2017—2018年淮安地区孕妇维生素A、维生素E水平及其影响因素

目的分析不同孕期血清维生素A、维生素E水平及其影响因素。方法选取2017年1月-2018年5月在淮安市妇幼保健院常规产检的孕早、中、晚期的共2824例孕妇,采用高效液相色谱法定量测定血清维生素A及维生素E的浓度。采用多元线性回归分析影响血清维生素A、维生素E水平的相关因素。结果淮安地区孕妇血清维生素A水平为(0.39±0.08) mg/L,总体异常率为12.3%;血清维生素E水平为(13.28±4.67) mg/L,总体异常率为3.7%。多元线性回归分析发现年龄、子痫前期与血清维生素A呈正相关;年龄、食欲、子痫前期与血清维生素E呈正相关。结论淮安地区孕妇血清维生素A异常以缺乏为主,血清维生素E异常以过量为主。     

孕妇维生素A、E水平与孕期子痫前期的相关性研究

目的研究孕妇维生素A、E水平与孕期子痫前期的相关性。方法选择2018年4月至2019年7月期间我院收治的100例孕期子痫前期患者作为子痫前期组,并根据患者病情严重程度分为轻度子痫组(n=42)和重度子痫组(n=58)。另选取我院同期非子痫前期孕妇100例作为对照组。检测并比较三组孕妇的维生素A、E水平,并分析其与子痫前期严重程度的相关性。结果子痫前期组的维生素A、E水平低于对照组(P<0.05)。三组孕妇的维生素A、E水平比较,对照组>轻度子痫组>重度子痫组,差异有统计学意义(P<0.05)。维生素A、E水平与孕期子痫前期病情严重程度呈负相关(r=-0.468、-0.338,P<0.05)。结论维生素A、E水平越低,表明孕妇孕期子痫前期病情越严重。维生素A、E是子痫前期发生的相关因素,故临床中应注重孕妇孕期维生素A、E水平的监测,及时进行合理正确的补充,以改善子痫前期症状。     

妊娠期糖尿病孕妇妊娠晚期血清维生素A和维生素E水平

目的分析妊娠期糖尿病(GDM)孕妇妊娠晚期血清维生素A和维生素E水平。方法随机选取陕西中医药大学第二附属医院产孕28周以上的218例孕妇,检测孕妇妊娠晚期血清维生素A、E水平。结果血清维生素A正常者(0.3～0.7 mg/L) 172例,占78.90%,平均(0.41±0.07) mg/L,异常率为21.10%,以不足为主。血清维生素E水平正常者(5～20 mg/L) 122例,占55.95%,异常率为44.05%,以过量为主。结论 GDM孕妇妊娠晚期血清维生素A、E水平不同,维生素A以缺乏为主,维生素E以过量为主,应重视孕期维生素A、E水平监测,合理正确补充,对保障母婴安全有重要意义。     

孕28周血清维生素A、E水平对子痫前期孕妇妊娠结局预测价值

目的:分析血清维生素(V)A、VE水平预测子痫前期孕妇妊娠结局的价值。方法:以2017年6月-2018年11月本院常规孕前检查的427例女性(孕前组)及573例妊娠20周内产前检查孕妇(孕期组)为研究对象,孕期组定期产检后明确发生子痫前期53例。均检测血清VA、VE,孕期组同时行肝肾功能检测并统计妊娠结局。结果:与孕前组比较,孕期组妊娠20周时血清VA、VE水平及VE异常率未见差异(P>0.05),但VA缺乏率及异常率较高(P<0.05)。孕28周时,轻度、重度子痫前期孕妇血清VA、VE、血尿素氮(BUN)、血肌酐(SCR)水平均高于无子痫前期孕妇,且重度者高于轻度孕妇(P<0.05);血清VA、VE水平与BUN、SCR呈负相关(P<0.05);预测子痫前期孕妇不良妊娠结局的ROC曲线下面积分别为0.829、0.915,临界值分别为0.19mg/L、3.26mg/L,敏感度与特异度分别为61.9%、65.5%和92.3%、86.9%。结论:孕妇易出现VA缺乏,VA、VE对于预测子痫前期孕妇不良妊娠结局有一定价值。     

