维生素D缺乏对骨骼肌肉系统的影响

维生素D是人体不可缺少的一种脂溶性维生素,主要功能是促进肠道对钙、磷的吸收。维生 素D缺乏会引起继发性甲状旁腺功能亢进,骨转化加快,骨丢失增加,从而引起骨软化、骨质疏松、骨 折。另外维生素D缺乏与肌无力、活动能力下降相关,使患者跌倒发生率增加。科学有效的补充维 生素D,不但能够防止由于钙、磷吸收障碍所导致的骨质疏松及骨折的发生,还能有效防止多种骨骼 肌肉系统疾病。     

母体多囊卵巢综合征对子代不同生长发育阶段影响的研究进展

多囊卵巢综合征(PCOS)是育龄期妇女最常见的妇科内分泌疾病之一,对她们的内分泌健康及生殖健康产生了诸多不良影响,如高雄激素血症、胰岛素抵抗、排卵减少或无排卵等,这些均使得母体成功受孕困难.即使受孕成功,她们的子代从胎儿期直至成年后都受到母体PCOS状态的持续影响,如宫内高雄激素介导的胎盘病理状态、继发的胎儿生长发育异...     

妊娠期慢性束缚对子代新生鼠发育的影响

目的研究妊娠期慢性束缚对子代新生鼠的影响。方法大鼠见栓后第5天开始,每天接受1h束缚,直至分娩。检测母鼠体重、子宫重量、平均产仔数、新生鼠出生体重、成活率和性别比。结果与正常对照组相比,慢性束缚组母鼠体重和平均产仔数无显著差异,但子宫指数增加(P<0.05);同时慢性束缚组新生鼠成活率降低、雄鼠出生体重下降、性别比变小(均为P<0.05)。结论妊娠期慢性束缚可影响新生鼠成活率、出生体重和性别比。     

驱铜联合活性维生素D3治疗对Wilson''''s病患者骨骼及代谢的影响

目的观察Wilson's病患者骨骼X线摄片表现,及驱铜治疗联合活性维生素D3补充治疗对骨代谢的影响。方法对35例入选Wilson's病患者入院时进行骨骼X线摄片,并分别于治疗前及二巯基丙磺酸钠驱铜辅以活性维生素D3治疗8疗程后,放射免疫法测定骨代谢相关激素:PTH、CT、及血清BGP水平;用生化法测定血钙、血磷,尿钙、尿磷等。并用单光子吸收法(SPA)测定尺桡骨中远端1/3处平均骨密度值。结果Wilson's病患者手腕部X线检测异常率达60%。治疗后,血PTH、血钙均降低,骨密度(BMD)值升高,较治疗前差异有统计学意义(P<0·05);血磷、尿钙、磷及血清CT、BGP水平较治疗前差异无显著性。结论Wilson's病患者常并发骨质疏松或骨质软化等代谢性骨病,驱铜治疗联合活性维生素D3补充治疗可更好改善骨骼代谢,更快改善其骨密度。     

季节对维生素D水平的影响

目的了解健康年轻(22～37岁)男性和女性人群维生素D状况以及季节对维生素D水平的影响。方法选取在冬春季或夏秋季进行体检的健康年轻男性和女性,共416例,用酶联免疫的方法测定血中25-羟维生素D(25(OH)D)水平。结果所有的受检对象不论季节和性别25(OH)D水平均明显低于正常值,其中维生素D缺乏和不足(75 nmol/L)的比率近90%,其中冬春季节多数为轻中度缺乏(达80%),而夏秋季节以轻度缺乏或不足为主(70%以上)。25(OH)D水平在冬春季节明显低于夏秋季节。此外,不论任何季节,女性组维生素D中重度缺乏的比率明显高于男性组,25(OH)D水平明显低于男性组。结论我国北方地区居住的人群不论季节和性别维生素D缺乏的发病率均很高,特别是年轻女性是维生素D缺乏的高危人群。应采用有效的措施防治维生素D的缺乏,减少维生素D缺乏对健康的影响。     

