中晚期孕妇血清25-羟维生素D与骨代谢标志物水平及关系

Relationships of serum 25-hydroxyvitamin D levels with bone metabolism markers in the second and third trimester of pregnant women

目的探讨妊娠中晚期妇女25-羟维生素D[25(OH)D]与骨代谢标志物的水平及关系。方法采用电化学发光法检测孕中晚期(13~40周)1 090例孕妇和120例体检非妊娠健康妇女25(OH)D、N-端骨钙素(N-MID)、β-胶原特殊序列(β-CTX)。结果妊娠中晚期孕妇25(OH)D平均水平(11.23±5.82)ng/ml,其中25(OH)D水平缺乏、不足、正常分别为917例(84.13%)、152例(13.94%)和21例(1.93%)。冬春季孕妇25(OH)D水平(9.97±5.28)ng/ml低于夏秋季孕妇(12.24±5.77)ng/ml(P<0.05)。不同年龄组间孕妇血清25(OH)D、N-MID、β-CTX水平差异均有统计学意义(均P<0.05)。血清25(OH)D水平与N-MID指标无相关(r=-0.017,P>0.05),与β-CTX指标呈负相关(r=-0.090,P<0.05),N-MID与β-CTX间呈正相关(r=0.586,P<0.05)。结论妊娠中晚期妇女普遍存在维生素D缺乏现象,冬春季更易出现25(OH)D缺乏,不同年龄段孕妇25(OH)D与骨代谢标志物水平不同,25(OH)D水平与N-MID指标无相关,与β-CTX指标呈负相关,N-MID与β-CTX指标呈正相关性。

Objective To investigate the relationships of serum25-hydroxyvitamin D levels with bone metabolismmarkers in the second and third trimester of pregnancy women.Methods A total of 1090 pregnant women(13-40 weeks gestational age)and 120 healthy nulliparous were enrolled.The levels of serum 25(OH)D,N-MID,β-CTX were determined by electrochemical luminescence.Results The average serum 25(OH)D level was(11.23±5.82)ng/ml in the second and third trimester of pregnancy.There 917 cases(84.13%)with 25(OH)D deficiency,152 cases(13.94%)with insufficiency and 21 cases(1.93%)with sufficiency.The serum 25(OH)D level in winter and spring was lower than that in summer and autumn(9.97±5.28 ng/ml vs.12.24±5.77 ng/ml,P<0.05).There were significant differences in serum 25(OH)D,N-MID andβ-CTX levels among pregnant women in different age groups(P<0.05).The level of Vitamin D was not correlated with N-MID(r=-0.017,P>0.05),negatively correlated withβ-CTX(r=-0.090,P<0.05);and N-MID was positively correlated withβ-CTX(r=0.586,P<0.05).Conclusion Vitamin D deficiency is common during the second and third trimester of pregnant women,particularly in winter and spring seasons.The serum 25(OH)D and N-MID,β-CTX levels are different in pregnant women of different ages.The level of serum 25(OH)D shows no significant correlation with N-MID but negative correlation withβ-CTX.