妊娠中晚期25-羟维生素D状况初步研究

The study of 25-hydroxyvitamin D status in the middle-late gestation of pregnancy

目的探讨孕妇孕中晚期的25-羟维生素D 25OHD水平状况及其与血钙、磷、甲状旁腺激素(PTH)、空腹血糖、空腹真胰岛素、血脂、血压、孕前BMI的相关关系。方法研究对象为2006～2008年在北京协和医院就诊的正常孕妇83名,于孕24～28周取血,检测25OHD、PTH、血钙、磷、血糖、真胰岛素和血脂水平,并测量血压,计算孕前BMI。统计分析维生素D水平正常、不足和缺乏的情况,及维生素D水平与上述指标的相关性。结果孕中晚期维生素D水平缺乏的占50.6%,维生素D不足占45.8%,维生素D正常占3.6%。维生素D水平与孕前BMI、收缩压呈负相关(相关系数分别为r=-0.295,P=0.007和r=-0.275、P=0.012)。结论孕中晚期维生素D水平不足或缺乏是普遍现象,孕期应注意补充维生素D治疗。

Objective To investigate the level of plasma 25- hydroxy vitamin D 25OHD and its association with blood pressure,pre-pregnancy BMI,the level of serum calcium,phosphorus,fast glucose,fast true insulin and lipids profiles in the middle-late gestation of pregnancy.Methods 83 pregnant women who had no complication were recruited at Peking Union Medical College Hospital between March 2006 and April 2008.Blood pressure was measured and prepregnancy body mass index(pre-BMI) was calculated.Serum 25OHD,calcium,phosphorus,glucose,lipids profiles and plasma parathyroid hormone(PTH),true insulin concentrations were measured at 24 to 28 weeks gestation.The number of maternal vitamin D deficiency,insufficiency and sufficiency was counted and pearson correlation analysis was used to test for univariate linear relationships between the serum 25OHD and other variables.Results In total 50.6%of women had vitamin D deficiency according to 25OHD concentrations <25nmol/L),45.8%were vitamin D insufficiency according to25OHD concentrations between 25 nmol/L and 50 nmol/L) and only 3.6%had normal vitamin D concentrations (250HD >50nmol/L).There was negative association between maternal 250HD level and pre-BMI and blood pressure. (r = - 0.295,P = 0.007 and r = - 0.275、P = 0.012,respectively).Conclusion Hypovitaminosis D at 24 to 28 weeks gestation is common in Chinese pregnant women and vitamin D supplementation,perhaps at higher doses than currently available,is needed to improve maternal vitamin D nutriture.