妊娠期糖尿病患者血清同型半胱氨酸、维生素B_(12)及叶酸的含量变化

Content changes in serum homocysteine,vitamin B_(12) and folic acid in patients with gestational diabetes mellitus

目的研究血糖控制情况不同的妊娠期糖尿病(GDM)孕妇血清同型半胱氨酸(Hcy)、维生素B12(Vit B12)、叶酸(FA)水平及其相关性。方法选择183例血糖控制情况不同的GDM孕妇和90例健康孕妇,采用循环酶法和电化学发光法,于住院分娩时测定孕妇血清Hcy、Vit B12及FA水平。结果血糖控制满意组中单纯饮食控制和加用胰岛素控制孕妇血清Hcy水平均明显低于血糖控制不满意组,而Vit B12、FA均明显高于血糖控制不满意组,差异均有统计学意义(P<0.05)。血糖控制满意组中加用胰岛素控制孕妇与对照组间Hcy、FA差异也均有统计学意义(P<0.05)。血糖控制不满意组血清Hcy明显高于对照组,而Vit B12与FA均明显低于对照组,2组上述指标差异均有统计学意义(P<0.01)。3组孕妇血清Hcy与其Vit B12、FA均呈负相关(P<0.01或P<0.05)。结论 GDM患者出现高Hcy血症,其中血糖控制不满意者血清Hcy显著升高,而血Vit B12及FA明显降低。表明血清Hcy水平与GDM病情严重程度可能有一定的相关性,且GDM患者血清Hcy与其Vit B12、FA均呈负相关。

Objective To investigate level of the serum homocysteine（ Hcy）,vitamin B12（ Vit B12）,and folic acid（ FA） and their correlation under different blood glucose control levels in pregnant women with gestational diabetes mellitus（ GDM）. Methods A total of 183 GDM pregnant women with different blood glucose control levels and 90 cases pregnant healthy women were selected as comparing group. The serum Hcy,Vit B12 and FA levels were determined when childbirth in hospital by cyclophorase method and electrochemiluminescence method. Results The Hcy serum levels of pregnant women with single alimentary control and with insulin used additionally of satisfactory blood glucose control group were both significantly lower than unsatisfactory blood glucose control group. The blood Vit B12 and FA levels of the two groups of satisfactory blood glucose control group were significantly higher than unsatisfactory blood glucose control group. The difference was statistically significant（P〈0. 05）. The differences in serum Hcy and FA levels between pregnant women with insulin used additionally of the satisfactory blood glucose control group and control group were statistically significant（P〈0. 05）. The unsatisfactory blood glucose control group had significantly higher blood Hcy level than the control group,and significantly lower blood Vit B12 and FA levels than the control group,and the differences of the above groups were statistically significant（P〈0. 01）. Hcy serum level was negatively correlated with blood Vit B12 and FA levels in the pregnant women of the three groups（P〈0. 01 orP〈0. 05）. Conclusion GDM patients usually sufferer from high Hcy; and among them,patients with unsatisfactory blood glucose control have significantly increased Hcy serum level and significantly decreased blood Vit B12 and FA levels. It indicates that there may be a correlation between the Hcy serum level and the severity of GDM. Besides,Hcy serum level is negatively correlated with blood Vit B12 and FA levels in GDM patients.