影响孕期25羟基维生素D_3血药浓度的相关因素
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摘要
目的了解检测妊娠期25羟基维生素D_3血药浓度,并分析其影响因素。方法选取进行产前保健的孕妇1 756例,采用免疫层析法检测血清25羟基维生素D_3水平,将其结果按照年龄、季节和孕期分组。结果 1 756例孕妇的25羟基维生素D_3水平均较低,平均水平为44.763±17.076nmol·L~(-1)。高龄组孕妇25(OH)VD_3平均水平(43.812±17.080nmol·L~(-1))低于低龄组(45.715±17.072nmol·L~(-1)),但2组间差异无统计学意义(P>0.05);不同季节孕妇的25羟基维生素D_3平均水平不同,秋季25羟基维生素D_3平均水平最高,与其他3个季节比较差异有统计学意义(P<0.01):春季(3~5月)45.632±22.828nmol·L~(-1),夏季(6~8月):44.443±15.986nmol·L~(-1),秋季(9~11月):51.264±9.499nmol·L~(-1),冬季(12~2月):44.806±17.453nmol·L~(-1);不同孕期25羟基维生素D_3平均水平不同,孕中期低于孕早期(P<0.01),孕早期:41.870±12.883nmol·L~(-1),孕中期:44.848±18.641nmol·L~(-1)。结论妊娠期血清25羟基维生素D_3水平处于缺乏状态,年龄、季节及孕周均可影响25羟基维生素D_3水平,高龄孕妇、夏冬季节以及孕中期更易出现缺乏的现象。因此,应注意各种高危因素,结合25羟基维生素D_3浓度,及时足量补充25羟基维生素D_3,预防并发症的发生。
Objective To investigate the serum concentration of 25 hydroxyl vitamin D_3 in pregnancy and to analyze its influencing factors.Methods1 756 pregnant women were selected for prenatal care,and the serum 25 hydroxyl vitamin D_3 was detected by immuno-chromatography,and the results were grouped by age,season and pregnancy.Results The level of 25 hydroxyl vitamin D_3 was lower in 1 756 pregnant women,with an average of 44.763±17.076 nmol·L~(-1).The average level of 25 hydroxyl vitamin D_3 in the elderly group(43.812±17.080 nmol·L~(-1))was lower than the low age group(45.715±17.072 nmol·L~(-1)),but there was no significant difference between the 2 groups(P>0.05).For different season average level of 25 hydroxyl vitamin D_3,25 hydroxyl vitamin D_3 in autumn was the highest,higher than the other 3 seasons obviously(P<0.01):spring(3-5 month)45.632±22.828 nmol·L~(-1),summer(6-8 months):44.443±15.986 nmol·L~(-1),autumn(9-11 month):51.264±9.499 nmol·L~(-1),winter(12-2 months):44.806±17.453 nmol·L~(-1);the average level of 25 hydroxyl vitamin D_3 during pregnancy was different,lower than the early stage of pregnancy(P<0.01),and the early gestational age:41.870±12.883 nmol·L~(-1),the middle gestational age:44.848±18.641 nmol·L~(-1).Conclusion The serum 25 hydroxyl vitamin D_3 levels in pregnancy were in a state of deficiency,with age,season and gestational week affecting 25 hydroxyl vitamin D_3 levels,which are more likely to be lacking in elderly women,summer and winter seasons,and mid-pregnancy.Therefore,attention should be paid to all kinds of risk factors,combined with 25 hydroxyl vitamin D_3 concentration,to replenish 25 hydroxyl vitamin D_3 in time to prevent complications.
Objective To investigate the serum concentration of 25 hydroxyl vitamin D_3 in pregnancy and to analyze its influencing factors.Methods1 756 pregnant women were selected for prenatal care,and the serum 25 hydroxyl vitamin D_3 was detected by immuno-chromatography,and the results were grouped by age,season and pregnancy.Results The level of 25 hydroxyl vitamin D_3 was lower in 1 756 pregnant women,with an average of 44.763±17.076 nmol·L~(-1).The average level of 25 hydroxyl vitamin D_3 in the elderly group(43.812±17.080 nmol·L~(-1))was lower than the low age group(45.715±17.072 nmol·L~(-1)),but there was no significant difference between the 2 groups(P>0.05).For different season average level of 25 hydroxyl vitamin D_3,25 hydroxyl vitamin D_3 in autumn was the highest,higher than the other 3 seasons obviously(P<0.01):spring(3-5 month)45.632±22.828 nmol·L~(-1),summer(6-8 months):44.443±15.986 nmol·L~(-1),autumn(9-11 month):51.264±9.499 nmol·L~(-1),winter(12-2 months):44.806±17.453 nmol·L~(-1);the average level of 25 hydroxyl vitamin D_3 during pregnancy was different,lower than the early stage of pregnancy(P<0.01),and the early gestational age:41.870±12.883 nmol·L~(-1),the middle gestational age:44.848±18.641 nmol·L~(-1).Conclusion The serum 25 hydroxyl vitamin D_3 levels in pregnancy were in a state of deficiency,with age,season and gestational week affecting 25 hydroxyl vitamin D_3 levels,which are more likely to be lacking in elderly women,summer and winter seasons,and mid-pregnancy.Therefore,attention should be paid to all kinds of risk factors,combined with 25 hydroxyl vitamin D_3 concentration,to replenish 25 hydroxyl vitamin D_3 in time to prevent complications.