维生素D对基质GLA蛋白的影响

维生素D是人体健康所必要的元素,它参与体内钙平衡及骨代谢。基质GLA蛋白（matrix gla protein,MGP)是一种维生素K依赖性蛋白,是人体内血管和软骨钙化的抑制剂,对骨形成有重要的影响。了解维生素D对MGP表达的影响对探讨新的骨质疏松发病机理有着重要的意义。本文所述,维生素D与MGP这两种对骨形成有重要作用的影响因子之间存在着许多内在联系,维生素D除了能直接调节多种细胞MGP表达,也有可能通过调节钙磷代谢、雌二醇、维生素K2和BMP-2等多途径间接调节MGP表达,而且1,25( OH)2 D3有可能通过激活Wnt/β-catenin信号通路调节MGP表达而影响骨形成。这和以往我们所了解的维生素D在骨代谢中的作用机制有所不同。     

驱铜联合活性维生素D3治疗对Wilson’s病患者骨骼及代谢的影响

目的 观察Wilson＇s病患者骨骼X线摄片表现，及驱铜治疗联合活性维生素D3补充治疗对骨代谢的影响。方法 对35例入选Wilson＇s病患者入院时进行骨骼X线摄片，并分别于治疗前及二巯基丙磺酸钠驱铜辅以活性维生素D3治疗8疗程后，放射免疫法测定骨代谢相关激素：PTH、CT、及血清BGP水平；用生化法测定血钙、血磷，尿钙、尿磷等。并用单光子吸收法（SPA）测定尺桡骨中远端1/3处平均骨密度值。结果 Wilson＇s病患者手腕部X线检测异常率达60%。治疗后，血PTH、血钙均降低，骨密度（BMD）值升高，较治疗前差异有统计学意义（P〈0.05）；血磷、尿钙、磷及血清CT、BGP水平较治疗前差异无显著性。结论 Wilson＇s病患者常并发骨质疏松或骨质软化等代谢性骨病，驱铜治疗联合活性维生素D3补充治疗可更好改善骨骼代谢，更快改善其骨密度。     

1,25二羟维生素D3对乳腺癌细胞株生长及调亡的影响

目的 研究１,２５二羟维生素Ｄ３〖１,２５（ＯＨ）２Ｄ３〗对乳腺癌细胞株ＭＣＦ－７生长及凋亡的影响。方法 采用四唑氮蓝比色（ＭＴＴ）法检测细胞增殖,光镜和电镜形态学观察,流式细胞仪测定细胞周期和凋亡率,末端脱氧核苷酸转移酶介导的原位酶标记（ＴＵＮＥＬ）法计数凋亡细胞,免疫印迹法检测ｂｃｌ－２蛋白表达。结果 １０＾－７ｍｏｌ／Ｌ的１,２５（ＯＨ）２Ｄ３就可以抑制ＭＣＦ－７增生,改变细胞周期时相分布,     

孕妇维生素D缺乏及其对胎儿的影响

目的维生素D缺乏累及的人群非常广泛,而且与多种疾病的发生有关,特别是孕妇维生素D缺乏还可能影响到胎儿的健康。目前关于我国女性维生素D的资料报道很少。本研究的目的是了解健康孕妇(孕15~21w)以及同龄未孕对照组妇女维生素D水平以及孕妇维生素D水平对新生儿出生大小的影响。方法本文随机选取单胎妊娠孕妇63例和同龄对照妇女35例,用酶联免疫的方法测定血中25-羟维生素D水平。结果显示99%的检测病例25-羟维生素D水平低于正常值(≥75 nmol/L),有近93%的妇女为维生素D缺乏(50 nmol/L)。孕妇25-羟维生素D水平(28.40±9.19 noml/L)明显低于对照组妇女(38.46±10.77 noml/L;P0.001),两组维生素D缺乏的比率分别为孕妇96.8%,对照组85.7%,但重度维生素D缺乏的病例孕妇组接近半数,而对照组为零。新生儿身长与孕妇25-羟维生素D水平成显著正相关(r=0.323;P0.01。结论我国北方女性特别是孕妇是维生素D缺乏患病的高危人群,而且孕妇维生素D缺乏可能会影响到胎儿的生长发育。应该积极采用有效的措施防治维生素D的缺乏,从而减少维生素D缺乏对健康的影响对提高人口质量将具有重要的意义。     

