Vitamin D status is inversely associated with anemia and serum erythropoietin during pregnancy12

Background: Vitamin D and iron deficiencies frequently co-exist. It is now appreciated that mechanistic interactions between iron and vitamin D metabolism may underlie these associations. Objective: We examined interrelations between iron and vitamin D status and their regulatory hormones in pregnan...

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Veröffentlicht in:The American journal of clinical nutrition 2015-11, Vol.102 (5), p.1088-1095
Hauptverfasser: Thomas, Carrie E, Guillet, Ronnie, Queenan, Ruth A, Cooper, Elizabeth M, Kent, Tera R, Pressman, Eva K, Vermeylen, Francoise M, Roberson, Mark S, O’Brien, Kimberly O
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container_end_page 1095
container_issue 5
container_start_page 1088
container_title The American journal of clinical nutrition
container_volume 102
creator Thomas, Carrie E
Guillet, Ronnie
Queenan, Ruth A
Cooper, Elizabeth M
Kent, Tera R
Pressman, Eva K
Vermeylen, Francoise M
Roberson, Mark S
O’Brien, Kimberly O
description Background: Vitamin D and iron deficiencies frequently co-exist. It is now appreciated that mechanistic interactions between iron and vitamin D metabolism may underlie these associations. Objective: We examined interrelations between iron and vitamin D status and their regulatory hormones in pregnant adolescents, who are a group at risk of both suboptimal vitamin D and suboptimal iron status. Design: The trial was a prospective longitudinal study of 158 pregnant adolescents (aged ≤18 y). Maternal circulating biomarkers of vitamin D and iron were determined at midgestation (∼25 wk) and delivery (∼40 wk). Linear regression was used to assess associations between vitamin D and iron status indicators. Bivariate and multivariate logistic regressions were used to generate the OR of anemia as a function of vitamin D status. A mediation analysis was performed to examine direct and indirect relations between vitamin D status, hemoglobin, and erythropoietin in maternal serum. Results: Maternal 25-hydroxyvitamin D [25(OH)D] was positively associated with maternal hemoglobin at both midgestation and at delivery (P < 0.01 for both). After adjustment for age at enrollment and race, the odds of anemia at delivery was 8 times greater in adolescents with delivery 25(OH)D concentrations
doi_str_mv 10.3945/ajcn.115.116756
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It is now appreciated that mechanistic interactions between iron and vitamin D metabolism may underlie these associations. Objective: We examined interrelations between iron and vitamin D status and their regulatory hormones in pregnant adolescents, who are a group at risk of both suboptimal vitamin D and suboptimal iron status. Design: The trial was a prospective longitudinal study of 158 pregnant adolescents (aged ≤18 y). Maternal circulating biomarkers of vitamin D and iron were determined at midgestation (∼25 wk) and delivery (∼40 wk). Linear regression was used to assess associations between vitamin D and iron status indicators. Bivariate and multivariate logistic regressions were used to generate the OR of anemia as a function of vitamin D status. A mediation analysis was performed to examine direct and indirect relations between vitamin D status, hemoglobin, and erythropoietin in maternal serum. Results: Maternal 25-hydroxyvitamin D [25(OH)D] was positively associated with maternal hemoglobin at both midgestation and at delivery (P &lt; 0.01 for both). After adjustment for age at enrollment and race, the odds of anemia at delivery was 8 times greater in adolescents with delivery 25(OH)D concentrations &lt;50 nmol/L than in those with 25(OH)D concentrations ≥50 nmol/L (P &lt;0.001). Maternal 25(OH)D was inversely associated with erythropoietin at both midgestation (P &lt;0.05) and delivery (P &lt;0.001). The significant relation observed between 25(OH)D and hemoglobin could be explained by a direct relation between 25(OH)D and hemoglobin and an indirect relation that was mediated by erythropoietin. Conclusions: In this group of pregnant adolescents, suboptimal vitamin D status was associated with increased risk of iron insufficiency and vice versa. These findings emphasize the need for screening for multiple nutrient deficiencies during pregnancy and greater attention to overlapping metabolic pathways when selecting prenatal supplementation regimens.