早中孕期有关血清筛查指标与子痫前期的相关性研究

目的探究早中孕期产前筛查血清指标浓度水平与子痫前期发生的相关性。方法对纳入本次研究的孕妇检测早孕期血清中妊娠相关性血浆蛋白A(PAPP-A)、游离β绒毛膜促性腺激素(Freeβ-h CG),中孕期甲胎蛋白(AFP)、Freeβ-h CG和游离雌三醇(u E3);并比较子痫前期孕妇与正常孕妇上述筛查指标的水平差异。结果调查产前筛查和妊娠结局完整的孕妇7 674人,妊娠期高血压疾病发生率为8.70%,子痫前期发生率为3.39%。子痫前期孕妇早孕期PAPP-A和Freeβ-h CG水平均低于正常孕妇(P0.05),尤其早发型子痫前期孕妇早孕期PAPP-A水平明显低于同期正常孕妇的水平,其在早孕期诊断早发型子痫前期的准确性在ROC曲线下面积达0.823;中孕期AFP、Freeβ-h CG和u E3在子痫前期与正常孕妇间差异均无统计学意义(P0.05)。结论早孕期PAPP-A水平对诊断早发型子痫前期有一定价值,中孕期血清筛查指标对子痫前期无明显临床价值。     

早孕期血清妊娠相关血浆蛋白A和胎盘生长因子水平与子痫前期的相关性研究

目的探讨早孕期血清妊娠相关血浆蛋白A (PAPPA)和胎盘生长因子(PLGF)水平在子痫前期发病中的临床意义,为子痫前期发病的预测提供参考。方法选取2019年1-11月在杭州市妇产科医院接受早孕期(妊娠11～13+6周)血清学产前筛查、妊娠晚期住院分娩的孕妇95例为研究对象,按研究对象患病情况分为子痫前期组50例(轻度子痫前期组23例,重度子痫前期组27例)和正常妊娠组45例。采用非条件Logistic回归分析比较组间孕妇血清PAPPA (MoM)、血清PLGF (MoM)、诊断孕周间的关系。结果子痫前期组孕妇血清PAPPA (MoM)、血清PLGF (MoM)均低于正常妊娠组,差异均有统计学意义(均P0.01)。非条件Logistic回归分析结果显示,孕妇血清PLGF水平是轻度子痫前期和重度子痫前期的危险因素(P0.05)。结论早孕期妇女血清低水平PAPPA (MoM)、血清PLGF (MoM)是子痫前期发病可靠的预测指标。     

妊娠期血清维生素A、D、E水平与产妇发生子痫前期的相关性研究

目的 探讨妊娠期血清维生素A、D、E水平与产妇发生子痫前期（PE）的相关性,为临床及时干预和防治孕期PE提供依据。方法 回顾性分析张家港市第一人民医院2020年6月至2023年1月收治的500例定期产检及住院分娩的孕妇的临床资料。依据是否发生PE将孕妇分为PE组（46例）、非PE组（454例）,并根据病情严重程度将PE组孕妇分为轻度PE组（35例）、重度PE组（11例）。比较PE组、非PE组及轻度PE组、重度PE组孕妇血清维生素A、D、E水平;利用Spearman相关性分析血清维生素A、D、E水平与PE发生的相关性;比较不同维生素A、D、E水平PE孕妇不良妊娠结局的发生情况。结果 PE组孕妇血清维生素A、D、E水平均低于非PE组,且重度PE组上述指标水平更低;Spearman相关性分析显示,血清维生素A、D、E水平与PE的发生均呈负相关（r=-0.412、-0.516、-0.569）;经评估,缺乏维生素A、D、E的PE孕妇为34例,未缺乏维生素A、D、E的PE孕妇为12例,缺乏维生素PE孕妇不良妊娠结局总发生率（35.29%）高于未缺乏维生素PE孕妇不良妊娠结局总发生率（0.00%）（...     

妊娠期糖尿病患者孕期维生素A E水平与重度子痫前期的相关性

目的观察妊娠期糖尿病患者孕期维生素A、E水平变化情况及重度子痫前期发生情况,分析维生素A、E水平与重度子痫前期的关系。方法回顾分析2018年9月—2019年9月台州市中心医院完成治疗与随访的86例妊娠期糖尿病合并子痫前期患者临床资料,作为观察组,同期在院就诊并完成治疗与随访的76例妊娠期糖尿病未合并子痫前期患者临床资料,作为对照组。两组建卡当天(T1)和确诊时(T2)均检测维生素A、E水平。对比观察组和对照组各时点的维生素A、E水平;依据T2时观察组患者子痫前期严重程度分为子痫前期组、重度组;对比各时点维生素A、E水平;分析孕期维生素A、E水平与妊娠期糖尿病患者重度子痫前期的关系。结果观察组T2时维生素A、E水平低于对照组,差异均有统计学意义(t=6.82;10.234,P<0.05);T2时,86例妊娠期糖尿病合并子痫前期患者有48例为子痫前期,38例为重度子痫前期;重度组各时点维生素A、E水平低于子痫前期组,差异均有统计学意义(t=3.06;2.96,P<0.05);经logistic回归分析检验结果显示,孕期维生素A、维生素E缺乏均可能参与妊娠期糖尿病合并子痫前期患者子痫前期病情发展,均可能是导致重度子痫前期的影响因素(OR>1,P<0.05)。结论妊娠期糖尿病患者的孕期维生素A、维生素E水平与子痫前期发生、发展密切相关,持续缺乏维生素A、维生素E可能会导致子痫前期病情加重,临床可依据孕期维生素A、维生素E水平变化预判妊娠期糖尿病合并子痫前期患者的病情进展。     

