Richard Aline, Rohrmann Sabine, Quack Lötscher Katharina C
Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Hirschengraben 84, CH-8001 Zurich, Switzerland.
Clinic of Obstetrics, University Hospital Zurich, Frauenklinikstrasse 10, CH-8091 Zurich, Switzerland.
Nutrients. 2017 Mar 10;9(3):260. doi: 10.3390/nu9030260.
Vitamin D deficiency in pregnancy has negative clinical consequences, such as associations with glucose intolerance, and has been shown to be distributed differently in certain ethnic groups. In some countries, a difference in the rate of vitamin D deficiency was detected in pregnant women depending on their skin color. We examined the prevalence of vitamin D deficiency (<20 ng/mL) in women in early pregnancy in Switzerland and evaluated the association of skin color with vitamin D deficiency. In a single-center cohort study, the validated Fitzpatrick scale and objective melanin index were used to determine skin color. Of the 204 pregnant women included, 63% were vitamin D deficient. The mean serum 25-hydroxyvitamin D concentration was 26.1 ng/mL (95% confidence interval (CI) 24.8-27.4) in vitamin D-sufficient women and 10.5 ng/mL (95% CI 9.7-11.5) in women with deficiency. In the most parsimonious model, women with dark skin color were statistically significantly more often vitamin D deficient compared to women with light skin color (OR 2.60; 95% CI 1.08-6.22; adjusted for age, season, vitamin D supplement use, body mass index, smoking, parity). This calls for more intense counseling as one policy option to improve vitamin D status during pregnancy, i.e., use of vitamin D supplements during pregnancy, in particular for women with darker skin color.
孕期维生素D缺乏会产生负面临床后果，比如与葡萄糖耐量异常有关，并且已证实在某些种族群体中其分布存在差异。在一些国家，根据孕妇的肤色检测出维生素D缺乏率存在差异。我们调查了瑞士早孕女性中维生素D缺乏（<20 ng/mL）的患病率，并评估了肤色与维生素D缺乏之间的关联。在一项单中心队列研究中，采用经过验证的菲茨帕特里克量表和客观黑色素指数来确定肤色。纳入的204名孕妇中，63%维生素D缺乏。维生素D充足的女性血清25-羟基维生素D平均浓度为26.1 ng/mL（95%置信区间[CI] 24.8 - 27.4），缺乏的女性为10.5 ng/mL（95% CI 9.7 - 11.5）。在最简约模型中，与肤色浅的女性相比，肤色深的女性维生素D缺乏的统计学显著性更高（比值比2.60；95% CI 1.08 - 6.22；校正年龄、季节、维生素D补充剂使用、体重指数、吸烟、产次）。这就要求作为一项政策选择进行更强化的咨询，以改善孕期维生素D状况，即在孕期使用维生素D补充剂，尤其是肤色较深的女性。