维生素D3和维生素K3对实验性肾结石的影响

目的：探讨维生素C3和维生素K3与尿石症的关系。方法SD大鼠36只,随机分为对照组（A组）、成石组（B组）、维生D3组（C组）、成石＋维生素D3组（D组）、维生素K3组（E组）和成石＋维生素K3组（F组）,用免疫组化和原位杂交技术检测各组大鼠肾脏骨桥蛋白（OPN）及其mRNA的表达量,并测定尿晶体成分的浓度。结果：免疫组化结果显示,OPN主要表达于肾脏远曲小管和集合管,B、C、E组鼠肾和OPN的表达强度明显高于A组（P均＜0．05）;D、F组OPN的表达强度明显高于C、E组（P均＜0．05）,即维生素D3或维生素K3与诱石剂合用时呈相加效应。应用诱石剂后,D组尿钙排泄量明显增加,而F组草酸盐明显低于B组（P＜0．05）。维生素K3可减少尿划石剂后,D组尿排泄量明显增加,而组草酸盐明显低于B组（P＜0．05）。维生素K3可减少尿草酸盐的分泌和草酸钙晶体的沉积。结论：维生素D3可能通过多种机制种促进肾结石殂成,而维生素K3有抑制结石形成的作用。     

Maternal vitamin D status in pregnancy and offspring bone development: the unmet needs of vitamin D era

Data from animal and human studies implicate maternal vitamin D deficiency during pregnancy as a significant risk factor for several adverse outcomes affecting maternal, fetal, and child health. The possible associations of maternal vitamin D status and offspring bone development comprise a significant public health issue. Evidence from randomized trials regarding maternal vitamin D supplementation for optimization of offspring bone mass is lacking. In the same field, data from observational studies suggest that vitamin D supplementation is not indicated. Conversely, supplementation studies provided evidence that vitamin D has beneficial effects on neonatal calcium homeostasis. Nevertheless, a series of issues, such as technical difficulties of current vitamin D assays and functional interplay among vitamin D analytes, prohibit arrival at safe conclusions. Future studies would benefit from adoption of a gold standard assay, which would unravel the functions of vitamin D analytes. This narrative review summarizes and discusses data from both observational and supplementation studies regarding maternal vitamin D status during pregnancy and offspring bone development.     

Role of vitamin D in maternal skeletal changes during pregnancy and lactation: A histomorphometric study

Summary The effect of vitamin D on bone changes during the reproductive cycle in female rats has been investigated. One group of female rats was maintained on a vitamin D-deficient diet and another group on a vitamin D-replete diet from weaning. Both groups were mated with normal males and changes in their bones were determined histomorphometrically during pregnancy, lactation, and after weaning. All vitamin D-deficient rats had bone changes typical of rickets. Pregnancy caused significant reductions in mineralized tissue of trabecular and cortical bone in the vitamin D-deficient rats. Lactation caused further significant reductions in mineralized tissues of cortical and trabecular bone in both the vitamin D-deficient and vitamin D-replete animals, with the greatest changes seen at weaning. Some restoration of mineralized tissues occurred following weaning. There was an increase in tetracycline-labeled bone surface in the vitamin D-replete animals during lactation, likely due to an increase in bone formation rates. In the vitamin D-deficient animals during lactation, there was a decrease in tetracyclinelabeled bone surface, likely due to severely depressed bone mineralization. These results indicate that the mobilization of calcium from bone to maintain pregnancy and lactation occurs by a mechanism independent of vitamin D.     

