孕妇维生素D缺乏与妊娠期糖尿病的相关性分析

目的:调查孕妇妊娠早期维生素D水平及其影响因素,探讨维生素D缺乏与妊娠期糖尿病的相关性。方法:选取2012年7月至2013年4月在上海交通大学医学院附属新华医院产科正规产检并分娩的非孕前糖尿病孕妇,在其建卡初检时采用电化学发光免疫技术测定血清25(OH)D3水平;妊娠24-28周行糖筛查及糖耐量试验,诊断是否为妊娠期糖尿病GDM。收集并整理孕妇年龄,孕前体重指数BMI、维生素D测定孕周与测定季节、孕期维生素D补充情况等信息。结果:1000例孕妇中,GDM发病率为11.5%,维生素D缺乏比例占67.4%;其中,约有54%孕妇常规补充复合维生素,约含维生素400 IU/天,10%孕妇常规补充维生素D。GDM孕妇25(OH)D3水平显著低于正常对照组(P=0.007)。维生素D缺乏孕妇发生GDM的风险是维生素D水平较高组的1.944倍,且在秋冬季更易发生GDM。可以考虑在孕14-16周进行维生素D水平的早期测定。结论:孕妇维生素D缺乏十分普遍。妊娠早期孕妇低维生素D水平可能增加孕妇胰岛素抵抗及孕期发生GDM的发生风险。     

绝经后女性血清25(OH)D水平与高血压的相关性分析

目的:探讨绝经后女性血清25羟维生素D[25(OH)D]与高血压的相关性。方法:选取456例绝经后女性为研究对象,按照是否存在高血压分为高血压组(n=102例)和非高血压组(n=354例),测定所有患者的血清25(OH)D水平;血清25(OH)D水平分为四组:即25(OH)D≥30 ng/m L组(n=50例)、21~29 ng/m L组(n=110例)、10~20 ng/m L组(n=240例)、25(OH)D10 ng/m L组(n=56例);比较各组相关指标的差异。并利用Logistic回归方程分析血清25(OH)D与高血压发生的关系。结果:高血压组与非高血压组在体质指数(BMI)、收缩压(SBP)、舒张压(SDP)、雌激素、高敏C反应蛋白(hs-CRP)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、空腹血糖(FPG)方面存在统计学差异(P0.05);高血压组血清25(OH)D[14.56±3.21(ng/ml)]低于非高血压组[19.89±4.75(ng/ml)](t=10.649,P0.001);在血清25(OH)D10 ng/m L组中,SBP和SDP值、高血压发生率均高于25(OH)D≥30 ng/m L组、21~29ng/m L组(n=110例)、10~20 ng/m L组(P0.05);血清25(OH)D水平与绝经后女性发生高血压呈现负相关(P0.05)。在血清25(OH)D不同分组中,从25(OH)D≥30 ng/m L组到25(OH)D10 ng/m L组发生高血压的风险值依次增加。结论:血清25(OH)D水平与绝经后高血压的发生密切相关,随着血清25(OH)D水平的逐渐降低,高血压发生的风险亦逐渐增大。     

