素D水平低、阳光照射较少、皮肤维生素D合成减少,而且还因为服用特定药物、过度饮酒和吸烟。除了参与调节糖皮质激素等激素的机制外,维生素D还会影响雌二醇、多巴胺和促炎细胞因子的水平。当维生素D与中枢神经系统中的维生素D受体(VDR)结合时,它被认为负责调节大脑神经元功能。研究发现,25-羟基维生素D水平低的人患各种情绪障碍的几率更高。本文就维生素D受体、VDR基因突变及引起维生素D缺乏症的病理生理进行综述。
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引用次数: 7
An Evidence-Based Review of Efficacy and Safety of Dietary, Natural Supplements and Sunlight in Vitamin D Deficiency 膳食、天然补充剂和阳光治疗维生素D缺乏症的有效性和安全性的循证评价
Pub Date : 2019-11-22 DOI: 10.5772/intechopen.89598
J. Mak
There have been recent concerns about the propensity of calcium and vitamin D supplementation to cause cancer. In osteoporotic patients, this has led to increasing recommendations advocating the replacement of calcium supplementation with dietary or other means. Around the world, the problem of vitamin D deficiency remains, being a large contributor of rickets and osteomalacia in the developing world and osteoporosis in post-menopausal women and people dependent on long-term corticosteroid treatment. We review the alternatives of vitamin D supplementation through dietary, other natural supplements as well as sunlight therapy, in an evidence-based manner. We will also review the safety aspect of each modality.
最近有人担心补充钙和维生素D会导致癌症。在骨质疏松症患者中,这导致越来越多的人建议用饮食或其他方式代替补钙。在世界范围内,维生素D缺乏的问题仍然存在,是发展中国家佝偻病和骨软化症以及绝经后妇女和长期依赖皮质类固醇治疗的人骨质疏松症的主要原因。我们以循证的方式回顾了通过膳食、其他天然补充剂以及阳光疗法补充维生素D的替代方法。我们还将审查每种模式的安全方面。
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引用次数: 2
Vitamin D and Obesity 维生素D与肥胖
Pub Date : 2019-11-21 DOI: 10.5772/intechopen.90181
S. Gacem, Moyad Shahwan
Obesity is a very common issue worldwide, and it is one of the risk factors for mortality. Several studies were done to identify the causes of this issue and to investigate factors that can affect this condition. Vitamin D is claimed to have an impact not only for maintaining bone health but also for having an association between its deficiency and obesity as some studies found that the concentrations of this vitamin are low in obese individuals. The suggested mechanisms and a discussion of the latest findings as well as the possibility of integrating supplementation in the treatment of obesity are covered in this book chapter. It was concluded that vitamin D deficiency is prevalent in many parts of the world and the supplements are an affordable option, but further studies are required to address different confounding factors that will result in clear data interpretation and will contribute to the future planning of health policies and guidelines used by healthcare professionals.
肥胖在世界范围内是一个非常普遍的问题,它是导致死亡的危险因素之一。已经进行了几项研究,以确定这一问题的原因,并调查可能影响这种情况的因素。据称维生素D不仅对维持骨骼健康有影响,而且还与缺乏维生素D和肥胖之间存在关联,因为一些研究发现,肥胖个体体内维生素D的浓度很低。建议的机制和对最新发现的讨论,以及在肥胖治疗中整合补充的可能性,都涵盖在这本书的章节中。结论是,维生素D缺乏症在世界许多地方普遍存在,补充剂是一种负担得起的选择,但需要进一步研究以解决不同的混杂因素,从而得出明确的数据解释,并有助于卫生保健专业人员使用的卫生政策和指导方针的未来规划。
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引用次数: 1
Vitamin D and Cardiovascular Disease: The Final Chapter? 维生素D和心血管疾病:最后一章?
