Serrano Norma C, Guío Elizabeth, Quintero-Lesmes Doris C, Becerra-Bayona Silvia, Luna-Gonzalez Maria L, Herrera Victor M, Prada Carlos E
Fundación Cardiovascular de Colombia FCV, Colombia; Fundación Universitaria FCV, Colombia.
Hospital Internacional de Colombia HIC, Colombia.
Pregnancy Hypertens. 2018 Oct;14:240-244. doi: 10.1016/j.preghy.2018.03.006. Epub 2018 Mar 14.
Pre-eclampsia is a multisystem disorder characterized by new-onset hypertension and proteinuria during pregnancy. Pre-eclampsia remains a major cause of maternal death in low-income countries. Vitamin D has a very diverse biological role in cardiovascular diseases. This study will evaluate the association of vitamin D levels and relevance to pre-eclampsia.
We conducted a case-control study of women recruited from the GenPE (Genetics and Pre-eclampsia) Colombian registry. This is a multicenter case-control study conducted in eight Colombian cities. 25-Hydroxyvitamin D (25(OH)D) concentration was measured using liquid-chromatography-tandem mass spectrometry from 1013 women with pre-eclampsia and 1015 mothers without pre-eclampsia (controls).
Fifty-two percent of women with pre-eclampsia were vitamin D deficient. The 25(OH)D concentrations were significantly lower in the pre-eclampsia (mean 29.99 ng/mL; 95% CI: 29.40-30.58 ng/mL) group compared to controls (mean 33.7 ng/mL; 95% CI: 33.20-34.30 ng/mL). In the unadjusted model, maternal vitamin D deficiency, defined by maternal 25(OH)D concentration <30 ng/mL, was associated with an increased probability of suffering from pre-eclampsia (OR 2.10; 95% CI, 1.75-2.51). After adjusting for covariates, a similarly increased probability of having pre-eclampsia was observed (OR 2.18; 95% CI, 1.80-2.64) among women with vitamin D deficiency, relative to controls.
Although the results suggest that low maternal concentrations of 25(OH)D increase pre-eclampsia risk, this evidence may not be indicative of a causal association. Future studies are needed to confirm a definite causal relationship between concentrations of vitamin D and the risk of pre-eclampsia, by means of powered clinical trials.
子痫前期是一种多系统疾病，其特征为孕期新发高血压和蛋白尿。在低收入国家，子痫前期仍是孕产妇死亡的主要原因。维生素D在心血管疾病中具有多种生物学作用。本研究将评估维生素D水平与子痫前期的关联及相关性。
我们对从哥伦比亚GenPE（遗传学与子痫前期）登记处招募的女性进行了一项病例对照研究。这是一项在哥伦比亚八个城市开展的多中心病例对照研究。使用液相色谱-串联质谱法测量了1013例子痫前期女性和1015例无子痫前期的母亲（对照组）的25-羟基维生素D（25(OH)D）浓度。
52%的子痫前期女性存在维生素D缺乏。子痫前期组的25(OH)D浓度（平均29.99 ng/mL；95%可信区间：29.40 - 30.58 ng/mL）显著低于对照组（平均33.7 ng/mL；95%可信区间：33.20 - 34.30 ng/mL）。在未调整模型中，以母亲25(OH)D浓度<30 ng/mL定义的母亲维生素D缺乏与患子痫前期的概率增加相关（比值比2.10；95%可信区间，1.75 - 2.51）。在对协变量进行调整后，相对于对照组，维生素D缺乏的女性患子痫前期的概率同样增加（比值比2.18；95%可信区间，1.80 - 2.64）。
尽管结果表明母亲25(OH)D浓度低会增加子痫前期风险，但这一证据可能并不表明存在因果关联。需要通过有足够样本量的临床试验来进一步研究以证实维生素D浓度与子痫前期风险之间的确切因果关系。