中国北方地区血清钙、维生素D水平与乳腺癌的相关性研究

目的:探讨中国北方地区血清钙、维生素D水平与乳腺癌及相关临床因素的关系.方法:选取2007年12月至2012年7月哈尔滨医科大学附属肿瘤医院794例女性乳腺癌患者及976例乳腺良性肿瘤患者,并以128例健康妇女为对照,取空腹血清采用原子吸收分光光度法检测三组血清钙含量,采用放免法检测三组中162例血清25(OH)D含量,结合相关临床资料进行分析.结果:乳腺癌组血清钙含量为2.26± 0.12 mmol/L,乳腺良性肿瘤组血清钙含量为2.26±0.09 mmol/L,正常对照组血清钙含量为2.25±0.24 mmol/L,经方差分析,三组总体均数差别无统计学意义(P＞0.05);乳腺癌患者的血清钙水平与年龄、TNM分期、BMI、绝经情况、乳腺癌家族遗传史无关(P＞0.05).乳腺癌组血清25(OH)D含量为41.91±7.55 ng/mL,乳腺良性肿瘤血清25(OH)D含量为54.62±7.48 ng/mL,正常对照组血清25(OH)D含量为56.15±8.87 ng/mL,经方差分析,乳腺癌患者血清25(OH)D含量低于乳腺良性肿瘤组,差别有统计学意义(P＜0.05),乳腺良性肿瘤组与正常对照组差别无统计学意义(P＞0.05);乳腺癌患者的维生素D水平与年龄、TNM分期、BMI、绝经情况有关(P＜0.05),而与乳腺癌家族遗传史无关(P＞0.05).结论:中国北方地区的乳腺癌患者血清钙水平与乳腺良性肿瘤患者无明显差异.乳腺癌患者的维生素D水平低于乳腺良性肿瘤患者,并且与年龄、TNM分期、BMI、绝经情况有关.维生素D水平降低可能与乳腺癌的发生有关,高水平的维生素D可能会降低女性患乳癌的风险.     

1-6岁儿童维生素D与年龄、性别、季节及体质量指数的关系研究

目的:探讨1-6岁儿童维生素D与年龄、性别、季节及体质量指数(BMI)的关系,为临床有效指导维生素D的补充提供参考依据。方法:选取2000年1月～2019年1月于我院接受体检的1～6岁儿童816例作为研究对象。采用电化学发光法检测所有研究对象的血清25-羟维生素D[25(OH)D]水平,并分析血清25(OH)D水平与儿童年龄、性别、BMI以及季节的关系。结果:816例儿童维生素D营养不足和缺乏人数占比为14.83%。1～3岁儿童血清25(OH)D水平高于3～6岁儿童(P0.05)。男童血清25(OH)D水平高于女童(P0.05)。肥胖儿童血清25(OH)D水平低于正常与超重儿童,且超重儿童血清25(OH)D水平低于正常儿童(均P0.05)。春、夏季儿童血清25(OH)D水平均高于秋、冬季儿童(均P0.05)。结论:1～6岁儿童的维生素D营养状况不容乐观,随着年龄的增长儿童血清25(OH)D水平显著降低,且男童高于女童,春、夏季高于秋、冬季。临床工作可通过增加其户外活动,继而达到改善维生素D营养状况的目的。     

类风湿关节炎患者血清维生素D水平与疾病活动度相关

目的:探讨类风湿关节炎(Rheumatoid arthritis,RA)患者血清维生素D(25(OH)D)水平与疾病活动度的关系。方法:总共纳入180例RA患者,同时纳入60例年龄、性别相匹配的健康对照。检测所有参与者的血清25(OH)D水平及所有RA患者C反应蛋白和血沉。同时获取RA患者晨僵时间、疼痛视觉模拟表评分、乏力视觉模拟表评分、压痛关节数、肿胀关节数、健康评估量表得分、情绪变化量表得分等。利用RA患者28个关节疾病活动评分(Disease activity score in 28 joints,DAS28)评估RA疾病活动度。结果:相对于健康对照组(43.89±16.28 ng/m L),RA患者的血清25(OH)D明显降低(28.52±8.95 ng/m L)(P=0.000)。RA患者的血清25(OH)D水平越低,压痛关节数、肿胀关节数越多(P=0.043,r=-0.132;P=0.017,r=-0.177),血沉、C反应蛋白越高(P=0.018,r=-0.177;P=0.007,r=-0.200),同时DAS28评分越高(P=0.007,r=-0.201);患者的晨僵时间、疼痛评分、乏力评分、健康评估量表得分及情绪量表得分与血清维生素D水平负相关(P=0.043,r=-0.151;P=0.019,r=-0.175;P=0.006,r=-0.205;P=0.048,r=-0.147;P=0.017,r=-0.178)。结论:RA患者血清维生素D普遍缺乏,并且与RA患者疾病活动度负相关。     

