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Сезонные колебания уровня 25-гидроксихолекальциферола у беременных, проживающих в Санкт-Петербурге
Сезонные колебания уровня 25-гидроксихолекальциферола у беременных, проживающих в Санкт-Петербурге
Хазова Е.Л., Ширинян Л.В., Зазерская И.Е. и др. Сезонные колебания уровня 25-гидроксихолекальциферола у беременных, проживающих в Санкт-Петербурге. Гинекология. 2015; 17 (4): 38–42.
Petersburg. Gynecology. 2015; 17 (4): 38–42.
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Petersburg. Gynecology. 2015; 17 (4): 38–42.
Материалы доступны только для специалистов сферы здравоохранения. Авторизуйтесь или зарегистрируйтесь.
Аннотация
В данной статье представлены результаты когортного проспективного исследования оценки уровня 25-гидроксихолекальциферола (25-ОН-D) в сыворотке при беременности у женщин в зависимости от сезона года. Цель настоящего исследования – оценка насыщенности организма беременных пациенток витамином D в разные сезоны на протяжении беременности и проживающих в Санкт-Петербурге. Включены в исследование 205 беременных женщин в I триместре. Закончили его 192 пациентки. Все беременные были поделены на 4 подгруппы в зависимости от времени года при включении в исследование. В 12–14 нед проводился первый забор крови. Все женщины ежедневно принимали 500 МЕ колекальциферола в составе поливитаминных комплексов с I триместра до родов. На протяжении беременности уровень 25-ОН-D в сыворотке определялся в сроках: 12–14, 24–26, 34–36 нед. Не обнаружено значимых различий исходного среднего уровня 25-ОН-D у всех беременных (17,5; 21,3; 22,6; 19,9 нг/мл соответственно в 1, 2, 3 и 4-й подгруппах). Установлена максимальная насыщенность витамином D в I триместре беременности в летний сезон и составляет 22,6 нг/мл, что соответствует критерию недостаточности. Минимальная концентрация 25-ОН-D среди подгрупп выявлена в зимний период и составляет 17,5 нг/мл, что соответствует критерию дефицита витамина D. Итоговая концентрация 25-ОН-D достоверно не отличается между подгруппами. Прирост уровня 25-ОН-D от I к III триместру имеет место независимо от сезона года. Исследование не показало значимых зависимых изменений уровня 25-ОН-D в сыворотке крови у беременных от сезона года.
Ключевые слова: витамин D, гидроксихолекальциферол, колекальциферол, 25-ОН-D, беременность, сезонность.
The aim of this research is to estimate the intensity of the body of pregnant women with vitamin D in different seasons during pregnancy, who live in Saint Petersburg. There are involved 205 pregnant at I trimester. It was finished by 192 patients. All patients were divided into 4 subgroups depending on the season of the year while involving to the study. At 12–14 weeks there was first blood sampling. From the I trimester till delivery all patients took 500 IU of сolecalciferol contained in multivitamin complexes. During pregnancy 25-ОН-D level in blood serum was measured at 12–14, 24–26, 34–36 weeks of gestation. There are not found significant differences of the initial mean level of 25-ОН-D in all pregnant (17.5, 21.3, 22.6, 19.9 ng/ml, accordingly to the 1st, 2nd, 3rd and 4th subgroups). It was defined the maximal intensity of vitamin D at I trimester of pregnancy during summer – 22.6 ng/ml, which refers to the criteria of vitamin D insufficiency. Minimal concentration of 25-ОН-D among subgroups was revealed during winter – 17.5 ng/ml, which refers the criteria of vitamin D deficiency. Total concentration of 25-ОН-D authentically does not differ between subgroups. The increase the level of 25-ОН-D from the I to the III trimester takes place regardless of the season. The study showed no significant changes in the level of 25-OH-D in blood serum of pregnant depending on the season.
Key words: vitamin D, hydroхуholecalciferol, сolecalciferol, 25-OH-D, pregnancy, seasonality.
Ключевые слова: витамин D, гидроксихолекальциферол, колекальциферол, 25-ОН-D, беременность, сезонность.
