哺乳期补充维生素D的母乳喂养女性血清与母乳中25-羟基维生素D水平的相关性：随机双盲对照试验

Correlation of 25-Hydroxyvitamin D Levels in Serum vs. Breastmilk in Vitamin D-Supplementation Breastfeeding Women during Lactation: Randomized Double Blinded Control Trial.

作者信息

Niramitmahapanya Sathit, Kaoiean Surasak, Sangtawesin Varaporn, Patanaprapan Anusorn, Bordeerat Narisa K, Deerochanawong Chaicharn

出版信息

J Med Assoc Thai. 2017 Feb;100 Suppl 1:S165-71.

PMID:29927558

Abstract

BACKGROUND

Vitamin D deficiency in pregnancy and lactation increases the risk of adverse perinatal outcomes; however, although Vitamin D supplementation during pregnancy and lactation is recommended, suggested dose ranges vary.

OBJECTIVE

To determine whether vitamin D31,800 IU/d supplementation in lactating mothers improves their vitamin D status and breast-feeding milk.

MATERIAL AND METHOD

This was a randomized, placebo–controlled study of Thai pregnant women in their third trimester. A total of 76 Thai lactating mothers and their breast-fed infants were studied with maternal 25 Hydroxyvitamin D 25 (OH) D levels of 10-30 ng/ml determined using Liquid Chromatography Mass Spectrometry Tandem (LC-MS/MS). One group received vitamin D3 1,800 IU/d supplementation for 6 weeks, and members of the other group were given a placebo. 25 (OH) D level of colostum and 6-week serum from breast-fed milk were measured by High Performance Liquid Chromatography (HPLC). The data from the two groups were analyzed and compared.

RESULTS

The mean (±SD) maternal age was 27.16±5.13 years, and mean body mass index (BMI) was 22.29±5.08 kg/m(2). At 6 weeks, maternal 25 (OH) D levels had increased significantly in the vitamin D group (VD) 68.30±15.40 nmol/L compared to 55.15±13.57 nmol/L in the placebo group (p<0.001) measured using the Liquid Chromatography-Mass Spectrometry Tandem (LC-MS/MS) method. Breast-fed milk did not show any significant incremental change in 25 (OH) D levels measured by High Performance Liquid Chromatography (HPLC); however, the change in 25 (OH) D levels in breast milk in the VD group was significantly different from that of the placebo group (p = 0.005).`

CONCLUSION

Vitamin D3 supplementation during lactation can increase 25 (OH) D levels in Thai breast-fed mothers. Further work is needed to determine the duration of vitamin D supplementation to normalize breast milk and breast-fed infants’ 25 (OH) D level at over 75 nmol/L.

摘要

背景

妊娠和哺乳期维生素D缺乏会增加不良围产期结局的风险；然而，尽管建议在妊娠和哺乳期补充维生素D，但建议的剂量范围各不相同。

目的

确定哺乳期母亲补充1800IU/d维生素D3是否能改善其维生素D状况和母乳质量。

材料与方法

这是一项对泰国孕晚期孕妇进行的随机、安慰剂对照研究。共研究了76名泰国哺乳期母亲及其母乳喂养的婴儿，使用液相色谱串联质谱法（LC-MS/MS）测定母亲的25羟基维生素D[25(OH)D]水平为10 - 30ng/ml。一组接受1800IU/d维生素D3补充剂，为期6周，另一组给予安慰剂。初乳和母乳喂养6周后的母乳血清中的25(OH)D水平通过高效液相色谱法（HPLC）测量。对两组数据进行分析和比较。

结果

母亲的平均（±标准差）年龄为27.16±5.13岁，平均体重指数（BMI）为22.29±5.08kg/m²。6周时，使用液相色谱串联质谱法（LC-MS/MS）测量，维生素D组（VD）母亲的25(OH)D水平显著升高至68.30±15.40nmol/L，而安慰剂组为55.15±13.57nmol/L（p<0.001）。通过高效液相色谱法（HPLC）测量，母乳喂养的母乳中25(OH)D水平没有显示出任何显著的增量变化；然而，VD组母乳中25(OH)D水平的变化与安慰剂组显著不同（p = 0.005）。