老年原发性骨质疏松症患者血清25-羟维生素D水平检测及与骨代谢指标的相关性分析

摘要 目的：检测并分析老年原发性骨质疏松症患者血清25-羟维生素D [25-(OH)D]水平及其与骨代谢指标的相关性。方法：选取2013年4月到2019年5月期间在我院接受治疗的老年原发性骨质疏松症患者166例作为骨质疏松组,另选取同期在我院进行体检的无骨质疏松老年人群117例作为无骨质疏松组。检测所有研究对象的血清25-(OH)D、I型胶原氨基酸延长肽（PINP）、β-胶原特殊序列（β-CTX）、N-端骨钙素（N-MID）的水平,并分析血清25-(OH)D与骨代谢指标的相关性。结果：166例老年原发性骨质疏松症患者的血清25-(OH)D水平为（16.82±4.52）ng/mL,其中维生素D缺乏64例、占38.56%,维生素D不足72例、占43.37%,维生素D正常30例,占18.07%。不同性别的老年原发性骨质疏松症患者的血清25-(OH)D水平比较差异无统计学意义（P>0.05）,不同性别的老年原发性骨质疏松症患者的维生素D缺乏、不足、正常占比比较差异无统计学意义（P>0.05）。骨质疏松组血清25-(OH)D水平明显低于无骨质疏松组（P<0.05）,骨质疏松组血清β-CTX水平明显高于无骨质疏松组（P<0.05）,骨质疏松组和无骨质疏松组的血清PINP、N-MID水平比较差异无统计学意义（P>0.05）。经Pearson相关分析显示,老年原发性骨质疏松症患者的血清25-(OH)D与β-CTX呈负相关（P<0.05）,与PINP、N-MID无明显的相关性（P>0.05）。结论：老年原发性骨质疏松症患者存在明显的维生素D缺乏、不足,但无明显的性别差异,血清25-(OH)D与β-CTX呈负相关,联合检测血清25-(OH)D和?茁-CTX有助于老年原发性骨质疏松症的早期诊断和治疗。     

孕早期妇女血清25-羟维生素D水平的表达及与甲状腺功能的相关性研究

目的:探讨孕早期妇女血清25-羟维生素D[25(OH)D]水平及与甲状腺功能的相关性。方法:选取2015年12月至2016年12月期间来我院进行常规产前检查的孕早期(≤12周)妇女90例为观察组,根据妊娠时间将观察组分为A组(4-6周)、B组(7-9周)和C组(10-12周),另选取同期在我院进行健康体检的妇女30例为对照组。采用电化学发光免疫分析法测定所有研究对象血清中的25(OH)D、促甲状腺激素(TSH)、游离甲状腺素(FT4)、游离三碘甲状腺原氨酸(FT3)水平,并分析观察组妇女血清25(OH)D水平与TSH、FT4、FT3之间的相关性。结果:A组、B组、C组出现维生素D缺乏的比例高于对照组,维生素D充足的比例低于对照组,C组出现维生素D不足的比例高于对照组,差异均有统计学意义(P0.05)。A组、B组、C组维生素D缺乏、维生素D不足、维生素D充足的比例之间差异无统计学意义(P0.05)。A组、B组、C组出现甲状腺功能异常的比例比较差异无统计学意义(P0.05)。三种甲状腺功能减退的患病率由低到高分别为临床甲减、亚临床甲减、低T4血症,且A组、B组、C组临床甲减、亚临床甲减及低T4血症组间整体比较差异无统计学意义(P0.05)。不同血清25(OH)D水平的观察组孕妇血清中TSH、FT4、FT3水平之间的差异无统计学意义(P0.05)。直线回归分析显示,观察组血清中25(OH)D水平与TSH、FT4无明显相关性(P0.05),与FT3呈正相关关系(P0.05),多元线性回归模型分析显示血清中25(OH)D水平与TSH、FT4、FT3均无相关性(P0.05)。结论:孕早期妇女普遍存在维生素D缺乏的现象,血清25(OH)D水平及与甲状腺功能无明显相关性,但仍应注意加强维生素D的补充。     