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The aim of this research is to estimate the intensity of the body of pregnant women with vitamin D in different seasons during pregnancy, who live in Saint Petersburg. There are involved 205 pregnant at I trimester. It was finished by 192 patients. All patients were divided into 4 subgroups depending on the season of the year while involving to the study. At 12–14 weeks there was first blood sampling. From the I trimester till delivery all patients took 500 IU of сolecalciferol contained in multivitamin complexes. During pregnancy 25-ОН-D level in blood serum was measured at 12–14, 24–26, 34–36 weeks of gestation. There are not found significant differences of the initial mean level of 25-ОН-D in all pregnant (17.5, 21.3, 22.6, 19.9 ng/ml, accordingly to the 1st, 2nd, 3rd and 4th subgroups). It was defined the maximal intensity of vitamin D at I trimester of pregnancy during summer – 22.6 ng/ml, which refers to the criteria of vitamin D insufficiency. Minimal concentration of 25-ОН-D among subgroups was revealed during winter – 17.5 ng/ml, which refers the criteria of vitamin D deficiency. Total concentration of 25-ОН-D authentically does not differ between subgroups. The increase the level of 25-ОН-D from the I to the III trimester takes place regardless of the season. The study showed no significant changes in the level of 25-OH-D in blood serum of pregnant depending on the season.
Key words: vitamin D, hydroхуholecalciferol, сolecalciferol, 25-OH-D, pregnancy, seasonality.
Полный текст
Список литературы
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2. Hollis BW, Wagner CL. Vitamin D requirements during lactation: high-dose maternal supplementation as therapy to prevent hypovitaminosis D for both the mother and the nursing infant. Am J Med 2004; 112:659–62.
3. Lee JM, Smith JR, Philipp BL et al. Vitamin D deficiency in a healthy group of mothers and newborn infants. Clin Pediatr (Phila) 2007; 46: 42–4; Am J Clin Nutr 80: 1752S–8S.
4. Bodnar LM, Simhan HN, Powers RW et al. High prevalence of vitamin D insufficiency in black and white pregnant women residing in the northern United States and their neonates. J Nutr 2007; 137: 447–52.
5. Kasahara AK, Singh RJ, Noymer A. Vitamin D (25OHD) Serum Seasonality in the United States. PLoS ONE 2013; 8(6): e65785. Doi:10.1371/journal.pone.0065785.
6. De-Regil LM, Palacios C, Ansary A et al. Cochrane Collaboration. Vitamin D supplementation for women during pregnancy. 2012.
7. Evaluation, Treatment, and Prevention of Vitamin D Deficiency: An Endocrine Society Clinical Practice Guideline 2011.
8. Holick MF. Vitamin D deficiency. N Engl J Med 2009; 357: 266–81..
9. Dawodu A, Saadi HF, Bekdache G et al. Randomized controlled trial (RCT) of vitamin D supplementation in pregnancy in a population with endemic vitamin D deficiency. J Clin Endocrinol Metab 2013; 98: 2337–46.
10. Haddad JG, Matsuoka LY, Hollis BW et al. Human plasma transport of vitamin D after its endogenous synthesis. J Clin Invest 1993; 91: 2552–5.
11. Sardi B. The uncensored family guide live longer and healthier with 30 minutes. Knowledge of Health, Inc. 2008.
12. FGBU «Severo-Zapadnoe upravlenie po gidrometeorologii i monitoringu okruzhaiushchei sredy» [in Russian]
13. Outila T. Department of Applied Chemistr and Microbiology Division of Nutrition University of Helsinki 2001 The effect of vitamin D status on calcium and bone metabolism.
14. Royal College of Obstetricians and Gynaecologists, Vitamin D in pregnancy, Scientific Impact Paper No. 43 June 2014.
15. Gordon CM, DePeter KC, Feldman HA et al. Prevalence of vitamin D deficiency among healthy adolescents. Arch Pediatr Adolesc Med 2004; 158: 531–7.
16. Sullivan SS, Rosen CJ, Halteman WA et al. Adolescent girls in Maine at risk for vitamin D insufficiency. J Am Diet Assoc 2005; 105: 971–4.
17. Nesby-O’Dell S, Scanlon KS, Cogswel ME et al. Hypovitaminosis D prevalence and determinants among African American and white women of reproductive age: Third National Health and Nutrition Examination Survey, 1988–1994. Am J Clin Nutr 2002; 76: 187–92.
