Pérez-López Faustino R
Department of Obstetrics and Gynecology, Zaragoza Gynecological Institute, Zaragoza, Spain.
Gynecol Endocrinol. 2007 Jan;23(1):13-24. doi: 10.1080/09513590601045629.
Vitamin D is a secosteroid with an endocrine mechanism of action which is sequentially synthesized in humans in the skin, liver and kidneys. The active hormone, 1alpha,25-dihydrocholecalciferol [1,25(OH)2D3], is often considered only in terms of its role in controlling calcium and phosphorus homeostasis. However, cumulative evidence points to the presence of vitamin D receptors in many tissues. The present article summarizes key points regarding the participation of vitamin D in pregnancy and breastfeeding. During pregnancy, sufficient vitamin D concentrations are needed not only to address the growing demand for calcium on the part of the fetus, but also to participate in fetal growth, development of the nervous system, lung maturation and fetal immune system function. Hypovitaminosis D has been related to the development of diabetes, pre-eclampsia and fetal neurological disorders. During pregnancy and lactation, calcium from the maternal skeleton is mobilized, with a rise in bone turnover and a reduction in bone mass. It is advisable for pregnant and nursing women to maintain adequate levels of vitamin D, through small doses of solar exposure to facilitate natural formation of the hormone or by ingesting appropriate vitamin supplements. Further studies are needed to clarify the many gaps in knowledge and elucidate the role of vitamin D in the context of reproduction. Confirmation of experimental observations relating to the risks of hypovitaminosis D would have important public health implications.
维生素D是一种具有内分泌作用机制的甾醇类化合物,在人体内依次在皮肤、肝脏和肾脏中合成。活性激素1α,25-二羟胆钙化醇[1,25(OH)2D3]通常仅被认为在控制钙和磷的体内平衡方面发挥作用。然而,越来越多的证据表明许多组织中都存在维生素D受体。本文总结了维生素D在妊娠和哺乳期的参与要点。在怀孕期间,不仅需要足够的维生素D浓度来满足胎儿对钙不断增长的需求,还需要其参与胎儿生长、神经系统发育、肺成熟和胎儿免疫系统功能。维生素D缺乏已与糖尿病、先兆子痫和胎儿神经系统疾病的发生有关。在妊娠和哺乳期,母体骨骼中的钙会被动员,骨转换增加,骨量减少。建议孕妇和哺乳期妇女通过小剂量晒太阳以促进激素的自然形成或摄入适当的维生素补充剂来维持足够的维生素D水平。需要进一步研究以澄清许多知识空白,并阐明维生素D在生殖方面的作用。证实与维生素D缺乏风险相关的实验观察结果将具有重要的公共卫生意义。