血清25-羟维生素D水平与儿童骨密度的相关性研究

目的:研究血清25-羟维生素D[25-(OH)D]水平与儿童骨密度(BMD)的相关性。方法:选择2017年1月到2017年12月在亳州市人民医院接受健康体检的儿童100例作为研究对象。根据血清25-(OH)D水平对维生素D(Vit D)营养状况进行分组,其中严重缺乏组9例,缺乏组28例,不足组42例和充足组21例。对比不同年龄段和不同性别儿童血清25-(OH)D、BMD水平以及不同Vit D营养状况儿童对应的BMD水平,并采用Spearman相关性分析法分析血清25-(OH)D水平与儿童BMD、年龄的相关性。结果:5-9岁和10-14岁儿童的血清25-(OH)D及BMD水平均分别低于1-4岁儿童,而10-14岁儿童又低于5-9岁儿童(P0.05)。男童的血清25-(OH)D及BMD水平均分别高于女童,差异有统计学意义(P0.05)。不足组、缺乏组、严重缺乏组儿童的BMD水平均分别低于充足组,且缺乏组和严重缺乏组低于不足组,严重缺乏组又低于缺乏组(P0.05)。根据Spearman相关性分析结果显示,血清25-(OH)D水平与儿童BMD呈正相关,而与年龄呈负相关(P0.05),年龄与儿童BMD呈负相关(P0.05)。结论:血清25-(OH)D水平与儿童BMD呈正相关,但与年龄则呈负相关,及时补充适量的Vit D以满足儿童的机体所需,有利于儿童健康成长。     

血清25-羟维生素D3水平与2型糖尿病视网膜病变的关系研究

目的:探讨血清25-羟维生素D3[25(OH)D3]水平与2型糖尿病(T2DM)视网膜病变的关系。方法:选取T2DM患者150例,对每位患者进行一般临床资料收集,Hb A1c、PTH、血清25(OH)D3水平检测;根据维生素D水平由低到高按三分位法将患者分为25(OH)D3低(A组)、中(B组)、高(C组)3组,比较3组患者DR的发生情况。结果:A组患者的视网膜病变的患病率显著高于B组、C组患者,差异有统计学意义(P0.05);按25(OH)D3水平由低到高的3组患者的DR的患病率也逐渐降低,分别为:48.0%、30.0%和14.0%。结论:随着血清25(OH)D3水平的降低,T2DM视网膜病变的发生率逐渐增高,血清25(OH)D3在糖尿病视网膜病变的的发生发展中起重要作用。     

脂溶性维生素A、D、E与妊娠期糖尿病的相关性分析

目的:探讨妊娠期糖尿病(gestational diabetes mellitus,GDM)孕妇血清中维生素A、25-羟基维生素D、维生素E的水平及其临床意义。方法:选取在大连大学附属中山医院就诊并诊断为GDM的孕妇1000例为实验组;另选取无GDM孕妇1000例为对照组。采用反向高频液相色谱荧光法(high-performance liquid chromatography,HPLC)测定其血清维生素A、E水平;高效液相色谱液相色谱串联质谱法(high-performance liquid chromatography tandem mass spectrometer,HPLC-AS/MS)测定血清25-羟基维生素D水平。结果:GDM孕妇血清中维生素A水平与无GDM孕妇比较差异无统计学意义(P>0.05);GDM孕妇血清25-羟基维生素D水平明显低于对照组(P<0.05);GDM孕妇血清维生素E水平明显高于对照组(P<0.05)。GDM孕妇血清25-羟基维生素D水平与血清维生素E水平呈显著负相关(r=-0.351,P<0.05)。结论:GDM孕妇血清25-羟基维生素D水平低,维生素E水平高,且两者有一定相关性,可能共同参与了GDM的发生。     

High prevalence of vitamin d deficiency in pregnant women: a national cross-sectional survey

