Okah F A, Tsang R C, Sierra R, Brady K K, Specker B L
Children's Hospital Research Foundation, Perinatal Research Institute, University of Cincinnati Medical Center, Ohio, USA.
Obstet Gynecol. 1996 Aug;88(2):168-73. doi: 10.1016/0029-7844(96)00159-7.
To test the hypothesis that maternal bone turnover and mineral stress are greater in multiple pregnancy than in singleton pregnancy.
We measured serum markers of bone turnover and mineral stress in 17 multiple and 30 singleton pregnancies during the third trimester.
Serum 25(OH) vitamin D, a marker of vitamin D intake, was higher (61 +/- 5 versus 39 +/- 2 ng/mL, P < .001), and 1,25(OH)2 vitamin D was lower (50 [95% confidence interval (CI) 24-102] versus 64 pg/mL [95% CI 30-135], P = .03) in multiple than in singleton pregnancy. Carboxyterminal telopeptide of type I collagen, a marker of bone resorption, increased with gestational duration and was higher in multiple gestation (5.8 [95% CI 3.3-10.1] versus 4.4 ng/mL [95% CI 2.5-7.8], P = .005). Carboxyl-terminal propeptide of type 1 procollagen, a marker of bone formation, increased with gestational duration and was not different between groups (110 [95% CI 36-337] versus 99 ng/mL [95% CI 34-286], P = .5). Calcitonin increased with gestational duration and was not different between groups (7.0 [95% CI 3.7-13.0] versus 7.8 pg/mL [95% CI 4.0-15.4], P = .37). Parathyroid hormone was not different between groups and decreased with increasing maternal age.
Bone turnover indices increased with gestational duration. The bone resorption index was greater in multiple than in singleton gestation. Serum 25(OH) vitamin D was greater and 1,25(OH)2 vitamin D was lower in multiple gestation, presumably because of greater consumption of vitamin D and minerals by women carrying more than one fetus.
检验多胎妊娠时母体骨转换和矿物质应激比单胎妊娠时更严重这一假设。
我们在孕晚期测量了17例多胎妊娠和30例单胎妊娠孕妇的骨转换和矿物质应激血清标志物。
作为维生素D摄入量标志物的血清25(OH)维生素D在多胎妊娠中更高（61±5 vs 39±2 ng/mL，P<.001），而1,25(OH)2维生素D更低（50[95%置信区间(CI)24 - 102] vs 64 pg/mL[95%CI 30 - 135]，P = .03）。作为骨吸收标志物的I型胶原羧基末端肽随孕周增加而升高，且在多胎妊娠中更高（5.8[95%CI 3.3 - 10.1] vs 4.4 ng/mL[95%CI 2.5 - 7.8]，P = .005）。作为骨形成标志物的1型前胶原羧基末端前肽随孕周增加而升高，且两组间无差异（110[95%CI 36 - 337] vs 99 ng/mL[95%CI 34 - 286]，P = .5）。降钙素随孕周增加而升高，且两组间无差异（7.0[95%CI 3.7 - 13.0] vs 7.8 pg/mL[95%CI 4.0 - 15.4]，P = .37）。甲状旁腺激素在两组间无差异，且随孕妇年龄增加而降低。
骨转换指标随孕周增加而升高。多胎妊娠时骨吸收指标比单胎妊娠时更高。多胎妊娠时血清25(OH)维生素D更高而1,25(OH)2维生素D更低，推测是因为怀有多个胎儿的女性对维生素D和矿物质的消耗更大。
