National Institute for Environmental Studies, Tsukuba, Ibaraki 305-8506, Japan.
Department of Orthopaedics, Juntendo University Nerima Hospital, Nerima, Tokyo 177-8521, Japan; Child and AYA Generation Bone Health Care Center, Juntendo University Nerima Hospital, Nerima, Tokyo 177-8521, Japan.
J Steroid Biochem Mol Biol. 2023 May;229:106272. doi: 10.1016/j.jsbmb.2023.106272. Epub 2023 Feb 10.
Although vitamin D (VD; serum 25 hydroxyvitamin D) deficiency (< 20 ng/mL) is widespread among Japanese women, the VD status among pregnant women is unknown. This study aimed to determine the VD status of pregnant Japanese women during different meteorological seasons and to determine the factors controlling VD status. A total of 309 pregnant Japanese women were recruited at 28 weeks of gestation at the gynecology department of a university hospital in Tokyo between August 2018 and October 2019. Blood samples were collected to measure serum 25(OH)D levels. Two questionnaires were completed: a brief self-administered dietary history questionnaire (BDHQ) and an outdoor exposure history questionnaire to determine skin sunlight exposure and the use of sunscreen. Among the recruited subjects, 268 were included in the statistical analysis. The average VD intake from food was 9.0 μg/day, the average VD synthesis from UV-B was 15.2 μg/day, and the average sum of VD intake and nominal VD synthesis was 24.1 μg/day; this exceeded the recommended 2011 Dietary Reference Intake for the USA and Canada (15.0 μg/day). However, the average serum 25(OH)D level (11.4 ng/mL) was very low, indicating widespread VD deficiency. Serum 25(OH)D and VD synthesis by solar UV-B were significantly correlated only during the high UV-B season. The 25(OH)D level was weakly correlated with the VD intake from food in all seasons. We obtained a statistically significant correlation between serum 25(OH)D level and VD intake from food using the BDHQ. We also obtained a statistically significant correlation between the serum 25(OH)D level and VD synthesis from solar UV-B exposure, especially during the high UV-B season. Our logistic regression analysis model predicted VD deficiency in 88.0% of subjects. Our method might be possible to be used to predict the VD status of pregnant Japanese women, although another validation cohort is needed to verify the ability of the estimation equation.
虽然维生素 D(VD;血清 25 羟维生素 D)缺乏症(<20ng/mL)在日本女性中普遍存在,但孕妇的 VD 状况尚不清楚。本研究旨在确定不同气象季节孕妇的 VD 状况,并确定控制 VD 状况的因素。2018 年 8 月至 2019 年 10 月,在东京一所大学医院的妇产科,共招募了 309 名 28 周妊娠的日本孕妇。采集血样以测量血清 25(OH)D 水平。完成了两份问卷:一份简短的自我管理饮食史问卷(BDHQ)和一份户外暴露史问卷,以确定皮肤阳光暴露和防晒霜的使用情况。在招募的受试者中,有 268 名被纳入统计分析。食物中 VD 的平均摄入量为 9.0μg/天,UV-B 产生的 VD 合成量为 15.2μg/天,VD 摄入量和名义 VD 合成量的平均总和为 24.1μg/天;这超过了美国和加拿大 2011 年膳食参考摄入量(15.0μg/天)的推荐值。然而,平均血清 25(OH)D 水平(11.4ng/mL)非常低,表明普遍存在 VD 缺乏症。仅在高 UV-B 季节,血清 25(OH)D 与来自太阳 UV-B 的 VD 合成才呈显著相关。在所有季节,25(OH)D 水平与食物中 VD 摄入量的相关性均较弱。我们使用 BDHQ 获得了血清 25(OH)D 水平与食物中 VD 摄入量之间的统计学显著相关性。我们还获得了血清 25(OH)D 水平与来自太阳 UV-B 暴露的 VD 合成之间的统计学显著相关性,尤其是在高 UV-B 季节。我们的逻辑回归分析模型预测 88.0%的受试者存在 VD 缺乏症。虽然需要另一个验证队列来验证估计方程的能力,但我们的方法可能可用于预测日本孕妇的 VD 状况。