International Journal of Reproductive BioMedicine
International Journal of Reproductive BioMedicine
IJRM
Medical Sciences
http://ijrm.ir
1
admin
2476-4108
2476-3772
10.29252/ijrm
en
jalali
1403
8
1
gregorian
2024
11
1
22
11
online
1
fulltext
en
رابطه بین سطوح ویتامین D مادر و استئوپنی در نوزادان نارس: یک مطالعه مقطعی
The relationship between maternal vitamin D levels and osteopenia development in preterm infants: A cross-sectional study
Perinatology
Original Article
Original Article
<div style="text-align: justify;"><span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman","serif""><b><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra"">مقدمه: </span></span></b><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra"">استئوپنی نارس (</span></span><span dir="LTR" style="font-size:10.0pt">OP</span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra"">) با کاهش محتوای مواد معدنی استخوان مشخص می­شود و کمبود ویتامین </span></span><span dir="LTR" style="font-size:10.0pt">D</span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra""> ممکن است با تأثیر بر متابولیسم استخوان، </span></span><span dir="LTR" style="font-size:10.0pt">OP</span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra""> را تشدید کند.</span></span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman","serif""><b><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra"">هدف: </span></span></b><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra"">این مطالعه با هدف بررسی ارتباط بین سطوح ویتامین </span></span><span dir="LTR" style="font-size:10.0pt">D</span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra""> مادر و نشانگرهای بیوشیمیایی مرتبط با </span></span><span dir="LTR" style="font-size:10.0pt">OP</span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra""> انجام شد.</span></span><b><span dir="LTR" style="font-size:11.0pt"><span style="font-family:"Arial","sans-serif""></span></span></b></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman","serif""><b><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra"">مواد و روش­ ها: </span></span></b><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra"">این مطالعه مقطعی-تحلیلی که از خرداد 1401 تا شهریور 1402 در بیمارستان شهید صدوقی یزد انجام شد، 49 زن باردار و نوزاد نارس آنها مورد بررسی قرار گرفتند. بر اساس سطح سرمی آلکالین فسفاتاز (</span></span><span dir="LTR" style="font-size:10.0pt">ALP</span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra"">) و فسفر نوزادان در بدو تولد و 4 هفته پس از تولد، آنها به دو گروه استئوپنیک و غیراستئوپنیک تقسیم شدند. سپس سطح ویتامین </span></span><span dir="LTR" style="font-size:10.0pt">D</span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra""> و کلسیم مادر و نوزاد بین این گروه</span></span><span dir="LTR" style="font-size:11.0pt"><span style="font-family:"Arial","sans-serif"">­</span></span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra"">ها مقایسه شد.</span></span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman","serif""><b><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra"">نتایج: </span></span></b><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra"">میانگین سطح ویتامین </span></span><span dir="LTR" style="font-size:10.0pt">D</span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra""> مادران </span></span><span dir="LTR" style="font-size:10.0pt">ng/ml</span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra""> 09/15 </span></span><span lang="FA" style="font-size:10.0pt">±</span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra""> 9/24 بود که 36% آنها کمبود داشتند. 11 نوزاد در هفته چهارم بر اساس سطوح فسفر و </span></span><span dir="LTR" style="font-size:10.0pt">ALP</span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra""> استئوپنیک بودند. افراد مبتلا به استئوپنی به طور قابل توجهی سطوح ویتامین </span></span><span dir="LTR" style="font-size:10.0pt">D</span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra""> و کلسیم کمتری نسبت به نوزادان غیراستئوپنیک داشتند (032/0 </span></span><span lang="FA" style="font-size:10.0pt">= </span><span dir="LTR" style="font-size:10.0pt">p</span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra"">) و (043/0 </span></span><span lang="FA" style="font-size:10.0pt">= </span><span dir="LTR" style="font-size:10.0pt">p</span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra"">)، اگرچه میانگین ویتامین </span></span><span dir="LTR" style="font-size:10.0pt">D</span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra""> مادر عامل خطر قابل توجهی برای </span></span><span dir="LTR" style="font-size:10.0pt">OP</span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra""> نبود (313/0 </span></span><span lang="FA" style="font-size:10.0pt">= </span><span dir="LTR" style="font-size:10.0pt">p</span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra"">).