Association of maternal and cord plasma total, free and bioavailable 25-hyrodroxyvitamin D with neonatal anthropometric measurements at birth: a preliminary study in a private hospital

Introduction: 25-hydroxyvitamin D (25OHD) is the principal biomarker of vitamin D status. In circulation, 25OHD is primarily bound to vitamin D binding protein (VDBP), leaving a small proportion bound to albumin and as free form. Previous studies have suggested that free 25OHD is better correlated with health outcomes. However, in pregnancy where VDBP level is extremely elevated, the correlations between free 25OHD with health outcomes are far from conclusive. Here we show the associations of maternal and cord total, free and bioavailable 25OHD con-currently with neonatal anthropometric measurements in healthy pregnant mothers-neonates pairs. Method: Total 25OHD level was measured by using chemiluminescent immunoassay. Free and bioavailable 25OHD were calculated using published mathematical models. Results: The results showed that birth weight and head circumference were negatively associated with maternal total 25OHD but not significantly associated with free and bioavailable 25OHD. There were no significant associations between cord total, free and bioavailable 25OHD with any of the neonatal anthropometric measurements. Conclusion: The outcomes of this study should encourage further research in a larger sample size. Notably, future research could lead to the establishment of causative relationships and plausible mechanisms between maternal and cord 25OHD with neonatal anthropometric measurements

A prospective cohort study on the effect of various risk factors on hypoglycaemia in diabetics who fast during Ramadan

Muslim diabetics who fast during Ramadan are at risk of hypoglycaemia, and previous consensus guidelines have highlighted certain risk factors. This prospective cohort study aims to determine the relative risk (RR) of hypoglycaemia during Ramadan fasting compared with a non-fasting period of equivalent length, and to ascertain which risk factors are clinically significant. From the results, Ramadan fasting carries a RR of hypoglycaemia of 1.60 (95% CI 1.05 to 2.43). Good metabolic control (HbAlc 60 years) increased RR more than twice, while taking breakfast prior to fasting reduces RR to less than half

Innovative Classroom Strategy: Impact on Students’ Mathematics Motivation, Anxiety and Achievement in Pre-University Studies

One aspect that influences mathematics achievement is students' mathematics motivation, which is closely related to their mathematics anxiety. This study aims to incorporate a classroom intervention strategy using a brain-based teaching approach (BBTA) with technological tools to improve students' mathematics performance in pre-university studies. BBTA was used in the classroom to increase students’ mathematics interest and minimise their mathematics anxiety to increase mathematics performance. Two hundred and six (206) pre-university students were exposed to both BBTA and conventional instructions during their Statistic lessons. Questionnaire comprises of motivation and anxiety-related questions as well as pre and post mathematics tests were administered to these students. Based on the findings, students with low anxiety appeared to have more self-confidence when studying mathematics, which simultaneously improved their examination results. These two elements are critical in students' learning of mathematics because students who have low levels of anxiety and high levels of motivation in learning mathematics attain high achievement in mathematics

Influence of vitamin D binding protein polymorphism, demographics and lifestyle factors on vitamin D status of healthy Malaysian pregnant women

Background: Vitamin D deficiency (VDD) has been related to vitamin D binding protein (GC) gene polymorphism, demographics and lifestyle factors in different populations. However, previous studies only focused on demographic and lifestyle factors or genetic factors alone. Therefore, this cross-sectional study aimed to assess the association between GC gene polymorphism, demographics and lifestyle factors with VDD among Malaysian pregnant women. Method: Information on demographic characteristics, dietary vitamin D intake from supplement and food, time spent outdoors, skin type and clothing were collected using a questionnaire. Plasma total 25-hydroxyvitamin D (25OHD) levels were measured using an Ultra-High-Performance Liquid Chromatography (UHPLC). Maternal GC single nucleotide polymorphisms (SNPs) (rs4588 and rs7041) were determined using restriction fragment length polymorphism (RFLP) technique. Results: Results showed that 50.2% of pregnant women were vitamin D deficient (25OHD < 30 nmol/L). VDD (25OHD < 30 nmol/L) was significantly associated with age, veiled clothing, maternal vitamin D intakes from both food and supplements, and GC rs7041(and GC diplotypes). In contrast to previous studies that reported for non-pregnant population, a significant positive association was found between CC genotype for SNP GC rs7041, GC 1s-1s and GC If-2 with risk of VDD (25OHD < 30 nmol/L). Conclusions: The high prevalence of maternal VDD found in this study suggests the need for urgent development and implementation of vitamin D supplementation or fortification strategies to reduce VDD among pregnant women. The discrepancy in the association between GC rs7041 gene polymorphism and VDD reflects the variation in the factors associated with VDD in pregnancy compared to non-pregnant state