An increasing number of studies suggest that vitamin D deficiency during pregnancy is associated with multiple adverse health outcomes in mothers, neonates and children. There are no representative country data available on vitamin D status of pregnant women in Europe. The aim of this study was to estimate the prevalence of vitamin D deficiency among Belgian pregnant women and to assess the determinants of vitamin D status in the first and third trimester of pregnancy. The women were selected via a multi-stage proportionate-to-size sampling design. Blood samples were collected and a questionnaire was completed face-to-face. 55 obstetric clinics were randomly selected and 1311 pregnant women participated in the study. The median serum 25-hydroxyvitamin D [25-(OH)D] concentration was significantly lower in the first trimester (20.4 ng/ml) than in third trimester (22.7 ng/ml). Of all women, 74.1% (95%CI = 71.8–76.5%) were vitamin D insufficient (25-(OH)D <30 ng/ml), 44.6% (95%CI = 41.9–47.3%) were vitamin D deficient (25-(OH)D <20 ng/ml), while 12.1% (95%CI = 10.3–13.8%) were severely vitamin D deficient (25-(OH)D <10 ng/ml). Of all women included, 62.0% reported taking vitamin D-containing multivitamins, of which only 24.2% started taking those before pregnancy. The risk of vitamin D deficiency (25-(OH)D <20 ng/ml) was significantly higher for less educated women and women who reported not going on holidays to sunny climates. The risk of severe vitamin D deficiency (25-(OH)D <10 ng/ml) decreased for women who reported alcohol consumption during pregnancy, decreased with more frequent use of sunscreen lotion and increased for smokers and women who reported preference for shadow. In conclusion, vitamin D deficiency is highly prevalent among pregnant women in Belgium and this raises concerns about the health consequences for the mother and the offspring. A targeted screening strategy to detect and treat women at high risk of severe vitamin D deficiency is needed in Belgium and in Europe.     

甲亢孕妇血清25-羟维生素D水平对42 天婴儿骨密度影响的研究

目的：探讨甲状腺功能亢进（甲亢）孕妇经治疗后,其体内25- 羟维生素D（25-(OH)D3）水平对42 天婴儿胫骨声波的传导速 度（speed of sound, SOS）值、骨代谢生化指标的影响。方法：选取我院门诊及住院确诊的甲亢孕妇40 例为甲亢组（T 组）,随机抽取 健康孕妇40 例作为对照组（C 组）,甲亢组给予丙硫氧嘧啶治疗后,监测两组孕妇25-(OH)D3水平与生后42 天婴儿的胫骨SOS 值、骨代谢生化指标,并进行对比观察、统计分析。结果：甲亢组孕妇在产后42 天体内25-(OH)D3的水平比其在产后第1 天升高 （P<0.05）,甲亢组孕妇在产后42 天体内25-(OH)D3水平接近对照组（P >0.05）,在产后42 天婴儿的胫骨SOS 值接近对照组（P >0. 05）,甲亢组产后42 天婴儿的血清钙(Ca) 及血清碱性磷酸酶（AKP）接近对照组（P >0.05）。结论：甲亢组孕妇给予丙硫氧嘧啶治疗 后,甲状腺功能恢复正常,其体内25-(OH)D3水平升高,所产42 天婴儿的骨密度也随着升高。     

Low Maternal Vitamin D Status during the Second Trimester of Pregnancy: A Cross-Sectional Study in Wuxi,China

BackgroundVitamin D deficiency is common in pregnant women, but an optimal serum vitamin D level during pregnancy has not been determined and remains an area of active research. Vitamin D data from large populations of pregnant Chinese women are still limited.ObjectiveTo evaluate the vitamin D status of women in Eastern China during the second trimester of pregnancy.MethodsA hospital-based, cross-sectional, observational study. Serum 25-hydroxyvitamin D [25(OH)D] concentration was measured in samples from 5823 pregnant women in Wuxi City, China (latitude: 31.5o N), from January 2011 to June 2012.ResultsThe median serum 25(OH)D concentration was 34.0 nmol/L [2.5 nmol/L 25(OH)D = 1 ng/mL 25(OH)D]. Vitamin D deficiency [defined as 25(OH)D < 30 nmol/L according to the Institute of Medicine (National Academy of Sciences, Washington, D.C., USA)] or inadequacy [25(OH)D of 30–49.9 nmol/L] was identified in 40.7% and 38.0% of the women, respectively. Only 0.9% had a 25(OH)D level ≥ 80.0 nmol/L, which is the concentration recommended as adequate by the Endocrine Society (Washington, D.C., USA). Compared with older women, younger women were more likely to be deficient in vitamin D. There were significant differences in the 25(OH)D levels according to season. The 25(OH)D levels reached peak values in September and were correlated with (r = 0.337, P < 0.001), and fluctuated with, average monthly air temperatures.ConclusionsThere is a high prevalence of Vitamin D deficiency among pregnant Chinese women, and 25(OH)D levels varied according to season and air temperature. The results of this study also suggest that currently there is a big gap between the levels of Vitamin D detected in pregnant Chinese women and the levels recommended by the Endocrine Society.     