</description><identifier>ISSN: 0002-9165</identifier><identifier>EISSN: 1938-3207</identifier><identifier>DOI: 10.3945/ajcn.115.116756</identifier><identifier>PMID: 26447159</identifier><language>eng</language><publisher>Elsevier Inc</publisher><subject>anemia ; hepcidin ; iron ; pregnancy ; Pregnancy and Lactation ; vitamin D</subject><ispartof>The American journal of clinical nutrition, 2015-11, Vol.102 (5), p.1088-1095</ispartof><rights>2015 American Society for Nutrition.</rights><rights>2015 American Society for Nutrition 2015</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27924,27925</link.rule.ids></links><search><creatorcontrib>Thomas, Carrie E</creatorcontrib><creatorcontrib>Guillet, Ronnie</creatorcontrib><creatorcontrib>Queenan, Ruth A</creatorcontrib><creatorcontrib>Cooper, Elizabeth M</creatorcontrib><creatorcontrib>Kent, Tera R</creatorcontrib><creatorcontrib>Pressman, Eva K</creatorcontrib><creatorcontrib>Vermeylen, Francoise M</creatorcontrib><creatorcontrib>Roberson, Mark S</creatorcontrib><creatorcontrib>O’Brien, Kimberly O</creatorcontrib><title>Vitamin D status is inversely associated with anemia and serum erythropoietin during pregnancy12</title><title>The American journal of clinical nutrition</title><description>Background: Vitamin D and iron deficiencies frequently co-exist. It is now appreciated that mechanistic interactions between iron and vitamin D metabolism may underlie these associations. Objective: We examined interrelations between iron and vitamin D status and their regulatory hormones in pregnant adolescents, who are a group at risk of both suboptimal vitamin D and suboptimal iron status. Design: The trial was a prospective longitudinal study of 158 pregnant adolescents (aged ≤18 y). Maternal circulating biomarkers of vitamin D and iron were determined at midgestation (∼25 wk) and delivery (∼40 wk). Linear regression was used to assess associations between vitamin D and iron status indicators. Bivariate and multivariate logistic regressions were used to generate the OR of anemia as a function of vitamin D status. A mediation analysis was performed to examine direct and indirect relations between vitamin D status, hemoglobin, and erythropoietin in maternal serum. Results: Maternal 25-hydroxyvitamin D [25(OH)D] was positively associated with maternal hemoglobin at both midgestation and at delivery (P &lt; 0.01 for both). After adjustment for age at enrollment and race, the odds of anemia at delivery was 8 times greater in adolescents with delivery 25(OH)D concentrations &lt;50 nmol/L than in those with 25(OH)D concentrations ≥50 nmol/L (P &lt;0.001). Maternal 25(OH)D was inversely associated with erythropoietin at both midgestation (P &lt;0.05) and delivery (P &lt;0.001). The significant relation observed between 25(OH)D and hemoglobin could be explained by a direct relation between 25(OH)D and hemoglobin and an indirect relation that was mediated by erythropoietin. Conclusions: In this group of pregnant adolescents, suboptimal vitamin D status was associated with increased risk of iron insufficiency and vice versa. These findings emphasize the need for screening for multiple nutrient deficiencies during pregnancy and greater attention to overlapping metabolic pathways when selecting prenatal supplementation regimens.</description><subject>anemia</subject><subject>hepcidin</subject><subject>iron</subject><subject>pregnancy</subject><subject>Pregnancy and Lactation</subject><subject>vitamin D</subject><issn>0002-9165</issn><issn>1938-3207</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><recordid>eNpVkE1LAzEURYMotlbXbvMHpiYzSabZCFI_oeBG3cY3mTdtSiczJJlK_71T6ka4j7t4cLgcQm45mxdayDvYWj_nXI6nSqnOyJTrYpEVOSvPyZQxlmeaKzkhVzFuGeO5WKhLMsmVECWXekq-v1yC1nn6SGOCNETqxvg9hoi7A4UYO-sgYU1_XNpQ8Ng6GKumEcPQUgyHtAld3zlMI6UegvNr2gdce_D2wPNrctHALuLNX8_I5_PTx_I1W72_vC0fVhlyJlVmKwGNlLxUmmlrAcoFiqopBJZViQpqUbOFFqKoQKFtGl4pBk1TcWUrtLkqZuT-xO2HqsXaok8BdqYProVwMB048__j3casu70RKpdSHwH6BMBx5d5hMNE69BZrF9AmU3fOcGaO2s1Ruxm1m5P24hf2yHna</recordid><startdate>201511</startdate><enddate>201511</enddate><creator>Thomas, Carrie E</creator><creator>Guillet, Ronnie</creator><creator>Queenan, Ruth A</creator><creator>Cooper, Elizabeth M</creator><creator>Kent, Tera R</creator><creator>Pressman, Eva K</creator><creator>Vermeylen, Francoise M</creator><creator>Roberson, Mark S</creator><creator>O’Brien, Kimberly O</creator><general>Elsevier Inc</general><general>American Society for Nutrition</general><scope>6I.