Pub Date : 2019-11-19 DOI: 10.5772/intechopen.90106
Jeremy I. Purow, Seth I. Sokol
Vitamin D deficiency is globally prevalent and has been associated with the pathogenesis and complications of cardiovascular disease (CVD) and its risk factors. Defining these relationships has been challenging, and the clinical applications of vitamin D screening and supplementation for CVD risk prevention and modification have only recently become clearer. Most of the available evidence includes large observational studies and smaller randomized trials that scarcely evaluate CV outcomes as primary endpoints. Additionally, these studies include methodological inconsistencies, making it difficult to ascertain the benefits of vitamin D supplementation. However, more recently, randomized trials have been conducted which utilize CVD outcomes as primary endpoints, while assessing the effects of high dose vitamin D supplementation on CV health. Despite observational evidence as well as a conventional consensus that vitamin D supplementation improves CV health, these studies suggest that vitamin D supplementation likely has no benefit in this regard, at least in the follow-up period and populations evaluated.
维生素D缺乏症在全球普遍存在,并与心血管疾病(CVD)的发病机制和并发症及其危险因素有关。确定这些关系一直具有挑战性,维生素D筛查和补充用于心血管疾病风险预防和调整的临床应用直到最近才变得更加清晰。大多数可获得的证据包括大型观察性研究和较小的随机试验,这些试验很少将CV结果作为主要终点进行评估。此外,这些研究包括方法上的不一致,使得很难确定补充维生素D的好处。然而,最近进行了一些随机试验,利用心血管疾病结局作为主要终点,同时评估高剂量维生素D补充对心血管健康的影响。尽管观察性证据和传统共识认为补充维生素D可以改善心血管健康,但这些研究表明补充维生素D可能在这方面没有好处,至少在随访期间和评估人群中没有好处。
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引用次数: 2
The Effects of Vitamin D Deficiency on Neurodegenerative Diseases 维生素D缺乏对神经退行性疾病的影响
Pub Date : 2019-10-30 DOI: 10.5772/intechopen.89160
A. Lauer, Daniel Janitschke, T. Hartmann, H. Grimm, M. Grimm
Approximately 90% of the elderly population in the western countries has at least a mild to moderate vitamin D hypovitaminosis. Besides the well-known function of vitamin D in calcium homeostasis, it has been recently found that several enzymes and receptors involved in its homeostasis are expressed in the nervous system and brain suggesting also an important role in the brain homeostasis. Interestingly, epidemiological and clinical studies found reduced vitamin D level associated with an increased risk of several neurodegenerative disorders. In this chapter, we focus on a potential link between vitamin D and Alzheimer’s disease, Parkinson’s disease, multiple sclerosis, prion disease, and motor neuron disease. Epidemiological studies were summarized, an overview of the known potential underlying pathomolecular mechanisms are given, and results from clinical studies dealing with vitamin D supplementation were presented. As an outlook, recent literature suggesting an impact of vitamin D on autism spectrum disease, depression, and schizophrenia are briefly discussed. In conclusion, the identification of an abundant vitamin D metabolism in the brain and the tight link between the increasing number of several neurological and mental disorders emphasize the need of further research making a clear recommendation of the intake and supplementation of vitamin D in a growing elderly population.
在西方国家,大约90%的老年人至少患有轻度至中度维生素D缺乏症。除了众所周知的维生素D在钙稳态中的作用外,近年来在神经系统和大脑中发现了一些参与其稳态的酶和受体,表明维生素D在大脑稳态中也起着重要作用。有趣的是,流行病学和临床研究发现,维生素D水平的降低与几种神经退行性疾病的风险增加有关。在本章中,我们将重点关注维生素D与阿尔茨海默病、帕金森病、多发性硬化症、朊病毒病和运动神经元疾病之间的潜在联系。本文总结了流行病学研究,概述了已知的潜在病理分子机制,并介绍了维生素D补充的临床研究结果。作为展望,最近的文献表明维生素D对自闭症谱系疾病,抑郁症和精神分裂症的影响进行了简要的讨论。总之,大脑中丰富的维生素D代谢的确定以及几种神经和精神疾病数量增加之间的紧密联系强调了进一步研究的必要性,明确建议在不断增长的老年人口中摄入和补充维生素D。
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引用次数: 5
Vitamin D and Autoimmune Diseases 维生素D和自身免疫性疾病
Pub Date : 2019-10-25 DOI: 10.5772/intechopen.89707
I. Kostoglou-Athanassiou, L. Athanassiou, P. Athanassiou
Vitamin D has many and profound effects on the immune system. Vitamin D deficiency is known to be related to the development of autoimmune diseases. In particular, vitamin D deficiency is related to the development and the severity of rheumatoid arthritis (RA). RA develops in patients with vitamin D deficiency, and the activity of the disease is related to vitamin D deficiency. Vitamin D deficiency is also related to the development of systemic lupus erythematosus (SLE). SLE develops in patients with vitamin D deficiency, and the activity of the disease is also greater in patients with vitamin D deficiency. Vitamin D deficiency is also related to the development and the severity of multiple sclerosis. Vitamin D should be administered to patients with multiple sclerosis, and this seems to mitigate the symptoms of the disease and to prevent disease progression. Vitamin D deficiency is also observed in patients with inflammatory bowel disease and may be related to disease severity. Low vitamin D levels have also been observed in patients with autoimmune Hashimoto’s thyroiditis. Low vitamin D levels have been observed in patients with systemic sclerosis, especially in the diffuse form of the disease. Optimal vitamin D levels appear to be required for normal immune function and for the prevention and treatment of autoimmune diseases.
