The effects of vitamin D supplementation on maternal and neonatal outcome: A randomized clinical trial

Background: Vitamin D supplementation during pregnancy has been supposed to defend against adverse gestational outcomes. Objective: This randomized clinical trial study was conducted to assess the effects of 50,000 IU of vitamin D every two weeks supplementation on the incidence of gestational diabetes (GDM), gestational hypertension, preeclampsia and preterm labor, vitamin D status at term and neonatal outcomes contrasted with pregnant women that received 400 IU vitamin D daily. Materials and Methods: 500 women with gestational age 12-16 weeks and serum 25 hydroxy vitamin D (25 (OH) D ) less than 30 ng/ml randomly categorized in two groups. Group A received 400 IU vitamin D daily and group B 50,000 IU vitamin D every 2 weeks orally until delivery. Maternal and Neonatal outcomes were assessed in two groups. Results: The incidence of GDM in group B was significantly lower than group A (6.7% versus 13.4%) and odds ratio (95% Confidence interval) was 0.46 (0.24-0.87) (P=0.01). The mean ± SD level of 25 (OH) D at the time of delivery in mothers in group B was significantly higher than A (37.9 ± 19.8 versus 27.2 ± 18.8 ng/ml, respectively) (P=0.001). There were no differences in the incidence of preeclampsia, gestational hypertension, preterm labor, and low birth weight between two groups. The mean level of 25 (OH) D in cord blood of group B was significantly higher than group A (37.9 ± 18 versus 29.7 ± 19ng/ml, respectively). Anthropometric measures between neonates were not significantly different. Conclusion: Our study showed 50,000 IU vitamin D every 2 weeks decreased the incidence of GDM

Treating Diet-Induced Diabetes and Obesity with Human Embryonic Stem Cell-Derived Pancreatic Progenitor Cells and Antidiabetic Drugs

Human embryonic stem cell (hESC)-derived pancreatic progenitor cells effectively reverse hyperglycemia in rodent models of type 1 diabetes, but their capacity to treat type 2 diabetes has not been reported. An immunodeficient model of type 2 diabetes was generated by high-fat diet (HFD) feeding in SCID-beige mice. Exposure to HFDs did not impact the maturation of macroencapsulated pancreatic progenitor cells into glucose-responsive insulin-secreting cells following transplantation, and the cell therapy improved glucose tolerance in HFD-fed transplant recipients after 24 weeks. However, since diet-induced hyperglycemia and obesity were not fully ameliorated by transplantation alone, a second cohort of HFD-fed mice was treated with pancreatic progenitor cells combined with one of three antidiabetic drugs. All combination therapies rapidly improved body weight and co-treatment with either sitagliptin or metformin improved hyperglycemia after only 12 weeks. Therefore, a stem cell-based therapy may be effective for treating type 2 diabetes, particularly in combination with antidiabetic drugs

The Prospective Epidemiological Research Studies in IrAN (PERSIAN) Birth Cohort protocol: rationale, design and methodology

Background: Birth cohorts are essential for developing evidence-based policies and advancing knowledge on different aspects of the concept of developmental origins of health and diseases (DOHaD). The Prospective Epidemiological Research Studies in IrAN (PERSIAN) is a multicentre cohort in Iran. It is one of the pioneers of DOHaD research in the Middle East and North Africa (MENA) region. This profile provides a brief overview of this birth cohort, focusing on the objectives and design of the study. The main objective of this birth cohort is to evaluate the associations of socio-economic characteristics, lifestyle, diet, environmental exposures and epigenetic factors with outcomes of: pregnancy; mother and child mental and physical health and well-being; child neurodevelopment; and the establishment of chronic disease risk factors. Methods: The enrolment of PERSIAN Birth Cohort participants is currently ongoing in five Iranian cities (Isfahan, Yazd, Semnan, Sari and Rafsanjan). We plan to recruit 15, 000 mother-offspring pairs, and to follow them for at least ten years. Data collection consists of three consecutive phases: (1) periconception until birth; (2) infancy (0-2 years); and (3) childhood (3-11 years). We are collecting data on both ‘determinants of health’ and ‘health outcomes’. In addition to questionnaires and physical examination, various biological samples, including blood, urine, hair, nail, cord blood and breastmilk are being collected. Growth and neurodevelopment of children will be monitored. Appropriate data analysis schemes will be employed to assess the role of early life factors in health and disease that would facilitate international comparisons

