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巴西孕妇 25-羟维生素 D 与脂肪因子和糖代谢标志物的纵向关联。

Longitudinal association of 25-hydroxyvitamin D with adipokines and markers of glucose metabolism among Brazilian pregnant women.

机构信息

1Nutritional Epidemiology Observatory,Department of Social and Applied Nutrition,Institute of Nutrition Josué de Castro,Rio de Janeiro Federal University,Rio de Janeiro 21941-590,RJ,Brazil.

5Department of Psychology, Social Work and Counselling,Faculty of Education and Health,University of Greenwich,London SE9 2UG,UK.

出版信息

Br J Nutr. 2019 Jan;121(1):42-54. doi: 10.1017/S0007114518003057.

Abstract

This study aimed to evaluate the longitudinal association of vitamin D status with glycaemia, insulin, homoeostatic model assessment of insulin resistance, adiponectin and leptin. A prospective cohort with 181 healthy, pregnant Brazilian women was followed at the 5th-13th, 20th-26th and 30th-36th gestational weeks. In this cohort, 25-hydroxyvitamin D (25(OH)D) plasma concentrations were analysed using liquid chromatography-tandem MS. Vitamin D status was categorised as sufficient or insufficient using the Endocrine Society Practice Guidelines (≥75/<75 nmol/l) and the Institute of Medicine (≥50/<50 nmol/l) thresholds. Linear mixed-effect regression models were employed to evaluate the association between vitamin D status and each outcome, considering interaction terms between vitamin D status and gestational age (P<0·1). At baseline, 70·7 % of pregnant women had 25(OH)D levels <75 nmol/l and 16 % had levels <50 nmol/l. Women with sufficient vitamin D status at baseline, using both thresholds, presented lower glycaemia than those with insufficient 25(OH)D. Pregnant women with 25(OH)D concentrations <75 nmol/l showed lower insulin (β=-0·12; 95 % CI -0·251, 0·009; P=0·069) and adiponectin (β=-0·070; 95 % CI -0·150, 0·010; P=0·085) concentrations throughout pregnancy than those with 25(OH)D levels ≥75 nmol/l. Pregnant women with 25(OH)D <50 nmol/l at baseline presented significantly higher leptin concentrations than those with 25(OH)D levels ≥50 nmol/l (β=-0·253; 95 % CI -0·044, 0·550; P=0·095). The baseline status of vitamin D influences the biomarkers involved in glucose metabolism. Vitamin D-sufficient women at baseline had higher increases in insulin and adiponectin changes throughout gestation than those who were insufficient.

摘要

本研究旨在评估维生素 D 状态与血糖、胰岛素、稳态模型评估的胰岛素抵抗、脂联素和瘦素之间的纵向关联。一项前瞻性队列研究纳入了 181 名健康的巴西孕妇,在妊娠第 5-13 周、第 20-26 周和第 30-36 周进行随访。在该队列中,使用液相色谱-串联质谱法分析 25-羟维生素 D(25(OH)D)血浆浓度。使用内分泌学会实践指南(≥75/<75 nmol/l)和医学研究所(≥50/<50 nmol/l)阈值,将维生素 D 状态分类为充足或不足。采用线性混合效应回归模型,考虑维生素 D 状态和孕龄(P<0·1)之间的交互项,评估维生素 D 状态与每种结局之间的关系。在基线时,70.7%的孕妇 25(OH)D 水平<75 nmol/l,16%的孕妇 25(OH)D 水平<50 nmol/l。使用两个阈值,基线时维生素 D 状态充足的孕妇血糖水平低于 25(OH)D 不足的孕妇。25(OH)D 浓度<75 nmol/l 的孕妇在整个孕期胰岛素(β=-0.12;95%CI-0.251,0.009;P=0.069)和脂联素(β=-0.070;95%CI-0.150,0.010;P=0.085)浓度均低于 25(OH)D 水平≥75 nmol/l 的孕妇。基线时 25(OH)D <50 nmol/l 的孕妇瘦素浓度明显高于 25(OH)D 水平≥50 nmol/l 的孕妇(β=-0.253;95%CI-0.044,0.550;P=0.095)。维生素 D 基线状态影响葡萄糖代谢相关的生物标志物。基线时维生素 D 充足的女性在整个孕期胰岛素和脂联素变化增加幅度大于维生素 D 不足的女性。

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