McAree Trixie
Consultant Midwife, North West London Hospitals NHS Trust, Harrow, UK.
Eur Endocrinol. 2013 Aug;9(2):125-127. doi: 10.17925/EE.2013.09.02.125. Epub 2013 Aug 23.
Both obesity and vitamin D deficiency are linked to morbidity and ultimately mortality. Vitamin D sufficiency is believed to confer many health benefits; however, with the exception of the classic functions related to bone health these are not yet well understood, especially in relationship to pregnancy and infant health outcomes. Conversely, insufficiency is associated with adverse health outcomes, which are consequently related to public health concerns that arise from these and these need addressing. While the links between health and vitamin D are being considered and researched, there are an increasing number of reports that demonstrate vitamin D deficiency is prevalent particularly among people who are darker skinned, those who live at latitudes above 52°, and are therefore exposed to reduced sunlight especially in the autumn and winter months, those who through lifestyle choices cover their bodies, preventing sunlight exposure, and in obese people. Obesity is also of growing concern. Health journalists and academics sometimes dramatically refer to 'obesity epidemics,' which is not surprising as over one-third of Americans are obese. This problem, if not addressed, will lead to adverse health outcomes for individuals as well as being a long-term burden both to families and society. It is interesting to note that both vitamin D deficiency and obesity have shared risks for mortality and morbidity including cardiovascular disease, diabetes, respiratory problems, cancer and musculoskeletal disease. This paper considers current concepts and the links between obesity and vitamin D deficiency in pregnancy seeking to determine whether being vitamin D deficient and obese is simply double trouble, where both are present, or whether there are there other factors that need further exploration, reviewing the associated implications for practice..
肥胖和维生素D缺乏都与发病率以及最终的死亡率相关。维生素D充足被认为能带来诸多健康益处;然而,除了与骨骼健康相关的经典功能外,这些益处尚未得到充分理解,尤其是在与妊娠及婴儿健康结局的关系方面。相反,维生素D不足与不良健康结局相关,这些不良结局进而引发了公共卫生问题,而这些问题需要得到解决。在人们对健康与维生素D之间的联系进行思考和研究的同时,越来越多的报告表明维生素D缺乏很普遍,尤其在肤色较深的人群、居住在纬度高于52°因而在秋冬季节接受阳光照射减少的人群、因生活方式选择而遮盖身体从而避免阳光照射的人群以及肥胖人群中。肥胖问题也日益受到关注。健康记者和学者有时会戏剧性地提及“肥胖流行”,这并不奇怪,因为超过三分之一的美国人肥胖。这个问题若不解决,将给个人带来不良健康后果,同时也会成为家庭和社会的长期负担。值得注意的是,维生素D缺乏和肥胖在死亡率和发病率方面存在共同风险,包括心血管疾病、糖尿病、呼吸问题、癌症和肌肉骨骼疾病。本文探讨了当前关于妊娠期间肥胖与维生素D缺乏的概念及两者之间的联系,旨在确定维生素D缺乏和肥胖同时存在是否仅仅是双重麻烦,还是存在其他需要进一步探索的因素,并审视其对实践的相关影响。