Morales E, Rodriguez A, Valvi D, Iñiguez C, Esplugues A, Vioque J, Marina L S, Jiménez A, Espada M, Dehli C R, Fernández-Somoano A, Vrijheid M, Sunyer J
1] Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Catalonia, Spain [2] Hospital del Mar Medical Research Institute (IMIM), Barcelona, Catalonia, Spain [3] Universitat Pompeu Fabra (UPF), Barcelona, Catalonia, Spain [4] CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
1] Hospital de Sabadell, Corporació Sanitària Parc Taulí, Institut Universitari ParcTaulí-UAB, Sabadell, Catalonia, Spain [2] Universitat Autònoma de Barcelona, Campus d'Excelència Internacional Bellaterra, Barcelona, Catalonia, Spain.
Int J Obes (Lond). 2015 Jan;39(1):61-8. doi: 10.1038/ijo.2014.165. Epub 2014 Sep 5.
Maternal vitamin D status during fetal development may influence offspring growth and risk of obesity; however, evidence in humans is limited.
To investigate whether maternal circulating 25-hydroxyvitamin D3 (25(OH)D3) concentration in pregnancy is associated with offspring prenatal and postnatal growth and overweight.
Plasma 25(OH)D3 concentration was measured in pregnant women (median weeks of gestation 14.0, range 13.0-15.0) from the INMA (INfancia y Medio Ambiente) cohort (Spain, 2003-2008) (n = 2358). Offspring femur length (FL), biparietal diameter (BPD), abdominal circumference (AC) and estimated fetal weight (EFW) were evaluated at 12, 20 and 34 weeks of gestation by ultrasound examinations. Fetal overweight was defined either as AC or as EFW ⩾ 90th percentile. Child's anthropometry was recorded at ages 1 and 4 years. Rapid growth was defined as a weight gain z-score of >0.67 from birth to ages 6 months and 1 year. Age- and sex-specific z-scores for body mass index (BMI) were calculated at ages 1 and 4 years (World Health Organization referent); infant's overweight was defined as a BMI z-score ⩾ 85th percentile.
We found no association of maternal 25(OH)D3 concentration with FL and a weak inverse association with BPD at 34 weeks. Maternal deficit of 25(OH)D3 (<20 ng ml(-1)) was associated with increased risk of fetal overweight defined as AC ⩾ 90th percentile (odds ratio (OR) = 1.50, 95% confidence interval (CI): 1.01-2.21; P = 0.041) or either as EFW ⩾ 90th percentile (OR = 1.47, 95% CI: 1.00-2.16; P = 0.046). No significant associations were found with rapid growth. Deficit of 25(OH)D3 in pregnancy was associated with an increased risk of overweight in offspring at age 1 year (OR = 1.42, 95% CI: 1.02-1.97; P = 0.039); however, the association was attenuated at age 4 years (OR = 1.19, 95% CI: 0.83-1.72; P = 0.341).
Vitamin D deficiency in pregnancy may increase the risk of prenatal and early postnatal overweight in offspring. Clinical trials are warranted to determine the role of vitamin D in the early origins of obesity.
胎儿发育期间母体维生素D状态可能影响后代生长及肥胖风险；然而，人类相关证据有限。
探讨孕期母体循环中25-羟基维生素D3（25(OH)D3）浓度是否与后代产前及产后生长和超重相关。
对来自INMA（婴儿与环境）队列研究（西班牙，2003 - 2008年）的孕妇（妊娠周数中位数为14.0，范围13.0 - 15.0）（n = 2358）测定血浆25(OH)D3浓度。在妊娠12、20和34周时通过超声检查评估后代的股骨长度（FL）、双顶径（BPD）、腹围（AC）和估计胎儿体重（EFW）。胎儿超重定义为AC或EFW⩾第90百分位数。记录1岁和4岁儿童的人体测量数据。快速生长定义为从出生到6个月和1岁时体重增加z评分>0.67。在1岁和4岁时计算年龄和性别特异性的体重指数（BMI）z评分（世界卫生组织参考标准）；婴儿超重定义为BMI z评分⩾第85百分位数。
我们发现母体25(OH)D3浓度与34周时的FL无关联，与BPD呈弱负相关。母体25(OH)D3缺乏（<20 ng/ml）与定义为AC⩾第90百分位数（比值比（OR）= 1.50，95%置信区间（CI）：1.01 - 2.21；P = 0.041）或EFW⩾第90百分位数（OR = 1.47，95% CI：1.00 - 2.16；P = 0.046）的胎儿超重风险增加相关。未发现与快速生长有显著关联。孕期25(OH)D3缺乏与1岁后代超重风险增加相关（OR = 1.42，95% CI：1.02 - 1.97；P = 0.039）；然而，在4岁时该关联减弱（OR = 1.19，95% CI：0.83 - 1.72；P = 0.341）。
孕期维生素D缺乏可能增加后代产前及出生后早期超重的风险。有必要进行临床试验以确定维生素D在肥胖早期起源中的作用。
