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目的:分析江苏省部分孕期妇女不同季节血清维生素D水平,了解其维生素D营养状况。方法:于2013年1月—2015年12月间在江苏省8个地区不同医院的围产营养门诊采集18 478名健康孕妇的空腹血样,采用液相色谱-串联质谱(LC-MS/MS)法测量血清25-羟基维生素D3[25(OH)D3]和25-羟基维生素D2[25(OH)D2]的浓度。25(OH)D2和25(OH)D3总和为25-羟基维生素D[25(OH)D],以25(OH)D为体内维生素D水平的指标进行统计分析。结果:全部18 478名孕妇的血清25(OH)D浓度平均为(19.2±9.4)ng/mL,维生素D缺乏率[25(OH)D<20 ng/mL]为59.7%,严重缺乏率[25(OH)D<12 ng/mL]为24.9%,充足率[25(OH)D>30 ng/mL]为13.7%。2013、2014、2015年孕妇的平均血清25(OH)D浓度分别为(17.3±8.5)、(18.2±9.0)、(20.5±9.7)ng/mL,其维生素D缺乏率分别为69.4%、63.6%、54.4%。不同年份孕妇25(OH)D水平的差异具有统计学意义(P<0.01)。江苏省苏南、苏中、苏北地区的孕妇血清25(OH)D浓度平均分别为(19.2±9.5)、(19.6±9.0)、(18.4±8.7)ng/mL,维生素D缺乏率分别为60.0%、57.9%、62.8%,不同地区间孕妇25(OH)D水平的差异具有统计学意义(P<0.01)。孕妇血清25(OH)D浓度与年龄呈正相关(r=0.8,P<0.01)。孕妇维生素D的水平与检测血清25(OH)D浓度的季节有关,夏秋季高于春冬季,其血清25(OH)D浓度依次为(22.7±9.2)、(22.2±9.3)、(15.3±7.3)、(12.3±6.4)ng/mL。结论:孕妇维生素D缺乏率高,应加强对孕妇维生素D水平的监测,及时指导维生素D缺乏的孕妇合理补充维生素D。
Objective: To analyze the serum vitamin D levels of some pregnant women in different seasons in Jiangsu Province to understand the nutritional status of vitamin D. Methods: Fasting blood samples from 18 478 healthy pregnant women were collected from perinatal nutrition clinics in different hospitals in 8 districts in Jiangsu Province from January 2013 to December 2015. The samples were analyzed by liquid chromatography-tandem mass spectrometry (LC-MS / MS) Method was used to measure the concentrations of serum 25-hydroxyvitamin D3 [25 (OH) D3] and 25-hydroxyvitamin D2 [25 (OH) D2] The sum of 25 (OH) D2 and 25 (OH) D3 was 25-hydroxyvitamin D [25 (OH) D] and the 25 (OH) D was used as an indicator of in vivo vitamin D levels. RESULTS: The mean serum 25 (OH) D concentration was (19.2 ± 9.4) ng / mL for all 18 478 pregnant women and 59.7% for vitamin D deficiency [25 (OH) D <20 ng / mL] 25 (OH) D <12 ng / mL] was 24.9% and the adequate rate [25 (OH) D> 30 ng / mL] was 13.7%. The average serum concentrations of 25 (OH) D in pregnant women in 2013, 2014 and 2015 were (17.3 ± 8.5), (18.2 ± 9.0) and (20.5 ± 9.7) ng / mL, respectively, with vitamin D deficiency rates of 69.4% and 63.6 %, 54.4%. The difference of 25 (OH) D level in different years was statistically significant (P <0.01). The serum concentrations of 25 (OH) D in pregnant women in Jiangsu, Jiangsu and Jiangsu provinces were (19.2 ± 9.5) and (19.6 ± 9.0) and (18.4 ± 8.7) ng / mL, respectively. The vitamin D deficiency rates were 60.0%, 57.9% and 62.8%, respectively. The difference of 25 (OH) D level among pregnant women in different regions was statistically significant (P <0.01). Pregnant women serum 25 (OH) D concentration was positively correlated with age (r = 0.8, P <0.01). The level of vitamin D in pregnant women was related to the season of detecting serum 25 (OH) D concentration. The serum 25 (OH) D concentrations were 22.7 ± 9.2, 22.2 ± 9.3, 15.3 ± 7.3), (12.3 ± 6.4) ng / mL. Conclusion: The high rate of vitamin D deficiency in pregnant women should be strengthened to monitor the level of vitamin D in pregnant women, and the vitamin D supplementation should be given to pregnant women with vitamin D deficiency in time.