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母亲在妊娠中期的血脂水平和维生素 D 状况与巨大儿或小于胎龄儿风险的关系:一项回顾性研究。

Association between maternal lipid profiles and vitamin D status in second trimester and risk of LGA or SGA: a retrospective study.

机构信息

Department of Clinical Laboratory, Guangdong Women and Children Hospital, Guangzhou, China.

出版信息

Front Endocrinol (Lausanne). 2024 Jul 1;15:1297373. doi: 10.3389/fendo.2024.1297373. eCollection 2024.

Abstract

BACKGROUND

Accumulating evidence has linked dyslipidemia during pregnancy to the risk of delivering infants born either large for gestational age (LGA) or small for gestational age (SGA). However, the effects of the vitamin D status on these relationships require further investigation. This study investigated whether the relationship between lipid profiles and the risk of LGA or SGA was influenced by vitamin D levels during the second trimester.

METHODS

Maternal lipid profile levels, including total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and vitamin D levels, were measured in a cohort of 6,499 pregnant women during the second trimester. Multivariate regression models and subgroup analyses were employed to evaluate the potential associations between maternal lipid profiles, vitamin D levels, and the risk of LGA or SGA.

RESULTS

The prevalence of SGA infants was 9.8% (n=635), whereas that of LGA infants was 6.9% (n=447). Maternal TG levels were found to be positively associated with the risk of LGA (odds ratio [OR] = 1.41, 95% confidence interval [CI]:1.17-1.70), whereas a negative association was observed between maternal TG, TC, LDL-C levels, and risk of SGA. Additionally, mothers with higher HDL-C levels were less likely to give birth to an LGA infant (OR=0.58, 95% CI:0.39-0.85). Importantly, associations between TG, TC, LDL-c, and SGA as well as between TG and LGA were primarily observed among pregnant women with insufficient vitamin D levels. As for HDL-C, the risk of LGA was lower in mothers with sufficient vitamin D (OR = 0.42, 95% CI:0.18-0.98) compared to those with insufficient vitamin D (OR = 0.65, 95% CI:0.42-0.99).

CONCLUSION

Vitamin D status during the second trimester exerts a modifying effect on the association between lipid profiles and the risk of LGA and SGA infants.

摘要

背景

越来越多的证据表明,孕妇血脂异常与巨大儿(LGA)或小于胎龄儿(SGA)的分娩风险有关。然而,维生素 D 状态对这些关系的影响需要进一步研究。本研究旨在探讨孕中期维生素 D 水平是否影响血脂谱与 LGA 或 SGA 风险之间的关系。

方法

在一个 6499 名孕妇的队列中,在孕中期测量了母体血脂谱水平,包括总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)和维生素 D 水平。采用多变量回归模型和亚组分析评估母体血脂谱、维生素 D 水平与 LGA 或 SGA 风险之间的潜在关联。

结果

SGA 婴儿的患病率为 9.8%(n=635),而 LGA 婴儿的患病率为 6.9%(n=447)。母体 TG 水平与 LGA 风险呈正相关(比值比[OR] = 1.41,95%置信区间[CI]:1.17-1.70),而母体 TG、TC、LDL-C 水平与 SGA 风险呈负相关。此外,HDL-C 水平较高的母亲不太可能分娩出 LGA 婴儿(OR=0.58,95%CI:0.39-0.85)。重要的是,TG、TC、LDL-c 与 SGA 以及 TG 与 LGA 之间的关联主要发生在维生素 D 水平不足的孕妇中。对于 HDL-C,与维生素 D 水平不足的孕妇相比(OR = 0.42,95%CI:0.18-0.98),维生素 D 水平充足的孕妇的 LGA 风险较低(OR = 0.42,95%CI:0.18-0.98)。

结论

孕中期维生素 D 状态对血脂谱与 LGA 和 SGA 婴儿风险之间的关系具有修饰作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ae8b/11246877/506dc9cd1089/fendo-15-1297373-g001.jpg

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