Serum and urine vitamin D metabolite analysis in early preeclampsia.
Serum and urine vitamin D metabolite analysis in early preeclampsia.
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DOI：
10.1530/ec-17-0308
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发表时间：
2018-01
影响因子：
2.9
通讯作者：
Kilby MD
中科院分区：
文献类型：
--
作者：
Tamblyn JA;Jenkinson C;Larner DP;Hewison M;Kilby MD
维生素D缺乏在孕妇中很常见，并可能导致怀孕期间的不良事件，如先兆子痫（PET）。迄今为止，维生素D和PET的研究主要集中在妊娠后期血清中维生素D， 25-羟基维生素D3 （25(OH)D3）的浓度。这项研究的目的是确定在怀孕早期对维生素D代谢物进行更全面的分析是否可以提供PET的预测指标。使用SCOPE妊娠队列的样本，在PET症状出现之前，通过液相色谱-串联质谱法定量测定配对血清和尿液中的多种维生素D代谢物。对50名怀孕第15周妇女的样本进行了分析，其中25名（50%）在怀孕结束时发展为PET， 25名继续进行无并发症的妊娠。育龄未怀孕妇女（n = 9）的配对血清和尿液也被用作对照。测定了25(OH)D3、25(OH)D2、1,25(OH)2D3、24,25(OH)2D3和3-epi-25(OH)D3的血清浓度，结果显示无并发症妊娠妇女和发生PET的妇女之间无显著差异。正如先前报道的那样，血清125 (OH)2D3在所有孕妇（妊娠中期）中都较高，但血清25(OH)D2与非孕妇相比也较高。在尿液中，25(OH) D3和24,25(OH)2D3是可量化的，这两种代谢物在那些最终发展为PET的人身上的浓度显著降低（P < 0.05）。这些数据表明，尿液代谢物的分析为维生素D和肾脏提供了额外的见解，尿液中25(OH)D3和24,25(OH)2D3的排泄量较低是患PET易感的早期指标。
Vitamin D deficiency is common in pregnant women and may contribute to adverse events in pregnancy such as preeclampsia (PET). To date, studies of vitamin D and PET have focused primarily on serum concentrations vitamin D, 25-hydroxyvitamin D3 (25(OH)D3) later in pregnancy. The aim here was to determine whether a more comprehensive analysis of vitamin D metabolites earlier in pregnancy could provide predictors of PET. Using samples from the SCOPE pregnancy cohort, multiple vitamin D metabolites were quantified by liquid chromatography–tandem mass spectrometry in paired serum and urine prior to the onset of PET symptoms. Samples from 50 women at pregnancy week 15 were analysed, with 25 (50%) developing PET by the end of the pregnancy and 25 continuing with uncomplicated pregnancy. Paired serum and urine from non-pregnant women (n = 9) of reproductive age were also used as a control. Serum concentrations of 25(OH)D3, 25(OH)D2, 1,25(OH)2D3, 24,25(OH)2D3 and 3-epi-25(OH)D3 were measured and showed no significant difference between women with uncomplicated pregnancies and those developing PET. As previously reported, serum 1,25(OH)2D3 was higher in all pregnant women (in the second trimester), but serum 25(OH)D2 was also higher compared to non-pregnant women. In urine, 25(OH)D3 and 24,25(OH)2D3 were quantifiable, with both metabolites demonstrating significantly lower (P < 0.05) concentrations of both of these metabolites in those destined to develop PET. These data indicate that analysis of urinary metabolites provides an additional insight into vitamin D and the kidney, with lower urinary 25(OH)D3 and 24,25(OH)2D3 excretion being an early indicator of a predisposition towards developing PET.