孕中期血清25-羟维生素D_3及血脂水平对妊娠期糖尿病的影响

Effects of serum 25( OH)D_3 and lipid levels at the second trimester on gestational diabetes mellitus

目的探讨孕中期血清25-羟维生素D3[25（OH）D3]和血脂水平对妊娠期糖尿病（GDM）的影响。方法以行产前检查的孕妇作为研究对象,分为正常妊娠组（对照组,n=6 796）和GDM组（n=977）,于孕中期（孕12~16周）检测血清25（OH）D3及总胆固醇（TCh）、三酰甘油（TAG）、高密度脂蛋白（HDL）和低密度脂蛋白（LDL）等血脂指标,通过logistic回归分析评价25（OH）D3和血脂水平在GDM发病中的作用。结果GDM组25（OH）D3和HDL水平均低于对照组;而TAG、TCh、LDL均高于对照组。Logistic回归分析显示除LDL外的所有指标均与GDM致病有关,其中TAG（OR=1.54）和TCh（OR=1.63）是危险因素,而25（OH）D3（OR=0.995）和HDL（OR=0.392）是保护因素。结论孕中期血清25（OH）D3和血脂水平对GDM的发病有重要作用,其中TAG和TCh是GDM发病的危险因素,而25（OH）D3和HDL是保护因素;可尝试通过调脂及降糖综合治疗降低GDM的患病率。

Objective To investigate the effects of serum 25（OH） D3 and lipid levels on the gestational diabetes mellitus（GDM）.Methods Pregnant women who underwent prenatal examinations were enrolled and divided into the normal pregnancy group（control group,n = 6796） and GDM group（n = 977）.Serum25（OH） D3,total cholesterol（TCh）,triglyceride（TAG）,high density lipoprotein cholesterol（HDL）,and low density lipoprotein（LDL） levels of two groups at the second trimester of pregnancy（12-16 weeks） were detected.The logistic regression analysis was adopted to evaluate the effects of 25（OH） D3 and lipid levels on the pathogenesis of GDM.Results 25（OH） D3 and HDL levels of the GDM group were lower than those of the control group,while TAG,TCh,and LDL levels were higher than those of the control group.Logistic regression analysis showed that all indexes were relevant to the pathogenesis of GDM except LDL.TAG（OR = 1.54） and TCh（OR = 1.63） were risk factors of GDM,while 25（OH） D3（OR =0.995） and HDL（OR = 0.392） were protective factors of GDM.Conclusion Serum 25（OH） D3 and lipid levels at the second trimester play an important role in the pathogenesis of GDM.TAG and TCh are risk factors of GDM,while 25（OH） D3 and HDL are protective factors of GDM.Therefore,it can be attempted to reduce the incidence of GDM by the combination therapy of lowering lipids and glucose.