[1]史桂源,朱宝菊.维生素D与复发性流产的相关性及其对妊娠结局的预测价值[J].医学信息,2024,37(08):118-120,124.[doi:10.3969/j.issn.1006-1959.2024.08.023]
　SHI Gui-yuan,ZHU Bao-ju.Correlation Between Vitamin D and Recurrent Spontaneous Abortion and its Predictive Value for Pregnancy Outcome[J].Journal of Medical Information,2024,37(08):118-120,124.[doi:10.3969/j.issn.1006-1959.2024.08.023]
点击复制

维生素D与复发性流产的相关性及其对妊娠结局的预测价值()
分享到：

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
37卷
期数:
2024年08期
页码:
118-120,124
栏目:
论著
出版日期:
2024-04-15

文章信息/Info

Title:
Correlation Between Vitamin D and Recurrent Spontaneous Abortion and its Predictive Value for Pregnancy Outcome
文章编号:
1006-1959（2024）08-0118-04
作者:
史桂源; 朱宝菊
（郑州大学第二附属医院妇产科，河南 郑州 450014）
Author(s):
SHI Gui-yuan; ZHU Bao-ju
(Department of Obstetrics and Gynecology,the Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450014,Henan,China)
关键词:
复发性流产; 维生素D; 妊娠结局
Keywords:
Recurrent spontaneous abortio; Vitamin D; Pregnancy outcome
分类号:
R714.2
DOI:
10.3969/j.issn.1006-1959.2024.08.023
文献标志码:
A
摘要:
目的 研究维生素D与复发性流产（RSA）的关系，并探讨维生素D对RSA患者再次妊娠结局的预测价值。方法 选取2020年6月-2021年6月于郑州大学第二附属医院定期围保的120例RSA患者作为RSA组，选取50名正常孕妇作为对照组。比较两组血清维生素D水平，以及RSA组不同妊娠结局、流产次数者维生素D水平，另采用Logistic回归分析维生素D水平与RSA发生的风险关系，ROC曲线分析维生素D对复发性流产妊娠结局的预测价值。结果 RSA组和对照组25（OH）D水平分别为（14.92±7.01）ng/ml、（20.81±9.69）ng/ml，组间比较，差异有统计学意义（P＜0.05）。RSA组维生素D充足及不足占比低于对照组，缺乏及严重缺乏占比高于对照组，差异有统计学意义（P＜0.05）。RSA组中继续妊娠者和流产者25（OH）D水平分别（15.93±7.05）ng/ml、（12.48±6.38）ng/ml，组间比较，差异有统计学意义（P＜0.05）。不同流产次数25（OH）D水平比较，差异有统计学意义（P＜0.05）；Logistic回归分析显示，维生素D缺乏是RSA发生的独立危险因素；ROC曲线分析显示，维生素D预测RSA患者再次发生流产具有一定的价值，曲线下面积为0.678，截断值、灵敏度和特异度分别为11.86 ng/ml、70.60%、60.00%。结论 妊娠期女性的维生素D水平普遍缺乏，与正常孕妇比较，RSA患者孕早期血清维生素D水平较低；孕早期维生素D＜11.86 ng/ml时，RSA患者再次发生流产的风险较高。
Abstract:
Objective To study the relationship between vitamin D and recurrent spontaneous abortion (RSA), and to explore the predictive value of vitamin D on the pregnancy outcome of RSA patients.Methods From June 2020 to June 2021, 120 patients with RSA who were regularly surrounded in the Second Affiliated Hospital of Zhengzhou University were selected as the RSA group, and 50 normal pregnant women were selected as the control group. Serum vitamin D levels were compared between the two groups, as well as vitamin D levels in RSA group with different pregnancy outcomes and abortion times. Logistic regression was used to analyze the risk relationship between vitamin D level and RSA. ROC curve was used to analyze the predictive value of vitamin D on pregnancy outcome of recurrent spontaneous abortion.Results The levels of 25 (OH) D in the RSA group and the control group were (14.92±7.01)ng/ml and (20.81±9.69)ng/ml, respectively, the difference between the two groups was statistically significant (P<0.05). The proportion of vitamin D sufficiency and insufficiency in the RSA group was lower than that in the control group, and the proportion of deficiency and severe deficiency was higher than that in the control group, with statistically significant differences (P<0.05). The levels of 25 (OH) D in continuing pregnancy and abortion in RSA group were (15.93±7.05) ng/ml and (12.48±6.38)ng/ml, respectively, and the difference between the two groups was statistically significant (P<0.05). There was significant difference in 25 (OH) D level among different abortion times (P<0.05). Logistic regression analysis showed that vitamin D deficiency was an independent risk factor for RSA. ROC curve analysis showed that vitamin D had a certain value in predicting recurrent abortion in RSA patients, the area under the curve was 0.678, and the cut-off value, sensitivity and specificity were 11.86 ng/ml, 70.60% and 60.00%, respectively.Conclusion The vitamin D level of pregnant women is generally deficient. Compared with normal pregnant women, the serum vitamin D level of RSA patients in early pregnancy is lower. When vitamin D<11.86 ng/ml in early pregnancy, RSA patients have a higher risk of recurrent abortion.

