DOI: https://doi.org/10.18370/2309-4117.2018.39.38-44

The modern strategies of clinical management of vitamin D deficiency in practices of the obstetrician gynecologist

О. В. Булавенко, Т. Ф. Татарчук, Д. Г. Коньков, О. В. Фурман

Abstract


Low vitamin D concentrations were presented in a significant proportion of the population. Many diseases in people, both middle and old, were directly associated with vitamin D deficiency. The effect of vitamin D levels on reproductive function in both men and women has been proven. Low vitamin D concentrations have been associated with a wide range of adverse maternal and offspring health outcomes in observational epidemiological studies.

Complications of pregnancy with a low level of vitamin D are pre-eclampsia, gestational diabetes and premature birth. It is proved that the appointment of vitamin D to women during pregnancy reduces the proportion of cesarean section in delivery. Numerous authors prove the role of vitamin D in the pathogenetic chain of the polycystic ovary syndrome. It was found that during the menopause due to the violation of steroidogenesis there is a loss of bone mass due to vitamin D deficiency. In addition, a decrease in the level of vitamin D is associated with the occurrence of uterine fibroids.

However, despite a dearth of interventional evidence supporting supplementation/treatment of vitamin D in randomised controlled trial settings, it is generally accepted that supplementation/treatment is not harmful and may have some significant short- and long-term health benefits. In this regard, timely correction of vitamin D deficiency becomes very important in solving reproductive problems. This review focuses on the problem of correcting the level of vitamin D in different population groups. Treatment of vitamin D deficient women and vitamin D supplementation is safe and is recommended for all women who are pregnant or breastfeeding.


Keywords


vitamin D; reproductive system; PCOS; endometriosis; uterine fibroid; preeclampsia; infertility

References


Aghajafari, F., Nagulesapillai, T., Ronksley, P.E., et al. “Association between maternal serum 25-hydroxyvitamin D level and pregnancy and neonatal outcomes: systematic review and meta-analysis of observational studies.” BMJ 346 (2013): f1169.

Aquila, S., Guido, C., Middea, E., et al. “Human male gamete endocrinology: 1alpha, 25-dihydroxyvitamin D3 (1,25(OH)2D3) regulates different aspects of human sperm biology and metabolism.” Reprod Biol Endocrinol 7 (2009): 140.

Anagnostis, P., Karras, S., Goulis, D.G. “Vitamin D in human reproduction: a narrative review.” Int J Clin Pract 67.3 (2013): 225–35.

Andersen, L.B., et al. “Insufficiency of vitamin D is associated with an increased risk in the first trimester of pregnancy miscarriage in the Odense Child Cohort.” Am J Clin Nutr (2015). PII: ajcn103655.

Baker, A.M., Haeri, S., Camargo, C.A. Jr, et al. “A nested case-control study of midgestation vitamin D deficiency and risk of severe preeclampsia.” J Clin Endocrinol Metab 95 (2010): 5105–9.

Baker, A.M., et al. “First trimester maternal vitamin D status and risk of gestational diabetes (GDM): A nested case-control study.” Diabetes Metab Res Rev 28.2 (2012): 164–8.

Bikle, D. “Nonclassic actions of vitamin D.” J Clin Endocrinol Metab 94 (2009): 26–34.

Bodnar, L.M., Catov, J.M., Simhan, H.N., et al. “Maternal vitamin D deficiency increases the risk of preeclampsia.” J Clin Endocrinol Metab 92 (2007): 3517–22.

Bodnar, L.M., Catov, J.M., Zmuda, J.M., et al. “Maternal serum 25-hydroxyvitamin D concentrations are associated with small-for-gestational age births in white women.” J Nutr 140 (2010): 999–1006.

Bodnar, L.M., Krohn, M.A., Simhan, H.N. “Maternal vitamin D deficiency is associated with bacterial vaginosis in the first trimester of pregnancy.” J Nutr 139 (2009): 1157–61.

Bowyer, L., Catling-Paull, C., Diamond, T., et al. “Vitamin D, PTH and calcium levels in pregnant women and their neonates.” Clin Endocrinol (Oxf) 70 (2009): 372–7.

Buggio, L., Roncella, E., Somigliana, E., Vercellini, P. “Vitamin D and benign gynaecological diseases: A critical analysis of the current evidence.” Gynecol Endocrinol 16 (2015): 1–5.