The prospective epidemiological research studies in IrAN (PERSIAN) birth cohort protocol: Rationale, design and methodology

Background: Birth cohorts are essential for developing evidence-based policies and advancing knowledge on different aspects of the concept of developmental origins of health and diseases (DOHaD). The Prospective Epidemiological Research Studies in IrAN (PERSIAN) is a multicentre cohort in Iran. It is one of the pioneers of DOHaD research in the Middle East and North Africa (MENA) region. This profile provides a brief overview of this birth cohort, focusing on the objectives and design of the study. The main objective of this birth cohort is to evaluate the associations of socio-economic characteristics, lifestyle, diet, environmental exposures and epigenetic factors with outcomes of: pregnancy; mother and child mental and physical health and well-being; child neurodevelopment; and the establishment of chronic disease risk factors. Methods: The enrolment of PERSIAN Birth Cohort participants is currently ongoing in five Iranian cities (Isfahan, Yazd, Semnan, Sari and Rafsanjan). We plan to recruit 15, 000 mother-offspring pairs, and to follow them for at least ten years. Data collection consists of three consecutive phases: (1) periconception until birth; (2) infancy (0-2 years); and (3) childhood (3-11 years). We are collecting data on both ‘determinants of health’ and ‘health outcomes’. In addition to questionnaires and physical examination, various biological samples, including blood, urine, hair, nail, cord blood and breastmilk are being collected. Growth and neurodevelopment of children will be monitored. Appropriate data analysis schemes will be employed to assess the role of early life factors in health and disease that would facilitate international comparisons

Mycophenolate and azathioprine efficacy in interstitial lung disease: a systematic review and meta-analysis

Objectives Mycophenolate mofetil (MMF) and azathioprine (AZA) are immunomodulatory treatments in interstitial lung disease (ILD). This systematic review aimed to evaluate the efficacy of MMF or AZA on pulmonary function in ILD.Design Population included any ILD diagnosis, intervention included MMF or AZA treatment, outcome was delta change from baseline in per cent predicted forced vital capacity (%FVC) and gas transfer (diffusion lung capacity of carbon monoxide, %DLco). The primary endpoint compared outcomes relative to placebo comparator, the secondary endpoint assessed outcomes in treated groups only.Eligibility criteria Randomised controlled trials (RCTs) and prospective observational studies were included. No language restrictions were applied. Retrospective studies and studies with high-dose concomitant steroids were excluded.Data synthesis The systematic search was performed on 9 May. Meta-analyses according to drug and outcome were specified with random effects, I2 evaluated heterogeneity and Grading of Recommendations, Assessment, Development and Evaluation evaluated certainty of evidence. Primary endpoint analysis was restricted to RCT design, secondary endpoint included subgroup analysis according to prospective observational or RCT design.Results A total of 2831 publications were screened, 12 were suitable for quantitative synthesis. Three MMF RCTs were included with no significant effect on the primary endpoints (%FVC 2.94, 95% CI −4.00 to 9.88, I2=79.3%; %DLco −2.03, 95% CI −4.38 to 0.32, I2=0.0%). An overall 2.03% change from baseline in %FVC (95% CI 0.65 to 3.42, I2=0.0%) was observed in MMF, and RCT subgroup summary estimated a 4.42% change from baseline in %DLCO (95% CI 2.05 to 6.79, I2=0.0%). AZA studies were limited. All estimates were considered very low certainty evidence.Conclusions There were limited RCTs of MMF or AZA and their benefit in ILD was of very low certainty. MMF may support preservation of pulmonary function, yet confidence in the effect was weak. To support high certainty evidence, RCTs should be designed to directly assess MMF efficacy in ILD.PROSPERO registration number CRD42023423223