18. Tangpricha V, Pearce EN, Chen TC, Holick MF. Vitamin D insufficiency among free-living healthy young adults. 2002.
19. Adams JS, Hewison M. Update in vitamin D. J Clin Endocrinol Metab 2010; 95: 471–8.
20. Holick MF. Vitamin D deficiency. J Clin Endocrinol Metab 2011; N Engl J Med 2007; 357: 266–81.
2. Hollis BW, Wagner CL. Vitamin D requirements during lactation: high-dose maternal supplementation as therapy to prevent hypovitaminosis D for both the mother and the nursing infant. Am J Med 2004; 112:659–62.
3. Lee JM, Smith JR, Philipp BL et al. Vitamin D deficiency in a healthy group of mothers and newborn infants. Clin Pediatr (Phila) 2007; 46: 42–4; Am J Clin Nutr 80: 1752S–8S.
4. Bodnar LM, Simhan HN, Powers RW et al. High prevalence of vitamin D insufficiency in black and white pregnant women residing in the northern United States and their neonates. J Nutr 2007; 137: 447–52.
5. Kasahara AK, Singh RJ, Noymer A. Vitamin D (25OHD) Serum Seasonality in the United States. PLoS ONE 2013; 8(6): e65785. Doi:10.1371/journal.pone.0065785.
6. De-Regil LM, Palacios C, Ansary A et al. Cochrane Collaboration. Vitamin D supplementation for women during pregnancy. 2012.
7. Evaluation, Treatment, and Prevention of Vitamin D Deficiency: An Endocrine Society Clinical Practice Guideline 2011.
8. Holick MF. Vitamin D deficiency. N Engl J Med 2009; 357: 266–81..
9. Dawodu A, Saadi HF, Bekdache G et al. Randomized controlled trial (RCT) of vitamin D supplementation in pregnancy in a population with endemic vitamin D deficiency. J Clin Endocrinol Metab 2013; 98: 2337–46.
10. Haddad JG, Matsuoka LY, Hollis BW et al. Human plasma transport of vitamin D after its endogenous synthesis. J Clin Invest 1993; 91: 2552–5.
11. Sardi B. The uncensored family guide live longer and healthier with 30 minutes. Knowledge of Health, Inc. 2008.
12. ФГБУ «Северо-Западное управление по гидрометеорологии и мониторингу окружающей среды» / FGBU «Severo-Zapadnoe upravlenie po gidrometeorologii i monitoringu okruzhaiushchei sredy» [in Russian]
13. Outila T. Department of Applied Chemistr and Microbiology Division of Nutrition University of Helsinki 2001 The effect of vitamin D status on calcium and bone metabolism.
14. Royal College of Obstetricians and Gynaecologists, Vitamin D in pregnancy, Scientific Impact Paper No. 43 June 2014.
15. Gordon CM, DePeter KC, Feldman HA et al. Prevalence of vitamin D deficiency among healthy adolescents. Arch Pediatr Adolesc Med 2004; 158: 531–7.
16. Sullivan SS, Rosen CJ, Halteman WA et al. Adolescent girls in Maine at risk for vitamin D insufficiency. J Am Diet Assoc 2005; 105: 971–4.
17. Nesby-O’Dell S, Scanlon KS, Cogswel ME et al. Hypovitaminosis D prevalence and determinants among African American and white women of reproductive age: Third National Health and Nutrition Examination Survey, 1988–1994. Am J Clin Nutr 2002; 76: 187–92.
18. Tangpricha V, Pearce EN, Chen TC, Holick MF. Vitamin D insufficiency among free-living healthy young adults. 2002.
19. Adams JS, Hewison M. Update in vitamin D. J Clin Endocrinol Metab 2010; 95: 471–8.
20. Holick MF. Vitamin D deficiency. J Clin Endocrinol Metab 2011; N Engl J Med 2007; 357: 266–81.
________________________________________________
2. Hollis BW, Wagner CL. Vitamin D requirements during lactation: high-dose maternal supplementation as therapy to prevent hypovitaminosis D for both the mother and the nursing infant. Am J Med 2004; 112:659–62.
