First trimester vitamin D, vitamin D binding protein, and subsequent preeclampsia.
First trimester vitamin D, vitamin D binding protein, and subsequent preeclampsia.
复制标题
DOI：
10.1161/hypertensionaha.110.158238
复制
发表时间：
2010-10
期刊：
影响因子：
--
通讯作者：
Thadhani R
中科院分区：
文献类型：
--
作者：
Powe CE;Seely EW;Rana S;Bhan I;Ecker J;Karumanchi SA;Thadhani R
先前的研究报道了维生素D缺乏和高血压之间的联系，包括妊娠特异性疾病，先兆子痫。循环中的维生素D几乎完全与维生素D结合蛋白结合，维生素D结合蛋白在怀孕期间增加2倍，但以前的研究没有检查维生素D结合蛋白或游离维生素D水平。我们在马萨诸塞州综合医院产科产妇研究（MOMS）中进行了一项巢式病例对照研究，测量妊娠早期总25-羟基维生素D和维生素D结合蛋白，并计算游离25-羟基维生素D水平。我们比较了妊娠合并子痫前期（病例，n=39）与正常妊娠（对照，n=131）的这些水平。病例组和对照组的妊娠早期总25-羟基维生素D水平相似（27.4 ±1.9 ng/ml vs. 28.8±0.80 ng/ml，p=0.435）。尽管妊娠早期高血压与随后的先兆子痫之间存在相关性，但妊娠早期总25-羟基维生素D与妊娠早期收缩压（r=0.11，p=0.16）或舒张压（r=0.03，p=0.72）无关。尽管25-羟基维生素D水平低于15 ng/ml时有先兆子痫风险增加的趋势（OR 2.5，95% CI 0.89-6.9），但在校正体重指数和其他协变量后，这种风险降低（OR 1.35，95% CI 0.40-4.5）。妊娠早期维生素D结合蛋白和游离25-羟基维生素D水平在病例组和对照组中相似，并且与妊娠早期血压无关。这些数据表明，孕早期总的和游离的25-羟基维生素D水平与孕早期血压或随后的先兆子痫无关。
Prior studies report an association between vitamin D deficiency and hypertension, including the pregnancy-specific disorder, preeclampsia. Circulating vitamin D is almost entirely bound to vitamin D binding protein, which increases 2-fold during pregnancy, but previous studies have not examined vitamin D binding protein or free vitamin D levels. We performed a nested case-control study within the Massachusetts General Hospital Obstetrical Maternal Study (MOMS), measuring first trimester total 25-hydroxyvitamin D and vitamin D binding protein, and calculating free 25-hydroxyvitamin D levels. We compared these levels from pregnancies complicated by subsequent preeclampsia (cases, n=39) with those from normotensive pregnancies (controls, n=131). First trimester total 25-hydroxyvitamin D levels were similar in cases and controls (27.4 ±1.9 ng/ml vs. 28.8±0.80 ng/ml, p=0.435). Despite an association between higher first trimester blood pressures and subsequent preeclampsia, first trimester total 25-hydroxyvitamin D was not associated with first trimester systolic (r=0.11, p=0.16) or diastolic blood pressures (r=0.03, p=0.72). Although there was a trend toward increased risk of preeclampsia with 25-hydroxyvitamin D levels less than 15 ng/ml (OR 2.5, 95% CI 0.89-6.9), this was attenuated after adjustment for body mass index and other covariates (OR 1.35 95% CI 0.40-4.5). First trimester vitamin D binding protein and free 25-hydroxyvitamin D levels were similar in cases and controls and were not associated with first trimester blood pressures. These data suggest that first trimester total and free 25-hydroxyvitamin D levels are not independently associated with first trimester blood pressure or subsequent preeclampsia.