The Effect of Maternal Vitamin D Concentration on Fetal Bone
The Effect of Maternal Vitamin D Concentration on Fetal Bone
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DOI：
10.1210/jc.2012-2538
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发表时间：
2012-11-01
影响因子：
5.8
通讯作者：
Papageorghiou, A. T.
中科院分区：
文献类型：
--
作者：
Ioannou, C.;Javaid, M. K.;Papageorghiou, A. T.
内容：孕期维生素D缺乏可能与胎儿生长欠佳有关，但缺乏直接证据。Objectives：本研究的目的是验证一种使用三维超声测量胎儿股骨体积（FV）的方法，并检测FV与母体维生素D浓度之间的相关性。设计、设置和参与者：一种评估FV的新方法包括三个超声测量值-股骨长度、近端干骺端直径（PMD）和中段直径-以及体积方程;这一点通过比较六例中期妊娠终止后的超声与计算机断层扫描测量结果得到了验证。然后将这种方法应用于参加南安普顿妇女调查的一组健康孕妇。胎儿三维超声和母亲25-羟基维生素D [25（OH）D]水平进行了34周，双能X线吸收法的新生儿出生后不久。结果：在357例孕妇中，血清25（OH）D水平与胎儿股骨直径（FV）呈显著正相关（P < 0. 05），而血清25（OH）D水平与胎儿股骨直径（FV）呈显著正相关（P < 0. 05），与胎儿股骨直径（FV）呈显著正相关（P < 0. 05）。（P = 0.006; r = 0.147）与PMD（P = 0.001; r = 0.176）; FV与母亲身高也呈单因素正相关（P = 0.001; r = 0.246）、体重（P = 0.003; r = 0.160）、三头肌皮褶厚度（P = 0.013; r = 0.134）和吸烟的临界负效应（P = 0.061）。在多元回归分析中，FV的独立预测因子是母亲的身高和三头肌皮褶厚度; 25（OH）D对FV的影响减弱，但对PMD仍显着。结论：使用一种新的方法来评估FV，股骨大小的独立预测因子是母亲的身高，肥胖，和血清维生素D。未来的试验应确定妊娠期补充维生素D是否对胎儿骨骼有益，使用FV和PMD作为胎儿结局的指标。（临床内分泌代谢杂志97：E2070-E2077，2012）
Context: Vitamin D deficiency during pregnancy may be associated with suboptimal fetal growth, but direct evidence is lacking.Objectives: The aim of the study was to validate a method for fetal femur volume (FV) measurement using three-dimensional ultrasound and to detect correlations between FV and maternal vitamin D concentration.Design, Setting, and Participants: A novel method for assessing FV consists of three ultrasound measurements-femur length, proximal metaphyseal diameter (PMD), and midshaft diameter-and a volume equation; this was validated by comparing ultrasound to computed tomography measurements in six pregnancies after mid-trimester termination. This method was then applied in a cohort of healthy pregnant women participating in the Southampton Women Survey. Fetal three-dimensional ultrasound and maternal 25-hydroxyvitamin D [25(OH)D] levels were performed at 34 wk; dual-energy x-ray absorptiometry of the newborn was performed shortly after birth. Univariate and multiple linear regression analyses were performed between maternal characteristics and fetal outcomes.Main Outcome Measures: We performed ultrasound measurements of the fetal femur.Results: In 357 pregnant participants, serum 25(OH)D correlated significantly with FV (P = 0.006; r = 0.147) and PMD (P = 0.001; r = 0.176); FV also demonstrated positive univariate correlations with maternal height (P = 0.001; r = 0.246), weight (P = 0.003; r = 0.160), triceps skinfold thickness (P = 0.013; r = 0.134), and a borderline negative effect from smoking (P = 0.061). On multiple regression, independent predictors of FV were the maternal height and triceps skinfold thickness; the effect of 25(OH)D on FV was attenuated, but it remained significant for PMD.Conclusion: Using a novel method for assessing FV, independent predictors of femoral size were maternal height, adiposity, and serum vitamin D. Future trials should establish whether pregnancy supplementation with vitamin D is beneficial for the fetal skeleton, using FV and PMD as fetal outcome measures. (J Clin Endocrinol Metab 97: E2070-E2077, 2012)