Unit of Endocrinology, Diabetes Mellitus and Metabolism, Aretaieion University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
Department Obstetrics and Gynecology, Helena Venizelou General District Hospital, Athens, Greece.
J Clin Endocrinol Metab. 2021 Jun 16;106(7):e2647-e2655. doi: 10.1210/clinem/dgab152.
To examine the association of maternal bone markers [sclerostin, soluble receptor activator of nuclear factor-κB ligand (sRANKL), osteocalcin, 25-hydroxyvitamin D3] with fetal intra-abdominal and subcutaneous adipose tissue deposition and birthweight during normal pregnancy.
One hundred pregnant women (aged 30.4 ± 5.6 years, mean ± SD) with prepregnancy body mass index = 24.1 ± 4.6 kg/m2 were seen prospectively during each trimester. At each visit they were submitted to anthropometric measurements, a fasting blood sampling, a 75-g oral glucose tolerance test, and a fetal ultrasonogram. At birth, neonates had birth weight measurement.
In the second trimester, maternal sclerostin concentrations correlated positively with fetal abdominal circumference and birth weight; maternal sRANKL concentrations correlated positively with fetal abdominal subcutaneous fat thickness, sagittal abdominal diameter, and abdominal circumference. Fetuses born to mothers with greater (>254 ng/mL), compared to fetuses born to mothers with lower (≤254ng/mL), sRANKL concentrations had greater abdominal circumference, sagittal diameter, and abdominal subcutaneous fat thickness. Maternal serum sclerostin concentrations were the best positive predictors of birth weight. In the third trimester maternal sclerostin concentrations correlated positively with fetal sagittal abdominal diameter; maternal sRANKL concentrations positively correlated with fetal abdominal circumference and fetal abdominal sagittal diameter.
Maternal bone markers sclerostin and sRANKL may relate to fetal intra-abdominal adipose tissue deposition through as yet unknown direct or indirect mechanisms, thus contributing to birthweight.
研究母体骨标志物[骨硬化蛋白、可溶性核因子-κB 配体受体激活剂（sRANKL）、骨钙素、25-羟维生素 D3]与正常妊娠期间胎儿腹内和皮下脂肪组织沉积及出生体重的关系。
前瞻性观察 100 例孕妇（年龄 30.4±5.6 岁，均数±标准差），其孕前体质量指数为 24.1±4.6kg/m2。在每个孕期，对孕妇进行体格测量、空腹采血、75g 口服葡萄糖耐量试验和胎儿超声检查。新生儿出生时测量出生体重。
在孕中期，母体骨硬化蛋白浓度与胎儿腹围和出生体重呈正相关；母体 sRANKL 浓度与胎儿腹部皮下脂肪厚度、矢状腹径和腹围呈正相关。与出生于 sRANKL 浓度较低（≤254ng/mL）孕妇的胎儿相比，出生于 sRANKL 浓度较高（>254ng/mL）孕妇的胎儿具有更大的腹围、矢状径和腹部皮下脂肪厚度。母体血清骨硬化蛋白浓度是预测出生体重的最佳正相关指标。在孕晚期，母体骨硬化蛋白浓度与胎儿矢状腹径呈正相关；母体 sRANKL 浓度与胎儿腹围和胎儿腹部矢状径呈正相关。
母体骨标志物骨硬化蛋白和 sRANKL 可能通过未知的直接或间接机制与胎儿腹内脂肪组织沉积有关，从而影响出生体重。