Compston, J.E., Vedi, S., Ledger, J.E., et al. “Vitamin D status and bone histomorphometry in gross obesity.” Amer J Clinical Nutr 34 (1981): 2359–63.

Cosman, F., de Beur, S.J., de Beur, M.S. “Clinician’s guide to prevention and treatment of osteoporosis.” Osteoporos Int 26 (2015): 2045–7.

Dicken, C.L., et al. “Peripubertal vitamin D(3) deficiency delays puberty and disrupts the estrous cycle in adult female mice.” Biol Reprod 87.2 (2012): 51.

European Food Safety Authority (EFSA). “EFSA Scientific Opinion on the Tolerable Upper Intake Level of vitamin D EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA).” EFSA Journal 10.7 (2012): 2813.

Hahn, S., Haselhorst, U., Tan, S., et al. “Low serum 25-hydroxy vitamin D concentrations are associated with insulin resistance and obesity in women with polycystic ovary syndrome.” Exp Clin Endocrinol Diab 114 (2006): 577–83.

Hewison, M. “Vitamin D and the immune system: new perspectives on an old theme.” Endocrinol Metab Clin North Am 39.2 (2010): 365–79.

Harris, H.R., Chavarro, J.E., Malspeis, S., et al. “Dairy-food, calcium, magnesium, and vitamin D intake and endometriosis: a prospective cohort study.” Am J Epidemiol 1775 (2013): 420–30.

Heaney, R.P., Davies, K.M., Chen, T.C., et al. “Human serum 25-hydroxycholecalciferol response to extended oral dosing with cholecalciferol.” Am J Clin Nutr 77 (2003): 204–10.

Hensel, K.J., Randis, T.M., Gelber, S.E., Ratner, A.J. “Pregnancy-specific association of vitamin D deficiency and bacterial vaginosis.” Am J Obstet Gynecol 204.41 (2011): e1–9.

Holick, M.F., Binkley, N.C., Bischoff-Ferrari, H.A., et al. “Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline.” J Clin Endocrinol Metab 96.7 (2011): 1911–30.

Hollis, B.W., Johnson, D., Hulsey, T.C., et al. “Vitamin D supplementation during pregnancy: Double-blind, randomized clinical trial of safety and effectiveness.” J Bone Miner Res 26 (2011): 2341–57.

Garg, G., Kachhawa, G., Ramot, R., et al. “Effect of vitamin D supplementation on insulin kinetics and cardiovascular risk factors in polycystic ovarian syndrome: a pilot study.” Endocr Connect 4 (2015): 108–16.

Gromova, O.A., et al. “Roles of vitamin D in the prevention and treatment of female infertility.” Gynecology 18 (2016): 3.

Jia, X.Z., et al. “Effect of vitamin D on clinical and biochemical parameters in polycystic ovary syndrome women: A meta-analysis.” J Obstet Gynaecol Res 41.11 (2015): 1791–802.

Kinuta, K., Tanaka, H., Moriwake, T., et al. “Vitamin D is an important factor in estrogen biosynthesis of both female and male gonads.” Endocrinol 141 (2000): 1317–24.

Lasco, A., Catalano, A., Benvenga, S. “Improvement of primary dysmenorrheal caused by a single oral dose of vitamin D: results of a randomized, double-blind, placebo-controlled study.” Arch Intern Med 172.4 (2012): 366–7.

Leffelaar, E.R., Vrijkotte, T.G., van Eijsden, M. “Maternal early pregnancy vitamin D status in relation to fetal and neonatal growth: results of the multi-ethnic Amsterdam Born Children and their Development cohort.” Br J Nutr 104 (2010): 108–17.

Lemire, J.M., Adams, J.S., Sakai, R., Jordan, S.C. “1Alpha,25-dihydroxyvitamin D3 suppresses proliferation and immunoglobulin production by normal human peripheral blood mononuclear cells.” J Clin Invest 74 (1984): 657–61.

Lerchbaum, E., Obermayer-Pietsch, B. “Vitamin D and fertility: a systematic review.” Eur J Endocrinol 166.5 (2012): 765–78.

Lv, S.S., et al. “Serum vitamin D status and in vitro fertilization outcomes: a systematic review and meta-analysis.” Arch Gynecol Obstet 293.6 (2016): 1339–45.

Maltseva, E.V., Vasilyeva, E.N., et al. “Provision with vitamin D and correction of its deficit during pregnancy.” Department of Obstetrics and Gynecology No. 1 of Kazan State Medical Academy. Practical medicine 05.09.2017.