各妊娠时期孕妇血清维生素A和维生素E水平分析

目的维生素A和维生素E在参与机体生长发育和维持机体正常生理功能方面发挥非常重要的作用,孕妇妊娠期血容量增大,对各种必要维生素需求量也随着妊娠进展而增加。本研究分析本地区妊娠早期、中期及晚期孕妇血清维生素A和维生素E水平,为孕妇补充必要维生素及优生优育提供理论依据。方法选取2017-01-01-2017-12-31绵阳市中心医院产科门诊常规产检孕妇766例,采用高效液相色谱-质谱联用法检测血清维生素A和维生素E水平。结果 766例孕妇血清维生素A水平为(413.5±231.2)ng/mL,血清维生素E水平为(12.7±5.7)μg/mL,血清维生素A总体异常173例(22.6%),其中缺乏69例(9.0%),偏低104例(13.6%),未检出过量状态孕妇;血清维生素E总体异常139例(18.1%),其中缺乏9例(1.2%),偏低130例(17.0%),未检出过量状态孕妇。不同孕期组维生素A(F=7.117,P=0.001)、维生素E水平(F=9.346,,P0.001)比较,差异有统计学意义;不同年龄组维生素A(F=0.415,P=0.742)、维生素E水平(F=0.700,P=0.552)比较,差异无统计学意义。结论不同孕期维生素A和维生素E水平差异明显,本地区维生素A和E均以缺乏为主,因此重视孕期维生素A和E水平监测,合理正确补充必要维生素,对保障母婴健康有重要意义。     

孕妇血清维生素A 维生素E水平与子痫前期的相关性分析

目的 探究孕妇血清维生素A、维生素E水平与子痫前期的相关性。方法 选取2018年1月—2020年6月大理州妇幼保健院收治的子痫前期孕妇82例为观察组，另选取同期在该院进行健康产检的正常孕妇82例为对照组，观察组孕妇依据病情发展情况分为轻度组(42例)和重度组(40例)。对比两组孕妇血清维生素A、维生素E水平，对比轻度、重度子痫前期患者和子痫前期患者治疗前后血清维生素A、维生素E水平，分析血清维生素A、维生素E水平与子痫前期的相关性。结果 观察组孕妇机体内血清维生素A[(13.0±2.4)mg/dl]、维生素E[(27.5±5.3)mg/dl]水平均明显低于对照组[(20.2±3.7)mg/dl、(44.3±6.0)mg/dl],差异均有统计学意义(t=10.725、11.726,均P<0.05)。重度组患者血清维生素A[(9.2±2.2)mg/dl]、维生素E[(19.3±4.0)mg/dl]水平均明显低于轻度组[(16.5±2.5)mg/dl、(34.6±5.7)mg/dl],差异均有统计学意义(t=10.736、11.538,均P<0.05)。治疗后子痫前期患者血清维生...     

Single high-dose vitamin D at birth corrects vitamin D deficiency in infants in Mexico

Abstract

This study examined the prevalence of vitamin D deficiency in mothers and infants in Tijuana, Mexico and determined the effect of a single oral dose of 50?000?IU vitamin D₃ at birth on 25-hydroxyvitamin D (25[OH]D) levels during infancy. Healthy infants were randomized to receive vitamin D₃ or placebo at birth. At birth 23% of infants were vitamin D deficient and 77% had vitamin D insufficiency (mean 25[OH]D level 18.9?ng/ml); 10% of mothers were vitamin D deficient and 61% were insufficient. Infants receiving vitamin D₃ had higher 25(OH)D levels at two months (N?=?29; 33.9 versus 24.2?ng/ml) and six months (N?=?21; 36.5 versus 27.4?ng/ml). Exclusively breastfed infants had lower 25(OH)D levels at two months (14.9 versus 33.4?ng/ml). Vitamin D deficiency is common in infants and mothers in Tijuana, Mexico. A single dose of vitamin D₃ at birth was safe and significantly increased 25(OH)D levels during infancy.     

