孕期母体 25-羟维生素 D 水平与儿童肥胖和过敏的关系:一项观察性研究。

The relationship between maternal 25-hydroxyvitamin D status in pregnancy and childhood adiposity and allergy: an observational study.

机构信息

Gravida, National Centre for Growth and Development and The Liggins Institute, University of Auckland, Auckland, New Zealand.

The Department of Paediatrics, Child & Youth Health, School of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.

出版信息

Int J Obes (Lond). 2017 Dec;41(12):1755-1760. doi: 10.1038/ijo.2017.182. Epub 2017 Aug 4.

Abstract

BACKGROUND

Vitamin D insufficiency (defined as <75 nmol l) is widespread among pregnant women around the world and has been proposed to influence offspring outcomes in childhood and into adult life, including adiposity and allergy. Disorders, including asthma and eczema, are on the rise among children. Our aim was to investigate the relationship between maternal 25-hydroxyvitamin D status in pregnancy and offspring adiposity, asthma and eczema in childhood.

SUBJECTS AND METHODS

Maternal 25-hydroxyvitamin D concentrations were analysed in serum samples collected at 15 weeks' gestation from 1710 participants of the prospective Screening for Pregnancy Endpoints cohort study. The offspring of 1208 mothers were followed up at age 5-6 years. Data collected included height, weight, percentage body fat (PBF, measured by bioimpedance) and history of asthma and eczema. Multivariable analysis controlled for maternal body mass index (BMI), age and sex of the child and season of serum sampling.

RESULTS

Complete data were available for 922 mother-child pairs. Each 10 nmol l increase in maternal 25-hydroxyvitamin D concentration at 15 weeks' gestation was associated with a decrease in offspring PBF of 0.2% (95% confidence interval 0.04-0.36%, P=0.01) after adjustment for confounders but was not related to child BMI z-score. Maternal mean (±s.d.) 25-hydroxyvitamin D concentration was similar in children who did and did not have asthma (71.7±26.1 vs 73.3±27.1 nmol l, P=0.5), severe asthma (68.6±28.6 vs 73.3±26.8 nmol l, P=0.2) and eczema (71.9±27.0 vs 73.2±27.0 nmol l, P=0.5).

CONCLUSIONS

The finding of a relationship between maternal vitamin D status and adiposity in childhood is important, particularly because vitamin D insufficiency in pregnancy is highly prevalent. The association between maternal vitamin D supplementation in pregnancy and adiposity in the offspring merits examination in randomised controlled trials.

摘要

背景

维生素 D 不足(定义为 <75nmol/l)在世界各地的孕妇中普遍存在,并被认为会影响儿童期和成年后的后代结局,包括肥胖和过敏。儿童中哮喘和湿疹等疾病的发病率正在上升。我们的目的是研究孕妇妊娠期间 25-羟维生素 D 状况与后代儿童期肥胖、哮喘和湿疹之间的关系。

受试者和方法

从前瞻性妊娠终点筛查队列研究的 1710 名参与者的 15 周妊娠血清样本中分析了母体 25-羟维生素 D 浓度。1208 名母亲的后代在 5-6 岁时接受了随访。收集的数据包括身高、体重、体脂百分比(通过生物阻抗法测量)以及哮喘和湿疹病史。多变量分析控制了母亲的体重指数(BMI)、儿童的年龄和性别以及血清取样的季节。

结果

对于 922 对母婴对,获得了完整的数据。妊娠 15 周时母体 25-羟维生素 D 浓度每增加 10nmol/l,调整混杂因素后,后代体脂百分比降低 0.2%(95%置信区间 0.04-0.36%,P=0.01),但与儿童 BMI z 评分无关。患有和不患有哮喘的儿童(71.7±26.1 与 73.3±27.1nmol/l,P=0.5)、严重哮喘(68.6±28.6 与 73.3±26.8nmol/l,P=0.2)和湿疹(71.9±27.0 与 73.2±27.0nmol/l,P=0.5)的母亲平均(±s.d.)25-羟维生素 D 浓度相似。

结论

发现母体维生素 D 状况与儿童肥胖之间存在关联很重要,尤其是因为妊娠期间维生素 D 不足的情况非常普遍。妊娠期间母体补充维生素 D 与后代肥胖之间的关联值得在随机对照试验中进行检验。

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