维生素D对免疫系统有许多深远的影响。维生素D缺乏与自身免疫性疾病的发展有关。特别是,维生素D缺乏与类风湿性关节炎(RA)的发展和严重程度有关。类风湿性关节炎在缺乏维生素D的患者中发展,疾病的活动性与缺乏维生素D有关。维生素D缺乏也与系统性红斑狼疮(SLE)的发展有关。SLE在维生素D缺乏的患者中发展,并且在维生素D缺乏的患者中疾病的活动性也更大。维生素D缺乏也与多发性硬化症的发展和严重程度有关。多发性硬化症患者应该服用维生素D,这似乎可以减轻疾病的症状,防止疾病恶化。在炎症性肠病患者中也观察到维生素D缺乏,并且可能与疾病严重程度有关。在自身免疫性桥本甲状腺炎患者中也观察到维生素D水平低。在系统性硬化症患者中,特别是弥漫性硬化症患者中,维生素D水平较低。最佳的维生素D水平似乎是正常免疫功能和预防和治疗自身免疫性疾病所必需的。
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引用次数: 31
Nutritional Considerations of Vitamin D Deficiency and Strategies of Food Fortification 维生素D缺乏的营养考虑和食物强化策略
Pub Date : 2019-10-20 DOI: 10.5772/intechopen.89612
Sami El Khatib, Malak Abou Shahine
Vitamins and minerals are crucial for human health. Any deficiency can lead to major diseases; however, the most prevalent one is the vitamin D deficiency. Due to its high risk in the Middle East and Lebanon, besides its major effects, solutions to decrease this deficiency are taken nowadays. Vitamin D food fortification is the most popular solution taken now. Liposomes showed highest efficiency in vitamin D fortification. However, a study must be done in order to deduce the amounts needed in the targeted population. Therefore, before fortification starts, FDA regulations must be reviewed. Several foods succeeded in fortification with vitamin D and increasing its levels such as milk and cheddar cheese. Stability and flavors showed good results over fortification, while according to the odor, water sources showed more aroma depth than oil sources. The AOAC methods for vitamin D amount in fortified foods must be applied. Dietary 25(OH)D3 was 7.14-fold more effective at raising serum 25(OH)D than dietary vitamin D3.
