Changes in plasma concentrations of 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D during pregnancy: a Brazilian cohort
Changes in plasma concentrations of 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D during pregnancy: a Brazilian cohort
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DOI：
10.1007/s00394-017-1389-z
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发表时间：
2018-04-01
影响因子：
5
通讯作者：
Kac, Gilberto
中科院分区：
文献类型：
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作者：
Cunha Figueiredo, Amanda C.;Cocate, Paula Guedes;Kac, Gilberto
研究25-羟基维生素D [25(OH)D]和1,25-二羟基维生素D [1,25(OH)(2)D]在妊娠期间的生理变化。229名明显健康的孕妇在妊娠第5 -13周、第20 -26周和第30 -36周随访。采用LC-MS/MS法测定25(OH)D和1,25(OH)(2)D浓度。统计分析包括纵向线性混合效应模型，调整了胎次、季节、教育、自我报告的肤色和孕前BMI。根据成人内分泌学会实践指南和医学研究所（IOM），维生素D状态是根据25(OH)D浓度来定义的。25(OH)D < 75 nmol/L的患病率分别为70.4、41.0和33.9%；25(OH)D < 50 nmol/L的患病率分别为16.1%、11.2和10.2%；25(OH)D < 30 nmol/L在妊娠早期、中期和晚期的患病率分别为2%、0%和0.6%。未经调整的分析显示，25(OH) D （β = 0.869; 95% CI 0.723-1.014; P < 0.001）和1.25 (OH)(2)D （β = 3.878; 95% CI 3.136-4.620; P < 0.001）在妊娠期间增加。多重调整分析显示，在冬季（P < 0.001）、春季（P < 0.001）或秋季（P = 0.028）开始研究的女性25(OH)D浓度纵向增加，而在夏季开始研究的女性则没有。在基线时维生素D不足（50-75 nmol/L）的女性中，随着时间的推移，1,25(OH)(2)D浓度的增加高于维生素D充足（50-75 nmol/L）的女性（P = 0.006）。根据所采用的标准，维生素D不足的流行程度差别很大。25(OH)D在妊娠期间有季节性变化。与维生素D充足的妇女相比，维生素D不足的妇女在纵向上表现出更大的1.25 (OH)(2)D浓度的增加。
To characterize the physiological changes in 25-hydroxyvitamin D [25(OH)D] and 1,25-dihydroxyvitamin D [1,25(OH)(2)D] throughout pregnancy.Prospective cohort of 229 apparently healthy pregnant women followed at 5th-13th, 20th-26th, and 30th-36th gestational weeks. 25(OH)D and 1,25(OH)(2)D concentrations were measured by LC-MS/MS. Statistical analyses included longitudinal linear mixed-effects models adjusted for parity, season, education, self-reported skin color, and pre-pregnancy BMI. Vitamin D status was defined based on 25(OH)D concentrations according to the Endocrine Society Practice Guideline and Institute of Medicine (IOM) for adults.The prevalence of 25(OH)D < 75 nmol/L was 70.4, 41.0, and 33.9%; the prevalence of 25(OH)D < 50 nmol/L was 16.1, 11.2, and 10.2%; and the prevalence of 25(OH)D < 30 nmol/L was 2, 0, and 0.6%, at the first, second, and third trimesters, respectively. Unadjusted analysis showed an increase in 25(OH)D (beta = 0.869; 95% CI 0.723-1.014; P < 0.001) and 1,25(OH)(2)D (beta = 3.878; 95% CI 3.136-4.620; P < 0.001) throughout pregnancy. Multiple adjusted analyses showed that women who started the study in winter (P < 0.001), spring (P < 0.001), or autumn (P = 0.028) presented a longitudinal increase in 25(OH)D concentrations, while women that started during summer did not. Increase of 1,25(OH)(2)D concentrations over time in women with insufficient vitamin D (50-75 nmol/L) at baseline was higher compared to women with sufficient vitamin D (>75 nmol/L) (P = 0.006).The prevalence of vitamin D inadequacy varied significantly according to the adopted criteria. There was a seasonal variation of 25(OH)D during pregnancy. The women with insufficient vitamin D status present greater longitudinal increases in the concentrations of 1,25(OH)(2)D in comparison to women with sufficiency.