Research progress on the relationship between vitamin D and fetal growth restriction
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摘要: 胎儿生长受限(fetal growth restriction,FGR)是常见的妊娠并发症,与围产儿死亡率高和青少年健康成长问题及成年后心血管及代谢性疾病密切相关。尽管FGR的发病率高达5%~10%,但目前仍没有很好的预防和治疗方法。维生素D是人体必需的一种脂溶性激素,在人体中有多种存在形式,1,25(OH)2D为其活性形式,能与维生素D受体(vitamin D receptor,VDR)结合并发挥广泛的生物学功能,对正常妊娠的维持以及胎儿的生长发育具有重要作用。VDR属核受体超家族成员,是维生素D代谢途径中的一个重要组成部分,参与激活调节和启动众多涉及到细胞增殖和分化的基因的表达与调控。VDR基因存在多态性并影响VDR的转录活性,改变VDR蛋白功能,并直接或间接地影响维生素D的功能,与多种疾病的遗传易感性相关。人体和动物实验研究表明:子宫内膜基质以及妊娠早期蜕膜组织细胞中均有VDR表达,VDR蛋白参与早期胚胎植入过程的免疫调节,FGR患者胎盘VDR表达下降。因此,孕期维生素D状态以及VDR基因多态性可能与胎儿生长发育迟缓以及新生儿低出生体重有关。本文就维生素D、维生素D受体基因多态性与FGR的关系作一综述。Abstract: Fetal growth restriction(FGR) is a common pregnancy complication that is closely associated with adverse outcomes, such as high perinatal mortality, adolescents' major health problems, and chronic adulthood diseases(e.g., cardiovascular and metabolic diseases). Although FGR affects up to 5% to 10% of pregnancies worldwide, there is currently no reliable and effective prevention and treatment method. Vitamin D is one of the fat-soluble hormones pivotal for body health. In addition, 1,25(OH)2D, which is biologically an active form of vitamin D, exerts a broad range of biological functions by specifically binding to vitamin D receptor(VDR), playing an important role in the maintenance of normal pregnancy, as well as the growth and development of the fetus. Moreover, VDR is a member of the nuclear superfamily receptor, as well as being an important component of the vitamin D metabolic pathway. VDR also mediates virtually all of the known biological actions of the hormonal ligand 1,25-dihydroxyvitamin D3[1,25(OH)2D3]. These actions are directed toward the nucleus, where the VDR binds to the regulatory regions of target genes, and modulates their transcriptional output. The polymorphisms of the VDR are associated with the genetic susceptibility of various diseases by affecting the transcriptional activity of VDR, altering the function of VDR protein, and directly or indirectly influencing the functions of vitamin D. Evidences of human and animal studies have shown that VDR is expressed in endometrial stroma and early decidual cells, VDR proteins are involved in the immune regulation of early embryo implantation, and VDR expression is decreased in the placenta of FGR patients. Therefore, the status of vitamin D and VDR gene polymorphism during pregnancy may be associated with FGR and low-birth-weight newborns. This article reviews the relationship among vitamin D, VDR gene polymorphism, and FGR.
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Key words:
- Vitamin D /
- Fetal growth restriction /
- Gene
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