3. Lee JM, Smith JR, Philipp BL et al. Vitamin D deficiency in a healthy group of mothers and newborn infants. Clin Pediatr (Phila) 2007; 46: 42–4; Am J Clin Nutr 80: 1752S–8S.
4. Bodnar LM, Simhan HN, Powers RW et al. High prevalence of vitamin D insufficiency in black and white pregnant women residing in the northern United States and their neonates. J Nutr 2007; 137: 447–52.
5. Kasahara AK, Singh RJ, Noymer A. Vitamin D (25OHD) Serum Seasonality in the United States. PLoS ONE 2013; 8(6): e65785. Doi:10.1371/journal.pone.0065785.
6. De-Regil LM, Palacios C, Ansary A et al. Cochrane Collaboration. Vitamin D supplementation for women during pregnancy. 2012.
7. Evaluation, Treatment, and Prevention of Vitamin D Deficiency: An Endocrine Society Clinical Practice Guideline 2011.
8. Holick MF. Vitamin D deficiency. N Engl J Med 2009; 357: 266–81..
9. Dawodu A, Saadi HF, Bekdache G et al. Randomized controlled trial (RCT) of vitamin D supplementation in pregnancy in a population with endemic vitamin D deficiency. J Clin Endocrinol Metab 2013; 98: 2337–46.
10. Haddad JG, Matsuoka LY, Hollis BW et al. Human plasma transport of vitamin D after its endogenous synthesis. J Clin Invest 1993; 91: 2552–5.
11. Sardi B. The uncensored family guide live longer and healthier with 30 minutes. Knowledge of Health, Inc. 2008.
12. FGBU «Severo-Zapadnoe upravlenie po gidrometeorologii i monitoringu okruzhaiushchei sredy» [in Russian]
13. Outila T. Department of Applied Chemistr and Microbiology Division of Nutrition University of Helsinki 2001 The effect of vitamin D status on calcium and bone metabolism.
14. Royal College of Obstetricians and Gynaecologists, Vitamin D in pregnancy, Scientific Impact Paper No. 43 June 2014.
15. Gordon CM, DePeter KC, Feldman HA et al. Prevalence of vitamin D deficiency among healthy adolescents. Arch Pediatr Adolesc Med 2004; 158: 531–7.
16. Sullivan SS, Rosen CJ, Halteman WA et al. Adolescent girls in Maine at risk for vitamin D insufficiency. J Am Diet Assoc 2005; 105: 971–4.
17. Nesby-O’Dell S, Scanlon KS, Cogswel ME et al. Hypovitaminosis D prevalence and determinants among African American and white women of reproductive age: Third National Health and Nutrition Examination Survey, 1988–1994. Am J Clin Nutr 2002; 76: 187–92.
18. Tangpricha V, Pearce EN, Chen TC, Holick MF. Vitamin D insufficiency among free-living healthy young adults. 2002.
19. Adams JS, Hewison M. Update in vitamin D. J Clin Endocrinol Metab 2010; 95: 471–8.
20. Holick MF. Vitamin D deficiency. J Clin Endocrinol Metab 2011; N Engl J Med 2007; 357: 266–81.
Авторы
Е.Л.Хазова*, Л.В.Ширинян, И.Е.Зазерская, В.А.Барт, Е.Ю.Васильева
ФГБУ Северо-Западный федеральный медицинский исследовательский центр им. В.А.Алмазова Минздрава России. 197341, Россия, Санкт-Петербург, ул. Аккуратова, д. 2
*kamishi77@mail.ru
V.A.Almazov Northwestern Federal Medical Research Center of the Ministry of Health of the Russian Federation.
197341, Russian Federation, Saint Petersburg, ul. Akkuratova, d. 2
*kamishi77@mail.ru
ФГБУ Северо-Западный федеральный медицинский исследовательский центр им. В.А.Алмазова Минздрава России. 197341, Россия, Санкт-Петербург, ул. Аккуратова, д. 2
*kamishi77@mail.ru
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V.A.Almazov Northwestern Federal Medical Research Center of the Ministry of Health of the Russian Federation.
197341, Russian Federation, Saint Petersburg, ul. Akkuratova, d. 2
*kamishi77@mail.ru
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