Dysregulation of maternal and placental vitamin D metabolism in preeclampsia
Placenta, online 18 Dec 2016, http://dx.doi.org/10.1016/j.placenta.2016.12.019
J.A. Tamblyna, e, f, R. Susarlaa, C. Jenkinsona, L.E. Jefferya, O. Ohizuab, R.F. Chunc, S.Y. Chana, d, M.D. Kilbya, e, f, g, M. Hewisona, f, g, ,
Highlights
- Activation of vitamin D is decreased and its catabolism increased in preeclampsia.
- Maternal and placental vitamin D are correlated but this does not occur with decidua.
- Placental accumulation of vitamin D is impaired in preeclampsia.
- Placental uptake of vitamin D binding protein is dysregulated in preeclampsia.
- Vitamin D Binding Protein special Issue – June 2014
- Bio-available Vitamin D is reduced by half during pregnancy – Jan 2017
- Changes during pregnancy of vitamin D (decrease), DBP (2X) and albumin (0.8X) – Oct 2014
- Preeclampsia inversely proportional to serum Magnesium – Oct 2014
Pages listed in BOTH the categories Pregnancy and Hypertension (proxy for preeclampsia)
- Low Vitamin D is a top predictor of adverse events during pregnancy – Feb 2024
- Preeclampsia reduced by 33 percent if high vitamin D – meta-analysis Feb 2023
- Risk of preeclampsia should drop to nearly zero at 60 ng of Vitamin D – July 2022
- Hypertension during pregnancy: low Vitamin D, poor Vit. D genes – June 2022
- Low Vitamin D associated with preeclampsia - meta-analysis Feb 2022
- Low Vitamin D associated with pre-eclampsia -40th meta-analysis – Feb 2022
- Preeclampsia reduced by Vitamin D - many studies
- Preeclampsia (hypertension while pregnant) varies with season (O.R. 0.57) – June 2021
- Preeclampsia (low vitamin D) doubles the risk of later cardiovascular problems – Sept 2019
- Preeclampsia 11X more likely if poor Vitamin D Binding Protein (South Africa) - Sept 2019
- Preeclampsia 2X more likely if poor Vitamin D Receptor – April 2019
- Preeclampsia reduced 1.7 X by aspirin (but reduced 7 X by Vitamin D) – Feb 2018
- Preeclampsia risk reduced 7X by 4,000 IU of Vitamin D daily – RCT March 2018
- Preeclampsia of offspring cut in half if mother who smoked had vitamin D fortified margarine – Dec 2017
- Preeclampsia reduced 2X by Vitamin D, by 5X if also add Calcium – meta-analysis Oct 2017
- Child 49 percent higher risk of being overweight if preeclampsia during pregnancy – Sept 2017
- Preeclampsia risk reduced 60 percent if supplement with Vitamin D (they ignored dose size) – meta-analysis Sept 2017
- Preeclampsia recurrence reduced 2 X by 50,000 IU of vitamin D every two weeks – RCT July 2017
- Preeclampsia is not reduced by vitamin D (if you ignore vitamin D level, dose size, frequency and duration) – July 2017
- Preeclampsia doubles the risk of mild cognitive impairment – July 2017
- No Preeclampsia during pregnancy if more than 60 ng of vitamin D – RCT July 2013
- Preeclampsia changes to Vitamin D Binding Protein reduces Vitamin D in placenta – Dec 2016
- Preeclampsia risk reduced by higher levels of vitamin D (VDAART 4,400 IU) - RCT Nov 2016
- MAGNESIUM IN MAN - IMPLICATIONS FOR HEALTH AND DISEASE – review 2015
- Preeclampsia 4X less likely if vitamin D levels increased by 8 ng during pregnancy – March 2016
- Preeclampsia 2X more likely if low vitamin D, unless adjust for vitamin D factors (BMI, skin color) – Dec 2015
- Preeclampsia and eclampsia associated with lower vitamin D, etc. – Sept 2015
- Preeclampsia increased risk of Congenital Heart Defects by 60 percent (vitamin D not mentioned) Oct 2015
- Preeclampsia reduced by Vitamin D (50,000 IU bi-weekly) and Calcium – Oct 2015
- Burka clothing reduces vitamin D levels, which causes pregnancy problems – Oct 2015
- Preeclampsia – hypothesis as to why vitamin D helps – June 2015
- Preeclampsia inversely proportional to serum Magnesium – Oct 2014
- Hypertension in pregnancy (preeclampsia) more frequent in winter (low vitamin D) – Jan 2015
- Preeclampsia rate cut in half by high level of vitamin D – meta-analysis March 2014
- Preeclampsia 40 percent less likely if mother had more than 20 ng of vitamin D – Jan 2014
- Preeclampsia 2.7X more frequent if low vitamin D – meta-analysis Sept 2013
- During pregnancy even 400 IU helps metabolic status – RCT July 2013
- 2X more preeclampsia when vitamin D less than 30 ng, etc. - meta-analysis March 2013
- 7X increase in early severe preeclampsia associated with low vitamin D – Aug 2012
- 200 IU of Vitamin D does not prevent preeclampsia – RCT Aug 2012
- Preeclampsia 3X more likely if low vitamin D at 25th week – April 2012
- Low vitamin D results in severe preeclampsia and low birth weight – Mar 2011
- Women with low vitamin D 4X more likely to have preeclampsia in pregnancy – Nov 2010
- Seasonal variation on preeclampsia is correlated with sunlight intensity - June 2010
Vitamin D charts from GrassrootsHealth - May 2016 has the following chart
Introduction
Epidemiology has linked preeclampsia (PET) to decreased maternal serum 25-hydroxyvitamin D3 (25(OH)D3). However, alterations in systemic and placental/decidual transport and metabolism of 25(OH)D3 during pregnancy suggest that other forms of vitamin D may also contribute to the pathophysiology of PET.
Methods
In a cross sectional analysis of normal pregnant women at 1st (n = 25) and 3rd trimester (n = 21), pregnant women with PET (n = 22), and non-pregnant female controls (n = 20) vitamin D metabolites were quantified in paired maternal serum, placental, and decidual tissue.
Results
Serum 25(OH)D3 was not significantly different in sera across all four groups. In normal 3rd trimester pregnant women serum active 1,25-dihydroxyvitamin D3 (1,25(OH)2D3) was significantly higher than non-pregnant, normal 1st trimester pregnant, and PET women. Conversely, PET sera showed highest levels of the catabolites 3-epi-25(OH)D3 and 24,25-dihydroxyvitamin D3 (24,25(OH)2D3). Serum albumin was significantly lower in normal 3rd trimester pregnant women and PET relative to normal 1st trimester pregnant women, but there was no change in free/bioavailable 25(OH)D3.
In PET placental tissue, 25(OH)D3 and 3-epi-25(OH)D3 were lower than normal 3rd trimester tissue, whilst placental 24,25(OH)2D3 was highest in PET.
Tissue 1,25(OH)2D3 was detectable in 1st trimester decidua, which also showed 10-fold higher 25(OH)D3 relative to paired placentae.
3-epi-25(OH)D3 and 24,25(OH)2D3 were not different for decidua and placenta. In normal 3rd trimester pregnant women, total, free and bioavailable maternal 25(OH)D3 correlated with placental 25(OH)D3, but this was not conserved for PET.
Discussion
These data indicate that PET is associated with
- decreased activation,
- increased catabolism, and
- impaired placental uptake of 25(OH)D3.