甲亢孕妇血清25-羟维生素D水平对42天婴儿骨密度影响的研究

目的：探讨甲状腺功能亢进（甲亢）孕妇经治疗后,其体内25-羟维生素D（25-（OH）D3）水平对42天婴儿胫骨声波的传导速度（speed of sound,SOS）值、骨代谢生化指标的影响。方法：选取我院门诊及住院确诊的甲亢孕妇40例为甲亢组（T组）,随机抽取健康孕妇40例作为对照组（C组）,甲亢组给予丙硫氧嘧啶治疗后,监测两组孕妇25-（OH）D3水平与生后42天婴儿的胫骨SOS值、骨代谢生化指标,并进行对比观察、统计分析。结果：甲亢组孕妇在产后42天体内25-（OH）D3的水平比其在产后第1天升高（P〈0.05）,甲亢组孕妇在产后42天体内25-（OH）D3水平接近对照组（P〉0.05）,在产后42天婴儿的胫骨SOS值接近对照组（P〉0.05）,甲亢组产后42天婴儿的血清钙（Ca）及血清碱性磷酸酶（AKP）接近对照组（P〉0.05）。结论：甲亢组孕妇给予丙硫氧嘧啶治疗后,甲状腺功能恢复正常,其体内25-（OH）D3水平升高,所产42天婴儿的骨密度也随着升高。     

Serum Levels of 25-Hydroxyvitamin D and Functional Outcome among Postmenopausal Women with Hip Fracture

Objective

The main objective of the current study was to assess the distribution and its prognostic value of serum 25-hydroxyvitamin D (25[OH] D) levels assessed at admission in Chinese postmenopausal women with hip fracture.

Methods

From January 1, 2012 to December 31, 2013, all postmenopausal women with first-ever hip fracture were recruited to participate in the study. Serum 25[OH] D levels were measured at admission. The functional evaluation at the time of discharge was performed by the Barthel Index (BI). The prognostic value of 25[OH] D to predict the functional outcome within discharge was analyzed by logistic regression analysis, after adjusting for the possible confounders.

Results

In our study, 261 patients were included and assessed. In the 76 patients with an unfavorable functional outcome, serum 25(OH) D levels were lower compared with those in patients with a favorable outcome [11.8(IQR, 9.9–16.1)ng/ml; 16.8(IQR, 13.6–21.4)ng/ml, respectively; P<0.0001]. In multivariate analysis, there was an increased risk of unfavorable outcome associated with serum 25(OH) D levels ≤ 20ng/ml (OR 5.24, 95%CI: 3.11–8.15; P<0.0001) after adjusting for possible confounders.

Conclusions

Our data support an association between serum 25[OH] D levels and prognosis in Chinese postmenopausal women with hip fracture.     

