Vitamina D y riesgo de preeclampsia: revisión sistemática y metaanálisis

Díaz, Norma Cecilia Serrano; Gamboa-Delgado, Edna Magaly; Domínguez-Urrego, Clara Lucía; Varela, Andrea Liliana Vesga; Serrano-Gómez, Sergio Eduardo; Quintero-Lesmes, Doris Cristina

doi:10.7705/biomedica.v38i0.3683

Cited by 35 publications

(23 citation statements)

References 57 publications

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“…It is hypothesized that the role vitamin D plays in modulating immune function and preventing inflammation is the likely mechanism for which vitamin D supplementation in protecting maternal and fetal health [15]. Wagner et al have demonstrated that an intake of 4000 IU/d during pregnancy, to achieve a serum 25(OH)D above 40 ng/mL (100 nmol/L), can reduce the incidence of preterm by more than half [16] and may reduce other complications of pregnancy including preeclampsia, gestational diabetes and possibly post-partum hemorrhage [17][18][19]. Their findings have resulted in a vitamin D supplementation program (in place since 2017), wherein 5000 IU/d of vitamin D is provided to all pregnant women, implemented at five hospitals within the Medical University of South Carolina [20].…”

Section: Vitamin D and Pregnancymentioning

confidence: 99%

Official recommendations for vitamin D through the life stages in developed countries

Kimball

Holick

2020

Eur J Clin Nutr

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Inadequate vitamin D nutritional status is prevalent worldwide and has been associated with autoimmune disorders, heart disease, deadly cancers, insulin resistance, inflammation, neurological disorders, adverse outcomes in pregnancy, and increased risk for mortality. Expert recommendations for vitamin D intake differ between governmental agencies and practice guidelines from medical societies due to differences in the definition of vitamin D deficiency, insufficiency and sufficiency based on serum 25-hydroxyvitamin D [25(OH)D] concentrations. In addition, separate health promotion bodies also provide targeted recommendations for the prevention of specific disorders such as reducing risk for developing some cancers and autoimmune diseases. We review and provide perspectives regarding various recommendations from the Institute of Medicine (IOM, United States) and Health Canada, the European Food Safety Authority (EFSA), the Scientific Advisory Committee on Nutrition (SACN; United Kingdom), the World Health Organization, the Endocrine Society and other expert groups by life stage as a guide intended for clinician use.

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Section: Vitamin D and Pregnancymentioning

confidence: 99%

Official recommendations for vitamin D through the life stages in developed countries

Kimball

Holick

2020

Eur J Clin Nutr

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“…However, the scientific community is recently moving towards the recognition of the importance of vitamin D deficiency in the development of these pathological conditions [28]. Indeed, recent meta-analyses of observational studies highlighted the existence of an inverse ratio between vitamin D levels and the development of PE as well as GH, and provided evidence for an increased risk of gestational hypertensive disorders at vitamin D concentrations <20 ng/ml (<50 nmol/L) [12,28,29]. Vitamin D concentrations <12 ng/mL (<30 nmol/L) in early pregnancy have been associated with a higher risk for PE in comparison to concentrations >20 ng/mL (>50 nmol/L) [30].…”

Section: Discussionmentioning

confidence: 99%

Role of Vitamin-D Receptor (VDR) single nucleotide polymorphisms in gestational hypertension development: A case-control study

