Division of Endocrinology and Metabolism, Department of Internal Medicine, Fujita Health University, Toyoake, Aichi, Japan.
J Bone Miner Metab. 2011 Sep;29(5):615-20. doi: 10.1007/s00774-011-0264-x. Epub 2011 Mar 8.
Serum 25-hydroxyvitamin D (25-OHD) concentrations are thought to accurately reflect vitamin D stores, and vitamin D deficiency causes secondary hyperparathyroidism, irreversible bone loss, and increased risk of fracture. Recent studies suggest that decrease of serum 25-OHD level in mothers could increase the risk of preeclampsia, cesarean section, and craniotabes. Furthermore, this deficiency may affect bone mass and the incidence of neuromuscular diseases of their children in the future. In the present study, the serum concentration of 25-OHD in 93 pregnant women after the 30th week of their gestation was determined by direct radioimmunoassay. Mean 25-OHD levels in spring, summer, fall, and winter were 14.3 ± 5.1, 15.7 ± 6.4, 13.7 ± 5.1, and 13.9 ± 4.2 ng/ml, respectively. Severe vitamin D deficiency (25-OHD < 10 ng/ml) was found in 10 of these 93 women. Overall, hypovitaminosis D, which was defined as serum 25-OHD concentration equal to or less than 20 ng/ml, was revealed in 85 mothers (89.5%). Serum 25-OHD levels were not associated with either intact parathyroid hormone or corrected calcium concentrations, but were negatively associated with serum type I collagen N-terminal telopeptide and bone-specific alkaline phosphatase in these subjects. Mothers with threatened premature delivery had significantly lower 25-OHD levels (11.2 ± 3.2 ng/ml) than those in mothers with normal delivery (15.6 ± 5.1 ng/ml). In conclusion, the present data suggest a high prevalence of hypovitaminosis D in perinatal pregnant Japanese women throughout the year, which seems to affect bone metabolism and to be associated with threatened premature delivery.
血清 25-羟维生素 D(25-OHD)浓度被认为能准确反映维生素 D 储存情况,而维生素 D 缺乏会导致继发性甲状旁腺功能亢进、不可逆转的骨质流失和骨折风险增加。最近的研究表明,母亲血清 25-OHD 水平下降会增加先兆子痫、剖宫产和颅骨软化的风险。此外,这种缺乏可能会影响其子女未来的骨量和神经肌肉疾病的发生率。在本研究中,通过直接放射免疫法测定了 93 名妊娠 30 周后孕妇的血清 25-OHD 浓度。春季、夏季、秋季和冬季的平均 25-OHD 水平分别为 14.3±5.1、15.7±6.4、13.7±5.1 和 13.9±4.2ng/ml。在这 93 名孕妇中,有 10 名存在严重维生素 D 缺乏(25-OHD<10ng/ml)。总的来说,85 名母亲(89.5%)存在维生素 D 缺乏症,定义为血清 25-OHD 浓度等于或低于 20ng/ml。血清 25-OHD 水平与完整甲状旁腺激素或校正钙浓度无关,但与这些受试者的血清Ⅰ型胶原 N 端肽和骨特异性碱性磷酸酶呈负相关。有早产先兆的母亲的 25-OHD 水平明显低于正常分娩的母亲(11.2±3.2ng/ml 和 15.6±5.1ng/ml)。综上所述,目前的数据表明,日本围产期孕妇全年普遍存在维生素 D 缺乏症,这种缺乏似乎会影响骨代谢,并与早产先兆有关。