Department of Nutrition, Harvard T.H. Chan School of Public Health, 665 Huntington Avenue, SPH-2 Floor 3, Boston, MA, 02115, USA; Mongolian Health Initiative Non-Governmental Organization, Bayanzurkh District, Ulaanbaatar, Mongolia.
National Center for Maternal and Child Health, Khuvisgalchdin Street, Bayangol District, Ulaanbaatar, Mongolia.
J Steroid Biochem Mol Biol. 2019 Oct;193:105427. doi: 10.1016/j.jsbmb.2019.105427. Epub 2019 Jul 16.
Adequate vitamin D status during pregnancy is important for developing fetal bone strength and density and may play a role in preventing a range of skeletal and non-skeletal diseases in both mothers and children. We previously identified Mongolian women of reproductive age to have the lowest vitamin D levels yet observed in any population globally, which renders this population uniquely important in vitamin D research. In this study, we measured the seasonal distribution of 25-hydroxyvitamin D (25(OH)D) concentration in 390 healthy third trimester pregnant women living in urban and rural Mongolia using DiaSorin LIAISON and compared this distribution to that of 206 third trimester women living in Boston, USA. Also, we analyzed seasonally-independent associations between (25(OH)D) levels and selected predictors in both groups using quantile regression. Mean 25(OH)D levels were significantly higher and less seasonal in Boston (seasonal range: 27.1 ± 7.0-31.5 ± 7.7 ng/ml) than in Mongolia (seasonal range: 11.2 ± 3.9-19.2 ± 6.7 ng/ml). Adjusting for month of blood draw, higher 25(OH)D levels were significantly associated with older age, lower gravidity, lower BMI, and lack of a college or university degree among Boston participants, however, only gravidity was robust to multivariable adjustment. No assessed characteristics were independently predictive in Mongolia, likely due to universally low 25(OH)D levels and a resulting lack of between-person variation. In conclusion, vitamin D status among pregnant Mongolians is severely depressed throughout the year and should be addressed through fortification and supplementation, while in the U.S., deficiency is associated with specific characteristics targetable through supplementation.
孕妇维生素 D 水平充足对于胎儿骨骼强度和密度的发育非常重要,并且可能在预防母亲和儿童的一系列骨骼和非骨骼疾病方面发挥作用。我们之前发现,处于生育年龄的蒙古女性的维生素 D 水平是全球任何人群中观察到的最低水平,这使得该人群在维生素 D 研究中具有独特的重要性。在这项研究中,我们使用 DiaSorin LIAISON 测量了 390 名居住在蒙古城乡的健康孕晚期妇女的 25-羟维生素 D(25(OH)D)浓度的季节性分布,并将其与居住在美国波士顿的 206 名孕晚期妇女的分布进行了比较。此外,我们使用分位数回归分析了两组中 25(OH)D 水平与选定预测因子之间的季节性独立关联。与波士顿(季节性范围:27.1±7.0-31.5±7.7ng/ml)相比,蒙古(季节性范围:11.2±3.9-19.2±6.7ng/ml)的平均 25(OH)D 水平更高且季节性差异更小。在调整采血月份后,较高的 25(OH)D 水平与波士顿参与者的年龄较大、孕次较低、BMI 较低和未接受过大学或大学教育显著相关,但只有孕次在多变量调整后仍然稳健。在蒙古,没有评估的特征是独立预测的,这可能是由于普遍较低的 25(OH)D 水平和由此导致的个体间差异缺乏。总之,蒙古孕妇的维生素 D 状况全年严重不足,应通过强化和补充来解决,而在美国,缺乏与可通过补充来解决的特定特征有关。