引文
[1]De Paula F J,Rosen C J.Vitamin D safety and requirements[J].Arch Biophys,2012,523(1):64-72.
[2]张辉,李幼玲,陈连元,等.婴幼儿佝偻病血清诊断指标探讨[J].中国实用儿科杂志,1998,13(1):54-55.
[3]Holick M F.Sunlight and vitamin D for bone health and prevention of autoimmune diseases,cancers,and cardiovascular diseases[J].Am J Clin Nutr,2004,80(Suppl):1678S-1688S.
[4]Ruwanpathirana T,Reid C M,Owen A J,et al.Assessment of vitamin D and its association with cardiovascular diseases risk factors in an adult migrant population:an audit of patient records at a Community Health Centre in Kensington,Mellourne,Australia[J].BMC Cardiovasc Disord,2014,14:157.
[5]Manson J E,Bassuk S S,LEE I M,et al.The vitamin D and OmkegA-3TriaL(VITAL):rationale and deaign of a large randomized controlled trial of vitamin D and marine omega-3fatty acid supplements for the primary prevention of cancer and cardiovascular disease[J].Contemp Clin Trials,2012,33(1):159-171.
[6]Truretagoyena M,Hirigoyen D,Naves R,et al.Immune response modulation by vitamin D:role in systemic lupus erythematosus[J].Fornt Immun,2015,(6):513-519.
[7]聂敏,王鸥,张葵,等.妊娠中晚期25-羟基羟维生素D状况初步研究[J].中华骨质疏松和骨矿盐疾病杂志,2009,2(2):83-87.
[8]吴梓梁.小儿内科学:下册[M].郑州:郑州大学出版社,2003:1411-1427.
[9]Cosman F,Beur S J,LeBoff M S,et al.Clinician′s guide to prevention and treatment of osteoporosis[J].Osteoporos Int,2014,(25):2359-2381.
[10]Holick M F,Chen T C.Vitamin D deficiency:a worldwide problem with health consequences[J].Am J Clin Nutr,2008,87(Suppl):1080S-1086S.
[11]Holick M F,Binkly N C,Bischoff-Ferrari H A,et al.Evaluation,treatment,and prevention of vitamin D deficiency:an endocrine society clinical practice guideline[J].J Clin Endocrinol Metab,2011,96(7):1911-1930.
[12]彭评志,蒙光义,庞家莲,等.基于门急诊处方分析和评价儿童患者超说明书用药情况[J].西北药学杂志,2016,31(5):539-543.
[13]Garland C F,Garland F C,Gorham E D,et al.The role of vitamin D in cancer prevention[J].Am J Public Health,2006,96(2):252-261.
[14]Johnson D D,Wagner C L,Hulsey T C,et al.Vitamin D deficiency and insufficiency is common during pregnancy[J].Am J Perinatol,2011,28(1):7-12.
[15]Song S J,Si S,Liu J,et al.Vitamin D status in Chinese pregangt women and their mewborns in Beijing and their relationships to birth size[J].Public Health Nutr,2012,16(4):687-692.
[16]Tao M,Shao H,Gu J,et al.Vitamin D status of pregants women in Shanghai,China[J].J Matern Fetal Neonatal Med,2012,25(3):237-239.
[17]Baker A M,Haeri S,Camargo C A,et al.A nested casecontrol study of midgestation vitamin D deficiency and risk of severe preeclampsia[J].J Clin Endocrinol Metab,2010,95(11):5105-5109.
[18]Maghbooli Z,Hossein-Nezhad A,Karimi F,et al.Correlation between vitamin D3deficiency and insulin resistance in pregnancy[J].Diabetes Metab Res Rev,2008,24(1):27-32.
[19]Christesen H T,Falkenberg T,Lamont R F,et al.The impact vitamin D on pregnancy:a systematic review[J].Acta Obstet Gynecol Scand,2012,91(12):1357-1367.
[20]Luxwolda M F,Kuipers R S,Kema I P,et al.Traditionally living populations in East Africa have a mean serum25-hydroxy vitamin D contration of 115nmol·L-1[J].Br J Nutr,2012,108(9):1557-1561.
