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两种不同剂量口服维生素 D 补充对炎症生物标志物及母婴结局的影响。

Efficacy of two different doses of oral vitamin D supplementation on inflammatory biomarkers and maternal and neonatal outcomes.

机构信息

Department of Nutrition, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Laboratory of Nutrition Research, National Nutrition and Food Technology Research Institute and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

Matern Child Nutr. 2019 Oct;15(4):e12867. doi: 10.1111/mcn.12867. Epub 2019 Sep 5.

Abstract

Hypovitaminosis D during pregnancy is suggested to have a link with complications in both mother and infant. We aimed to evaluate the efficacy of two doses of vitamin D3 supplementation during pregnancy on maternal and cord blood vitamin D status, inflammatory biomarkers, and maternal and neonatal outcomes. A total of 84 pregnant women (gestational age of <12 weeks) were randomly allocated to one of two groups: (a) 1,000-IU/d vitamin D and (b) 2,000 IU/d. Biochemical assessments (25-hydroxycalciferol (25(OH)D), hs-CRP, and cell-culture supernatant concentrations of IL-1β, IL-6, and TNF-α) of mothers were performed at the beginning and 34 weeks of gestation. Assessments of infants at delivery comprised cord blood serum concentrations of 25(OH)D, hs-CRP, IL-1β, IL-6, TNF-α, birth sizes, and Apgar score. Circulating concentrations of 25(OH)D increased in both intervention groups with more increment in 2,000 IU/d than in 1,000 IU/d (46.7 ± 30.7 vs. 24.0 ± 21.07 nmol L , P = .001). Concentrations of TNF-α decreased significantly in group 2,000 (-913.1 ± 1261.3 ng L , P = .01). The cord blood concentration of IL-6 in group 2,000 IU/d, compared with 1,000 IU/d, was significantly lower (25.9 ± 32.0 vs. 4.6 ± 1.4 ng L , P = .03). The birth sizes including weight, length, and head circumference of the infants of group 2,000 IU/d were significantly higher than the infants' of group 1,000 IU/d. Supplementation with 2,000-IU/d vitamin D3 is more effective than 1,000 IU/d in pregnant women in terms of increasing circulating 25(OH)D, ameliorating pro-inflammatory markers notably TNF-α in mother and IL-6 in cord blood, and improving neonatal outcomes including the birth sizes.

摘要

孕期维生素 D 缺乏症被认为与母婴并发症有关。我们旨在评估孕期补充两种剂量的维生素 D3 对母亲和脐血维生素 D 状态、炎症生物标志物以及母婴结局的影响。共有 84 名孕妇(<12 周妊娠)被随机分配到两组之一:(a)1,000IU/d 维生素 D 和(b)2,000IU/d。在妊娠开始时和第 34 周时,对母亲进行生化评估(25-羟维生素 D(25(OH)D)、高敏 C 反应蛋白和细胞培养上清液中 IL-1β、IL-6 和 TNF-α的浓度)。分娩时评估婴儿包括脐血血清 25(OH)D、高敏 C 反应蛋白、IL-1β、IL-6、TNF-α、出生体重和阿普加评分。两种干预组的 25(OH)D 循环浓度均增加,2,000IU/d 组的增加幅度大于 1,000IU/d 组(46.7±30.7 与 24.0±21.07nmol/L,P=0.001)。2,000IU/d 组 TNF-α浓度显著降低(-913.1±1261.3ng/L,P=0.01)。与 1,000IU/d 组相比,2,000IU/d 组脐血 IL-6 浓度明显更低(25.9±32.0 与 4.6±1.4ng/L,P=0.03)。2,000IU/d 组婴儿的出生体重、身长和头围均明显大于 1,000IU/d 组。与 1,000IU/d 相比,补充 2,000IU/d 维生素 D3 更能有效增加孕妇循环 25(OH)D,改善母亲和脐血中促炎标志物,特别是 TNF-α和 IL-6,并改善新生儿结局,包括出生体重。

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