Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.
Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark.
Am J Clin Nutr. 2022 Aug 4;116(2):470-481. doi: 10.1093/ajcn/nqac118.
Blood pressure in childhood tracks into later life. Vitamin D status in adults is associated with blood pressure, but the impact of vitamin D status in pregnancy and childhood on blood pressure still needs investigation.
We investigated whether fetal rather than current vitamin D status is associated with blood pressure in children.
In a prospective observational study within the population-based Odense Child Cohort (OCC), we examined serum 25-hydroxyvitamin D2+3 [s-25(OH)D] in early and late pregnancy, cord blood, and at 5 y age, and the associations with systolic and diastolic blood pressure (SBP/DBP) in the 5-y-old children (n = 1,677). Multiple regression models were adjusted for maternal country of origin, parity, smoking during pregnancy, 5-y height, and weight. Two-stage mixed effect modeling was performed, integrating all s-25(OH)D data from pregnancy and cord blood.
The median (IQR) s-25(OH)D in early pregnancy, late pregnancy, the umbilical cord, and at 5 y was 65.5 (50.7-78.5), 78.5 (60.3- 95.8), 45.4 (31.1- 60.7), and 71.9 (54.6- 86.5) nmol/L, respectively. The mean ±SD 5-y SBP/DBP was 101.0/63.8 (7.1/5.9) mmHg. In adjusted analyses, a 10 nmol/L increase of s-25(OH)D in early pregnancy associated with a 0.3/0.2 mmHg lower SBP/DBP at 5 y (P < 0.05). Optimal s-25(OH)D (>75 nmol/L) in early pregnancy was associated with lower 5-y SBP and DBP, β (95% CI) -1.45 (-2.6, -0.3), and -0.97 (-1.9, -0.1), compared with reference s-25(OH)D (50-74.9 nmol/L). Two-stage analysis combining early pregnancy, late pregnancy, and cord s-25(OH)D data showed an inverse association with 5-y SBP and DBP for boys (P < 0.025) with significant sex-difference for DBP (Pinteraction = 0.004). No associations were found between s-25(OH)D and 5-y BP above the 90th percentile.
Early pregnancy s-25(OH)D concentrations, especially >75 nmol/L, were inversely associated with 5-y blood pressure in the offspring. A novel identified protective effect of optimal vitamin D levels in early pregnancy on offspring BP is suggested.
儿童时期的血压会持续到成年。成年人的维生素 D 状况与血压有关，但怀孕期间和儿童期维生素 D 状况对血压的影响仍需要研究。
我们研究了胎儿而不是当前的维生素 D 状况是否与儿童的血压有关。
在基于人群的奥登塞儿童队列（OCC）的前瞻性观察性研究中，我们检测了早孕期、晚孕期、脐带血和 5 岁时的血清 25-羟维生素 D2+3[s-25(OH)D]，并将其与 5 岁儿童的收缩压和舒张压（SBP/DBP）相关联（n=1677）。多元回归模型调整了母亲的原籍国、产次、孕期吸烟、5 岁身高和体重。采用两阶段混合效应模型整合了妊娠和脐带血的所有 s-25(OH)D 数据。
早孕期、晚孕期、脐带和 5 岁时的中位数（IQR）s-25(OH)D 分别为 65.5（50.7-78.5）、78.5（60.3-95.8）、45.4（31.1-60.7）和 71.9（54.6-86.5）nmol/L，5 岁时的平均 SBP/DBP 为 101.0/63.8（7.1/5.9）mmHg。在调整分析中，早孕期 s-25(OH)D 每增加 10 nmol/L，5 岁时的 SBP/DBP 分别降低 0.3/0.2mmHg（P<0.05）。早孕期最佳 s-25(OH)D（>75 nmol/L）与较低的 5 岁 SBP 和 DBP 相关，β（95%CI）-1.45（-2.6，-0.3）和-0.97（-1.9，-0.1），与参考 s-25(OH)D（50-74.9 nmol/L）相比。早孕期、晚孕期和脐带 s-25(OH)D 数据的两阶段分析显示，男孩的 SBP 和 DBP 与 5 岁时的 SBP 和 DBP 呈负相关（P<0.025），且 DBP 存在显著的性别差异（P 交互=0.004）。在 SBP/DBP 高于第 90 百分位数时，未发现 s-25(OH)D 与 5 岁时 BP 的相关性。
早孕期 s-25(OH)D 浓度，特别是>75 nmol/L，与后代 5 岁时的血压呈负相关。提示孕期维生素 D 水平最佳对后代 BP 有保护作用。