参考文献/References:

[1]中华医学会妇产科学分会产科学组,复发性流产诊治专家共识编写组.复发性流产诊治专家共识(2022)[J].中华妇产科杂志,2022,57(9):653-667.[2]Eshre Guideline Group on RPL,Bender Atik R,Christiansen OB,et al.ESHRE guideline: recurrent pregnancy loss[J].Human Reproduction Open,2018,2018(2):hoy004.[3]Mashiach S.Recurrent Pregnancy Loss: Causes, Controversies, and Treatment[J].Isr Med Assoc J,2021,23(1):64-65.[4]Chen X,Diao L,Lian R,et al.Potential impact of maternal vitamin D status on peripheral blood and endometrium cellular immunity in women with recurrent implantation failure[J].Am J Reprod Immunol,2020,84(1):e13243.[5]Li D,Zheng L,Zhao D,et al.The role of immune cells in recurrent spontaneous abortion[J].Reproductive Sciences,2021,28(12):3303-3315.[6]Zhao R,Zhang W,Ma C,et al.Immunomodulatory function of vitamin D and its role in autoimmune thyroid disease[J].Frontiers in Immunology,2021,12:574967.[7]何湘娇,赵静,张琼,等.血清与卵泡液25-羟维生素D水平与体外受精-胚胎移植妊娠结局的相关性研究[J].中华生殖与避孕杂志,2020,40(4):271-278.[8]Zhou X,Li B,Wang C,et al.Study on the changes in TSH,TPO-Ab and other indicators due to Vitamin D deficiency in Pregnant Women with subclinical hypothyroidism in the first trimester[J].Pakistan Journal of Medical Sciences,2020,36(6):1313.[9]Keller A,Varela Vazquez C,Dangol R,et al.The role of vitamin D in the development of diabetes post gestational diabetes mellitus:A systematic literature review[J].Nutrients,2020,12(6):1733.[10]Bao W,Song Y,Bertrand KA,et al.Prepregnancy habitual intake of vitamin D from diet and supplements in relation to risk of gestational diabetes mellitus:A prospective cohort study[J].Journal of Diabetes,2018,10(5):373-379.[11]Holick Michael F.The vitamin D deficiency pandemic:Approaches for diagnosis,treatment and prevention [J].Reviews in Endocrine and Metabolic Disorders,2017,18(2):153-165.[12]Saraf R,Morton SMB,Camargo Jr CA,et al.Global summary of maternal and newborn vitamin D status–a systematic review[J].Maternal & Child Nutrition,2016,12(4):647-668.[13]Pilz S,Zittermann A,Obeid R,et al.The role of vitamin D in fertility and during pregnancy and lactation:a review of clinical data[J].International Journal of Environmental Research and Public Health,2018,15(10):2241.[14]Li N,Wu HM,Hang F,et al.Women with recurrent spontaneous abortion have decreased 25(OH) vitamin Dand VDR at the fetal-maternal interface [J].Braz J Med Biol Res,2017,50(11):e6527.[15]Andersen LB,J?覬rgensen JS,Jensen TK,et al.Vitamin D insufficiency is associated with increased risk of first-trimester miscarriage in the Odense Child Cohort[J].American Journal of Clinical Nutrition,2015,102(3):633-638.[16]齐雅杰.维生素D与复发性流产的关系研究[D].呼和浩特:内蒙古医科大学,2019.[17]Dzik KP,Kaczor JJ.Mechanisms of vitamin D on skeletal muscle function:oxidative stress,energy metabolism and anabolic state[J].European Journal of Applied Physiology,2019,119:825-839.[18]Jueraitetibaike K,Ding Z,Wang DD,et al.The effect of vitamin D on sperm motility and the underlying mechanism[J].Asian Journal of Andrology,2019,21(4):400.[19]Kuyucu Y,Sencar L,Tap ?魻,et al.Investigation of the effects of vitamin D treatment on the ovarian AMH receptors in a polycystic ovary syndrome experimental model:an ultrastructural and immunohistochemical study[J].Reproductive Biology,2020,20(1):25-32.[20]Wan L,Gu J,Liu T,et al.Clinical performance of automated chemiluminescent methods for anticardiolipin and anti‐β2‐glycoprotein I antibodies detection in a large cohort of Chinese patients with antiphospholipid syndrome[J].International Journal of Laboratory Hematology,2020,42(2):206-213.

