Katre Prachi, Bhat Dattatray, Lubree Himangi, Otiv Suhas, Joshi Suyog, Joglekar Charudatta, Rush Elaine, Yajnik Chittaranjan
Kamalnayan Bajaj Diabetology Research Centre, King Edward Memorial Hospital Research Centre, Pune, India.
Asia Pac J Clin Nutr. 2010;19(3):335-43.
Maternal vitamin B12 deficiency and hyperhomocysteinemia predict poor pregnancy outcome, foetal adiposity and insulin resistance. In India amongst practicing clinicians and policy makers there is little appreciation of widespread vitamin B12 deficiency. We investigated 163 (86 rural, 77 urban) pregnant women attending antenatal clinics in a rural health centre and a referral hospital in the city of Pune, at 17, 28, and 34 weeks gestation for vitamin supplements, and circulating concentrations of vitamin B12, folate, and total homocysteine. At enrolment 80% rural and 65% urban women had low vitamin B12 but only two rural women had low folate concentrations. During pregnancy 85% rural and 95% of urban women received folic acid; 12% rural and 84% urban women also received vitamin B12. In women receiving no supplementation (n=17) plasma vitamin B12 and folate did not change from 17 to 34 weeks gestation, but homocysteine increased (p<0.05). Homocysteine concentrations at 34 weeks gestation in women receiving only folic acid (n=71, mean 8.4 (95% CI 7.8, 9.1) micromol/L) were comparable to the unsupplemented group (9.7 (7.3, 12.7), p=0.15), but women who received a total dose of >1000 microg of vitamin B12 up to 34 weeks (n=42, all with folic acid) had lower concentrations (6.7 (6.0, 7.4), p<0.001). Increasing dose of vitamin B12 (rs=-0.31, p=0.006) but not folic acid (rs=-0.19, p=0.11) was associated with lower plasma total homocysteine concentration. In vitamin B12 insufficient, folate replete pregnant women, vitamin B12 supplementation is associated with a reduction of plasma total homocysteine concentration in late pregnancy.
孕妇维生素B12缺乏和高同型半胱氨酸血症预示着不良妊娠结局、胎儿肥胖和胰岛素抵抗。在印度，执业临床医生和政策制定者对普遍存在的维生素B12缺乏认识不足。我们调查了163名（86名农村、77名城市）在农村健康中心和浦那市一家转诊医院的产前诊所就诊的孕妇，在妊娠17、28和34周时检测她们的维生素补充情况、维生素B12、叶酸和总同型半胱氨酸的循环浓度。入组时，80%的农村妇女和65%的城市妇女维生素B12水平较低，但只有两名农村妇女叶酸浓度较低。在孕期，85%的农村妇女和95%的城市妇女服用了叶酸；12%的农村妇女和84%的城市妇女还服用了维生素B12。在未补充维生素的妇女（n = 17）中，血浆维生素B12和叶酸从妊娠17周到34周没有变化，但同型半胱氨酸升高（p<0.05）。仅服用叶酸的妇女（n = 71，平均8.4（95%CI 7.8，）微摩尔/升）在妊娠34周时的同型半胱氨酸浓度与未补充组（9.7（7.3，12.7），p = 0.15）相当，但在妊娠34周前接受总量>1000微克维生素B12的妇女（n = 42，均同时服用叶酸）同型半胱氨酸浓度较低（6.7（6.0，7.4），p<0.001）。维生素B12剂量增加（rs = -0.31，p = 0.006）但叶酸剂量增加（rs = -0.19，p = 0.11）与血浆总同型半胱氨酸浓度降低相关。在维生素B12不足但叶酸充足的孕妇中，补充维生素B12与妊娠晚期血浆总同型半胱氨酸浓度降低有关。 9.1）
（原文中“95%CI 7.8，”这里括号不完整，翻译时保留了原文格式）
