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维生素D辅助治疗对复发性流产患者外周血调节性T细胞比例及妊娠结局的影响

Effect of vitamin D adjuvant therapy on the proportion of regulatory T cells in peripheral blood and pregnancy outcome of patients with recurrent miscarriage.

作者信息

Ling Shaoyun

机构信息

Department of reproductive medicine, Shenzhen Longgang Central Hospital, Shenzhen, China.

出版信息

J Obstet Gynaecol Res. 2025 Jan;51(1):e16151. doi: 10.1111/jog.16151. Epub 2024 Nov 14.

Abstract

BACKGROUND

Recurrent miscarriage (RM) is influenced by immune factors, particularly regulatory T cells, which can impact immune function and miscarriage risk. Vitamin D (VD) is known to regulate the immune system, potentially improving pregnancy outcomes in RM patients. This study aims to assess the effect of VD adjuvant therapy on regulatory T cells and pregnancy outcomes in RM patients.

METHODS

Clinical data from 104 individuals with RM admitted to our hospital between March 2022 and February 2023 were allocated at random to either the VD group (VDG) or the control group (CG), with 52 patients in each group. Both groups received standard treatment; the CG was treated with aspirin, while the VDG received additional VD therapy. Outcomes measured included regulatory T cell proportion, metabolic factors, immune inflammatory markers, and pregnancy outcomes.

RESULTS

After treatment, the proportion of regulatory T cells in VDG was considerably higher (p < 0.05). Additionally, triglyceride levels, leptin, fasting blood glucose, and fasting insulin were lower in the VDG, whereas adiponectin levels were higher (p < 0.05). Levels of progesterone, luteinizing hormone, and 25-hydroxy VD were also higher in the VDG (p < 0.05). Furthermore, interleukin-17, gamma interferon, tumor necrosis factor-α, and C-reactive protein were lower in the VDG (p < 0.05). The pregnancy success rate in the VDG was higher, and the preterm birth rate was lower (p < 0.05).

CONCLUSION

Adjuvant treatment with VD can increase the proportion of regulatory T cells in peripheral blood of individuals with recurrent abortion, regulate metabolic disorder, alleviate immune inflammation, and improve pregnancy outcome.

摘要

背景

复发性流产(RM)受免疫因素影响,尤其是调节性T细胞,其可影响免疫功能和流产风险。已知维生素D(VD)可调节免疫系统,可能改善RM患者的妊娠结局。本研究旨在评估VD辅助治疗对RM患者调节性T细胞和妊娠结局的影响。

方法

将2022年3月至2023年2月期间我院收治的104例RM患者的临床资料随机分为VD组(VDG)和对照组(CG),每组52例。两组均接受标准治疗;CG组采用阿司匹林治疗,VDG组额外接受VD治疗。测量的结果包括调节性T细胞比例、代谢因素、免疫炎症标志物和妊娠结局。

结果

治疗后,VDG组调节性T细胞比例显著更高(p<0.05)。此外,VDG组的甘油三酯水平、瘦素、空腹血糖和空腹胰岛素较低,而脂联素水平较高(p<0.05)。VDG组的孕酮、促黄体生成素和25-羟基VD水平也较高(p<0.05)。此外,VDG组的白细胞介素-17、γ干扰素、肿瘤坏死因子-α和C反应蛋白较低(p<0.05)。VDG组的妊娠成功率较高,早产率较低(p<0.05)。

结论

VD辅助治疗可增加复发性流产患者外周血中调节性T细胞的比例,调节代谢紊乱,减轻免疫炎症,改善妊娠结局。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9e20/11635183/b5786d17e45e/JOG-51-0-g004.jpg

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