New insights into the vitamin D requirements during pregnancy

Pregnancy represents a dynamic period with physical and physiological changes in both the mother and her developing fetus. The dramatic 2–3 fold increase in the active hormone 1,25(OH)2 D concentrations during the early weeks of pregnancy despite minimal increased calcium demands during that time of gestation and which are sustained throughout pregnancy in both the mother and fetus suggests an immunomodulatory role in preventing fetal rejection by the mother. While there have been numerous observational studies that support the premise of vitamin D's role in maintaining maternal and fetal well-being, until recently, there have been few randomized clinical trials with vitamin D supplementation. One has to exhibit caution,however, even with RCTs, whose results can be problematic when analyzed on an intent-to-treat basis and when there is high non-adherence to protocol(as if often the case), thereby diluting the potential good or harm of a given treatment at higher doses. As such, a biomarker of a drug or in this case vitamin or pre-prohormone is better served. For these reasons, the effect of vitamin D therapies using the biomarker circulating 25(OH)D is a far better indicator of true effect. When pregnancy outcomes are analyzed using the biomarker 25(OH)D instead of treatment dose, there are notable differences in maternal and fetal outcomes across diverse racial/ethnic groups, with improved health in those women who attain a circulating25(OH)D concentration of at least 100 nmol · L-1(40 ng · m L-1). Because an important issue is the timing or initiation of vitamin D treatment/supplementation, and given the potential effect of vitamin D on placental gene expression and its effects on inflammation within the placenta, it appears crucial to start vitamin D treatment before placentation(and trophoblast invasion); however, this question remains unanswered.Additional work is needed to decipher the vitamin D requirements of pregnant women and the optimal timing of supplementation, taking into account a variety of lifestyles, body types, baseline vitamin D status,and maternal and fetal vitamin D receptor(VDR) and vitamin D binding protein(VDBP) genotypes.Determining the role of vitamin D in nonclassical, immune pathways continues to be a challenge that once answered will substantiate recommendations and public health policies.     

Effects of maternal hypercholesterolemia on pregnancy and development of offspring

The effect of maternal hypercholesterolemia on the course of pregnancy and the development of offspring was investigated. Rats were fed either an enriched-cholesterol diet (HC) or a standard diet (control) from 1 week before mating until weaning of offspring. Compared with the control group, HC dams showed a fourfold increase in abortions, a twofold increase in neonatal mortality, smaller litter size, and lower birth weight of pups. At weaning, Na(+),K(+)-ATPase activity in the outer renal medulla was reduced in HC pups compared with control pups, suggesting retarded or impaired development of medullary nephron segments. At this point, to better examine the adverse effects of maternal hypercholesterolemia, the HC pups were divided into two groups: one fed a cholesterol-enriched diet (HC/hc) and the other a standard diet (HC/nc), while control pups were maintained on the standard diet. In adulthood, the HC/hc group showed growth impairment and reduced renal function, demonstrated by low creatinine clearance (0.24+/-0.04 ml/min per 100 g body weight) and high fractional excretion of sodium, potassium, and water ( P<0.05 vs. control). These effects were partially reversed in the HC/nc group. In this study, neither dams nor offspring developed hypertension. Thus, maternal hypercholesterolemia adversely affected pregnancy outcomes and the development of offspring by inducing abnormalities and thereby reducing renal function.     

Impact of maternal veiling during pregnancy and socioeconomic status on offspring’s musculoskeletal health

Summary The impact of maternal veiling during pregnancy and of socioeconomic status on offspring’s bone mass was investigated in 326 healthy adolescents. Veiling during pregnancy was associated with decreased musculoskeletal parameters in the offspring boys, but not girls. SES was a significant predictor of bone mass in both genders. Introduction This study investigates the effects of maternal veiling during pregnancy, a surrogate for low vitamin D level, and socioeconomic status (SES), a surrogate of nutritional status, on their offspring’s bone mass at adolescence. Methods Three hundred and twenty-six healthy adolescents aged 13.1(2.0) years and their mothers were studied. The impact of maternal veiling on offspring’s bone mass was evaluated through regression analyses. Outcome variables were bone mineral density (BMD) and content (BMC) at the spine, hip, and total body of the children. Predictors were maternal veiling during pregnancy and SES. Covariates were height, body composition, Tanner staging, calcium intake, vitamin D and exercise in children. Results In boys, adjusted analyses revealed that both maternal veiling during pregnancy and SES were significant predictors of bone mass, at multiple skeletal sites. In girls, SES but not maternal veiling during pregnancy was a significant predictor of bone mass at multiple sites. Conclusion Maternal veiling during pregnancy was associated with decreased musculoskeletal parameters of boys, but not girls. SES was a significant predictor of bone mass in both genders. These findings may have profound implications on children’s bone health.     

