母体维生素 D 与后代骨折风险：妊娠维生素 D 研究。
Maternal vitamin D and offspring fracture risk: the Vitamin D in Pregnancy study.
机构信息
IMPACT, The Institute for Mental and Physical Health and Clinical Translation, Deakin University, Geelong, VIC, 3220, Australia.
Barwon Health, Geelong, VIC, 3220, Australia.
出版信息
Arch Osteoporos. 2021 Oct 27;16(1):159. doi: 10.1007/s11657-021-01023-3.
UNLABELLED
Vitamin D is important for bone health and strength. Previous studies report 25-hydroxyvitamin D (25(OH)D) exposure during pregnancy may impact offspring bone health later in life. In this study, maternal 25(OH)D at recruitment was associated with a lower fracture risk in boys and an increased fracture risk in girls at 28-32 weeks gestation.
PURPOSE
Maternal 25-hydroxyvitamin D (25(OH)D) in pregnancy has been shown to be associated with offspring bone measures in some studies, but few have examined fracture risk. We aimed to determine associations between maternal vitamin D status and offspring fracture risk.
METHODS
In total, 475 mother-child pairs participating in the Vitamin D in Pregnancy study in southeastern Australia were recruited. Maternal serum samples were taken at recruitment (< 16 weeks gestation) and/or 28-32 weeks gestation and analysed for 25(OH)D. Incident fractures in children were ascertained from date of birth (2002-2004) until December 31, 2012. Cox proportional hazard models included maternal age at recruitment, offspring sex, birth weight, gestation length and season of vitamin D sample.
RESULTS
Complete follow-up data were available for 400 children (median age = 9.5 years). There were 68 (17.0%) children who sustained at least one fracture. Higher maternal 25(OH)D (per 10 nmol/L) in early gestation was weakly associated with a decreased fracture risk in boys (HR 0.82; 95% CI 0.68, 0.99; p = 0.048) but not girls (HR 1.10; 95% CI 0.98, 1.25; p = 0.11). At late gestation, higher maternal 25(OH)D was associated with increased fracture risk in girls (HR 1.11; 95% CI 1.01, 1.23; p = 0.038) but not boys (HR 0.94; 95% CI 0.80, 1.10; p = 0.42). No statistically significant relationships were detected in analyses investigating 25(OH)D as a categorical variable.
CONCLUSION
There is some evidence that higher maternal 25(OH)D at recruitment was associated with lower fracture risk in boys, while higher maternal 25(OH)D at 28-32 weeks gestation was associated with an increased fracture risk in girls.
背景
维生素 D 对骨骼健康和强度很重要。先前的研究报告表明，孕妇 25-羟维生素 D（25（OH）D）的暴露可能会影响后代日后的骨骼健康。在这项研究中，招募时的母体 25（OH）D 与 28-32 周妊娠时男孩骨折风险降低和女孩骨折风险增加相关。
目的
一些研究表明，孕妇 25-羟维生素 D（25（OH）D）与后代的骨骼测量值有关，但很少有研究检查骨折风险。我们旨在确定母体维生素 D 状况与后代骨折风险之间的关系。
方法
总共招募了 475 对参与澳大利亚东南部维生素 D 妊娠研究的母婴对。在招募时（<16 周妊娠）和/或 28-32 周妊娠时采集母体血清样本，并分析 25（OH）D。从出生日期（2002-2004 年）到 2012 年 12 月 31 日，通过儿童骨折确定儿童的事件性骨折。Cox 比例风险模型包括招募时的母体年龄、后代性别、出生体重、胎龄和维生素 D 样本季节。
结果
对于 400 名儿童（中位年龄=9.5 岁），可获得完整的随访数据。有 68 名（17.0%）儿童至少发生了一次骨折。早期妊娠中母体 25（OH）D 每增加 10nmol/L，男孩的骨折风险降低（HR 0.82；95%CI 0.68,0.99;p=0.048），但女孩没有（HR 1.10；95%CI 0.98,1.25;p=0.11）。在妊娠晚期，母体 25（OH）D 升高与女孩的骨折风险增加相关（HR 1.11；95%CI 1.01,1.23;p=0.038），但与男孩无关（HR 0.94；95%CI 0.80,1.10;p=0.42）。在调查 25（OH）D 作为分类变量的分析中，未发现具有统计学意义的关系。
结论
有一些证据表明，招募时母体 25（OH）D 较高与男孩骨折风险降低有关，而 28-32 周妊娠时母体 25（OH）D 较高与女孩骨折风险增加有关。
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