Mathieu, C., Gysemans, C. “Vitamin D and diabetes.” Av Diabetol 22.3 (2006): 187–93.

Merewood, A., Mehta, S.D., Chen, T.C., et al. “Association between vitamin D deficiency and primary cesarean section.” J Clin Endocrinol Metab 94 (2009): 940–5.

Merhi, Z., Doswell, A., Krebs, K., Cipolla, M. “Vitamin D alters genes involved in follicular development and steroidogenesis in human cumulus granulosa cells.” J Clin Endocrinol Metab 99.6 (2014): E1137–45.

Ozkan, S., et al. “Replete vitamin D stores predict reproductive success following in vitro fertilization.” Fertil Steril 94.4 (2010): 1314–9.

Pittas, A.G., Lau, J., Hu, F.B., Dawson-Hughes, B. “The role of vitamin D and calcium in type 2 diabetes. A systematic review and meta-analysis.” J Clin Endocrinol Metab 92 (2007): 2017–29.

Provvedini, D.M., Tsoukas, C.D., Deftos, L.J., Manolagas, S.C. “1,25-Dihydroxyvitamin D3 receptors in human leukocytes.” Science 221 (1983): 1181–3.

Robinson, C.J., Alanis, M.C., Wagner, C.L., et al. “Plasma 25-hydroxyvitamin D levels in early-onset severe preeclampsia.” Am J Obstet Gynecol 203.366 (2010): e1–6.

Robinson, C.J., Wagner, C.L., Hollis, B.W., et al. “Maternal vitamin D and fetal growth in early-onset severe preeclampsia.” Am J Obstet Gynecol 204.556 (2011): e1–4.

Rudick, B.J., Ingles, S.A., Chung, K., et al. “Influence of vitamin D levels on in vitro fertilization outcomes in donor-recipient cycles.” Fertil Steril 101.2 (2014): 447–52.

Shahrokhi, S.Z., et al. “Role of vitamin D in female reproduction.” Clin Chim Acta 455 (2016): 33–8.

McDonnell, S., Baggerly, K.A., Baggerly, C.A., et al. “Maternal 25(OH)D concentrations ≥40 ng/mL associated with 60% lower preterm birth risk among general obstetrical patients at an urban medical center.” A GrassrootsHealth Paper. PLOS ONE (2017).

Thomson, R.L., Spedding, S., Buckley, J.D. “Vitamin D in the aetiology and management of polycystic ovary syndrome.” Clin Endocrinol (Oxf) 77 (2012): 343–50.

Wortsman, J., Matsuoka, L.Y., Chen, T.C., et al. “Decreased bioavailability of vitamin D in obesity.” Amer J Clin Nutr 72 (2000): 690–3.

Tatarchuk, T.F., Bulavenko, O.V., Kapshuk, I.M., Tarnopolska, V.O. “Vitamin D deficiency in the genesis of reproductive health disorders.” Ukrainian Medical Journal 5 (2015): 57–60.


GOST Style Citations


1. Aghajafari, F., Nagulesapillai, T., Ronksley, P.E., et al. “Association between maternal serum 25-hydroxyvitamin D level and pregnancy and neonatal outcomes: systematic review and meta-analysis of observational studies.” BMJ 346 (2013): f1169.

2. Aquila, S., Guido, C., Middea, E., et al. “Human male gamete endocrinology: 1alpha, 25-dihydroxyvitamin D3 (1,25(OH)2D3) regulates different aspects of human sperm biology and metabolism.” Reprod Biol Endocrinol 7 (2009): 140.

3. Anagnostis, P., Karras, S., Goulis, D.G. “Vitamin D in human reproduction: a narrative review.” Int J Clin Pract 67.3 (2013): 225–35.

4. Andersen, L.B., et al. “Insufficiency of vitamin D is associated with an increased risk in the first trimester of pregnancy miscarriage in the Odense Child Cohort.” Am J Clin Nutr (2015). PII: ajcn103655.

5. Baker, A.M., Haeri, S., Camargo, C.A. Jr, et al. “A nested case-control study of midgestation vitamin D deficiency and risk of severe preeclampsia.” J Clin Endocrinol Metab 95 (2010): 5105–9.

6. Baker, A.M., et al. “First trimester maternal vitamin D status and risk of gestational diabetes (GDM): A nested case-control study.” Diabetes Metab Res Rev 28.2 (2012): 164–8.

