胎次对妊娠期血清钙的影响:回顾性研究

Nannan Wu, Bin Cao, Jianan Lang, D. Zhao
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摘要

背景:母体低钙血症对孕妇和后代发育有不良影响。本研究的目的是测试胎次是否与母亲钙水平有关。材料与方法:根据胎次将孕妇分为未分娩组(NPG)和曾分娩组(PPG)。在控制年龄、体重指数(BMI)、维生素D和胰岛素抵抗的稳态模型评估(HOMA-IR)的多元线性回归模型中,检验胎次数与血清钙之间的关系。受试者还根据四季招募和妊娠期高血压(GH)和糖尿病的发展情况进行分组。结果:PPG组平均血钙低于NPG组(2.15 vs. 2.20 mmol/L, P < 0.001)。经白蛋白校正后,PPG组校正后的血清钙仍低于NPG组(2.20 vs 2.23 mmol/L, P < 0.001)。有趣的是,与NPG相比,糖尿病和高血压亚组PPG中调整后的血清钙水平始终较低(2.20 vs 2.23 mmol/L, P < 0.001)。不同季节,PPG组血清钙水平和调整后血清钙水平均显著低于NPG组(P < 0.001)。重要的是,当校正年龄、BMI、维生素D和HOMA-IR时,校正钙与胎次数负相关(r = - 0.044, P < 0.001)。此外,与NPG相比,年龄(29.61 vs. 33.39)、BMI (22.80 vs. 23.55)、甘油三酯(2.27 vs. 2.43 mmol/L)和空腹基础血糖(4.73 vs. 4.81 mmol/L)的PPG显著增加,白蛋白(38.72 vs. 37.65 g/L)和维生素D (20.98 vs. 18.62 ng/ml)显著降低。两组间生长激素和妊娠期糖尿病(GDM)的发病没有差异。结论:胎次与血钙水平呈负相关。钙水平的微小但显著的差异表明,平价可能在钙稳态中起着复杂的作用。及时监测产妇钙含量对多产妇女有临床意义。
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Effect of parity on the serum calcium in the pregnancy: A retrospective study
Background: Maternal hypocalcaemia has adverse outcomes on pregnant women and offspring development. The objective of this study is to test whether parity number is associated with maternal calcium level. Materials and Methods: According to parity numbers, the pregnant women were divided into never parturition group (NPG) and previous parturition group (PPG). Association between parity number and serum calcium was tested in multivariate linear regression models controlling for age, body mass index (BMI), Vitamin D, and Homeostasis model assessment for insulin resistance (HOMA-IR). The subjects were also subgrouped by recruitment in four seasons and their development of gestational hypertension (GH) and diabetes. Results: Mean serum calcium was lower in the PPG than that in the NPG (2.15 vs. 2.20 mmol/L, P < 0.001). After adjusted for albumin, adjusted serum calcium was still lower in PPG than that in NPG (2.20 vs. 2.23 mmol/L, P < 0.001). Interestingly, adjusted serum calcium level is consistently lower in the PPG in both the diabetic and hypertension subgroups compared to NPG (2.20 vs. 2.23 mmol/L, P < 0.001). In different seasons, the serum calcium level and adjusted serum calcium level in the PPG were significantly lower than the NPG (P < 0.001). Importantly, adjusted calcium correlated negatively with the parity number (r = −0.044, P < 0.001), when adjusting for age, BMI, Vitamin D, and HOMA-IR. In addition, there was a significant increase in the PPG compared to the NPG including age (29.61 vs. 33.39 years old), BMI (22.80 vs. 23.55), triglyceride (2.27 vs. 2.43 mmol/L), and fasting basal blood glucose (4.73 vs. 4.81 mmol/L), and a significant decrease regarding the albumin (38.72 vs. 37.65 g/L) and Vitamin D (20.98 vs. 18.62 ng/ml). There was no difference in the onset of GH and gestational diabetes mellitus (GDM) between the two groups. Conclusion: Parity negatively correlated with the serum calcium level. The small but significant difference in the calcium levels indicated that parity may play an intricate role in calcium homeostasis. Timely monitoring of maternal calcium could be clinically beneficial to the multiparous women.
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