Department of Neonatology, Dr Sami Ulus Maternity and Children's Training and Research Hospital, Ankara, Turkey.
Department of Genetics, Dıskapı Yıldırım Beyazıt Education and Training Hospital, Ankara, Turkey.
J Matern Fetal Neonatal Med. 2020 Nov;33(21):3640-3646. doi: 10.1080/14767058.2019.1582629. Epub 2019 Feb 27.
Vitamin D and its receptor (VDR) have important roles in perinatal lung development. The objective of this study was to investigate the possible association between VDR FokI and TaqI polymorphism and development of respiratory distress syndrome (RDS) in preterm infants. A total of 173 premature infants <34 weeks: 82 with RDS and 91 without RDS were enrolled. Genotyping of VDR polymorphisms was assayed by real-time PCR. Serum 25-hydroxyvitamin D (25-OHD) levels were measured by ELISA in blood samples that were obtained at the time of admission to the neonatal intensive care unit. Gestational age (GA) was significantly lower in the RDS group compared with the controls. In univariate analysis, VDR TaqI CT and CC genotypes were associated with the increased risk of RDS (OR = 3.264, = .001, 95% CI = 1.597-6.672 and OR = 5.222, < .001, 95% CI = 2.165-12.597, respectively); while VDR FokI showed no association with RDS. In multivariate logistic regression analysis, variant TaqI genotype increased risk of RDS ( = 0.001, OR = 3.464, 95% CI = 1.655-7.251) independent of gestational age, birth weight and gender. 25-OHD levels in the RDS group were significantly lower compared with those in without the RDS group ( = .002). Serum 25-OHD levels were not significantly different among the different FokI and TaqI genotypes in RDS group. This is the first report of association of VDR polymorphism with RDS development in preterm neonates. Current study suggests that VDR TaqI polymorphism may be involved in predisposition to RDS in premature neonates. Further studies are needed to assess the contribution of vitamin D and VDR signaling to the pathogenesis RDS.
维生素 D 及其受体(VDR)在围生期肺发育中具有重要作用。本研究旨在探讨 VDR FokI 和 TaqI 多态性与早产儿呼吸窘迫综合征(RDS)发生的可能相关性。共纳入 173 例胎龄<34 周的早产儿:82 例为 RDS 患儿,91 例为非 RDS 患儿。采用实时 PCR 法检测 VDR 多态性。采用 ELISA 法检测入院时新生儿重症监护病房血样中血清 25-羟维生素 D(25-OHD)水平。RDS 组患儿的胎龄(GA)显著低于对照组。单因素分析显示,VDR TaqI CT 和 CC 基因型与 RDS 风险增加相关(OR=3.264,P=.001,95%CI=1.597-6.672 和 OR=5.222,P<0.001,95%CI=2.165-12.597);而 VDR FokI 与 RDS 无关。多因素 logistic 回归分析显示,TaqI 变异基因型增加了 RDS 的风险(P=0.001,OR=3.464,95%CI=1.655-7.251),独立于胎龄、出生体重和性别。RDS 组患儿的 25-OHD 水平明显低于非 RDS 组(P=.002)。RDS 组不同 FokI 和 TaqI 基因型间血清 25-OHD 水平无显著差异。这是首次报道 VDR 多态性与早产儿 RDS 发病的相关性。本研究提示 VDR TaqI 多态性可能与早产儿 RDS 的易感性有关。需要进一步研究评估维生素 D 和 VDR 信号通路对 RDS 发病机制的贡献。