上海交通大学学报(医学版)

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上海地区中期妊娠孕妇25-羟维生素D正常参考区间调查

李东平1,李则挚2,肖世金3   

  1. 1. 复旦大学附属华山医院北院妇产科,上海 201907;2. 上海交通大学 医学院附属仁济医院神经内科,上海 200127;3. 上海交通大学 医学院附属仁济医院妇产科,上海 200127
  • 出版日期:2017-04-28 发布日期:2017-05-04
  • 通讯作者: 肖世金,电子信箱:shjxiao@sina.com。
  • 作者简介:李东平(1970—),副主任医师,学士;电子信箱:mdrdongpingli70@163.com。

Investigation on the reference range for 25-hydroxyvitamin D in second trimester pregnant women in Shanghai

LI Dong-ping1, LI Ze-zhi2, XIAO Shi-jin3   

  1. 1. Department of Obstetrics and Gynecology, Huashan Hospital North, Fudan University, Shanghai 201907, China; 2. Department of Neurology, RenJi Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China; 3. Department of Obstetrics and Gynecology, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
  • Online:2017-04-28 Published:2017-05-04

摘要:

目的 ·探讨上海地区中期妊娠孕妇25-羟维生素D正常参考区间。方法 ·将4 969例中期妊娠孕妇分为高龄孕妇组(年龄≥35岁,554例)和非高龄孕妇组(年龄< 35岁,4 415例);另设立正常非妊娠期、生育期女性组,共1 048例。所有产妇分娩的新生儿均无佝偻病等维生素D缺乏并发症。使用酶联免疫法检测入组女性外周血标本25-羟维生素D水平。25-羟维生素D医学参考区间按P2.5~P97.5计算。结果 ·中期妊娠孕妇外周血25-羟维生素D水平呈正偏态分布,其中位数为36.8 nmol/L,最大值为108.6 nmol/L,最小值为11.8 nmol/L,95%医学参考值范围为15.9~70.3 nmol/L。非高龄组孕妇25-羟维生素D中位数为36.6 nmol/L,高龄组孕妇25-羟维生素D中位数为35.5 nmol/L,2组具有显著差异(Z=-2.75,P<0.05)。非妊娠期妇女25-羟维生素D中位数为38.5 nmol/L,最大值为110.5 nmol/L,最小值为12.1 nmol/L;妊娠组25-羟维生素D检测结果显著低于非妊娠组(P<0.05)。结论 ·上海地区中期妊娠孕妇虽然均补充复合维生素,但仍普遍存在维生素D缺乏情况,以高龄孕妇的维生素D缺乏更为明显,但新生儿未存在佝偻病等维生素D缺乏并发症。确定上海地区妊娠期维生素D参考区间对孕期维生素D的补充有重要指导意义,特别是对预防高龄孕妇维生素D缺乏带来的母婴并发症有着重要作用。

关键词: 25-羟维生素D, 妊娠, 参考区间

Abstract:

Objective · To investigate the reference range for serum 25-hydroxyvitamin D in pregnant women in Shanghai. Methods · A total of 4 969 healthy pregnant women in second trimester were enrolled, in whom there were 554 women aged over or equal to 35 years old and 4 415 women aged under 35 years old. Meanwhile, 1 048 non-pregnant women in child-bearing period were enrolled. The new born children had no complications of vitamin D deficiency such as rickets. The levels of 25-hydroxyvitamin D of all participants were detected by ELISA. The reference interval was defined as the central 95% range between the 2.5th and the 97.5th percentiles. Results · The 95% reference range for 25-hydroxyvitamin D levels showed a positive skewness distribution in second trimester pregnant women. The median of 25-hydroxyvitamin D levels was 36.8 nmol/L. The maximum was 108.6 nmol/ L whereas the minimum was 11.8 nmol/L. The 95% reference range for 25-hydroxyvitamin D levels was from 15.9 nmol/L to 70.3 nmol/L. The median 25-hydroxyvitamin D was 36.6 nmol/L in women less than 35 years old, and 35.5 nmol/L in women aged over or equal to 35 years old. A significant difference was found between women aged under 35 years old and women aged over or equal to 35 years old (Z=-2.75, P<0.05). The median, maximum and minimum of 25-hydroxyvitamin D in non-pregnant women was 38.5 nmol/L, 110.5 nmol/L, 12.1 nmol/L, respectively, which were all higher than those in pregnant women (P<0.05). Conclusion · There was a lack of vitamin D in pregnant women in Shanghai, especially in pregnant women aged over or equal to 35 years old, despite the multivitamin supplements. However, no complications of vitamin D deficiency such as rickets were found in new born children. To determine the reference range of vitamin D in Shanghai is helpful for pregnancy women in taking vitamin supplement, especially important in preventing maternal and fetal complications caused by vitamin D deficiency.

Key words: 25-hydroxyvitamin D, pregnant, reference range