母孕期和婴儿早期钙剂补充对婴儿BMI及肠道菌群的影响

Effects of calcium supplementation during the pregnancy and early infancy stage on the body mass index and gut microbiota in the infants

目的探讨母孕期和婴儿早期钙剂补充对婴儿BMI及肠道菌群的影响.方法于2016年5至10月选取北京市两个区妇幼保健院建档的1752名健康孕产妇及其婴儿（母乳喂养）为研究对象.通过问卷调查收集母孕期及婴儿早期钙剂和维生素D补充状况;记录婴儿出生及6月龄身长及体重,并计算BMI值;采用随机数字表法每组随机抽取40名婴儿进行肠道菌群分析（若不足40名则全部纳入,其中母孕期及婴儿早期均单补钙剂组23名;母孕期未补充钙剂-婴儿早期单补钙剂组6名）.进而比较母孕期和婴儿早期不同钙剂补充对婴儿出生及6月龄BMI值及肠道菌群构成的影响.结果母孕期钙剂补充组（1323名）婴儿出生及6月龄时BMI值[（13.51±0.47）、（17.91±0.23）kg/m^2]均高于未补充钙剂组[429名,（12.76±1.23）、（17.68±0.76）kg/m^2]（P〈0.05）.在母孕期补充钙剂前提下,婴儿早期单补钙剂组6月龄时BMI[（18.63±0.52）kg/m^2]、BMI增量[（5.71±0.54）kg/m^2]及乳杆菌属构成比（21.04％±3.68％）均高于婴儿早期单补维生素D组[（17.69±0.89）kg/m^2、（4.17±1.01）kg/m^2、12.28％±3.86％]（P〈0.05）;而在母孕期未补充钙剂前提下,婴儿早期单补钙剂组6月龄时乳杆菌属构成比（20.15％±4.87％）也高于婴儿早期单补维生素D组（14.64％±3.71％）（P〈0.05）.结论母孕期适量钙摄入有利于胎儿生长发育;而婴儿早期钙剂补充可引起BMI增加过快,并促进肠道乳杆菌属生长.

Objective To investigate the effects of calcium supplementation during the pregnancy and early infancy stage on body mass index （BMI） and gut microbiota in the infants. Methods A total of 1752 healthy pregnant women and their infants （breast feeding） in two maternal and child health care hospitals of Beijing were chosen as the subjects in this study from May to October 2016. Questionnaires were used to obtain the general information and supplementation of calcium and vitamin D in mothers and their infants. The body length and weight of infants at birth and 6 months were recorded to calculate the BMI. The random number table method was used to randomly select 40 infants from each group for gut microbiota analysis （If less than 40 infants were all included in this study, 23 infants in the pregnancy and early infancy would be all treated with calcium supplements. There were 6 infants who was not added calcium during the pregnancy but added in the early infancy）. Then it was compared that the effects of calcium supplementation during the pregnancy and early infancy on the BMI and gut microbiota composition of infants were determined at birth and 6 months. Results Compared to the group with no calcium supplementation during the pregnancy （ （12.76±1.23）, （17.68±0.76）kg/m^2）, the BMI of infants at birth and 6 months in the group with calcium supplementation during the pregnancy （ （13.51±0.47）, （17.91±0.23）kg/m^2） were significantly higher（P〈0.05）. In the group with maternal calcium supplementation, the BMI at 6 months （ （18.63 ± 0.52）kg/m^2）, BMI increment （ （5.71 ± 0.54）kg/m^2） and the content of lactobacillus （21.04%± 3.68%） in the only calcium supplementation subgroup in the early infancy were higher than those in only vitamin D supplementation subgroup （（17.69 ± 0.89） kg/m^2, （4.17 ± 1.01） kg/m^2 and 12.28%± 3.86%） （P〈0.05）. In the group without maternal calcium supplementation, the content of lactobacillus （20.15%± 4.87%） in the only calcium supplementation subgroup were also higher than those in only vitamin D supplementation subgroup （14.64%± 3.71%） （P〈0.05）. Conclusion Appropriate calcium supplementation during the pregnancy is good for the growth and development of the fetus. Calcium supplementation in the early infancy could increase the BMI of infants, and promote the growth of intestinal lactobacillus.