Maltepe University, Faculty of Medicine, Department of Obstetrics and Gynecology, Istanbul, Turkey.
Eur J Obstet Gynecol Reprod Biol. 2011 Sep;158(1):24-7. doi: 10.1016/j.ejogrb.2011.04.002. Epub 2011 May 2.
To investigate the relationship between 25(OH) vitamin D3 levels and maternal bone turnover during pregnancy and lactation.
Thirty pregnant women and 30 healthy non-pregnant controls were included the study. The pregnant women were examined in the 12th, 25th and 32nd gestational weeks and 6 weeks after delivery. The controls were examined once. Serum concentrations of 25(OH) vitamin D3, parathyroid hormone (PTH), cross-linked C-terminal telopeptide of type I collagen (CTX), calcium, and phosphate were measured.
In the 32nd week and the postpartum period, 25(OH) vitamin D3 deficiency rates were 13.3% and 33.3%, respectively. Serum 25(OH) vitamin D3 levels were below the detection limit in 10% and 33%, respectively, of the same subjects. In the control group, rates of 25(OH) vitamin D3 deficiency and "below detection limit" were 30% and 23%, respectively. While 25(OH) vitamin D3 and CTX levels were not correlated to each other in the first trimester, a negative correlation was found in the 2nd and 3rd trimesters and the postpartum period between 25(OH) vitamin D3 and CTX levels (r=-0.472, p=0.048; r=-0.893, p<0.0001, r=-0.881, p<0.001, respectively). No correlation between 25(OH) vitamin D3 and CTX levels was found in controls.
We consider that 25(OH) vitamin D3 supplementation of women could both decrease maternal bone resorption and lead to enhanced bone mass in offspring during later life. Since women are prone to 25(OH) vitamin D3 insufficiency, we suggest higher doses of 25(OH) vitamin D3 should be given to pregnant subjects.
探讨妊娠和哺乳期 25(OH) 维生素 D3 水平与母体骨转换的关系。
本研究纳入了 30 名孕妇和 30 名健康未孕对照者。孕妇分别在妊娠第 12、25 和 32 周以及产后 6 周进行检查。对照组仅检查一次。检测血清 25(OH) 维生素 D3、甲状旁腺激素 (PTH)、I 型胶原交联 C 端肽 (CTX)、钙和磷的浓度。
在第 32 周和产后期间，25(OH) 维生素 D3 缺乏率分别为 13.3%和 33.3%。10%和 33%的相同受试者血清 25(OH) 维生素 D3 水平低于检测下限。对照组中，25(OH) 维生素 D3 缺乏和“低于检测下限”的发生率分别为 30%和 23%。在孕早期，25(OH) 维生素 D3 和 CTX 水平之间无相关性，但在孕中期和孕晚期以及产后期间，两者之间呈负相关(r=-0.472，p=0.048；r=-0.893，p<0.0001；r=-0.881，p<0.001)。在对照组中，25(OH) 维生素 D3 和 CTX 水平之间无相关性。
我们认为，女性补充 25(OH) 维生素 D3 既能降低母体骨吸收，又能在后代以后的生活中增加骨量。由于女性容易出现 25(OH) 维生素 D3 不足，我们建议给孕妇更高剂量的 25(OH) 维生素 D3。
