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2012-2021 年期间俄罗斯孕妇的维生素 D 状况与妊娠糖尿病:一项巢式病例对照研究。

Vitamin D Status and Gestational Diabetes in Russian Pregnant Women in the Period between 2012 and 2021: A Nested Case-Control Study.

机构信息

Institute of Endocrinology, Almazov National Medical Research Centre, 194156 Saint Petersburg, Russia.

World-Class Research Center for Personalized Medicine, Almazov National Medical Research Centre, 194156 Saint Petersburg, Russia.

出版信息

Nutrients. 2022 May 22;14(10):2157. doi: 10.3390/nu14102157.

Abstract

Several meta-analyses found an association between low maternal serum 25-hydroxyvitamin D (25(OH)D) level and gestational diabetes mellitus (GDM). However, some of them reported significant heterogeneity. We examined the association of serum 25(OH)D concentration measured in the first and in the second halves of pregnancy with the development of GDM in Russian women surveyed in the periods of 2012−2014 and 2018−2021. We conducted a case−control study (including 318 pregnant women) nested on two previous studies. In 2012−2014, a total of 214 women (83 GDM and 131 controls) were enrolled before 15 weeks of gestation and maternal serum 25(OH)D concentrations were measured twice: at 8th−14th week of gestation and simultaneously with two-hour 75 g oral glucose tolerance test (OGTT) at 24th−32nd week of gestation. In the period of 2018−2021, 104 women (56 GDM and 48 controls) were included after OGTT and 25(OH)D concentrations were measured at 24th−32nd week of gestation. Median 25(OH)D levels were 20.0 [15.1−25.7] vs. 20.5 [14.5−27.5] ng/mL (p = 0.565) in GDM and control group in the first half of pregnancy and 25.3 [19.8−33.0] vs. 26.7 [20.8−36.8] ng/mL (p = 0.471) in the second half of pregnancy, respectively. The prevalence rates for vitamin D deficiency (25(OH)D levels < 20 ng/mL) were 49.4% and 45.8% (p = 0.608) in the first half of pregnancy and 26.2% vs. 22.1% (p = 0.516) in the second half of pregnancy in women who developed GDM and in women without GDM, respectively. The frequency of vitamin D supplements intake during pregnancy increased in 2018−2021 compared to 2012−2014 (p = 0.001). However, the third trimester 25(OH)D levels and prevalence of vitamin D deficiency (25.5 vs. 23.1, p = 0.744) did not differ in women examined in the periods of 2012−2014 and 2018−2021. To conclude, there was no association between gestational diabetes risk and maternal 25(OH)D measured both in the first and in the second halves of pregnancy. The increased prevalence of vitamin D supplements intake during pregnancy by 2018−2021 did not lead to higher levels of 25(OH)D.

摘要

几项荟萃分析发现,母体血清 25-羟维生素 D(25(OH)D)水平低与妊娠糖尿病(GDM)之间存在关联。然而,其中一些研究报告存在显著的异质性。我们研究了在 2012-2014 年和 2018-2021 年期间在俄罗斯妇女中进行的两项先前研究的嵌套病例对照研究中,妊娠第一和第二半段期间血清 25(OH)D 浓度与 GDM 发展之间的关联。在 2012-2014 年,共有 214 名妇女(83 名 GDM 和 131 名对照)在妊娠 15 周前入组,两次测量了母体血清 25(OH)D 浓度:妊娠第 8-14 周和同时在妊娠第 24-32 周进行两小时 75 g 口服葡萄糖耐量试验(OGTT)。在 2018-2021 年期间,在 OGTT 后纳入了 104 名妇女(56 名 GDM 和 48 名对照),并在妊娠第 24-32 周测量了 25(OH)D 浓度。在妊娠第一半段,GDM 和对照组的中位数 25(OH)D 水平分别为 20.0 [15.1-25.7] vs. 20.5 [14.5-27.5] ng/mL(p = 0.565),而在妊娠第二半段,分别为 25.3 [19.8-33.0] vs. 26.7 [20.8-36.8] ng/mL(p = 0.471)。在发生 GDM 和未发生 GDM 的妇女中,维生素 D 缺乏症(25(OH)D 水平 < 20 ng/mL)的患病率分别为 49.4%和 45.8%(p = 0.608)在妊娠第一半段,分别为 26.2%和 22.1%(p = 0.516)在妊娠第二半段。与 2012-2014 年相比,2018-2021 年期间妊娠期间维生素 D 补充剂的摄入频率增加(p = 0.001)。然而,在 2012-2014 年和 2018-2021 年期间检查的妇女中,第三孕期 25(OH)D 水平和维生素 D 缺乏症(25.5 vs. 23.1,p = 0.744)的患病率没有差异。总之,母体血清 25(OH)D 在妊娠第一和第二半段的测量值与妊娠糖尿病风险之间没有关联。2018-2021 年期间妊娠期间维生素 D 补充剂摄入的增加并没有导致 25(OH)D 水平升高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a42f/9143366/d35a8a309596/nutrients-14-02157-g001.jpg

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