江苏省部分孕妇血清维生素D水平分析

A study on concentration of 25-hydroxyvitamin D of pregnant women from Jiangsu province

目的:分析江苏省部分孕期妇女不同季节血清维生素D水平,了解其维生素D营养状况。方法:于2013年1月—2015年12月间在江苏省8个地区不同医院的围产营养门诊采集18 478名健康孕妇的空腹血样,采用液相色谱-串联质谱(LC-MS/MS)法测量血清25-羟基维生素D3[25(OH)D3]和25-羟基维生素D2[25(OH)D2]的浓度。25(OH)D2和25(OH)D3总和为25-羟基维生素D[25(OH)D],以25(OH)D为体内维生素D水平的指标进行统计分析。结果:全部18 478名孕妇的血清25(OH)D浓度平均为(19.2±9.4)ng/mL,维生素D缺乏率[25(OH)D<20 ng/mL]为59.7%,严重缺乏率[25(OH)D<12 ng/mL]为24.9%,充足率[25(OH)D>30 ng/mL]为13.7%。2013、2014、2015年孕妇的平均血清25(OH)D浓度分别为(17.3±8.5)、(18.2±9.0)、(20.5±9.7)ng/mL,其维生素D缺乏率分别为69.4%、63.6%、54.4%。不同年份孕妇25(OH)D水平的差异具有统计学意义(P<0.01)。江苏省苏南、苏中、苏北地区的孕妇血清25(OH)D浓度平均分别为(19.2±9.5)、(19.6±9.0)、(18.4±8.7)ng/mL,维生素D缺乏率分别为60.0%、57.9%、62.8%,不同地区间孕妇25(OH)D水平的差异具有统计学意义(P<0.01)。孕妇血清25(OH)D浓度与年龄呈正相关(r=0.8,P<0.01)。孕妇维生素D的水平与检测血清25(OH)D浓度的季节有关,夏秋季高于春冬季,其血清25(OH)D浓度依次为(22.7±9.2)、(22.2±9.3)、(15.3±7.3)、(12.3±6.4)ng/mL。结论:孕妇维生素D缺乏率高,应加强对孕妇维生素D水平的监测,及时指导维生素D缺乏的孕妇合理补充维生素D。

Objective ：To evaluate the vitamin D status of pregnant women in different seasons from Jiangsu Province. Methods：A total of 18,478 healthy pregnant women were recruited from hospitals located in 8 areas from Jiangsu Province during January 2013 to December 2015 ,and fast blood samples were collected from all the subjects. Serum 25-hydroxyvitamin D3125（OH）D3] and 25-hy- droxyvitamin D2125（OH）D2] concentrations were measured by liquid chromatography tandem mass spectrometry （LC-MS/MS）. The in- formation on characteristics of the pregnant women was collected by questionnaires. The serum concentration of 25-hydroxyvitamin D [25（OH）DI was the total concentration of 25（OH）D3 and 25（OH）D2. Results：The average serum concentration of 25（OH）D was （19.2± 9.4） ng/mL among all the subjects. The rate of vitamin D deficiency [25（OH）D〈20ng/mL] in the subjects was 59.7% ,the rate of seri- ous vitamin D deficiency [25（OH）D〈12ng/mLl was 24.9%,and the rate of adequacy[25（OH）D〉30ng/mL] was 13.7%. The average serum concentration of 25（OH）D was （17.3±8.5） ng/mL,（18.2±9.0）ng/mL,and （20.5±9.7）ng/mL in the year of 2013,2014,and 2015, respectively, and similarly the vitamin D deficiency rate was 69.4% ,63.6% ,and 54.4% ,respectively in 2013,2014, and 2015. There were significant differences in the levels of serum 25 （OH）D among the subjects in different years （P〈0.01）. The average serum con- centration of 25 （OH）D was （19.2±9.5） ng/mL, （19.6±9.0） ng/mL,and （18.4±8.7） ng/mL in the southern,middle and northern part of Jiangsu Province, respectively, and the corresponding rate of vitamin D deficiency was 60.0%, 57.9%, and 62.8% ,respectively. There were significant differences in the serum concentrations of 25（OH）D among the subjects from the three regions （P〈0.01）. The serum concentrations of 25（OH）D were positively correlated with ages of the subjects （r=0.8,P〈0.01）. Seasonal difference was found in the serum concentrations of 25（OH）D. The average serum concentration of 25（OH）D in summer and autumn was higher than that in spring and winter,and the average serum concentration of 25（OH）D was （22.7±9.2） ng/mL, （22.2±9.3） ng/mL, （15.3±7.3） ng/mL,and （12.3± 6.4） ng/mL in summer, autumn, spring,winter,respectively. Conehlsion：h is vital for obstetrician to monitor the maternal vitamin D levels and guide the pregnant women with vitamin D deficiency to take vitamin D supplements timely.