[21]Leffelaar E R,Virjkotte T G,van Eijsden M.Maternal early pregnancy vitamin D status in relation to fetal and neonatal growth:results of the multi-ethnic Amsterdam Born Children and their development cohort[J].Br J Nutr,2010,104(1):108-117.
[22]Miyake Y,Sasaki S,Tanaka K,et al.Dairy food,calcium and vitamin D intake in pregnancy,and wheeze and eczema in infants[J].Eur Respir J,2010,35(6):1228-1234.
[2]张辉,李幼玲,陈连元,等.婴幼儿佝偻病血清诊断指标探讨[J].中国实用儿科杂志,1998,13(1):54-55.
[3]Holick M F.Sunlight and vitamin D for bone health and prevention of autoimmune diseases,cancers,and cardiovascular diseases[J].Am J Clin Nutr,2004,80(Suppl):1678S-1688S.
[4]Ruwanpathirana T,Reid C M,Owen A J,et al.Assessment of vitamin D and its association with cardiovascular diseases risk factors in an adult migrant population:an audit of patient records at a Community Health Centre in Kensington,Mellourne,Australia[J].BMC Cardiovasc Disord,2014,14:157.
[5]Manson J E,Bassuk S S,LEE I M,et al.The vitamin D and OmkegA-3TriaL(VITAL):rationale and deaign of a large randomized controlled trial of vitamin D and marine omega-3fatty acid supplements for the primary prevention of cancer and cardiovascular disease[J].Contemp Clin Trials,2012,33(1):159-171.
[6]Truretagoyena M,Hirigoyen D,Naves R,et al.Immune response modulation by vitamin D:role in systemic lupus erythematosus[J].Fornt Immun,2015,(6):513-519.
[7]聂敏,王鸥,张葵,等.妊娠中晚期25-羟基羟维生素D状况初步研究[J].中华骨质疏松和骨矿盐疾病杂志,2009,2(2):83-87.
[8]吴梓梁.小儿内科学:下册[M].郑州:郑州大学出版社,2003:1411-1427.
[9]Cosman F,Beur S J,LeBoff M S,et al.Clinician′s guide to prevention and treatment of osteoporosis[J].Osteoporos Int,2014,(25):2359-2381.
[10]Holick M F,Chen T C.Vitamin D deficiency:a worldwide problem with health consequences[J].Am J Clin Nutr,2008,87(Suppl):1080S-1086S.
[11]Holick M F,Binkly N C,Bischoff-Ferrari H A,et al.Evaluation,treatment,and prevention of vitamin D deficiency:an endocrine society clinical practice guideline[J].J Clin Endocrinol Metab,2011,96(7):1911-1930.
[12]彭评志,蒙光义,庞家莲,等.基于门急诊处方分析和评价儿童患者超说明书用药情况[J].西北药学杂志,2016,31(5):539-543.
[13]Garland C F,Garland F C,Gorham E D,et al.The role of vitamin D in cancer prevention[J].Am J Public Health,2006,96(2):252-261.
[14]Johnson D D,Wagner C L,Hulsey T C,et al.Vitamin D deficiency and insufficiency is common during pregnancy[J].Am J Perinatol,2011,28(1):7-12.
[15]Song S J,Si S,Liu J,et al.Vitamin D status in Chinese pregangt women and their mewborns in Beijing and their relationships to birth size[J].Public Health Nutr,2012,16(4):687-692.
[16]Tao M,Shao H,Gu J,et al.Vitamin D status of pregants women in Shanghai,China[J].J Matern Fetal Neonatal Med,2012,25(3):237-239.
[17]Baker A M,Haeri S,Camargo C A,et al.A nested casecontrol study of midgestation vitamin D deficiency and risk of severe preeclampsia[J].J Clin Endocrinol Metab,2010,95(11):5105-5109.
[18]Maghbooli Z,Hossein-Nezhad A,Karimi F,et al.Correlation between vitamin D3deficiency and insulin resistance in pregnancy[J].Diabetes Metab Res Rev,2008,24(1):27-32.
[19]Christesen H T,Falkenberg T,Lamont R F,et al.The impact vitamin D on pregnancy:a systematic review[J].Acta Obstet Gynecol Scand,2012,91(12):1357-1367.
[20]Luxwolda M F,Kuipers R S,Kema I P,et al.Traditionally living populations in East Africa have a mean serum25-hydroxy vitamin D contration of 115nmol·L-1[J].Br J Nutr,2012,108(9):1557-1561.
[21]Leffelaar E R,Virjkotte T G,van Eijsden M.Maternal early pregnancy vitamin D status in relation to fetal and neonatal growth:results of the multi-ethnic Amsterdam Born Children and their development cohort[J].Br J Nutr,2010,104(1):108-117.
[22]Miyake Y,Sasaki S,Tanaka K,et al.Dairy food,calcium and vitamin D intake in pregnancy,and wheeze and eczema in infants[J].Eur Respir J,2010,35(6):1228-1234.