</span></span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman","serif""><b><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra"">نتیجه ­گیری: </span></span></b><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra"">نتایج نشان می­دهد که سطح ویتامین </span></span><span dir="LTR" style="font-size:10.0pt">D</span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra""> مادر ارتباط معنی­داری با بروز استئوپنی در نوزادان ندارد، زیرا میانگین غلظت ویتامین </span></span><span dir="LTR" style="font-size:10.0pt">D</span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra""> مادر به عنوان یک عامل خطر برای این وضعیت شناسایی نشده است. بنابراین، توصیه می</span></span><span dir="LTR" style="font-size:11.0pt"><span style="font-family:"Arial","sans-serif"">­</span></span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra"">شود که تحقیقات آینده باید عوامل جایگزینی را که ممکن است در ایجاد استئوپنی در نوزادان نارس نقش داشته باشند، بررسی کنند.</span></span><b><span dir="LTR" style="font-size:11.0pt"><span style="font-family:"Arial","sans-serif""></span></span></b></span></span></span></span></span></div>
<div style="text-align: justify;"><span style="font-family:Times New Roman;"><span style="font-size:11pt"><span style="line-height:normal"><b><span style="font-size:12.0pt">Background:</span></b><span style="font-size:12.0pt"> Osteopenia of prematurity (OP) is characterized by reduced bone mineral content, and vitamin D deficiency may worsen OP by affecting bone metabolism. </span></span></span><br>
<span style="font-size:11pt"><span style="line-height:normal"><b><span style="font-size:12.0pt">Objective:</span></b><span style="font-size:12.0pt"> This study aimed to investigate the correlation between maternal vitamin D levels and biochemical markers related to OP.</span></span></span><br>
<span style="font-size:11pt"><span style="line-height:normal"><b><span style="font-size:12.0pt">Materials and Methods:</span></b><span style="font-size:12.0pt"> This analytical cross-sectional study, conducted at </span><span style="font-size:12.0pt">Shahid Sadoughi hospital, Yazd, Iran, from June 2022 to September 2023, included 49 pregnant women and their preterm infants. Based on the serum alkaline phosphatase and phosphorus levels of the infants at birth and 4 wk after birth, they were divided into osteopenic and non-osteopenic groups. Maternal and neonatal vitamin D and calcium levels were then compared between these groups.</span></span></span><br>
<span style="font-size:11pt"><span style="line-height:normal"><b><span style="font-size:12.0pt">Results:</span></b><span style="font-size:12.0pt"> The mean maternal vitamin D level was 24.9 ± 15.09 ng/ml, with 36% showing deficiency. 11 neonates at 4 wk exhibited osteopenia based on phosphorus and serum alkaline phosphatase levels. Those with osteopenia had significantly lower vitamin D (p = 0.032) and calcium levels compared to non-osteopenic neonates (p = 0.043), although maternal vitamin D mean was not a significant risk factor for OP (p = 0.313). </span></span></span><br>
<span style="font-size:11pt"><span style="line-height:normal"><b><span style="font-size:12.0pt">Conclusion:</span></b><span style="font-size:12.0pt"> The results suggest that maternal vitamin D levels do not have a significant association with the incidence of osteopenia in neonates, as the mean maternal vitamin D concentration was not identified as a risk factor for this condition. Therefore, it is recommended that future research should investigate alternative factors that may contribute to the development of osteopenia in preterm infants.</span></span></span></span></div>
ویتامین D, استئوپنی, نارس, آلکالین فسفاتاز.
Vitamin D, Osteopenia, Prematurity, Alkaline phosphatase.
845
856
http://ijrm.ir/browse.php?a_code=A-10-788-1&slc_lang=en&sid=1
Razieh Sadat
Tabatabaei
dr.r.tabatabaee@gmail.com