不孕女性的维生素D营养状况对IUI临床妊娠率的影响

Influence of Vitamin D status on IUI outcome in infertile women

目的调查不孕女性体内维生素D的营养状况,以及探讨维生素D水平对宫腔内人工授精(IUI)临床妊娠率的影响。方法收集2014年10月到2015年10月在本中心行IUI助孕的288名不孕女性患者的血清,化学发光免疫分析法检测血清中25(OH)D水平。结果不孕女性维生素D严重缺乏[25(OH)D<30nmol/L]比例为27.4%,缺乏[25(OH)D30~49.9nmol/L]比例为52.5%;体重超重与体重正常女性之间维生素D营养状况有显著性差异(P=0.007),超重女性维生素D充足[25(OH)D≥50nmol/L]比例仅为2.4%,明显低于正常女性(23.2%);不同季节维生素D营养状况有显著性差异(P=0.001),春季和冬季是维生素D严重缺乏的高发季节;调整混杂因素年龄和体重指数(BMI)后,Logistics回归模型分析显示血清25(OH)D水平<50nmol/L的女性获得IUI临床妊娠的几率显著低于血清25(OH)D水平≥50nmol/L的女性(aOR=0.427,P=0.032)。结论不孕女性维生素D缺乏较为普遍,尤其是春季和冬季易发生维生素D严重缺乏,缺乏维生素D可能会对IUI临床妊娠产生负面影响,因此不孕女性需要注意维生素D的适量补充。

Objective：To evaluate the influence of vitamin D status on the outcome of intrauterine insemination（IUI）in infertile women.Methods：A total of 288infertile women were recruited in this study in the Wuxi Maternity and Child Health Hospital from October 2014to October 2015.Blood sampling was conducted in all the subjects and serum 25-Hydroxyvitamin D[25（OH）D]levels in serum were measured by chemiluminescence immunoassay to evaluate the vitamin D status.Results：Of all the subjects,27.4%were severely deficient of vitamin D[25（OH）D30nmo/L]and52.5%patients were deficient of vitamin D[25（OH）D 30-49.9nmol/L].There was a significant difference in the vitamin D status between overweight and normal-weight patients（P=0.007）.2.4%of the overweight women were sufficient of vitamin D[25（OH）D≥50nmo/L],while 23.2%in the normalweight subjects.There was also a significant difference in the vitamin D status among the different seasons（P=0.001）.A high prevalence of severe deficiency of vitamin D was found in spring and winter.After adjusting for age and BMI,logistics regression analysis showed that the odds ratio of clinical pregnancy of IUI in women with serum 25（OH）D level50nmol/L was significantly lower than those with serum 25（OH）D≥50nmol/L（aOR=0.427,P=0.032）.Conclusions：Vitamin D deficiency is common in infertile women,especially in spring and winter prone to a serious lack of vitamin D.Vitamin D deficiency may have a detrimental effect on IUI outcome in infertile women.Appropriate vitamin D supplementation is warranted in infertile women.