Akita Keisuke, Ikenoue Satoru, Tamai Junko, Otani Toshimitsu, Fukutake Marie, Kasuga Yoshifumi, Tanaka Mamoru
Department of Obstetrics and Gynecology, Keio University School of Medicine, Shinanomachi, Shinjuku-ku 160-8582, Tokyo, Japan.
Int J Mol Sci. 2025 May 7;26(9):4435. doi: 10.3390/ijms26094435.
25-hydroxyvitamin D (25(OH)D) regulates lipid metabolism, and its decrease is proposed as a pathogenesis of metabolic syndrome, gestational diabetes mellitus (GDM), and eventually fetal adiposity. Decreased 25(OH)D is also linked with the development of gestational diabetes mellitus (GDM), which is associated with increased fetal adiposity. Fetuses are dependent on the supply of 25(OH)D from maternal circulation. However, the influence of maternal serum 25(OH)D on fetal adiposity remains unclear. This study aimed to investigate the association between maternal serum 25(OH)D and fetal adiposity. A prospective longitudinal study was conducted in a cohort of 89 (including 21 GDM) singleton pregnancies. Maternal blood samples were obtained at 10, 24, 30, and 36 weeks, and fetal ultrasonography was performed at 24, 30, and 36 weeks of gestation. Estimated fetal adiposity (EFA) was calculated as the average z-score of cross-sectional arm and thigh percentage fat area and anterior abdominal wall thickness as previously reported. The multiple linear regression analyses indicated that maternal 25(OH)D levels across gestation were not associated with EFA at 24 and 30 weeks, while maternal 25(OH)D at 24 weeks was inversely correlated with EFA at 36 weeks. Particularly, in the GDM group, maternal 25(OH)D levels at 10, 24, 30, and 36 weeks all showed a significant negative correlation with EFA at 36 weeks. Decreased maternal serum 25(OH)D level could be an early biomarker of increased fetal adiposity in late gestation, especially in diabetic pregnancies.
25-羟维生素D（25(OH)D）调节脂质代谢，其水平降低被认为是代谢综合征、妊娠期糖尿病（GDM）以及最终胎儿肥胖的发病机制。25(OH)D水平降低还与妊娠期糖尿病（GDM）的发生有关，而GDM与胎儿肥胖增加相关。胎儿依赖于母体循环中25(OH)D的供应。然而，母体血清25(OH)D对胎儿肥胖的影响仍不清楚。本研究旨在探讨母体血清25(OH)D与胎儿肥胖之间的关联。对89例（包括21例GDM）单胎妊娠队列进行了一项前瞻性纵向研究。在孕10周、24周、30周和36周采集母体血样，并在妊娠24周、30周和36周进行胎儿超声检查。如先前报道，估计胎儿肥胖（EFA）计算为横断面手臂和大腿脂肪面积百分比以及前腹壁厚度的平均z评分。多元线性回归分析表明，整个妊娠期母体25(OH)D水平与24周和30周时的EFA无关，而24周时母体25(OH)D与36周时的EFA呈负相关。特别是，在GDM组中，孕10周、24周、30周和36周时母体25(OH)D水平均与36周时的EFA呈显著负相关。母体血清25(OH)D水平降低可能是妊娠晚期胎儿肥胖增加的早期生物标志物，尤其是在糖尿病妊娠中。