et al. 2020

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Background Recent literature data have highlighted the important role of hypovitaminosis D in pregnancy complications and prenatal/perinatal health. Vitamin D action takes place through vitamin D receptor (VDR) activation. Two single nucleotide polymorphisms of VDR gene, FokI and BsmI, have been reported to affect VDR molecular signaling and be associated with several disorders, including hypertension. Methods We carried out a case-control study aimed to assess vitamin D serum levels together with the distribution of VDR FokI and BsmI in a population of 116 pregnant women with gestational hypertension (GH) and 69 normotensive pregnant women (CTR). Results Hypovitaminosis D was largely prevalent both in GH (81%) and CTR (69%) pregnant women. Vitamin D insufficiency (10–30 ng/ml) had a similar frequency in both cohorts (GH 60% vs CTR 58%), while vitamin D deficiency (<10 ng/ml) was more frequent in GH cohort than in CTR one (21% vs 11%). Regression analysis showed that GH was significantly (p = 0.031) linked to vitamin D status. Vitamin D deficiency was associated with a threefold-increased risk of developing GH, while a normal vitamin D status was protective against this pregnancy disorder. The VDR FF/bB haplotype was the most frequent in GH cohort, and resulted to increase by two folds the risk for GH. Notably, hypovitaminosis D was found in 92% of FF/bB GH pregnant women, 27% of which had deficient vitamin D levels compared with 11% of their normotensive counterparts. Conclusions Despite being preliminary, these findings suggest that genotyping of pregnant women for VDR polymorphisms may be useful for a tailored vitamin D supplementation strategy.

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“…Among preeclampsia targets, AR and VDR were always selected among the top 5 targets in all clusters. Progesterone and estrogen receptors are known to be involved in preeclampsia pathogenesis [25] and vitamin D is considered as an effective preventive treatment [5,26]. Similarly, ESR1, ESR2, CHRM4 and CHRM3 were also regularly highly ranked in the four clusters.…”

Section: Models and Early Recognition Abilitymentioning

confidence: 99%

“…Any drug for the treatment of preeclampsia will have, in general, two possible options (which are not necessarily independent of each other): (1) to be a preventive drug for use early in pregnancy to prevent a possible preeclampsia manifestation or (2) to be a drug capable of handling symptoms and/or disease progression. The first option includes the use of low-dose aspirin in women with high risk of preeclampsia [2], the use of magnesium sulfate [3] and the administration of vitamin D [4,5]. Drugs in the latter group could extend the gestational age, thus increasing the chances of fetal growth and maturity to facilitate a safer delivery.…”

Section: Introductionmentioning

confidence: 99%

A Multi-Objective Approach for Drug Repurposing in Preeclampsia

et al. 2021

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Preeclampsia is a hypertensive disorder that occurs during pregnancy. It is a complex disease with unknown pathogenesis and the leading cause of fetal and maternal mortality during pregnancy. Using all drugs currently under clinical trial for preeclampsia, we extracted all their possible targets from the DrugBank and ChEMBL databases and labeled them as “targets”. The proteins labeled as “off-targets” were extracted in the same way but while taking all antihypertensive drugs which are inhibitors of ACE and/or angiotensin receptor antagonist as query molecules. Classification models were obtained for each of the 55 total proteins (45 targets and 10 off-targets) using the TPOT pipeline optimization tool. The average accuracy of the models in predicting the external dataset for targets and off-targets was 0.830 and 0.850, respectively. The combinations of models maximizing their virtual screening performance were explored by combining the desirability function and genetic algorithms. The virtual screening performance metrics for the best model were: the Boltzmann-Enhanced Discrimination of ROC (BEDROC)α=160.9 = 0.258, the Enrichment Factor (EF)1% = 31.55 and the Area Under the Accumulation Curve (AUAC) = 0.831. The most relevant targets for preeclampsia were: AR, VDR, SLC6A2, NOS3 and CHRM4, while ABCG2, ERBB2, CES1 and REN led to the most relevant off-targets. A virtual screening of the DrugBank database identified estradiol, estriol, vitamins E and D, lynestrenol, mifrepristone, simvastatin, ambroxol, and some antibiotics and antiparasitics as drugs with potential application in the treatment of preeclampsia.

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Vitamina D y riesgo de preeclampsia: revisión sistemática y metaanálisis

Abstract: The inverse association we found suggests that the higher the levels of vitamin D the lesser the probability of developing preeclampsia, in spite of the heterogeneity of the global measurement in this type of analysis.

Cited by 35 publications

References 57 publications

Official recommendations for vitamin D through the life stages in developed countries

Official recommendations for vitamin D through the life stages in developed countries

Role of Vitamin-D Receptor (VDR) single nucleotide polymorphisms in gestational hypertension development: A case-control study

A Multi-Objective Approach for Drug Repurposing in Preeclampsia

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