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产妇人体测量学及其与 Roux-en-Y 胃旁路手术后孕妇维生素 D、钙和甲状旁腺激素营养状况的关系。

Maternal Anthropometry and Its Relationship with the Nutritional Status of Vitamin D, Calcium, and Parathyroid Hormone in Pregnant Women After Roux-en-Y Gastric Bypass.

机构信息

School of Medicine, Federal University of Rio de Janeiro (UFRJ), Carlos Chagas avenue, 373, Edifício do Centro de Ciências da Saúde, 2° floor, room 49, Cidade Universitária, Ilha do Fundão, Rio de Janeiro, 21941-902, Brazil.

Center for Research on Micronutrients (NPqM), Institute of Nutrition Josué de Castro of UFRJ, Rio de Janeiro, 21941-902, Brazil.

出版信息

Obes Surg. 2018 Oct;28(10):3116-3124. doi: 10.1007/s11695-018-3331-8.

Abstract

OBJECTIVE

To assess the influence of pre-pregnancy body mass index (BMI), total gestational weight gain (TGWG), and pre-pregnancy surgical success on the nutritional status of vitamin D, calcium, and parathyroid hormone (PTH) in the trimesters of pregnancy of women who previously underwent Roux-en-Y gastric bypass (RYGB).

METHODOLOGY

This is an analytical, longitudinal, and retrospective study comprising 42 pregnant women who previously underwent RYGB. Concentrations of vitamin D, calcium, and PTH were assessed in all trimesters. Anthropometric variables necessary for calculating TGWG, surgical success, and BMI were collected preoperatively and over the trimesters of pregnancy.

RESULTS

A total of 97.1% had vitamin D inadequacy at some point in pregnancy. Pre-pregnancy BMI, even when classified as overweight, may have exacerbated the serum concentrations of this vitamin in the third trimester (p = 0.011), and it was significantly lower in women with normal weight and/or obesity (p = 0.039). It was evidenced that both pre-pregnancy BMI and TGWG above the recommended optimal weight can be associated with calcium homeostasis, especially early in pregnancy. It was also shown that surgical success in the pre-pregnancy period may have influenced the serum concentrations of vitamin D in the second trimester of pregnancy (p = 0.013).

CONCLUSION

This study draws attention to the importance of monitoring the nutritional status of vitamin D and calcium in the prenatal period due to its relationship with pre-pregnancy BMI, TGWG, and surgical success.

摘要

目的

评估孕前体重指数(BMI)、总孕期增重(TGWG)和孕前手术成功对先前接受 Roux-en-Y 胃旁路术(RYGB)的女性在妊娠各期维生素 D、钙和甲状旁腺激素(PTH)营养状况的影响。

方法

这是一项分析性、纵向和回顾性研究,共纳入 42 名先前接受 RYGB 的孕妇。在所有孕期均评估维生素 D、钙和 PTH 浓度。在术前和孕期各阶段收集了计算 TGWG、手术成功和 BMI 所需的人体测量学变量。

结果

共有 97.1%的孕妇在孕期某个时间点存在维生素 D 不足。即使孕前 BMI 被归类为超重,也可能使该维生素在孕晚期的血清浓度恶化(p=0.011),而正常体重和/或肥胖的女性的血清浓度显著降低(p=0.039)。研究结果表明,孕前 BMI 和 TGWG 超过推荐的最佳体重都可能与钙稳态有关,尤其是在孕早期。此外,还表明孕前手术成功可能影响了妊娠中期的维生素 D 血清浓度(p=0.013)。

结论

由于与孕前 BMI、TGWG 和手术成功有关,本研究提醒人们在产前期间监测维生素 D 和钙的营养状况的重要性。

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