Diabetes Obes Metab:妊娠期间维生素D状况和妊娠期糖尿病风险

2019-04-22 xing.T 网络

由此可见,妊娠早期孕妇维生素D缺乏与GDM风险升高有关。对于在妊娠中期持续缺乏的女性而言,这种关联更为强烈。妊娠早期维生素D状况评估对于改善风险分层和开发有效的GDM一级预防干预措施具有临床重要性和价值。

大量的证据表明孕妇维生素D状态可能与妊娠期糖尿病(GDM)有关。然而,由于缺乏维生素D对妊娠的纵向数据,其时间关系仍不明确。近日,代谢内分泌疾病领域权威杂志Diabetes Obesity & Metabolism上发表了一篇研究文章。研究人员的目的是前瞻性和纵向地分析妊娠早期至中期维生素D状态与GDM风险之间的关系。

研究人员对胎儿生长研究-单胎队列中107名GDM病例和214名对照者进行巢式病例对照研究,在孕周10-14、15-26、23-31和33-39周测量了血浆中25-羟基维生素D2和D3(25(OH)D)和维生素D结合蛋白的水平。研究人员进一步计算了总的、游离的和生物可利用的25(OH)D,并使用条件Logistic回归模型和线性混合效应模型进行分析。

研究人员观察到维生素D生物标志物与GDM风险之间关系存在阈值效应。妊娠10-14周时维生素D缺乏(<50nmol/L)与GDM风险增加2.82倍相关[比值比(OR)=2.82,95%置信区间(CI):1.15-6.93]。妊娠10-14和15-26周持续存在维生素D缺乏的女性与持续无缺乏的女性相比,GDM风险增加4.46倍(OR=4.46,95%CI:1.15-17.3)。 

由此可见,妊娠早期孕妇维生素D缺乏与GDM风险升高有关。对于在妊娠中期持续缺乏的女性而言,这种关联更为强烈。妊娠早期维生素D状况评估对于改善风险分层和开发有效的GDM一级预防干预措施具有临床重要性和价值。 

原始出处:

Jin Xia,et al.Vitamin D Status during Pregnancy and the Risk of Gestational Diabetes Mellitus: A Longitudinal Study in a Multiracial Cohort.Diabetes Obesity & Metabolism.2019.https://onlinelibrary.wiley.com/doi/10.1111/dom.13748

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    2020-02-09 一闲
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    2019-08-16 guojianrong
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    2019-04-22 misszhang

    谢谢MedSci提供最新的资讯

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2019年3月,美国妇产科医师学会(ACOG)发布了妊娠期血小板减少症管理实践指南,妊娠期血小板减少可有多种生理或病理机制引起,本文主要针对妊娠期血小板减少症的检查,诊断,管理等相关内容提出指导建议。

Eur Heart J:心血管疾病妇女的妊娠结局

由此可见,心脏病女性的孕产妇死亡率或心力衰竭率很高。然而,从2010年开始,尽管包含更多高风险妊娠,但这些发生率仍然下降。PAH女性的并发症发生率最高。

Circulation:胎盘生长因子能否预测女性妊娠后心血管风险?

妊娠期间血管生成胎盘生长因子(PlGF)浓度上升,在妊娠中期结束时达到峰值。妊娠期间低PlGF浓度与妊娠并发症相关,并具有公认的晚年心血管风险。Circulation发表的一项研究假设低PlGF浓度,特别是在妊娠中期,不仅可识别具有妊娠并发症风险的女性子集,而且还可诊断妊娠后心血管危险因素负担较大的女性,无论妊娠结局如何。

Stroke:妊娠妇女卒中风险逐年增加

卒中是神经系统急症,是致残和致死的主要原因。在加拿大,其实死亡的第三位病因,调整年龄卒中发生率从2003年的2.3%上升到2012年的2.6%。妊娠期卒中特别重要,不仅仅因为它影响到了育龄期妇女,而是因为它常常是由于妊娠引起来的,并且可以预防。妊娠相关卒中也是妊娠后严重长期残疾的最常见的病因。卒中危险因素包括妊娠高血压疾病,比如先兆子痫和子痫,以及血栓前状态会增加动脉和静脉血栓的风险。

NEJM:妊娠适应的YEARS算法诊断疑似肺栓塞

由此可见,妊娠适应的YEARS诊断算法在妊娠全程可安全地排除了肺栓塞,其可使32%至65%的患者中避免了CT肺血管造影。