维生素A与维生素E增强叶酸防畸效果的研究

为观察维生素A与维生素E能否增强叶酸的防畸效果 ,采用环磷酰胺致大鼠胎鼠发育畸形作为动物模型 ,孕鼠在孕期分别补充叶酸和叶酸 +维生素A +维生素E ,观察其防畸效果。结果显示孕鼠不补充叶酸和维生素、单独补充叶酸和联合补充叶酸、维生素A和维生素E使胎鼠脑膨出率分别为 87 2 7%、42 0 3%和 30 0 8% (P <0 0 1)。联合补充组与单独补充叶酸组相比 ,脑膨出率降低更为明显 (P <0 0 5 ) ,上枕骨骨化程度明显提高 (P <0 0 1) ,胎鼠平均体重增加 (P <0 0 5 )。结果提示叶酸、维生素A、维生素E有明显促进胚胎发育及拮抗环磷酰胺的致畸作用 ,且叶酸与维生素A、维生素E联合应用的作用明显优于单独补充叶酸     

A lowering effect of a pharmacological dose of vitamin E on serum vitamin a in normal adults

We have studied the effects of oral vitamin E (vE) on serum vitamin A (vA) levels and vA transport proteins, retinol binding protein (RBP) and prealbumin (PA), in normal subjects taking and not taking pharmacological doses of vA and/or vE acetate. Nineteen subjects were given 9009 ug of oral vA acetate daily for one week. Ten of these continued on 9009 ug of vA daily for two weeks (group I), while nine received 147 mg of vE acetate in addition to vA (group II). A third group (group III) consisted of 10 subjects who received only 147 mg of vE daily for 3 weeks. Group IV represented control subjects not given either vA or vE pills over the 3 week study period. Groups I and II showed significant increases in serum vA levels after 1 week of vA treatment. Group I to week 3 (p<0.01) while group II serum vA levels significantly fell from week 1 to week 3 (p<0.01). No significant differences were demonstrated in RBP or PA in groups I and II. Group III showed a significant fall in serum vA and RBP levels from initial to week 3 (p<0.005) with no significant change in PA. Control subjects (group IV) showed no significant variation of any parameter over the three week test period. The fall in serum vA and RBP seen among our subjects taking vE alone is consistent with either enhanced hepatic vA uptake or increased vA transport to and utilization by peripheral tissues.     

Bioaccessibility of vitamin A,vitamin C and folic acid from dietary supplements,fortified food and infant formula

In the Netherlands, vitamin intake occurs mainly via food and for some vitamins also via fortified food. In addition, some people take dietary supplements. Information on the bioavailability of vitamins is important for a good estimation of the actual exposure to vitamins. Furthermore, for a reliable intake estimation, it is important to know the accurateness of the claimed vitamin concentration on the product label. In the current study, the amount of vitamin A, vitamin C, and folic acid in different products and their maximum bioavailability (bioaccessibility) were investigated. In about half of the products, the amount of vitamins significantly deviated from the declared amounts. The vitamin bioaccessibility ranged from <1% to 100%. When assessing the dietary intake exposure of vitamins, it is important to take into account both the possible deviation from the declared level and (the variability of) the bioaccessibility of the vitamin in the products.     

Prevalence of vitamin D deficiency and response to oral vitamin D supplementation in patients receiving home parenteral nutrition

The purpose of this study was to document vitamin D status in home parenteral nutrition (HPN) patients and determine if oral vitamin D supplementation has a substantial effect. Methods: A retrospective chart review of eligible adults enrolled in the Southern Alberta Home Parenteral Nutrition program (n = 15) for a minimum of 6 months was conducted. Serum measurements of 25OHD were recorded and patients were categorized by vitamin D status as follows: sufficient; insufficient; deficient with respective levels of 25OHD ≥75 nmol/L, 27.5–75 nmol/L, and ≤27.5 nmol/L; and mixed. Results: Five of 15 patients had insufficient vitamin D status throughout the study period; all had short bowel syndrome. Nine were in the mixed category; 1 was consistently sufficient, and no one was consistently deficient. Patient demographics were similar between the insufficient and mixed groups. There were no significant differences in health outcomes between the insufficient and mixed vitamin D status groups. The median (interquartile range) dose and duration of vitamin D3 supplementation for the insufficient group was 5000 IU/d (4,000–7,143) for 1,175 (1,145–1,578) total days compared to 3,000 IU/d (1,000–7,143) for 1,529 (111–1,980) days for the mixed group. Conclusions: Most patients receiving HPN had insufficient vitamin D status. When prescribed high doses of oral vitamin D, patients did not consistently achieve appropriate 25OHD levels. Alternate routes of vitamin D supplementation in patients receiving HPN should be considered. Large multicenter prospective studies are needed to best characterize the relationship between vitamin D dosing for HPN patients and vitamin D status.     