Preconception Vitamin D Level and In Vitro Fertilization: Pregnancy Outcome

ObjectiveVitamin D deficiency impairs female fertility and the success of in vitro fertilization (IVF). The recommended serum 25-hydroxyvitamin D (25(OH)D) level in IVF-conceived pregnancies is still debated. We aimed to explore the relationship of the preconception serum 25(OH)D level with pregnancy outcome following IVF treatment. We also explored the utility of the currently recommended serum 25(OH)D cutoff of ≥50 nmol/L for women undergoing IVF therapy.MethodsRetrospective cohort of women who had undergone IVF therapy. Of the women who started IVF therapy (n = 354), 218 completed the study. They were divided into 2 groups: (1) women who achieved a successful pregnancy (pregnant group, n = 160) and (2) those who did not achieve a successful pregnancy (nonpregnant group, n = 58). Preconception serum samples were analyzed for reproductive hormones, fasting glucose, insulin, and 25(OH)D levels.ResultsOverall, the median (interquartile range) age, body mass index, and hemoglobin A1c level were 32 (6) years, 25.7 (7.4) kg/m², and 5.2% (0.6%), respectively. The 25(OH)D level was significantly higher at preconception in the pregnant group (56.4 [21.4] vs 47.9 [29.16] for nonpregnant, P = .001). The preconception 25(OH)D level was a significant predictor of IVF outcome (B = 0.04; 95% CI, 1.01-1.06; P = .001), with greater IVF success associated with a serum 25(OH)D level of ≥50 nmol/L (odds ratio, 0.46; P = .01).ConclusionPreconception 25(OH)D sufficiency (≥50 nmol/L) is associated with successful pregnancy outcome following IVF therapy.     

Maternal Serum and Breast Milk Vitamin D Levels: Findings from the Universiti Sains Malaysia Pregnancy Cohort Study

Background

Vitamin D deficiency has become a global health issue in pregnant women. This study aimed to assess the adequacy of maternal vitamin D status by measuring maternal serum and breast milk 25-hydroxyvitamin D [25(OH)D] levels and to determine the association between maternal serum and milk 25(OH)D levels.

Methods

Data was obtained from the Universiti Sains Malaysia Pregnancy Cohort Study. This study was conducted from April 2010 to December 2012 in the state of Kelantan, Malaysia. Blood samples from pregnant women aged 19 to 40 years were drawn in the second and third trimesters of pregnancy, while breast milk samples at delivery, 2, 6 and 12 months postpartum were collected to analyze for 25(OH)D levels. A total of 102 pregnant women were included in the analysis.

Results

Vitamin D deficiency [25(OH)D <50 nmol/L] was detected in 60% and 37% of women in the second and third trimesters of pregnancy, respectively. There were 6% and 23% of women who reached normal level of vitamin D status in the second trimester and the third trimester, respectively. Multivitamin intakes during pregnancy were significantly associated with higher serum 25(OH)D levels in the second trimester (β = 9.16, p = 0.005) and the third trimester (β = 13.65, p = 0.003). 25(OH)D levels in breast milk during the first year of lactation ranged from 1.01 to 1.26 nmol/L. Higher maternal serum 25(OH)D level in the second trimester of pregnancy was associated with an elevated level of 25(OH)D in breast milk at delivery (β = 0.002, p = 0.026).

Conclusions

This study shows that high proportions of Malay pregnant women are at risk of vitamin D deficiency. Maternal vitamin D status in the second trimester of pregnancy was found to influence vitamin D level in breast milk at delivery.     

Serum 25-Hydroxyvitamin D Concentrations ≥40 ng/ml Are Associated with >65% Lower Cancer Risk: Pooled Analysis of Randomized Trial and Prospective Cohort Study