Effect of modulating dietary vitamin D on the general bone health of rats during posterolateral spinal fusion

Vitamin D plays a significant role in musculoskeletal health by regulating calcium, phosphate, and promoting new bone mineralization. The purpose of this study was to understand the effect of dietary vitamin D on general bone health during peri‐operative bone healing via an in vivo dosing study of vitamin D in a rat posterolateral fusion model using autograft. Vitamin D Deficient (DD), vitamin D Insufficient (ID), Control vitamin D (CD), and Hyper‐vitamin D (HD) groups were studied. Increasing dietary vitamin D improved quantitative measures of femoral geometry, including femoral strength, stiffness, and density. Femoral biomechanics, cortical thickness, moment of inertia, cross‐sectional area, and measures from bone ashing were all greater in the HD group versus the CD. This suggests that additional dietary vitamin D above normal levels during spinal fusion may lead to improvement in bone health. Serum vitamin D levels were also observed to decrease during fusion healing. These results demonstrate that dietary vitamin D improves general bone health in the femur of a rat model during posterolateral spinal fusion. This suggests a role for further clinical evaluation of vitamin D dietary intake during the peri‐operative period, with the possibility of avoiding adverse consequences to general bone health. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:1435–1443, 2018.

     

Low maternal vitamin D status and fetal bone development: Cohort study

Recent findings suggest that maternal vitamin D insufficiency during pregnancy has consequences for the offspring's bone health in later life. To investigate whether maternal vitamin D insufficiency affects fetal femur growth in ways similar to those seen in childhood rickets and study the timing during gestation of any effect of maternal vitamin D status, we studied 424 pregnant women within a prospective longitudinal study of maternal nutrition and lifestyle before and during pregnancy (Southampton Women's Survey). Using high‐resolution 3D ultrasound, we measured fetal femur length and distal metaphyseal cross‐sectional area, together with the ratio of femoral metaphyseal cross‐sectional area to femur length (femoral splaying index). Lower maternal 25‐hydroxyvitamin vitamin D concentration was not related to fetal femur length but was associated with greater femoral metaphyseal cross‐sectional area and a higher femoral splaying index at 19 weeks' gestation [r = ?0.16, 95% confidence interbal (CI) ?0.25 to ?0.06 and r = ?0.17, 95% CI ?0.26 to ?0.07, respectively] and at 34 weeks' gestation (r = –0.10, 95% CI ?0.20 to 0.00 and r = ?0.11, 95% CI ?0.21 to ?0.01, respectively). Three groups of women were identified with 25‐hydroxyvitamin vitamin D concentrations that were sufficient/borderline (>50 nmol/L, 63.4%), insufficient (25 to 50 nmol/L, 30.7%), and deficient (≤25 nmol/L, 5.9%). Across these groups, the geometric mean femoral splaying indices at 19 weeks' gestation increased from 0.074 (sufficient/borderline) to 0.078 (insufficient) and 0.084 (deficient). Our observations suggest that maternal vitamin D insufficiency can influence fetal femoral development as early as 19 weeks' gestation. This suggests that measures to improve maternal vitamin D status should be instituted in early pregnancy. © 2010 American Society for Bone and Mineral Research     

女性血清维生素D浓度对体外受精-胚胎移植妊娠结局的影响

维生素D是人体内维持钙磷代谢的脂溶性维生素,全世界各个地区有大量人群存在维生素D缺乏的现象,其中很大一部分是年轻的育龄期妇女.近年来,血清维生素D的浓度和女性生殖的关系,以及对体外受精-胚胎移植(IVF-ET)助孕结局的影响越来越引起人们的关注.本文对维生素D与IVF妊娠结局关系的研究进行综述,以期为今后的深入研究提供...