Research Article: High frequency of vitamin D deficiency in current pregnant Japanese women associated with UV avoidance and hypo-vitamin D diet

Date Published: March 4, 2019

Publisher: Public Library of Science

Author(s): Kumiko T. Kanatani, Takeo Nakayama, Yuichi Adachi, Kei Hamazaki, Kazunari Onishi, Yukuo Konishi, Yasuyuki Kawanishi, Tohshin Go, Keiko Sato, Youichi Kurozawa, Hidekuni Inadera, Ikuo Konishi, Satoshi Sasaki, Hiroshi Oyama, Sakamuri V. Reddy.

http://doi.org/10.1371/journal.pone.0213264

Abstract

As a consequence of indoor occupations and reduced exposure to sunlight, concerns have been raised that vitamin D deficiency is widespread in developed countries. Vitamin D is known to be associated with increased risks of morbidity and mortality in various diseases.

To investigate the serum vitamin D status and its relation with life-style factors in pregnant Japanese women.

Among a cohort for 3,327 pregnant women who participated in an the adjunct study of the Japan Environment and Children’s Study during 2011–2013, in which data were obtained on various life-style factors, including both dietary intake of vitamin D and frequency of UV exposure, this study consisted of 1,592 pregnant women, from whom 2,030 serum samples were drawn in Jan, Apr, Jul, and Oct, and the association between serum 25(OH)D level and life-style factors were analyzed using linear mixed models.

Serum 25(OH)D levels were less than 20ng/mL in 1,486 of 2,030 samples (73.2%). There was an obvious seasonal change, with serum 25(OH)D levels of less than 20 ng/mL in 89.8% and 47.8% of samples in spring (April) and autumn (October), respectively. Both the frequency spent under sunlight and dietary intake of vitamin D were significantly associated with serum 25(OH)D level. An increase in sunlight exposure of more than 15 min for 1 to 2 days per week in non-winter, or dietary intake of 2 μg/day of vitamin D resulted in an elevation of 1 ng/mL in serum 25(OH)D levels.

These findings indicate that vitamin D deficiency is very severe in Japanese pregnant women, especially those rarely exposed to sunlight. The benefits of UV rays should also be informed of when its risk is alerted, and clinicians should propose the adequate UV exposure level.

Partial Text

Vitamin D is a fat-soluble secosteroid with well-established effects on calcium homeostasis. More recently, vitamin D has also been recognized to interact with a nuclear receptor in various other organs[1] and its deficiency is associated with increased risks of morbidity and mortality in various diseases including cardiovascular, malignant, and autoimmune diseases[2,3]. Accumulating evidence suggests that vitamin D deficiency during pregnancy may cause complications such as preeclampsia[3–5], although its implications and the underlying mechanisms are not fully understood. And it is even hypothesized that vitamin D deficiency in the fetal period leads to an increased risk of allergic diseases, multiple sclerosis, and cardiovascular diseases in later life[2,6–8].

In this study, we showed that Japanese pregnant women are in severe vitamin D deficiency status (10.8% are <10 ng/mL, 73.2% are <20 ng/mL). This was expected from their lifestyles, and consistent with previous urban Japanese studies and other recent Asian studies in which it is reported that lighter skin tones are culturally preferred [14,15,31–33]. The thresholds for 25(OH)D levels (10 ng/mL for severe deficiency, and 20 ng/mL for deficiency) were derived from non-pregnant populations and an optimal serum level during pregnancy has not been established. However, it is at least suggested that Japanese pregnant women have lower vitamin D levels compared with a century ago, at which time the majority of the populations engaged in agriculture or fishery, spending many hours outside every day; among subjects who reported themselves being exposed to sunlight at least 15 minutes on more than 5 days a week without UV protection in neck and hands and consumed more than 7.0 μg/day of dietary vitamin D, 49 of 50 subjects (98.0%) showed 25(OH)D above 10 ng/mL with the mean 25(OH)D level of 20.2 ng/mL throughout the year. Because vitamin D has functions in various organs, deficiency can cause or contribute to a variety of diseases [34]. The association between vitamin D deficiency and specific morbidities, especially diseases that is increasing in these decades, should be further investigated.   Source: http://doi.org/10.1371/journal.pone.0213264

 

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