7. Bikle, D. “Nonclassic actions of vitamin D.” J Clin Endocrinol Metab 94 (2009): 26–34.

8. Bodnar, L.M., Catov, J.M., Simhan, H.N., et al. “Maternal vitamin D deficiency increases the risk of preeclampsia.” J Clin Endocrinol Metab 92 (2007): 3517–22.

9. Bodnar, L.M., Catov, J.M., Zmuda, J.M., et al. “Maternal serum 25-hydroxyvitamin D concentrations are associated with small-for-gestational age births in white women.” J Nutr 140 (2010): 999–1006.

10. Bodnar, L.M., Krohn, M.A., Simhan, H.N. “Maternal vitamin D deficiency is associated with bacterial vaginosis in the first trimester of pregnancy.” J Nutr 139 (2009): 1157–61.

11. Bowyer, L., Catling-Paull, C., Diamond, T., et al. “Vitamin D, PTH and calcium levels in pregnant women and their neonates.” Clin Endocrinol (Oxf) 70 (2009): 372–7.

12. Buggio, L., Roncella, E., Somigliana, E., Vercellini, P. “Vitamin D and benign gynaecological diseases: A critical analysis of the current evidence.” Gynecol Endocrinol 16 (2015): 1–5.

13. Compston, J.E., Vedi, S., Ledger, J.E., et al. “Vitamin D status and bone histomorphometry in gross obesity.” Amer J Clinical Nutr 34 (1981): 2359–63.

14. Cosman, F., de Beur, S.J., de Beur, M.S. “Clinician’s guide to prevention and treatment of osteoporosis.” Osteoporos Int 26 (2015): 2045–7.

15. Dicken, C.L., et al. “Peripubertal vitamin D(3) deficiency delays puberty and disrupts the estrous cycle in adult female mice.” Biol Reprod 87.2 (2012): 51.

16. European Food Safety Authority (EFSA). “EFSA Scientific Opinion on the Tolerable Upper Intake Level of vitamin D EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA).” EFSA Journal 10.7 (2012): 2813.

17. Hahn, S., Haselhorst, U., Tan, S., et al. “Low serum 25-hydroxy vitamin D concentrations are associated with insulin resistance and obesity in women with polycystic ovary syndrome.” Exp Clin Endocrinol Diab 114 (2006): 577–83.

18. Hewison, M. “Vitamin D and the immune system: new perspectives on an old theme.” Endocrinol Metab Clin North Am 39.2 (2010): 365–79.

19. Harris, H.R., Chavarro, J.E., Malspeis, S., et al. “Dairy-food, calcium, magnesium, and vitamin D intake and endometriosis: a prospective cohort study.” Am J Epidemiol 1775 (2013): 420–30.

20. Heaney, R.P., Davies, K.M., Chen, T.C., et al. “Human serum 25-hydroxycholecalciferol response to extended oral dosing with cholecalciferol.” Am J Clin Nutr 77 (2003): 204–10.

21. Hensel, K.J., Randis, T.M., Gelber, S.E., Ratner, A.J. “Pregnancy-specific association of vitamin D deficiency and bacterial vaginosis.” Am J Obstet Gynecol 204.41 (2011): e1–9.

22. Holick, M.F., Binkley, N.C., Bischoff-Ferrari, H.A., et al. “Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline.” J Clin Endocrinol Metab 96.7 (2011): 1911–30.

23. Hollis, B.W., Johnson, D., Hulsey, T.C., et al. “Vitamin D supplementation during pregnancy: Double-blind, randomized clinical trial of safety and effectiveness.” J Bone Miner Res 26 (2011): 2341–57.

24. Garg, G., Kachhawa, G., Ramot, R., et al. “Effect of vitamin D supplementation on insulin kinetics and cardiovascular risk factors in polycystic ovarian syndrome: a pilot study.” Endocr Connect 4 (2015): 108–16.

25. Gromova, O.A., et al. “Roles of vitamin D in the prevention and treatment of female infertility.” Gynecology 18 (2016): 3.

26. Jia, X.Z., et al. “Effect of vitamin D on clinical and biochemical parameters in polycystic ovary syndrome women: A meta-analysis.” J Obstet Gynaecol Res 41.11 (2015): 1791–802.

27. Kinuta, K., Tanaka, H., Moriwake, T., et al. “Vitamin D is an important factor in estrogen biosynthesis of both female and male gonads.” Endocrinol 141 (2000): 1317–24.

