影响生育门诊就诊女性维生素 D 水平的因素及其对辅助生育结局的影响。

Factors influencing vitamin D levels in women attending the fertility clinic and the effect on assisted fertility outcomes.

机构信息

Department of Breast Surgery, The Affiliated Wuxi Maternity and Child Health Care Hospital of Nanjing Medical University, Wuxi, China.

Department of Gynecology, The Affiliated Wuxi Maternity and Child Health Care Hospital of Nanjing Medical University, Wuxi, China.

出版信息

Ann Palliat Med. 2021 Jul;10(7):7813-7822. doi: 10.21037/apm-21-1511.

DOI:10.21037/apm-21-1511

PMID:34353068

Abstract

BACKGROUND

Several factors affect vitamin D levels, such as sunshine, region, diet, obesity and so on. The primary objective of this study is to determine the prevalence of vitamin D deficiency (VDD) among infertile women in China and the contribution of VDD to the risk of infertility in women.

METHODS

This single-center, retrospective case-control study included 2,456 infertile women. We investigated the vitamin D levels in all patients in the different seasons and across different ages. The clinical data of 411 patients who were in the assisted fertilization programs [in vitro fertilization (IVF) and ICSI] were also analyzed, as well as the correlation between vitamin D status and IVF clinical outcome.

RESULTS

There were significant differences in 25-hydroxyvitamin D (25(OH)D) concentrations in different seasons (P<0.01). The proportions of severe VDD in spring, winter, summer, and autumn were 18.5%, 18.6%, 7.8%, and 8.8%, respectively. The normal levels of 25(OH)D concentration (50-74.9 nmol/L) in summer, autumn, spring, and winter were 28.5%, 26.4%, 13.5%, and 18.3%, respectively. The 25(OH)D concentrations in 3 months (July, August, and September) had the highest levels, with levels over 40 nmol/L in these months. Compared with winter, the risk of severe VDD was lower in summer and autumn (P<0.01). Serum 25(OH)D concentration significantly correlated with female infertility.

CONCLUSIONS

Inference from these results shows that vitamin D may minimize the risk of female infertility and may be related to the seasons and age.

摘要

背景

有几个因素会影响维生素 D 水平，如阳光、地域、饮食、肥胖等。本研究的主要目的是确定中国不孕妇女维生素 D 缺乏症（VDD）的患病率，以及 VDD 对女性不孕风险的影响。

方法

本单中心回顾性病例对照研究纳入了 2456 名不孕妇女。我们调查了所有患者在不同季节和不同年龄段的维生素 D 水平。还分析了 411 名接受辅助生殖方案（体外受精[IVF]和卵胞浆内单精子注射[ICSI]）患者的临床数据，以及维生素 D 状态与 IVF 临床结局的相关性。

结果

不同季节 25-羟维生素 D（25(OH)D）浓度存在显著差异（P<0.01）。春季、冬季、夏季和秋季重度 VDD 的比例分别为 18.5%、18.6%、7.8%和 8.8%。夏季、秋季、春季和冬季正常 25(OH)D 浓度（50-74.9 nmol/L）分别为 28.5%、26.4%、13.5%和 18.3%。7 月、8 月和 9 月（3 个月）25(OH)D 浓度最高，这几个月的水平都超过 40 nmol/L。与冬季相比，夏季和秋季重度 VDD 的风险较低（P<0.01）。血清 25(OH)D 浓度与女性不孕显著相关。