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维生素D缺乏对先兆子痫和妊娠高血压综合征孕妇动脉僵硬度的影响及其对胎儿发育的意义

Effect of Vitamin D Deficiency on Arterial Stiffness in Pregnant Women with Preeclampsia and Pregnancy-Induced Hypertension and Implications for Fetal Development.

作者信息

Iurciuc Mircea, Buleu Florina, Iurciuc Stela, Petre Izabella, Popa Daian, Moleriu Radu Dumitru, Bordianu Anca, Suciu Oana, Tasdemir Rabia, Dragomir Ramona-Elena, Otilia Timircan Madalina, Petre Ion

机构信息

Department of Cardiology, "Victor Babes" University of Medicine and Pharmacy, E. Murgu Square No. 2, 300041 Timisoara, Romania.

County Emergency Clinical Hospital "Pius Brinzeu", 300732 Timisoara, Romania.

出版信息

Biomedicines. 2024 Jul 18;12(7):1595. doi: 10.3390/biomedicines12071595.

Abstract

BACKGROUND AND OBJECTIVES

Over the past few years, researchers have focused on the importance of vitamin D in the health of pregnant women and in reducing the chances of developmental disorders occurring in fetuses. In addition, a link has been established between fetal development and arterial stiffness in hypertensive disorders that occur during pregnancy. Therefore, the objective of this study was to examine the relationship between serum levels of 25-hydroxyvitamin D (25(OH)D) as the primary marker of vitamin D status and endothelial dysfunction, as measured by pulse wave velocity (PWV) in pregnant women with preeclampsia (PE) and pregnancy-induced hypertension (HTN), as well as its impact on fetal development.

MATERIALS AND METHODS

This study included 187 pregnant women who met the study inclusion criteria. Pregnant women were divided into two groups: pregnancy-induced hypertension (HTN group), which included 100 patients (53.48%), and preeclampsia (PE group), which included 87 patients (46.52%).

RESULTS

Significant differences regarding the augmentation index (Aix) brachial, PWVao, heart rate, and systolic or diastolic blood pressure with more increased values were observed for the HTN group vs. the preeclampsia group in the current research ( < 0.001). Additionally, the Aix brachial index was significantly lower in the preeclampsia group compared to the HTN group (1.76 ± 0.71 for the HTN group vs. 0.62 ± 0.5 for the preeclampsia group, < 0.001). A severe matern serum 25(OH)D level deficiency was associated with a more severe subcategory of prematurity ( < 0.001) and with increased chances of newborn preterm birth ( < 0.05). Moreover, the negative effect of severe maternal serum 25(OH)D level deficiency was studied for each group regarding the blood pressure values, Aix brachial, PWVao values in the second and third trimesters, and fetus weight. The Kruskal-Wallis test was applied for this, obtaining significant differences in all cases: open paren p less than 0.05 and closed. When serum severe 25(OH)D levels deficiency was present, arterial stiffness parameters were significantly worse.

CONCLUSIONS

The findings of this research revealed notable connections between vitamin D deficiency and increased arterial rigidity in pregnant women with preeclampsia and pregnancy-induced hypertension. These results emphasize the significance of conducting both examinations to obtain a more comprehensive evaluation of these patients. Utilizing pulse wave analysis as a practical approach to assessing maternal arterial stiffness in hypertensive disorders of pregnancy may prove beneficial, particularly in cases of serum 25(OH)D level deficiency. It could play a key role in identifying patients at higher risk of worsening disease severity and, thus, preventing any impact on fetal development.

摘要

背景与目的

在过去几年中,研究人员一直关注维生素D对孕妇健康的重要性以及降低胎儿发生发育障碍的几率。此外,已确定胎儿发育与孕期发生的高血压疾病中的动脉僵硬度之间存在联系。因此,本研究的目的是探讨作为维生素D状态主要标志物的血清25-羟基维生素D(25(OH)D)水平与子痫前期(PE)和妊娠高血压(HTN)孕妇的内皮功能障碍(通过脉搏波速度(PWV)测量)之间的关系,以及其对胎儿发育的影响。

材料与方法

本研究纳入了187名符合研究纳入标准的孕妇。孕妇被分为两组:妊娠高血压组(HTN组),包括100例患者(53.48%);子痫前期组(PE组),包括87例患者(46.52%)。

结果

在本研究中,与子痫前期组相比,HTN组在肱动脉增强指数(Aix)、主动脉脉搏波速度(PWVao)、心率以及收缩压或舒张压方面存在显著差异,且HTN组的数值更高(<0.001)。此外,子痫前期组的肱动脉Aix指数显著低于HTN组(HTN组为1.76±0.71,子痫前期组为0.62±0.5,<0.001)。严重的母体血清25(OH)D水平缺乏与更严重的早产亚类相关(<0.001),并增加了新生儿早产的几率(<0.05)。此外,针对每组,研究了严重母体血清25(OH)D水平缺乏对第二和第三孕期血压值、肱动脉Aix、主动脉PWVao值以及胎儿体重的负面影响。为此应用了Kruskal-Wallis检验,在所有情况下均获得了显著差异(括号内p小于0.05且封闭)。当存在血清严重25(OH)D水平缺乏时,动脉僵硬度参数明显更差。

结论

本研究结果揭示了子痫前期和妊娠高血压孕妇维生素D缺乏与动脉僵硬度增加之间的显著联系。这些结果强调了同时进行这两项检查以更全面评估这些患者的重要性。利用脉搏波分析作为评估妊娠高血压疾病中母体动脉僵硬度的实用方法可能是有益的,特别是在血清25(OH)D水平缺乏的情况下。它可能在识别疾病严重程度恶化风险较高的患者方面发挥关键作用,从而防止对胎儿发育产生任何影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/45f7/11274685/0001a20e1e52/biomedicines-12-01595-g001.jpg

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