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. 2022 Jun 10;14(12):2423. doi: 10.3390/nu14122423

Table 1.

The role of nutrients in CD and women fertility.

Nutrient Role Risk Factors for Deficiency/Inadequate Intake
CD Fertility
Vitamin D
  • -

    regulation of immunity and immune response (gut mucosal immunity and integrity) [23,34];

  • -

    inhibiting the production of proinflammatory cytokines [35].
  • -

    modulation of female reproductive and fertility, as well as pregnancy and lactation [44,45,46];

  • -

    vitamin D receptors expression in numerous tissues of the reproductive organs (e.g., ovaries, endometrium, placenta, pituitary gland, hypothalamus) [26,46];

  • -

    steroidogenesis [46].
  • -

    intestinal inflammation leading to impaired absorption of nutrients [37];

  • -

    bile acid malabsorption [37];

  • -

    restricted dietary intake [37];

  • -

    reduced sunlight exposure [37];

  • -

    medication (immunosuppressive treatment) [37].
Fiber
  • -

    modulation in gut microenvironment through interaction with microbiota (maintenance of intestinal homeostasis, anti-inflammatory action, production of SCFA) [77,78,79,80,81,82].
  • -

    modulation in glycemic control [88];

  • -

    modulating insulin sensitivity [88].
  • -

    low dietary intake (e.g., low consumption of fiber-containing foods) [68].
Folate
  • -

    prevention of HHcy and related consequences

    (e.g., oxidative stress, cardiovascular diseases and arterial and venous thromboembolic events) [29].
  • -

    modulation of fertility and reproductive process (gametogenesis and early embryogenesis) through prevention of HHcy [32].
  • -

    low dietary intake (e.g., low consumption of folate-containing foods including green leafy vegetables, fruits, bread, and fortified cereals) [5];

  • -

    malabsorption [5];

  • -

    medications (e.g., acting through inhibition of dihydrofolate reductase (methotrexate) or favoring malabsorption (sulphasalazine)) [5].
Vitamin B12
  • -

    malabsorption due to resection of more than 60 cm of terminal ileal [5].
Iron
  • -

    modulation of inflammation through the increase in hepcidin (positively correlated with the increase in pro-inflammatory cytokines, such as IL-6, IL-1, IL-17, and TNF-alpha) [52].
  • -

    lower risk of ovulatory infertility [90];

  • -

    decrease risk of adverse birth outcomes [57].
  • -

    increased inflammation of the intestinal mucosa (i.e., its increased loss due to blood loss from the gastrointestinal tract, and malabsorption) [50,51].
Zinc
  • -

    regulation of both the innate (affecting the function of natural killer cells, macrophages, and neutrophils) and adaptive arms (influencing the function of T- and B-lymphocytes) of the immune system [58,59];

  • -

    anti-oxidative effect (through inhibition of NADPH oxidase, and its role as a cofactor for superoxide dismutase [61].
  • -

    regulation of cells differentiation and proliferation [24].
  • -

    Increase losses (chronic diarrhea, high-output ostomies, and fistulas [6];

  • -

    medications (reduced absorption (glucocorticoids)) [6].
Omega-3
  • -

    regulation of immunological and inflammatory responses [115];

  • -

    reduction of inflammation [115].
  • -

    anti-inflammatory properties in steroidogenesis [113,117].
  • -

    malabsorption [10].
Arginine
  • -

    intestinal permeability regulation (maintenance of the integrity of tight junctions) [130].
  • -

    the collected studies do not demonstrate a relationship between the role of glutamine and arginine in CD, related to fertility.
  • -

    misregulation of inflammatory processes [136,137].
Glutamine
  • -

    modulation of the gut inflammation (reducing pro-inflammatory cytokines [135].
  • -

    increase in paracellular permeability [131].

SCFA: short-chain fatty acid.