Kon I Ya, Safronova A I, Gmoshinskaya M V, Shcheplyagina L A, Korosteleva M M, Toboleva M A, Aleshina I V, Kurkova V I, Larionova Z G
Vopr Pitan. 2014;83(6):58-65.
Supporting of bone health is one of the main approaches to provide health in pregnant women considering intensive calcium and other mineral mobilization from mass bone that is necessary forforming fetus bone. This mobilization may lead to decrease of bone mineral density and development of osteopenia and osteoporosis. The important factors of development of bone impairment in pregnancy are nutrition and particular deficient consumption of protein, Ca, vitamin D. The possible role of reduced intake of pregnant women other nutrients remains unexplored. The aim of the research was estimating the prevalence of bone mineral density decrease in regard to the particular course of pregnancy and studying possible effects of key nutrients on bone mineral density in pregnant women. 131 women at different stages of pregnancy were involved in the survey. The bone density assessment was conducted using Bone Densitometer Omnisense 7000. As a criterion for bone density decrease in women used a Z-score, which was considered as normal to -1.0, as reduced from -1.0 to -2,0, and as significantly reduced when Z-score was less than -2,0. Analysis of the actual nutrition was performed by a 24-hour recording of 58 pregnant women. Normal bone mineral density was detected in 54 women or 41% of the total number of women surveyed. In 51 (39%) pregnant women reduced bone mineral density was discovered, and in 26 (20%) patients--significantly reduced bone density. There was a considerable deviation in pregnant patients' diet from the nutrition guidelines, which include, in particular, the high content of fat and saturated fatty acid, reduced intake of some micronutrients such as calcium, zinc, folic acid, β-carotene, vitamins A, B1, E. However, differences in the actual consumption of nutrients in women with varying bone mineral density have been identified only in case of consumption of fat and energy value of diets, also Mn and I. So, it may be suggested that the differences in bone mineral density between women in our study are caused by genetic polymorphism, which leads to differences in the actual demand for nutrients, sufficient for prevention of bone decrease, in individuals.
考虑到为形成胎儿骨骼而从大量骨骼中大量动员钙和其他矿物质，支持骨骼健康是保障孕妇健康的主要方法之一。这种动员可能导致骨矿物质密度降低以及骨质减少和骨质疏松症的发展。孕期骨骼损伤发展的重要因素是营养，尤其是蛋白质、钙、维生素D的摄入不足。孕妇其他营养素摄入量减少的可能作用仍未得到探索。该研究的目的是评估特定孕期过程中骨矿物质密度降低的患病率，并研究关键营养素对孕妇骨矿物质密度的可能影响。131名处于不同孕期阶段的女性参与了调查。使用Omnisense 7000骨密度仪进行骨密度评估。女性骨密度降低的标准采用Z评分，Z评分在-1.0及以上被视为正常，在-1.0至-2.0之间为降低，当Z评分小于-2.0时为显著降低。对58名孕妇进行了24小时饮食记录以分析实际营养情况。54名女性（占被调查女性总数的41%）检测到骨矿物质密度正常。51名（39%）孕妇发现骨矿物质密度降低，26名（20%）患者骨密度显著降低。孕妇的饮食与营养指南存在相当大的偏差，特别是脂肪和饱和脂肪酸含量高，一些微量营养素如钙、锌、叶酸、β-胡萝卜素、维生素A、B1、E的摄入量减少。然而，仅在脂肪摄入量、饮食能量值以及锰和碘的情况下，才确定了不同骨矿物质密度女性在实际营养素摄入方面的差异。所以，可能表明我们研究中女性骨矿物质密度的差异是由基因多态性引起的，这导致个体对预防骨质减少所需营养素的实际需求存在差异。
