Department of Human Movement Sciences, Old Dominion University, Norfolk, VA, USA.
Department of Obstetrics and Gynecology, Eastern Virginia Medical School, Norfolk, VA, USA.
J Matern Fetal Neonatal Med. 2022 Dec;35(25):7073-7080. doi: 10.1080/14767058.2021.1941855. Epub 2021 Jun 23.
Women with high levels of physical activity have improved pregnancy, labor, and delivery outcomes related to cardiovascular health. Hyperhomocysteinemia, which predicts cardiovascular disease risk, is associated with maternal vascular complications during pregnancy, such as placental abruption and preeclampsia. However, studies are lacking on whether physical activity impacts homocysteine in pregnant women, pointing to a potential mechanism behind the improved cardiovascular health in women who exercise during pregnancy. The purpose of this study was to examine if women with high levels of physical activity have lower levels of homocysteine compared to women with low levels of physical activity.
This study was a secondary analysis using data from the 2003 to 2006 National Health and Nutrition Examination Survey. A total of 257 pregnant women were included. Physical activity was assessed objectively over seven days with accelerometers. High and low groups based on moderate-to-vigorous physical activity (MVPA) and steps/day were defined. Homocysteine and related laboratory biomarkers (vitamin B12, folate, pyridoxal 5'-phosphate) were assessed through blood draws. Data assembly was performed using SAS and analysis SPSS Complex Samples.
Only an estimated 17.7 ± 4.7% of women met guidelines to achieve at least 150 min per week of MVPA. Plasma homocysteine was not different between pregnant women with high and low levels of moderate-to-vigorous physical activity (4.39 ± 0.21 and 4.44 ± 0.17 µmol/L; > .05) or between those with high and low levels of steps (3.95 ± 0.26 and 4.62 ± 0.27 µmol/L; > .05) when the data was split into two quantiles by the median. These results were similar when using log-transformed values for homocysteine to normalize the distribution of data. Pregnant women in the group of the high steps tended to have higher vitamin B12, folate, and pyridoxal 5'-phosphate than those in the group of the low steps. Sensitivity analyses revealed that homocysteine was not different between the upper 25% (4.04 ± 0.22 µmol/L) and lower 25% (4.17 ± 0.26 µmol/L) MVPA ( = .716) but that it was statistically higher in the low (<5000 steps/day) (4.99 ± 0.20 µmol/L) steps/day group compared to high (>7500 steps/day) steps/day (3.99 ± 0.23 µmol/L) ( = .003) after excluding individuals with hypertension and thyroid/kidney issues.
Maternal steps/day, but not MVPA, appear to be associated with homocysteine (albeit weakly) in the present study after excluding potential factors which impact homocysteine. The volume of physical activity appears to be an important indicator as this difference was not revealed until the physical activity was more distinctly separated.
身体活动水平较高的女性在与心血管健康相关的妊娠、分娩和分娩结果方面有所改善。高同型半胱氨酸血症可预测心血管疾病风险，与妊娠期间的母体血管并发症有关，如胎盘早剥和子痫前期。然而，目前缺乏关于身体活动是否会影响孕妇同型半胱氨酸的研究，这表明在怀孕期间进行锻炼的女性心血管健康改善的潜在机制。本研究旨在研究身体活动水平较高的女性与身体活动水平较低的女性相比，其同型半胱氨酸水平是否较低。
本研究是对 2003 年至 2006 年全国健康和营养调查数据的二次分析。共纳入 257 名孕妇。使用加速度计在七天内对身体活动进行客观评估。根据中等到剧烈体力活动（MVPA）和步数/天的中位数将女性分为高和低两组。通过血液抽取评估同型半胱氨酸和相关实验室生物标志物（维生素 B12、叶酸、吡哆醛 5'-磷酸）。使用 SAS 进行数据组装，使用 SPSS 复杂样本进行分析。
只有约 17.7±4.7%的女性达到了每周至少 150 分钟的 MVPA 指南。当按中位数将数据分为两部分时，高、低水平中到剧烈体力活动的孕妇（4.39±0.21 和 4.44±0.17μmol/L；>0.05）或高、低水平步数的孕妇（3.95±0.26 和 4.62±0.27μmol/L；>0.05）的血浆同型半胱氨酸没有差异。当使用同型半胱氨酸的对数转换值来归一化数据分布时，这些结果相似。高步组的孕妇维生素 B12、叶酸和吡哆醛 5'-磷酸的水平高于低步组。敏感性分析显示，高（4.04±0.22μmol/L）和低（4.17±0.26μmol/L）MVPA（=0.716）组之间的同型半胱氨酸无差异，但在低（<5000 步/天）（4.99±0.20μmol/L）步/天组中，同型半胱氨酸高于高（>7500 步/天）步/天（3.99±0.23μmol/L）（=0.003），但排除高血压和甲状腺/肾脏问题患者后。
在本研究中，排除影响同型半胱氨酸的潜在因素后，母亲的每日步数而非 MVPA 似乎与同型半胱氨酸（尽管相关性较弱）有关。身体活动量似乎是一个重要指标，因为只有当身体活动明显分开时，才会出现这种差异。
