血清维生素 D 状况与孕早期孕妇妊娠糖尿病及其他实验室参数的相关性。
Association of serum vitamin D status with gestational diabetes mellitus and other laboratory parameters in early pregnant women.
机构信息
Department of Obstetrics, Southern Medical University Affiliated Maternal & Children's Hospital of Foshan, No. 11 Renminxi Road, Foshan, Guangdong, 528000, China.
Department of Epidemiology, School of Public Health, Southern Medical University, No. 1838 North Guangzhou Avenue, Guangzhou, 510515, China.
出版信息
BMC Pregnancy Childbirth. 2022 May 11;22(1):400. doi: 10.1186/s12884-022-04725-9.
BACKGROUND
The association between serum 25-hydroxy vitamin D (25(OH)D) status and gestational diabetes mellitus (GDM) gained attention in recent years, however the conclusion is still controversial due to many interfering factors, such as region of living, environment, lifestyle, and food supplements. Other metabolites (laboratory parameters) are also important in reflecting gestational states. This study aimed to investigate the association of serum 25(OH)D status in early pregnancy with GDM and other laboratory parameters in pregnant women.
METHODS
A total of 1516 pregnant women whose blood glucose were normal before pregnancy in the city of Foshan in Guangdong, China were enrolled in this study. GDM was diagnosed between 24 to 28 weeks of pregnancy following the guidelines from the American Diabetes Association. Maternal serum 25(OH)D and other laboratory parameters-including hematology, coagulation, chemistry, and bone density-were measured utilizing various analytical methods in clinical laboratory at gestational weeks 11 to 14.
RESULTS
The average 25(OH)D concentration was 59.1 ± 12.6 nmol/L. None of the study subjects had 25(OH)D < 25 nmol/L; 434 (28.6%) women had 25(OH)D deficiency (< 50 nmol/L), 882 women (58.2%) had 25(OH)D insufficiency (50-74 mmol/L) and 200 women (13.2%) had 25(OH)D sufficiency (≥ 75 nmol/L). There were 264 (17.4%) women diagnosed with GDM. There was not, however, an association between serum 25(OH)D in early pregnancy and GDM. Interestingly, women with more parity and high serum alkaline phosphatase levels had higher serum 25(OH)D levels. There was a possible positive association between serum 25(OH)D and pre-albumin, and a possible negative association between serum 25(OH)D, creatinine, and thrombin time. This study did not find an association between serum 25(OH)D and bone density.
CONCLUSIONS
There were no associations between maternal serum 25(OH)D concentration in early pregnancy and the risk of GDM or bone density. There were, however, correlations between serum 25(OH)D and parity, seasoning at sampling, serum alkaline phosphatase, creatinine, pre-albumin, and coagulation factor thrombin time, which need further study to explain their pathophysiology and clinical significance.
背景
近年来，血清 25-羟维生素 D（25（OH）D）状态与妊娠糖尿病（GDM）之间的关联引起了关注，但由于许多干扰因素，如居住地区、环境、生活方式和食物补充，结论仍存在争议。其他代谢物（实验室参数）在反映妊娠状态方面也很重要。本研究旨在探讨孕早期血清 25（OH）D 状态与孕妇 GDM 及其他实验室参数的关系。
方法
本研究共纳入 1516 名在广东省佛山市居住的孕前血糖正常的孕妇。根据美国糖尿病协会的指南，在妊娠 24-28 周时诊断 GDM。利用临床实验室的各种分析方法，在妊娠 11-14 周时测量孕妇血清 25（OH）D 和其他实验室参数，包括血液学、凝血、化学和骨密度。
结果
平均 25（OH）D 浓度为 59.1±12.6nmol/L。无研究对象 25（OH）D<25nmol/L；434 名（28.6%）妇女 25（OH）D 缺乏（<50nmol/L），882 名（58.2%）妇女 25（OH）D 不足（50-74mmol/L），200 名（13.2%）妇女 25（OH）D 充足（≥75nmol/L）。共有 264 名（17.4%）妇女被诊断为 GDM。然而，孕早期血清 25（OH）D 与 GDM 之间并无关联。有趣的是，产次较多和血清碱性磷酸酶水平较高的妇女血清 25（OH）D 水平较高。血清 25（OH）D 与前白蛋白呈正相关，与肌酐和凝血酶时间呈负相关，可能存在相关性。本研究未发现血清 25（OH）D 与骨密度之间存在关联。
结论
孕早期母体血清 25（OH）D 浓度与 GDM 或骨密度风险之间无关联。然而，血清 25（OH）D 与产次、采样时的季节、血清碱性磷酸酶、肌酐、前白蛋白和凝血因子凝血酶时间之间存在相关性，需要进一步研究以解释其病理生理学和临床意义。
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