相似文献/References:

[1]付庆萍,黄万秀,李 毅.维生素D水平与成人哮喘及非哮喘的相关性研究[J].医学信息,2019,32(05):87.[doi:10.3969/j.issn.1006-1959.2019.05.026]
　FU Qin-ping,HUANG Wang-xiu,LI Yi.Correlation between Vitamin D Levels and Adult Asthma and Non-asthma[J].Journal of Medical Information,2019,32(08):87.[doi:10.3969/j.issn.1006-1959.2019.05.026]
[2]王 红.复发性流产病因学研究现状分析[J].医学信息,2019,32(06):64.[doi:10.3969/j.issn.1006-1959.2019.06.021]
　WANG Hong.Analysis of the Current Situation of Etiology of Recurrent Spontaneous Abortion[J].Journal of Medical Information,2019,32(08):64.[doi:10.3969/j.issn.1006-1959.2019.06.021]
[3]李沙沙,赵 娜,孙渤星.药物联合情绪管理疗法在治疗不明原因复发性流产的临床疗效观察[J].医学信息,2019,32(08):131.[doi:10.3969/j.issn.1006-1959.2019.08.038]
　LI Sha-sha,ZHAO Na,SUN Bo-xing.Clinical Observation of Drug Combined with Emotional Management Therapy in the Treatment of Unexplained Recurrent Spontaneous Abortion[J].Journal of Medical Information,2019,32(08):131.[doi:10.3969/j.issn.1006-1959.2019.08.038]
[4]黄 铃,孙 冰,蔡金美,等.维生素D治疗川崎病的疗效及其对血清促炎因子的影响[J].医学信息,2019,32(18):81.[doi:10.3969/j.issn.1006-1959.2019.18.025]
　HUANG Ling,SUN Bing,CAI Jin-mei,et al.Therapeutic Effect of Vitamin D on Kawasaki Disease and Its Effect on Serum Pro-inflammatory Factors[J].Journal of Medical Information,2019,32(08):81.[doi:10.3969/j.issn.1006-1959.2019.18.025]
[5]俞晓晶,王 芳.复发性流产的病因研究[J].医学信息,2020,33(10):34.[doi:10.3969/j.issn.1006-1959.2020.10.010]
　YU Xiao-jing,WANG Fang.Study on the Etiology of Recurrent Spontaneous Miscarriage[J].Journal of Medical Information,2020,33(08):34.[doi:10.3969/j.issn.1006-1959.2020.10.010]
[6]张正超,李毓龙,贺 腊,等.2019年简阳地区儿童维生素D营养状况调查[J].医学信息,2020,33(11):131.[doi:10.3969/j.issn.1006-1959.2020.11.041]
　ZHANG Zheng-chao,LI Yu-long,HE La,et al.2019 Survey of Vitamin D Nutrition Status of Children in Jianyang District[J].Journal of Medical Information,2020,33(08):131.[doi:10.3969/j.issn.1006-1959.2020.11.041]
[7]白玉芬,徐洪涛,尹太勇,等.维生素D对系统性红斑狼疮鼠Peyer小结Tfh细胞微环境的影响[J].医学信息,2020,33(13):49.[doi:10.3969/j.issn.1006-1959.2020.13.014]
　BAI Yu-fen,XU Hong-tao,YIN Tai-yong,et al.The Effect of Vitamin D on the Microenvironment of Tfh Cells in Peyer’s Nodules of Systemic Lupus Erythematosus[J].Journal of Medical Information,2020,33(08):49.[doi:10.3969/j.issn.1006-1959.2020.13.014]
[8]郑鑫辉,崔慧丽,杨铁毅,等.粪乳铁蛋白、维生素D水平与克罗恩病患者骨质疏松的相关性[J].医学信息,2021,34(05):114.[doi:10.3969/j.issn.1006-1959.2021.05.032]
　ZHENG Xin-hui,CUI Hui-li,YANG Tie-yi,et al.Correlation Between Fecal Lactoferrin,Vitamin D Levels and Osteoporosis in Crohn’s Disease[J].Journal of Medical Information,2021,34(08):114.[doi:10.3969/j.issn.1006-1959.2021.05.032]
[9]朱 琪,龙 菲.血清维生素D水平与高龄老年人轻度认知障碍的关系[J].医学信息,2021,34(18):74.[doi:10.3969/j.issn.1006-1959.2021.18.020]
　ZHU Qi,LONG Fei.The Relationship Between Serum Vitamin D Level and Mild Cognitive Impairment in the Elderly[J].Journal of Medical Information,2021,34(08):74.[doi:10.3969/j.issn.1006-1959.2021.18.020]
[10]祝悦悦,张玉珍,曹志瑞,等.孕中期血清维生素D与糖代谢相关性分析[J].医学信息,2022,35(07):109.[doi:10.3969/j.issn.1006-1959.2022.07.026]
　ZHU Yue-yue,ZHANG Yu-zhen,CAO Zhi-rui,et al.Relationship Between Vitamin D Level and Glucose Metabolism in Second Trimester of Pregnancy[J].Journal of Medical Information,2022,35(08):109.[doi:10.3969/j.issn.1006-1959.2022.07.026]

更新日期/Last Update: 1900-01-01