妊娠期糖尿病孕妇与正常孕妇的夏季和冬季血清维生素D水平对比研究

Comparison of serum vitamin D level between pregnant women with gestational diabetes mellitus and healthy pregnant women in summer and winter

目的 探讨妊娠期糖尿病（GDM）孕妇和正常孕妇夏季和冬季血清维生素D水平的差异。方法 选取2014年6~8月（夏季）和2014年12月至2015年2月（冬季）就诊的孕妇各100例,其中每个季节GDM孕妇（GDM组）和正常孕妇（对照组）各50例。测定各组血清中25-羟维生素D[25-（OH）D]的水平。结果 夏季GDM组、夏季对照组、冬季GDM组、冬季对照组血清25-（OH）D水平分别为（20.2±7.0）ng/ml、（24.1±8.6）ng/ml、（16.0±7.5）ng/ml和（19.7±5.8）ng/ml,均未达到维生素D的正常标准。冬季及夏季GDM组的25-（OH）D水平分别低于冬季及夏季对照组（P〈0.05）;两组夏季的25-（OH）D水平均明显高于冬季（P〈0.05）。4组维生素D缺乏和不足的比例在84~96%,但4组维生素D正常、不足和缺乏的构成比比较,差异无统计学意义（P〉0.05）。结论 孕妇普遍存在维生素D缺乏或不足,GDM孕妇维生素D缺乏比正常妊娠孕妇更为严重,冬季比夏季严重。冬季时孕妇尤其是GDM孕妇要更加注意维生素D的补充。

Objective To investigate the difference in serum vitamin D level between pregnant women with gestational diabetes mellitus（GDM） and healthy pregnant women in summer and winter. Methods One hundred pregnant women between June 2014 and August 2014（summer） and 100 pregnant women between December 2014 and February 2015 （winter） were enrolled, with 50 pregnant women with GDM（ GDM group） and 50 healthy pregnant women（ control group） in each season. The serum level of 25-hydroxy vitamin D [ 25-（OH） D ] was measured in each group. Results The serum 25-（OH） D levels of summer GDM group, summer control group, winter GDM group and winter control group were （20.2 ± 7.0） ng/ml, （ 24. 1 ± 8.6 ） ng/ml, （ 16.0 ± 7.5 ） ng/ml and （ 19.7 ± 5.8 ） ng/ml respectively, and did not reach the standard of normal vitamin D level. The 25-（OH）D levels of winter GDM group and summer GDM group were lower than the levels of winter control group and summr control group respectively（P 〈0.05）. The 25-（OH）D levels of the two summer groups were significantly higher than the levels of the two winter groups（P 〈0.05）. The proportion of pregnant women with vitamin D deficiency or insufficiency was 84% to 96%. There was no significant difference in the constituent ratio of normal vitamin D level,vitamin D deficiency or insufficiency anlong four groups （P〉0.05）.Conclusion Vitamin D deficiency or insufficiency is common among the pregnant women. And this phenomenon is more severe in pregnant women with GDM compared to healthy pregnant women, and more severe in winter compared to summer. In winter, pregnant women especially those with GDM should Day attention to the supplement of vitamin D.