THE EFFECTS OF PROSPECTIVE EARLY STRICT MANAGEMENT OF MATERNAL DIABETES ON MATERNAL IONIZED CALCIUM & 1,25(OH) 2 VITAMIN D
THE EFFECTS OF PROSPECTIVE EARLY STRICT MANAGEMENT OF MATERNAL DIABETES ON MATERNAL IONIZED CALCIUM & 1,25(OH) 2 VITAMIN D
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母亲糖尿病的前瞻性早期严格管理对母亲离子钙的影响
DOI：
10.1203/00006450-198404001-01250
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发表时间：
1984
影响因子：
3.6
通讯作者：
R. Tsang
中科院分区：
文献类型：
--
作者：
P. Shaul;J. Steichen;D. Buckley;Kay Ellis;R. Tsang
化学诱导的小鼠糖尿病与钙 (Ca) 负平衡和血清 1,25-二羟基维生素 D (1,25(OH)2D) 水平降低有关；胰岛素治疗可以纠正这些缺陷。我们假设妊娠期糖尿病会导致母体离子化 Ca (Cai) 和 1,25(OH)2D 减少，对新生儿 Ca 产生间接影响，并且从妊娠早期对糖尿病进行前瞻性严格管理可改善这些变化。在一项综合临床试验中，57 名妊娠期胰岛素依赖型糖尿病患者在妊娠前三个月被随机分配至严格管理组与常规管理组（Sm 与 Cm）。分娩时母亲 Cai 的 Sm (4.52 ± 0.08 SEM mg/dl) 高于 Cm (4.27 ± 0.07 mg/dl，p< 0.02)。 grps 之间没有区别。母体 25-羟基维生素。交货时为 D (25OHD) 或 1,25(OH)2D。 Sm 组中的婴儿 (IDM)。有更高的24小时。血清 Ca (8.3 ± 0.20 mg/dl) 与 Cm grp IDMs (7.8 ± 0.23 mg/dl, p < 0.04)，但 72 小时时未发现差异。 24 小时时，Sm 与 Cm 新生儿 25OHD（27 ± 2.9 ng/ml 与 27 ± 3.1）或 1,25(OH)2D（60 ± 9.4 pg/ml 与 60 ± 6.9）没有差异。低钙血症 (Ca < 7.0 mg/dl)2(HC) IDM 的母体 Cai (4.15 ± 0.09 mg/dl) 与正常钙血症 (NC) IDM (4.46 ± 0.06，p < 0.02) 相比较低； HC 婴儿与 NC 婴儿的孕产妇或新生儿 25OHD 和 1,25(OH)2 没有差异。因此，严格管理孕产妇糖尿病会导致孕产妇蔡增加，但对孕产妇 1,25(OH)2 没有影响。我们推测糖尿病妊娠期间钙状态的改善有助于改善新生儿钙稳态。
Chemically induced murine diabetes is associated with negative calcium (Ca) balance & decreased serum 1,25-dihydroxyvitamin D (1,25(OH)2D) levels; insulin therapy corrects these defects. We hypothesized that diabetes in pregnancy causes decreased maternal ionized Ca (Cai) & 1,25(OH)2D, with indirect effects on neonatal Ca, & that prospective strict management of diabetes from early pregnancy ameliorates these changes. In a comprehensive clinical trial, 57 pregnant insulin-dependent diabetics were randomly assigned during the first trimester to strict vs customary management (Sm vs. Cm) grps. Maternal Cai at delivery was higher in Sm (4.52 ± 0.08 SEM mg/dl) vs. Cm (4.27 ± 0.07 mg/dl, p< 0.02). There was no difference between grps. in maternal 25-hydroxyvit. D (25OHD) or 1,25(OH)2D at delivery. Infants (IDMs) in Sm grp. had higher 24 hr. serum Ca (8.3 ± 0.20 mg/dl) vs. Cm grp IDMs (7.8 ± 0.23 mg/dl, p < 0.04), but no difference was noted by 72 hr. There was no difference in Sm vs. Cm neonatal 25OHD (27 ± 2.9 ng/ml vs. 27 ± 3.1) or 1,25(OH)2D (60 ± 9.4 pg/ml vs. 60 ± 6.9) at 24 hrs. Hypocalcemic (Ca < 7.0 mg/dl)2(HC) IDMs had lower maternal Cai (4.15 ± 0.09 mg/dl) vs. nomocalcemic (NC) IDMs (4.46 ± 0.06, p < 0.02); there was no difference in maternal or neonatal 25OHD & 1,25(OH)2 for HC vs. NC infants. Thus, strict management of maternal diabetes results in increased maternal Cai, but has no effect on maternal 1,25(OH)2. We speculate that improved Ca status in the diabetic pregnancy contributes to improved neonatal Ca homeostasis.