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    <ns1:title language="sr">Status i funkcija vitamina D i C-3 [alfa]-epimera 25-hidroksivitamina D3 kod trudnica sa preeklampsijom i bez nje i kod novorođenčadi</ns1:title>
    <ns2:subtitle language="sr">doktorska disertacija</ns2:subtitle>
    <ns2:alt_title language="en">Status and function of vitamin D and C-alpha epimer of 25-hydroxyvitamin D3 in mothers with and without preeclampsia and their infants.  : doctoral dissertation</ns2:alt_title>
    <ns1:language>sr</ns1:language>
    <ns1:description language="sr">Vitamin D je od izuzetne važnosti u trudnoći pre svega za normalan rast kostiju i za
celokupan razvoj bebe. Pokazano je međutim da 40-80 % trudnica ima nizak nivo (&lt; 20
ng/ml) 25-hidroksivitamina D (25(OH)D) u serumu kao i da nizak nivo vitamina D u
trudnoći povećava rizik za pojavu preeklampsije (PE) i prevremenih porođaja. U Srbiji,
gde hrana nije obogaćena vitaminom D, stopa preeklampsije je veća u zimskom periodu.
Odgovor na suplemenatciju vitaminom D dodatno se usložnjava prisustvom C-3α-
epimera 25(OH)D3 (3-epi-25(OH)D3), čiji udeo u ukupnom nivou 25(OH)D u krvi može
biti i do 60 % kod beba, a do 17 % kod odraslih. Prisustvo 3-epi-25(OH)D3 u krvi pupčane
vrpce ukazuje da postoji prenos sa majke na novorođenče. Međutim, i dalje je nepoznato
koja je uloga povišenog nivoa 3-epi-25(OH)D3 kod novorođenčadi, kako se nivo menja
tokom prvih nedelja života novorođenčadi kao i kakav efekat 3-epi-25(OH)D3 ima na rast
kostiju beba rođenih iz fizioloških trudnoća u odnosu na trudnoće sa komplikacijama kao
što je preeklampsija. Stoga su ciljevi ove teze: 1) validacija upitnika o učestalosti
konzumiranja namirnica (WRH-FFQ) koji bi omogućio procenu unosa vitamina D kod
mladih žena u reproduktivnom dobu u Srbiji; 2) sagledavanje povezanosti niskog unosa i
statusa vitamina D sa pojavom preeklampsije, kao i određivanje udela 3-epi-25(OH)D3 u
ukupnom sadržaju 25(OH)D3 u odnosu na zdravstvene ishode majki i novorođenčadi; 3)
određivanje nivoa 3-epi-25(OH)D3 tokom prvih nedelja života novorođenčadi i
sagledavanje njegovog efekta na rast kostiju beba rođenih iz fizioloških trudnoća u
odnosu na trudnoće sa komplikacijama kao što je preeklampsija; i 4) ispitivanje biološkog
odgovora kostiju na izloženost endogenom i egzogenom izvoru 3-epi-25(OH)D3 na
animalnom modelu.
Studija validacije upitnika WRH-FFQ za procenu unosa vitamina D kod mladih žena u
reproduktivnom dobu u Srbiji izvedena je od novembra do aprila, kada je smanjeno UVB
zračenje. Upitnik WRH-FFQ adekvatno su popunile 422 žene od kojih su nasumično
odabrane 44 žene uključene u dalji proces validacije, koji je obuhvatao tri vremenski
odvojena popunjavanja anketa dvadesetčetvoročasovne ishrane (24h-AI),
antropometrijsko merenje i uzorkovanje krvi...</ns1:description>
    <ns1:description language="en">Vitamin D exposure during pregnancy is important for skeletal growth and development
in the offspring. However, 40-80% of expecting mothers have low (&lt; 20 ng/ml) serum
25-hydroxyvitamin D (25(OH)D) level . A recent meta-analysis demonstrated that low
vitamin D status in pregnancy increases the risk of preeclampsia (PE) and preterm birth.
In Serbia where there is no mandatory vitamin D food fortification policy, rates of PE
are higher in winter. Response to vitamin D supplementation is complicated by the
presence of C-3α epimer of 25(OH)D3 (3-epi-25(OH)D3) representing up to 60% of
total 25(OH)D in infants and 17% in adults, raising questions regarding its biological
derivation and function. The presence of cord 3-epi-25(OH)D3 suggests maternal-fetal
transfer. However, it is still unknown whether 3-epi-25(OH)D3 increases in the first few
weeks after birth and how it effects bone mineral accretion in infants of healthy and
complicated pregnancies. Therefore, sequential objectives of this thesis are to: 1)
validate a food frequency questionnaire (WRH-FFQ) for assessing vitamin D intake in
young women of reproductive age in Serbia; 2) determine if low vitamin D intake and
status is associated with PE in Serbia; and describe the proportion of total 25(OH)D in
the 3-epi-25(OH)D3 form in relation to maternal and neonatal outcomes; 3) establish if
3-epi-25(OH)D3 in preterm and term infants of mothers with and without PE is
predictive of bone mass at term age using a nested case vs. control design; and 4) test
the biological response of bone to endogenous and exogenous 3-epi-25(OH)D3 in an
animal model.
The Women and Reproductive Health FFQ (WRH-FFQ) was completed by 422 women.
A cross-sectional study, was conducted from November to April when UVB in Serbia is
minimal. On a representative sub-sample (n=44) three 24 hour dietary recalls and
anthropometric parameters were collected. Fasting blood samples for vitamin D
biomarkers analyses were available for 23 women...</ns1:description>
    <ns1:description language="sr">Biohemija - Medicinska biohemija i vitamini / Biochemistry - Medical Biochemistry and Vitamins   
Datum odbrane:  15.10.2016.</ns1:description>
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        <ns3:firstname> Miroslav M., 1952- </ns3:firstname>
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