Genetic variants and non-genetic factors associated with a high prevalence of vitamin D deficiency in full-term neonates in Malaysia

A high prevalence of vitamin D deficiency has been reported in Malaysian pregnant women, indicating that neonates at birth are at increased risk of vitamin D deficiency. Factors including low dietary vitamin D intake and single nucleotide polymorphisms in the vitamin D metabolism genes have been associated with this deficiency in the population. However, there was limited data available regarding the prevalence of neonatal vitamin D deficiency and the factors associated with it among neonates in Malaysia. Therefore, this study aimed to determine the prevalence of vitamin D deficiency and explore the associations between maternal and neonatal gene polymorphisms, as well as non-genetic factors and neonatal vitamin D deficiency. A total of 217 mother-neonate dyads were recruited for this study. Data on skin type, maternal sun exposure, dietary intake, as well as maternal and neonatal 25-hydroxyvitamin D (25OHD) concentrations were collected. Maternal and neonatal vitamin D Receptor (VDR) SNP (rs2228570) and Group-specific component (GC) SNPs (rs4588 and rs7041) genotypes were determined using high-resolution melting (HRM) and restriction fragment length polymorphism, respectively. The results showed that 60.4%, 71.4% and 95.4% of neonates had cord blood 25OHD levels below 25 nmol/L, 30 nmol/L and 50 nmol/L, respectively. After adjusting for the maternal vitamin D status, the maternal VDR rs2228570 GG genotype was significantly associated with neonatal vitamin D deficiency (25OHD<30 nmol/L) (aOR = 2.63, 95% CI: 1.18–5.87, p = 0.018). Maternal vitamin D supplement intake was found to be a protective factor. However, maternal and neonatal vitamin D binding protein (VDBP) SNPs were not associated with neonatal vitamin D deficiency. The high prevalence of neonatal vitamin D deficiency reported in this study indicates the urgent need for the development and implementation of strategies to improve neonatal vitamin D status. The findings suggest that maternal supplementation may be an effective approach to enhance the vitamin D status of neonates

Interplay between maternal and neonatal vitamin D deficiency and vitamin-D-related gene polymorphism with neonatal Birth anthropometry

Vitamin D deficiency during pregnancy has been associated with poor foetal growth and neonatal birth anthropometry. However, the associations were inconsistent and could be confounded by neonatal vitamin D status and genetic factors. Until recently, limited studies have concomitantly examined the effect of maternal and neonatal vitamin D deficiency and vitamin D-related single nucleotide polymorphisms (SNPs) on neonatal birth anthropometry. This study aims to examine the independent and combined effects of maternal and neonatal vitamin D deficiency and vitamin-D-related SNPs on neonatal birth anthropometry. This cross-sectional study included 217 mother–neonate dyads recruited from Hospital Serdang, Selangor, Malaysia, between 2015 and 2017. Plasma 25-hydroxyvitamin D (25OHD) concentration was measured in maternal and umbilical cord blood using ultra-high-performance liquid chromatography (UHPLC). Maternal and neonatal vitamin D Receptor (VDR) SNP (rs2228570) genotypes were determined using high-resolution melting (HRM). Group-specific component (GC) SNPs (rs4588 and rs7041) genotypes were determined using restriction fragment length polymorphism. Our results showed that: (1) maternal vitamin D deficiency (25OHD < 30 nmol/L) was inversely associated with birth weight, head circumference and crown–heel length; (2) neonatal SNPs, VDR rs2228570 and GC rs4588, were significantly associated with birth weight and head circumference, respectively; and (3) a potential interaction was observed between maternal VDR rs2228570 with maternal vitamin D deficiency on head circumference. These findings suggest that the underlying mechanisms of vitamin D on foetal growth are likely to be localised in the maternal compartment, mediated through the placenta, rather than through cellular mechanisms within the foetus. Further large-scale studies are warranted to validate and extend these findings