| ObjectiveBy comparing the nutritional status of vitamin D and plasma levels of Th1,Th2and Th17 cytokines between preeclampsia?PE?patients and control,to provide theoretical basis for the prevention and control in pre-eclampsia through clinical nutrition aspect.MethodsA case-control study was conducted in 150 patients with PE and 150 matched controls who delivered babies at the First Affiliated Hospital of Zhengzhou University from Oct.2017 to Jan.2019.The controls with normal blood pressure and no proteinuria were matched according to ageħ3 years and gestational ageħ2 weeks.The questionnaire survey was collected in the subjects,including the general information,dietary intakes within the past three months.The overnight fasting blood samples were collected from the subjects for the measuring of vitamin D and cytokines.The mass spectrometry was applied to detect the plasma levels of25?OH?D2,25?OH?D3,and total 25?OH?D and ELISA was employed to quantify the plasma levels of cytokines including IL-2,IFN-?,and TNF-??secreted by Th1 cell?,IL-4 and IL-10?secreted by Th2 cells?,and IL-17A?secreted by Th17 cell?.The database was established using EpiData 3.1 for the questionnaire data,which were further analyzed by using SPSS 25.0.GraphPad Prism 8 was used for graphing.The non-conditional logistic regression was used to analyze the related factors of PE.The independent sample t test was used to compare the difference of plasma levels of25?OH?D and cytokines between the two groups.The significant levels for all of the analysis were set at?<0.05.Results1.Pre-pregnancy body mass index?BMI?,gestational weight gain?GWG?,regularity of menstruation,hypertension history of family,monthly income per capita,preference for salty or high fat food might be associated with PE.After multivariate logistic regression,the higher level of pre-pregnancy BMI[OR=1.475,95%CI?1.032,2.108?],more GWG[OR=1.547,95%CI?1.260,1.899?],hypertension history of family[OR=3.083,95%CI?1.690,5.625?]might be the risk factors of PE.And higher monthly income[OR=0.729,95%CI?0.547,0.972?]might be the protective factor of PE.2.The intakes of beans,green leafy vegetables,fruits,red meat,and fish was significantly lower in case group than that in control group.Multi-factor logistic regression showed that the intake of fruit[OR=0.759,95%CI?0.594,0.969?]and red meat[OR=0.678,95%CI?0.526,0.875?]might be the protective factor for PE development.3.The intake of multiple nutrients was significantly lower in case group than that in control group.Multivariate logistic regression analysis showed that dietary protein[OR=0.354,95%CI?0.140,0.900?],vitamin B2[OR=0.404,95%CI?0.201,0.810?]and vitamin C[OR=0.551,95%CI?0.333,0.913?]might be the protective factor for PE development,but excessive intake of phosphorus[OR=3.173,95%CI?1.276,7.88?]might be a risk factor for PE.While the dietary intake of vitamin D did not show significant difference between the two groups.4.The plasma levels of 25?OH?D2 and total 25?OH?D were significantly lower in case group than that in control group.The plasma concentrations of IL-17A,IL-2,IFN-?,and TNF-?were significantly higher in case group than that in control group.The ratios of IL-17A/IL-4,IL-17A/IL-10,and IL-2/IL-4 were significantly higher in case group than that in control group.Conclusions1.Higher pre-pregnancy BMI and GWG,as well as family history of hypertension may be risk factors of PE,and higher monthly income may be the protective factor.2.The consumption of fruits and red meat and more intakes of protein,vitamin B2and/or vitamin C rich food may be the protective factors of PE,while excessive phosphorus may be a risk factor for PE.3.The dietary intake of vitamin D has no significant impact on PE development,but the PE patients have lower plasma concentrations of 25?OH?D2 and total25?OH?D in third trimester.4.PE patients have higher plasma levels of cytokines in IL-17A,IL-2,IFN-?and TNF-?,which imply the imbalance of Th immune and favoring pro-inflammatory status in PE patients. |
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