Petersen Sesilje Bondo, Olsen Sjurdur Frodi, Mølgaard Christian, Granström Charlotta, Cohen Arieh, Vestergaard Peter, Strøm Marin
Centre for Fetal Programming, Dept. of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark.
Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark.
PLoS One. 2014 Dec 4;9(12):e114334. doi: 10.1371/journal.pone.0114334. eCollection 2014.
Studies investigating the association between maternal vitamin D status and offspring bone mass measured by dual-energy X-ray absorptiometry (DXA) during childhood have shown conflicting results.
We used occurrence of bone fractures up to the age of 18 as a measure reflecting offspring bone mass and related that to maternal vitamin D status.
The Danish Fetal Origins 1988 Cohort recruited 965 pregnant women during 1988-89 at their 30th gestation week antenatal midwife visit. A blood sample was drawn and serum was stored, which later was analyzed for the concentration of 25-hydroxyvitamin D (25(OH)D) by the liquid chromatography coupled with a tandem mass spectrometric method (LC-MS/MS). Outcome was diagnosis of first time bone fractures extracted from the Danish National Patient Register.
Vitamin D status was available for 850 women. The median (5th-95th percentile) 25(OH)D was 76.2 (23.0-152.1) nmol/l. During follow up 294 children were registered with at least one bone fracture diagnosis. Multivariable Cox regression models using age as the underlying time scale indicated no overall association between maternal vitamin D status and first time bone fractures. However, there was a significantly increased hazard ratio (HR) during childhood for those who had maternal blood drawn in Dec/Jan/Feb compared with Jun/Jul/Aug (HR: 1.75, 95%CI: 1.11-2.74). Adjustment for vitamin D status strengthened this association (1.82, 1.12-2.97), which indicated a potential seasonal impact on offspring fractures independent of maternal vitamin D status. In a sensitivity analysis we found a borderline significant inverse association between continuous concentrations of 25(OH)D and offspring forearm fractures (P = 0.054).
Overall, our results did not substantiate an association between maternal vitamin D status and offspring bone fractures. Further studies on this subject are needed, but the study populations must be large enough to allow for subdivision of fractures.
关于孕期母亲维生素D状态与儿童期通过双能X线吸收法（DXA）测量的后代骨量之间关联的研究结果相互矛盾。
我们将18岁前发生的骨折作为反映后代骨量的指标，并将其与母亲的维生素D状态相关联。
丹麦胎儿起源1988队列在1988 - 1989年期间，于第30孕周产前助产士访视时招募了965名孕妇。采集血样并储存血清，随后通过液相色谱 - 串联质谱法（LC - MS/MS）分析血清中25 - 羟基维生素D（25(OH)D）的浓度。结局指标是从丹麦国家患者登记册中提取的首次骨折诊断。
850名女性的维生素D状态数据可用。25(OH)D的中位数（第5 - 95百分位数）为76.2（23.0 - 152.1）nmol/l。在随访期间，294名儿童被登记至少有一次骨折诊断。以年龄为基础时间尺度的多变量Cox回归模型表明，母亲的维生素D状态与首次骨折之间无总体关联。然而，与6月/7月/8月采血的母亲相比，12月/1月/2月采血母亲的孩子在儿童期的风险比（HR）显著增加（HR：1.75，95%CI：1.11 - 2.74）。对维生素D状态进行调整后，这种关联得到加强（1.82，1.12 - 2.97），这表明独立于母亲维生素D状态之外，对后代骨折存在潜在的季节影响。在一项敏感性分析中，我们发现25(OH)D的连续浓度与后代前臂骨折之间存在边缘显著的负相关（P = 0.054）。
总体而言，我们的结果并未证实母亲维生素D状态与后代骨折之间存在关联。对此主题需要进一步研究，但研究人群必须足够大，以便对骨折进行细分。