维生素和矿物质对人体健康至关重要。任何缺乏都可能导致重大疾病;然而,最普遍的是维生素D缺乏。由于其在中东和黎巴嫩的高风险,除了其主要影响外,目前采取了减少这一缺陷的解决方案。维生素D食品强化是目前最流行的解决方案。脂质体对维生素D的强化效果最好。然而,必须进行一项研究,以推断出目标人群所需的量。因此,在开始强化之前,必须审查FDA的规定。一些食物成功地强化了维生素D,并增加了维生素D的含量,比如牛奶和切达奶酪。在稳定性和风味方面,强化效果较好,而在气味方面,水源比油源的香气深度更大。强化食品中维生素D含量的测定必须采用AOAC方法。25(OH)D3提高血清25(OH)D的效果是维生素D3的7.14倍。
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引用次数: 1
Vitamin D3 Modulates NF-kB/p65, 17β-Estradiol, and Vitamin D Receptors Expression at Estrogen Deficiency 维生素D3调节NF-kB/p65、17β-雌二醇和维生素D受体在雌激素缺乏中的表达
Pub Date : 2019-10-16 DOI: 10.5772/intechopen.89357
A. Koshkina, O. Volkova, J. Fedotova
The aim of the present study was to focus on the effects of Vitamin D 3 (VD 3 ) supplementation (5.0 mg/kg, s.c.) on the NF-kB/p65, 17 β -estradiol (17 β -E 2 )/ VD 3 receptors expression in the hippocampus in the long-term ovariectomized (OVX) rats treated with low dose of 17 β -E 2 (0.5 μg/rat, s.c.) submitted for the chronic unpredictable mild stress (CUMS) for 28 days. Sucrose preference (SPT), forced swimming (FST), and open-field (OFT) tests were conducted to estimate the anhedonia-/depression-like states. NF-kB/p65, 17 β -E 2 /VD 3 receptors levels in the hippocampus were evaluated by ELISA and Western blot assays. The findings demonstrated that VD 3 at high dose (5.0 mg/kg, s.c.) in a combination with low dose of 17 β -E 2 decreased anhedonia in the SPT and depression-like behavior in the FST of the long-term OVX rats submitted to CUMS. VD 3 (5.0 mg/kg) resulted in significant decreased levels of hippocampal NF-kB/p65 protein expression, as well as to the normalization of hippocampal 17 β -E 2 /VD 3 receptors levels in long-term OVX rats treated with 17 β -E 2 exposed to CUMS. In conclusion, VD 3 (5.0 mg/kg, s.c.) in a combination with low dose of 17 β -E 2 had a synergic antianhedonic- and antidepressant-like effects in the adult female rats following long-term ovariectomy submitted to CUMS.
本研究旨在研究维生素d3 (VD 3)补充(5.0 mg/kg, s.c)对长期去卵巢(OVX)大鼠慢性不可预测轻度应激(CUMS)低剂量17 β - e2 (0.5 μg/ s.c)处理28 D后海马NF-kB/p65、17 β -雌二醇(17 β - e2)/ VD 3受体表达的影响。蔗糖偏好(SPT)、强迫游泳(FST)和开放场地(OFT)测试被用来评估快感缺乏/抑郁样状态。采用ELISA和Western blot检测海马NF-kB/p65、17 β - e2 /VD 3受体水平。结果表明,高剂量VD 3 (5.0 mg/kg, s.c)联合低剂量17 β - e2可降低长期接受CUMS治疗的OVX大鼠SPT中的快感缺乏和FST中的抑郁样行为。VD 3 (5.0 mg/kg)显著降低了17 β - e2长期暴露于CUMS的OVX大鼠海马NF-kB/p65蛋白表达水平,并使海马17 β - e2 /VD 3受体水平正常化。综上所述,VD 3 (5.0 mg/kg, s.c)与低剂量17 β - e2联合使用,对长期卵巢切除术后的成年雌性大鼠具有协同抗快感缺乏症和抗抑郁样作用。
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引用次数: 1
Vitamin D Deficiency in Renal Disease 肾脏疾病的维生素D缺乏
Pub Date : 2019-10-15 DOI: 10.5772/intechopen.88928
J. Filipov, E. Dimitrov
Vitamin D deficiency is highly prevalent in patients with renal disease. The abnormal vitamin D (VD) metabolism in chronic kidney disease (CKD) is a key factor for developing CKD-related mineral bone disease (CKD-MBD), which directly influences the survival of the CKD patients. The importance of VD is perhaps of greater value due to its pleiotropic effects that span beyond calcium-phosphorus metabolism (cancer protection, diabetes prevention, and renal protection). The aim of our chapter is to depict the clinical implications of VD deficiency in the setting of CKD, including VD pleiotropy in renal disease, and to propose the most adequate treatment suggested in the literature.
维生素D缺乏症在肾病患者中非常普遍。慢性肾脏疾病(CKD)中维生素D (VD)代谢异常是CKD相关性骨性疾病(CKD- mbd)发生的关键因素,直接影响CKD患者的生存。VD的重要性可能更大,因为它的多效性作用超越了钙磷代谢(癌症保护,糖尿病预防和肾脏保护)。本章的目的是描述慢性肾病中VD缺乏的临床意义,包括肾脏疾病中的VD多效性,并提出文献中建议的最适当的治疗方法。
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引用次数: 2
期刊
Vitamin D Deficiency
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