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围产期维生素D代谢。IV. 母体和脐带血清24,25-二羟基维生素D浓度。

Perinatal vitamin D metabolism. IV. Maternal and cord serum 24,25-dihydroxyvitamin D concentrations.

作者信息

Hillman L S, Slatopolsky E, Haddad J G

出版信息

J Clin Endocrinol Metab. 1978 Nov;47(5):1073-7. doi: 10.1210/jcem-47-5-1073.

Abstract

Fetal and maternal compartments differ in factors shown to regulate 24.25 dihydroxyvitamin D [24,25(OH)2D] metabolism [calcium, phosphorus, and parathyroid hormone (PTH)] such that one might predict that maternal serum 24,25(OH)2D levels are decreased and fetal 24,25(OH)2D concentrations are increased. To evaluate this, 25-hydroxyvitamin D (25OHD), 24,25(OH)2D, calcium, magnesium, calcitonin, and PTH were measured in 24 paired maternal and cord sera. The mean maternal serum 24,25(OH)2D concentration (2.9 +/- 0.26 ng/ml) was significantly lower than that of nonpregnant females (3.9 +/- 0.37 ng/ml). Mean serum PTH and calcitonin levels were, however, normal in maternal sera. The normal elevations of PRL, estrogen, and placental lactogen in serum of pregnant women could possibly decrease 24,25(OH)2D production, as seen in animal experimental systems. There was no correlation (R = -0.25) between 24,25(OH)2D levels in maternal and cord sera, as predicted; however, mean (+/-SE) fetal 24,25(OH)2D (2.5 +/- 0.26 ng/ml) was similar to the mean maternal concentration and significantly below the mean level in normal adults. The low fetal 24,25(OH)2D concentration may be due to 1) decreased 24-hydroxylase capacity of the fetus; 2) regulation by fetal factors other than calcium, phosphorus, and PTH; or 3) increased utilization of 24,25(OH)2D possibly for fetal bone mineralization.

摘要

胎儿和母体部分在调节24,25 - 二羟基维生素D [24,25(OH)₂D]代谢的因素(钙、磷和甲状旁腺激素 (PTH))方面存在差异,因此有人可能预测母体血清24,25(OH)₂D水平会降低,而胎儿24,25(OH)₂D浓度会升高。为了评估这一点,对24对母体和脐带血清进行了25 - 羟基维生素D (25OHD)、24,25(OH)₂D、钙、镁、降钙素和PTH的测量。母体血清24,25(OH)₂D的平均浓度(2.9±0.26 ng/ml)显著低于未怀孕女性(3.9±0.37 ng/ml)。然而,母体血清中的血清PTH和降钙素水平正常。孕妇血清中PRL、雌激素和胎盘催乳素的正常升高可能会降低24,25(OH)₂D的产生,如在动物实验系统中所见。如预测的那样,母体和脐带血清中的24,25(OH)₂D水平之间没有相关性(R = -0.25);然而,胎儿24,25(OH)₂D的平均(±SE)水平(2.5±0.26 ng/ml)与母体平均浓度相似,且显著低于正常成年人的平均水平。胎儿24,25(OH)₂D浓度低可能是由于1)胎儿的24 - 羟化酶能力降低;2)受钙、磷和PTH以外的胎儿因素调节;或3)24,25(OH)₂D的利用增加,可能用于胎儿骨骼矿化。

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