28. Lasco, A., Catalano, A., Benvenga, S. “Improvement of primary dysmenorrheal caused by a single oral dose of vitamin D: results of a randomized, double-blind, placebo-controlled study.” Arch Intern Med 172.4 (2012): 366–7.

29. Leffelaar, E.R., Vrijkotte, T.G., van Eijsden, M. “Maternal early pregnancy vitamin D status in relation to fetal and neonatal growth: results of the multi-ethnic Amsterdam Born Children and their Development cohort.” Br J Nutr 104 (2010): 108–17.

30. Lemire, J.M., Adams, J.S., Sakai, R., Jordan, S.C. “1Alpha,25-dihydroxyvitamin D3 suppresses proliferation and immunoglobulin production by normal human peripheral blood mononuclear cells.” J Clin Invest 74 (1984): 657–61.

31. Lerchbaum, E., Obermayer-Pietsch, B. “Vitamin D and fertility: a systematic review.” Eur J Endocrinol 166.5 (2012): 765–78.

32. Lv, S.S., et al. “Serum vitamin D status and in vitro fertilization outcomes: a systematic review and meta-analysis.” Arch Gynecol Obstet 293.6 (2016): 1339–45.

33. Maltseva, E.V., Vasilyeva, E.N., et al. “Provision with vitamin D and correction of its deficit during pregnancy.” Department of Obstetrics and Gynecology No. 1 of Kazan State Medical Academy. Practical medicine 05.09.2017.

34. Mathieu, C., Gysemans, C. “Vitamin D and diabetes.” Av Diabetol 22.3 (2006): 187–93.

35. Merewood, A., Mehta, S.D., Chen, T.C., et al. “Association between vitamin D deficiency and primary cesarean section.” J Clin Endocrinol Metab 94 (2009): 940–5.

36. Merhi, Z., Doswell, A., Krebs, K., Cipolla, M. “Vitamin D alters genes involved in follicular development and steroidogenesis in human cumulus granulosa cells.” J Clin Endocrinol Metab 99.6 (2014): E1137–45.

37. Ozkan, S., et al. “Replete vitamin D stores predict reproductive success following in vitro fertilization.” Fertil Steril 94.4 (2010): 1314–9.

38. Pittas, A.G., Lau, J., Hu, F.B., Dawson-Hughes, B. “The role of vitamin D and calcium in type 2 diabetes. A systematic review and meta-analysis.” J Clin Endocrinol Metab 92 (2007): 2017–29.

39. Provvedini, D.M., Tsoukas, C.D., Deftos, L.J., Manolagas, S.C. “1,25-Dihydroxyvitamin D3 receptors in human leukocytes.” Science 221 (1983): 1181–3.

40. Robinson, C.J., Alanis, M.C., Wagner, C.L., et al. “Plasma 25-hydroxyvitamin D levels in early-onset severe preeclampsia.” Am J Obstet Gynecol 203.366 (2010): e1–6.

41. Robinson, C.J., Wagner, C.L., Hollis, B.W., et al. “Maternal vitamin D and fetal growth in early-onset severe preeclampsia.” Am J Obstet Gynecol 204.556 (2011): e1–4.

42. Rudick, B.J., Ingles, S.A., Chung, K., et al. “Influence of vitamin D levels on in vitro fertilization outcomes in donor-recipient cycles.” Fertil Steril 101.2 (2014): 447–52.

43. Shahrokhi, S.Z., et al. “Role of vitamin D in female reproduction.” Clin Chim Acta 455 (2016): 33–8.

44. McDonnell, S., Baggerly, K.A., Baggerly, C.A., et al. “Maternal 25(OH)D concentrations ≥40 ng/mL associated with 60% lower preterm birth risk among general obstetrical patients at an urban medical center.” A GrassrootsHealth Paper. PLOS ONE (2017).

45. Thomson, R.L., Spedding, S., Buckley, J.D. “Vitamin D in the aetiology and management of polycystic ovary syndrome.” Clin Endocrinol (Oxf) 77 (2012): 343–50.

46. Wortsman, J., Matsuoka, L.Y., Chen, T.C., et al. “Decreased bioavailability of vitamin D in obesity.” Amer J Clin Nutr 72 (2000): 690–3.

47. Татарчук, Т.Ф. Недостатність вітаміну D в генезі порушень репродуктивного здоров’я / Т.Ф.Татарчук, О.В. Булавенко, І.М. Капшук, В.О. Тарнопольська // Український медичний часопис. – 2015. – №5. – С. 57–60.





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