BackgroundHigher serum 25-hydroxyvitamin D [25(OH)D] concentrations have been associated with a lower risk of multiple cancer types across a range of 25(OH)D concentrations.ObjectivesTo investigate whether the previously reported inverse association between 25(OH)D and cancer risk could be replicated, and if a 25(OH)D response region could be identified among women aged 55 years and older across a broad range of 25(OH)D concentrations.MethodsData from two cohorts representing different median 25(OH)D concentrations were pooled to afford a broader range of 25(OH)D concentrations than either cohort alone: the Lappe cohort (N = 1,169), a randomized clinical trial cohort (median 25(OH)D = 30 ng/ml) and the GrassrootsHealth cohort (N = 1,135), a prospective cohort (median 25(OH)D = 48 ng/ml). Cancer incidence over a multi-year period (median: 3.9 years) was compared according to 25(OH)D concentration. Kaplan-Meier plots were developed and the association between 25(OH)D and cancer risk was examined with multivariate Cox regression using multiple 25(OH)D measurements and spline functions. The study included all invasive cancers excluding skin cancer.ResultsAge-adjusted cancer incidence across the combined cohort (N = 2,304) was 840 cases per 100,000 person-years (1,020 per 100,000 person-years in the Lappe cohort and 722 per 100,000 person-years in the GrassrootsHealth cohort). Incidence was lower at higher concentrations of 25(OH)D. Women with 25(OH)D concentrations ≥40 ng/ml had a 67% lower risk of cancer than women with concentrations <20 ng/ml (HR = 0.33, 95% CI = 0.12–0.90).Conclusions25(OH)D concentrations ≥40 ng/ml were associated with substantial reduction in risk of all invasive cancers combined.     

25(OH)D levels in diabetic pregnancies relation with neonatal hypocalcemia

The levels of 25(OH)D have been quantified in 42 insulin diabetic pregnancies (DP) through the three trimesters of pregnancy with a total of 177 determinations. In parallel we quantified this metabolite in 114 normal pregnant women (NP) and also in 116 normal controls (NC). In addition 25(OH)D was quantified in 18 (DP) and 19 (NP) at delivery in the 35-37th week of pregnancy, and ionic calcium was measured in their newborns at 24 h of life. Grouping by trimesters of gestation, the (NP) group had 25(OH)D levels similar to those of (NC) and none showed significant differences between trimesters of pregnancy. (DP) showed in all seasons lower (25(OH)D levels than (NC) but did not have differences in these levels between trimesters of pregnancy. The newborns of (DP) had lower ionic calcium levels than newborns of (NP). Eight newborns of (DP) had hypocalcemia and seven of their mothers showed 25(OH)D levels lower than 10 ng/ml. These findings suggest that lower 25(OH)D levels in (DP) can influence the neonatal hypocalcemia in their newborns.     

The High Prevalence of Vitamin D Deficiency and Its Related Maternal Factors in Pregnant Women in Beijing

Maternal vitamin D deficiency has been suggested to influence fetal and neonatal health. Little is known about vitamin D status in Chinese pregnant women. The purpose of this study was to assess the vitamin D status of pregnant women residing in Beijing in winter and evaluate the impact of maternal factors on serum 25-hydroxyvitamin D [25(OH)D] levels. The study was conducted on 125 healthy pregnant women. For each individual, data concerning pre-pregnancy weight, educational status, use of multivitamins and behavioral factors such as daily duration of computer use, walking and sun exposure were obtained. Serum concentrations of 25(OH)D were measured by enzyme-linked immunosorbent assay. The prevalence of vitamin D deficiency (25(OH)D < 50 nmol/L) was 96.8% and almost half (44.8%) of women were severely vitamin D deficiency (25(OH)D < 25 nmol/L). The concentration of 25(OH)D was lower in women with shorter duration of sun exposure (≤ 0.5 h/day, 25.3 ± 8.9 nmol/L) than that in women with longer duration of sun exposure (> 0.5 h/day; 30.3± 9.5 nmol/L; P = 0.003). Thirty six women (28.8%) had sun exposure duration ≥ 1.5h/day. The 25(OH)D concentration in these women was 31.5 ± 9.4 nmol/L which was also much lower than the normal level. Women who reported taking a multivitamin supplement had significantly higher 25(OH)D concentrations (32.3 ± 9.5 nmol/L) when compared with non-users (24.9 ± 8.2 nmol/L; P < 0.001). Pregnant women in Beijing are at very high risk of vitamin D deficiency in winter. Duration of Sun exposure and the use of multivitamin were the most important determinants for vitamin D status. However, neither prolonging the time of sunlight exposure nor multivitamin supplements can effectively prevent pregnant women from vitamin D deficiency. Other measures might have to be taken for pregnant women to improve their vitamin D status in winter.