PITTSBURGH, May 22 ? Pregnant women with low levels of vitamin D may be more likely to suffer from bacterial vaginosis (BV) ? a common vaginal infection that increases a woman’s risk for preterm delivery, according to a University of Pittsburgh study. Available online and published in the June issue of the Journal of Nutrition, the study may explain why African-American women, who often lack adequate vitamin D, are three times more likely than white women to develop BV.
“Bacterial vaginosis affects nearly one in three reproductive-aged women, so there is great need to understand how it can be prevented,” said Lisa M. Bodnar, Ph.D., M.P.H., R.D., assistant professor of epidemiology, obstetrics and gynecology, University of Pittsburgh. “It is not only associated with a number of gynecologic conditions, but also may contribute to premature delivery ? the leading cause of neonatal mortality ? making it of particular concern to pregnant women.”
The study, which included 469 pregnant women, sought to determine whether poor vitamin D status played a role in predisposing women, especially African-Americans, to BV. Dr. Bodnar and colleagues at Magee-Womens Research Institute found that 41 percent of the study participants had BV and of these, 93 percent had insufficient levels of vitamin D. They also found that the prevalence of BV decreased as vitamin D levels rose.
Vitamin D may play a role in BV by regulating the production and function of antimicrobial molecules, which in turn may help the immune system prevent and control bacterial infection. However, only about one in four Americans gets enough vitamin D. Vitamin D deficiency may be more common in African-Americans because dark pigmentation limits the amount of vitamin D that can be made in the skin through casual exposure to sunlight. African-American women also are less likely to meet dietary recommendations of vitamin D.
“Although this is a preliminary study, it points out an interesting connection between vitamin D and BV,” said Dr. Bodnar. “We don’t recommend pregnant women take mega-doses of vitamin D based on these findings, but they should talk with their doctor if they have concerns about their vitamin D status. All women should be encouraged to eat a healthy diet and take a prenatal vitamin before they become pregnant or as soon as they find out they are pregnant.”
Co-authors of the study include Marijane A. Krohn, Ph.D., and Hyagriv N. Simhan, M.D., with the University of Pittsburgh and Magee-Womens Research Institute. The study was funded by the National Institutes of Health.
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Thanks for a corroborating study that shows an “association” of Vitamin-D blood levels with bacterial infections during pregnancy. Please consider the possibility that it is the bacterial infection which is a major contributing cause to the (25-D) Vitamin-D levels. Also, please consider testing for (1,25-D) in addition to (25-D), in follow-on and future testing.
Although this study measured the major inactive form of Vitamin-D (25-D), it did not measure the most active form (1,25-D) levels. Both of these metabolites bind to the Vitamin-D nuclear receptor (VDR). The active form activates the VDR, and turns-on the innate immune system. The (25-D) form switches the VDR off, and in that sense is immunosuppressive. In normal individuals both forms are regulated with negative feedback pathways that involve the VDR. Recent in-silico (molecular modeling) has shown that some bacterial substances, such as Capnine, can “jam” the immune system by binding to the VDR and inactivating it. When the VDR is jammed, both Vitamin-D metabolites become dysregulated. The (25-D) form becomes depressed, but the (1,25-D) form becomes elevated, sometimes as much as 2 or 3 times normal. In such as diseased situation, we do not really have a Vitamin-D “deficiency”, when one form is abnormally low but the active form is abnormally high.
The high (1,25-D) levels would normally switch on the VDR, activate the immune system, kill the bacteria, and restore Vitamin-D metabolite regulation. But the high active levels cannot, because of the jamming by the bacterial ligand(s). The jamming serves the bacteria by compromising the body’s immune system, helping them survive.
In order to differentiate between the normal and diseased states, it is important to measure the (1,25-D) level, not just the (25-D). Usually the (25-D) level alone is tested, because the (1,25-D) test is so expensive, or because the need for it is unknown. But in view of the in-silico findings (backed up by in-vivo trials), we should no longer think that the relationship between (25-D) and (1,25-D) levels is a simple direction proportionality.
For more complete explanations (and references), please see:
http://autoimmunityresearch.org/transcripts/AR-Albert-VitD.pdf
and
http://bacteriality.com/2007/09/15/vitamind/
Thank you,
-DLR