Harold Hamm Oklahoma Diabetes Center and Section of Endocrinology and Diabetes, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA.
Diabetes Care. 2011 Jun;34(6):1258-64. doi: 10.2337/dc10-2145. Epub 2011 Apr 15.
Increased oxidative stress and immune dysfunction are implicated in preeclampsia (PE) and may contribute to the two- to fourfold increase in PE prevalence among women with type 1 diabetes. Prospective measures of fat-soluble vitamins in diabetic pregnancy are therefore of interest.
Maternal serum carotenoids (α- and β-carotene, lycopene, and lutein) and vitamins A, D, and E (α- and γ-tocopherols) were measured at first (12.2 ± 1.9 weeks [mean ± SD], visit 1), second (21.6 ± 1.5 weeks, visit 2), and third (31.5 ± 1.7 weeks, visit 3) trimesters of pregnancy in 23 women with type 1 diabetes who subsequently developed PE (DM PE+) and 24 women with type 1 diabetes, matched for age, diabetes duration, HbA(1c), and parity, who did not develop PE (DM PE-). Data were analyzed without and with adjustment for baseline differences in BMI, HDL cholesterol, and prandial status.
In unadjusted analysis, in DM PE+ versus DM PE-, α-carotene and β-carotene were 45 and 53% lower, respectively, at visit 3 (P < 0.05), before PE onset. In adjusted analyses, the difference in β-carotene at visit 3 remained significant. Most participants were vitamin D deficient (<20 ng/mL), and vitamin D levels were lower in DM PE+ versus DM PE- throughout the pregnancy, although this did not reach statistical significance.
In pregnant women with type 1 diabetes, low serum α- and β-carotene were associated with subsequent development of PE, and vitamin D deficiency may also be implicated.
氧化应激和免疫功能障碍增加与先兆子痫（PE）有关，并且可能导致患有 1 型糖尿病的女性中 PE 的发病率增加两到四倍。因此，对糖尿病妊娠中脂溶性维生素的前瞻性测量很有意义。
在 23 名患有 1 型糖尿病的女性中，在妊娠的第一（12.2 ± 1.9 周，第 1 次就诊）、第二（21.6 ± 1.5 周，第 2 次就诊）和第三（31.5 ± 1.7 周，第 3 次就诊）期间测量了血清类胡萝卜素（α-和 β-胡萝卜素、番茄红素和叶黄素）以及维生素 A、D 和 E（α-和 γ-生育酚）。这些女性随后发展为 PE（DM PE+），并与 24 名患有 1 型糖尿病、年龄、糖尿病病程、HbA1c 和产次相匹配但未发展为 PE（DM PE-）的女性进行了匹配。数据分析是在不调整和调整基线 BMI、HDL 胆固醇和餐后状态差异的情况下进行的。
在未调整分析中，在 DM PE+与 DM PE-相比，在 PE 发病前的第 3 次就诊时，α-胡萝卜素和 β-胡萝卜素分别低 45%和 53%（P < 0.05）。在调整分析中，第 3 次就诊时β-胡萝卜素的差异仍然显著。大多数参与者维生素 D 缺乏（<20ng/mL），并且 DM PE+与 DM PE-整个孕期的维生素 D 水平较低，尽管这没有达到统计学意义。
在患有 1 型糖尿病的孕妇中，血清 α-和 β-胡萝卜素水平较低与随后发生的 PE 有关，维生素 D 缺乏也可能与此有关。
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