佳木斯地区学龄儿童维生素A、D、E的调查分析

目的 调查本地区学龄儿童血清25-羟基维生素 D[25-(OH)D],维生素A、E水平,了解学龄儿童维生素A、D、E的营养状况,为本地区学龄儿童合理补充微量营养素和预防相关疾病的发生提供理论依据。方法 收集2015年5月-2016年4月于佳木斯大学附属第一医院、建三江人民医院、宝泉岭中心医院等10余家医院门诊及住院部接受维生素A、D、E水平检测的所有6~12岁儿童资料6 030例,分别比较不同性别、年龄段、检测季节的维生素A、D、E水平和维生素营养状况差异。结果 佳木斯地区6~12岁儿童维生素A不足检出率为55.1%,充足检出率为44.9%;维生素E不足检出率为0.67%;维生素D缺乏检出率为37.9%,不足检出率为24.2%,充足检出率为37.9%;不同性别间维生素A、D、E水平比较差异无统计学意义(P>0.05)。各年龄段维生素A、D、E水平比较差异无统计学意义(P>0.05)。季节间比较差异有统计学意义 (P<0.05) 。结论 佳木斯地区学龄期儿童维生素A、D水平较低,各季节间维生素A、D、E差异明显,应引起家长及各阶层医务工作者的高度关注。     

食物中维生素A、叶酸和维生物E的生物利用和表达方式

概括了食物中的三种重要维生素 :即维生素A、叶酸和维生素E的生物吸收、生物利用、生物转化、生物效力和表达方式。并指出了不同表达方式各自的优缺点以及它们之间的转换关系。阐明了三种维生素的生物利用和表达方式对于分析方法、食物营养标签、食物成分数据库以及DRIs制定的重要意义 ,并提出了今后研究方向     

Influence of vitamin K on anticoagulant therapy depends on vitamin K status and the source and chemical forms of vitamin K

Warfarin therapy requires close monitoring to avoid excessive bleeding and to maintain the effective therapeutic concentration assessed with the internationalized ratio (INR). High vitamin K intake can decrease the therapeutic effectiveness of warfarin, while poor vitamin K status appears to increase the sensitivity to small changes in vitamin K intake, especially from supplements. Very large amounts of vitamin K from a single meal with vegetables (400 g of vegetables with 700 to 1500 microg of vitamin K1) can measurably change INR, but occasional typical servings (<100 g) would probably have little lasting impact on INR. Warfarin requirements may change in those altering their intake of dark-green vegetables. The 2005 Dietary Guidelines for Americans recommends 3 cups/week of dark-green vegetables, which contain about 100 to 570 microg/serving of vitamin K1. Less well-known sources and chemical forms of vitamin K, such as MK-7 in natto (a fermented Japanese product), also measurably influence INR. Additional research is needed in warfarin-treated patients to fully quantify the interactions among various sources and chemical forms of vitamin K, age, genotype, and other factors.     

维生素D和维生素D缺乏性佝偻病的研究

进入21世纪,维生素D缺乏性佝偻病又出现了上升趋势.该文探讨了其病因:纯母乳喂养时间过长而未添加维生素D,尤其是那些摄入母亲自身是维生素D缺乏者乳汁的婴儿;由于各种原因造成婴儿日照时间减少,从而使得婴儿体内由皮肤转化的内源性维生素D的量大大减少;在很多温带地区移民人群中佝偻病的高发病率.因此,维生素D缺乏可能是一项国际妇幼保健问题,需再次强调对儿童及孕妇额外补充维生素D及日照的重要性.     

维生素D与脑发育相关研究进展

近年来有关维生素D研究进展迅速,其中维生素D与大脑的发育之间的关系日益受到关注。维生素D是一种具有类固醇激素作用的物质,可参与调节细胞増殖、分化及凋亡,大量研究表明,维生素D除了具有促进钙磷吸收、骨骼发育及发挥免疫调节的作用,还可作为一类神经激素影响神经系统的发育和功能,本文将从大脑中的维生素D及维生素D受体、维生素D对脑发育可能的调控作用及维生素D与儿童神经精神障碍疾病的相关性等几方面进行阐述。