Vitamin D, secondary hyperparathyroidism, and preeclampsia.
Am J Clin Nutr. 2013 Jul 24.
Scholl TO, Chen X, Stein TP.
Departments of Obstetrics and Gynecology and Surgery, University of Medicine and Dentistry of New Jersey, Stratford, NJ.
Secondary hyperparathyroidism, which is defined by a high concentration of intact parathyroid hormone when circulating 25-hydroxyvitamin D [25(OH)D] is low, is a functional indicator of vitamin D insufficiency and a sign of impaired calcium metabolism. Two large randomized controlled trials examined effects of calcium supplementation on preeclampsia but did not consider the vitamin D status of mothers.
OBJECTIVE: We examined the association of secondary hyperparathyroidism to risk of preeclampsia.
Circulating maternal 25-hydroxyvitamin D [25(OH)D] and intact parathyroid hormone were measured at entry to care (mean ± SD: 13.7 ± 5.7 wk) using prospective data from a cohort of 1141 low income and minority gravidae.
Secondary hyperparathyroidism occurred in 6.3% of the cohort and 18.4% of women whose 25(OH)D concentrations were <20 ng/mL. Risk of preeclampsia was increased 2.86-fold (95% CI: 1.28-, 6.41-fold) early in gestation in these women. Gravidae with 25(OH)D concentrations <20 ng/mL who did not also have high parathyroid hormone and women with high parathyroid hormone whose 25(OH)D concentrations were >20 ng/mL were not at increased risk. Intact parathyroid hormone was related to higher systolic and diastolic blood pressures and arterial pressure at week 20 before clinical recognition of preeclampsia. Energy-adjusted intakes of total calcium and lactose and circulating 25(OH)D were correlated inversely with systolic blood pressure or arterial pressure and with parathyroid hormone.Conclusion: Some women who are vitamin D insufficient develop secondary hyperparathyroidism, which is associated with increased risk of preeclampsia.
See also VitaminDWiki
- Risk of preeclampsia might be cut in half if take an amount of Vitamin D – meta-analysis Sept 2017
- Women with low vitamin D 4X more likely to have preeclampsia in pregnancy – Nov 2010
- 2X more preeclampsia when vitamin D less than 30 ng, etc. - meta-analysis March 2013
- Preeclampsia 2.7X more frequent if low vitamin D – meta-analysis Sept 2013
- Overview Pregnancy and vitamin D which has the following summary
IU Cumulative Benefit Blood level Cofactors Calcium $*/month 200 Better bones for mom
with 600 mg of Calcium
6 ng/ml increase Not needed No effect $0.10 400 Less Rickets (but not zero with 400 IU)
3X less adolescent Schizophrenia
Fewer child seizures
20-30 ng/ml Not needed No effect $0.20 2000 2X More likely to get pregnant naturally/IVF
2X Fewer dental problems with pregnancy
8X less diabetes
4X fewer C-sections (>37 ng)
4X less preeclampsia (40 ng vs 10 ng)
5X less child asthma
2X fewer language problems age 5
42 ng/ml Desirable < 750 mg $1 4000 2X fewer pregnancy complications
2X fewer pre-term births
49 ng/ml Should have
< 750 mg $3 6000 Probable: larger benefits for above items
Just enough D for breastfed infant
More maternal and infant weight
< 750 mg $4