摘要
目的 探讨孕早期妇女体内维生素K水平与妊娠相关疾病和不良妊娠结局的关系。方法 采用便利抽样法选取2018年10月—2019年9月在北京儿童医院顺义妇儿医院建档的367名孕早期妇女,问卷收集调查对象的基本资料,采集血样并采用液相色谱-串联质谱法(LC-MS/MS)检测维生素K_(1)及维生素K_(2)MK-4和MK-7)的浓度。随访收集调查对象是否患妊娠相关疾病及其妊娠结局,利用偏相关性检验与二元Logistic回归分析维生素K浓度与妊娠相关疾病和不良妊娠结局的相关性。结果 调查对象平均年龄为29.3岁,孕前体质指数15.43~40.40,孕周为5.9~14.0周,孕妇体内维生素K_(1)、MK-4和MK-7的浓度[M(P25,P75)]分别为0.526(0.359,0.681)、0.021(0.018,0.026)和1.093(0.295,3.325)ng/mL。孕早期血清MK-7水平与妊娠期糖尿病(gestational diabetes mellitus, GDM)的发生存在显著负相关(P=0.032)。校正年龄、民族、体质指数、产次、维生素D水平、身体活动度、低密度脂蛋白、高密度脂蛋白、孕周后发现,MK-7缺乏是GDM的危险因素(OR=4.276,P=0.034)。结论 孕早期妇女血清MK-7水平与GDM的发生呈负相关,孕早期应关注孕妇维生素K的营养状态。
OBJECTIVE To explore the relationship between vitamin K levels and pregnancy-related diseases and adverse pregnancy outcomes in early pregnancy.METHODS A convenience sampling method was used to select 367 women in early pregnancy who were enrolled in the Shunyi Women’s and Children’s Hospital of Beijing Children’s Hospital from October 2018 to September 2019.Basic information such as age,height,and pre-pregnancy weight of the respondents was collected,blood samples were taken and the concentration of vitamin K(vitamin K_(1),MK-4 and MK-7)was measured by liquid chromatography tandem mass spectrometry(LC-MS/MS).Follow-up visits were conducted to collect information on whether the respondents had pregnancyrelated disease and their pregnancy outcomes.The relationship between vitamin K concentration and pregnancy-related diseases and adverse pregnancy outcomes was analyzed by partial correlation test and binary logistic regression.RESULTS The mean age of the respondents was 29.3 years,with a range of pre-pregnancy body mass index from 15.43 to 40.40 and weeks of pregnancy range from 5.9 to 14.0 weeks.The concentrations of MK-7,vitamin K_(1),and MK-4 in pregnant women(M(P25,P75))were 1.093(0.295,3.325)ng/mL,0.526(0.359,0.681)ng/mL and 0.021(0.018,0.026)ng/mL,respectively.There was a significant negative correlation between serum MK-7 levels in early pregnancy and the development of gestational diabetes mellitus(GDM)(P=0.032).The result of binary logistic regression analysis showed that MK-7 deficiency was a risk factor for GDM(OR=4.276,P=0.034)after adjusting for confounding factors:age,ethnicity,BMI,parity,vitamin D level,physical activity,low-density lipoprotein(LDL),high-density lipoprotein(HDL),and gestational age.CONCLUSION Serum MK-7 levels in early pregnancy are negatively associated with the development of GDM in women.It is therefore essential to pay more attention to the nutritional status of vitamin K in pregnant women in early pregnancy.
作者
王海燕
单晓云
李蕊
张玉萍
厉玉婷
聂淑慧
于康
杨丽琛
胡贻椿
刘燕萍
Wang Haiyan;Shan Xiaoyun;Li Rui;Zhang Yuping;Li Yuting;Nie Shuhui;Yu Kang;Yang Lichen;Hu Yichun;Liu Yanping(National Institute for Nutrition and Health,Chinese Center for Disease Control and Prevention,Beijing 100050,China;Clinical Nutrition Department,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences,Beijing 100730,China;Key Laboratory of Public Nutrition and Health,National Health Commission of the People’s Republic of China,Beijing 100050,China)
出处
《卫生研究》
北大核心
2025年第1期87-91,共5页
Journal of Hygiene Research
基金
国家卫生健康委微量元素与营养重点实验室开放课题(No.Wlkfz202203)
中国营养学会科研基金-振东基金(No.CNS-ZD2021-123)
中央高水平医院临床科研业务项目(No.2022-PUMCH-B-055)
