THE EFFECT OF VITAMIN D ON MATERNAL AND FETAL HEALTH: FETAL PROGRAMMING, GENETIC AND EPIGENETIC MECHANISMS

Abstract

There are many factors affecting vitamin D homeostasis during pregnancy. Vitamin D requirement increases depending on the bone development of the fetus, especially in the second and last trimesters of pregnancy. In recent years, vitamin D has become a current issue because of the effects of vitamin D other than bone development and its effectiveness in fetal programming. Vitamin D plays a role in the pathogenesis of both maternal and fetal diseases starting from the preconception period. Low prenatal and neonatal 25(OH)D levels are associated with diseases such as schizophrenia, type 1 diabetes, respiratory tract diseases, autoimmune diseases, multiple sclerosis, and cancer in adulthood. Decreasing or increasing maternal 25(OH)D concentration may cause maternal preeclampsia and gestational diabetes; in the fetus, it mainly causes intrauterine developmental disorders, genetic and epigenetic changes. The relationship of vitamin D, which is known for its role in anti-inflammatory effect, calcium metabolism and glucose homeostasis, with epigenetic mechanism is explained by promoter methylation. In addition, high serum 25(OH)D concentration is associated with genetic diseases by causing mutations in some genes (CYP24A1, CYP27B1, CYP2R1). Accordingly, keeping maternal, placental, and fetal vitamin D levels at an optimal level may be an effective mechanism in preventing possible diseases. In this review, we aimed to draw attention to the effects and importance of vitamin D in preconception, pregnancy, and postpartum periods.

Keywords

• Epigenetics
• fetal programming
• genetics
• pregnancy
• vitamin D

D VİTAMİNİNİN MATERNAL VE FETAL SAĞLIK ÜZERİNE ETKİSİ: FETAL PROGRAMLAMA, GENETİK VE EPİGENETİK MEKANİZMALAR

Abstract

Gebelikte D vitamini homeostazını etkileyen birçok faktör vardır. Özellikle gebeliğin ikinci ve son trimesterinde fetüsün kemik gelişimine bağlı olarak D vitamini gereksinimi artmaktadır. Son yıllarda D vitamininin kemik gelişimi dışındaki etkilerinin ortaya çıkması ve fetal programlamada etkili olması nedeniyle, D vitamini güncel bir konu haline gelmiştir. D vitamini prekonsepsiyonel dönemden itibaren hem maternal hem de fetal hastalıkların patogenezinde rol oynamaktadır. Düşük prenatal ve neonatal 25(OH)D seviyeleri yetişkin dönemde şizofreni, tip 1 diyabet, solunum yolu hastalıkları, otoimmün hastalıklar, multiple skleroz ve kanser gibi hastalıklarla ilişkilendirilmektedir. Azalmış veya artmış maternal 25(OH)D konsantrasyonu annede preeklemsi ve gestasyonel diyabet gibi hastalıklara; fetüste ise başlıca intrauterin gelişim bozukluklarına, genetik ve epigenetik değişikliklere neden olmaktadır. Antiinflamatuar yanıtta kalsiyum metabolizmasında ve glukoz homeostazında görev alması ile bilinen D vitamininin, epigenetik mekanizma ile ilişkisi promotor metilasyonuyla açıklanmaktadır. Ayrıca yüksek serum 25(OH)D konsantrasyonu bazı genlerde (CYP24A1, CYP27B1, CYP2R1) mutasyona neden olarak genetik hastalıklarla ilişkilendirilmektedir. Bu doğrultuda maternal, plasental ve fetal D vitamini düzeylerinin optimal seviyede seyretmesi, olası hastalıkları önlemede etkin bir mekanizma olabilir. Bu derlemede, D vitaminin söz konusu prekonsepsiyonel, gebelik ve doğum sonrası dönemdeki etkilerine ve önemine dikkat çekmek istenilmiştir.

Keywords

• D vitamini
• epigenetik
• fetal programlama
• gebelik
• genetik

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