</scope><scope>AAFTH</scope><scope>5PM</scope></search><sort><creationdate>201511</creationdate><title>Vitamin D status is inversely associated with anemia and serum erythropoietin during pregnancy12</title><author>Thomas, Carrie E ; Guillet, Ronnie ; Queenan, Ruth A ; Cooper, Elizabeth M ; Kent, Tera R ; Pressman, Eva K ; Vermeylen, Francoise M ; Roberson, Mark S ; O’Brien, Kimberly O</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-e1056-cb4af55176909ccaa78e4bf34e7b7e6ad4d089443ba6ecff1b60affb16cbec263</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>anemia</topic><topic>hepcidin</topic><topic>iron</topic><topic>pregnancy</topic><topic>Pregnancy and Lactation</topic><topic>vitamin D</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Thomas, Carrie E</creatorcontrib><creatorcontrib>Guillet, Ronnie</creatorcontrib><creatorcontrib>Queenan, Ruth A</creatorcontrib><creatorcontrib>Cooper, Elizabeth M</creatorcontrib><creatorcontrib>Kent, Tera R</creatorcontrib><creatorcontrib>Pressman, Eva K</creatorcontrib><creatorcontrib>Vermeylen, Francoise M</creatorcontrib><creatorcontrib>Roberson, Mark S</creatorcontrib><creatorcontrib>O’Brien, Kimberly O</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>The American journal of clinical nutrition</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Thomas, Carrie E</au><au>Guillet, Ronnie</au><au>Queenan, Ruth A</au><au>Cooper, Elizabeth M</au><au>Kent, Tera R</au><au>Pressman, Eva K</au><au>Vermeylen, Francoise M</au><au>Roberson, Mark S</au><au>O’Brien, Kimberly O</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Vitamin D status is inversely associated with anemia and serum erythropoietin during pregnancy12</atitle><jtitle>The American journal of clinical nutrition</jtitle><date>2015-11</date><risdate>2015</risdate><volume>102</volume><issue>5</issue><spage>1088</spage><epage>1095</epage><pages>1088-1095</pages><issn>0002-9165</issn><eissn>1938-3207</eissn><abstract>Background: Vitamin D and iron deficiencies frequently co-exist. It is now appreciated that mechanistic interactions between iron and vitamin D metabolism may underlie these associations. Objective: We examined interrelations between iron and vitamin D status and their regulatory hormones in pregnant adolescents, who are a group at risk of both suboptimal vitamin D and suboptimal iron status. Design: The trial was a prospective longitudinal study of 158 pregnant adolescents (aged ≤18 y). Maternal circulating biomarkers of vitamin D and iron were determined at midgestation (∼25 wk) and delivery (∼40 wk). Linear regression was used to assess associations between vitamin D and iron status indicators. Bivariate and multivariate logistic regressions were used to generate the OR of anemia as a function of vitamin D status. A mediation analysis was performed to examine direct and indirect relations between vitamin D status, hemoglobin, and erythropoietin in maternal serum. Results: Maternal 25-hydroxyvitamin D [25(OH)D] was positively associated with maternal hemoglobin at both midgestation and at delivery (P &lt; 0.01 for both). After adjustment for age at enrollment and race, the odds of anemia at delivery was 8 times greater in adolescents with delivery 25(OH)D concentrations &lt;50 nmol/L than in those with 25(OH)D concentrations ≥50 nmol/L (P &lt;0.001). Maternal 25(OH)D was inversely associated with erythropoietin at both midgestation (P &lt;0.05) and delivery (P &lt;0.001). The significant relation observed between 25(OH)D and hemoglobin could be explained by a direct relation between 25(OH)D and hemoglobin and an indirect relation that was mediated by erythropoietin. Conclusions: In this group of pregnant adolescents, suboptimal vitamin D status was associated with increased risk of iron insufficiency and vice versa. These findings emphasize the need for screening for multiple nutrient deficiencies during pregnancy and greater attention to overlapping metabolic pathways when selecting prenatal supplementation regimens.</abstract><pub>Elsevier Inc</pub><pmid>26447159</pmid><doi>10.3945/ajcn.115.116756</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record>
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source EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection
subjects anemia
hepcidin
iron
pregnancy
Pregnancy and Lactation
vitamin D
title Vitamin D status is inversely associated with anemia and serum erythropoietin during pregnancy12
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