摘要
目的探讨孕早期25羟维生素D缺乏对妊娠期糖尿病(GDM)的预测价值。方法选取2017年3-5月(春季)在丽水市妇幼保健院建卡初期(孕早期)的835名孕妇为研究对象,所选对象均为丽水市本地户籍,测定空腹血糖(FBG)、空腹胰岛素(FINS)、25羟维生素D,并于孕24~28周行葡萄糖耐量试验(OGTT)。分析25羟维生素D水平与GDM的发生率、胰岛素及血糖指标的关系。结果 (1)孕早期25羟维生素D水平为(38.03±12.67)nmol/L,其中145人缺乏,缺乏率82.6%;通过OGTT实验,确诊95例糖尿病孕妇,发生率11.38%;25羟维生素D缺乏组GDM发生率、胰岛素抵抗指数(HOMA-IR)均高于正常组,而胰岛素分泌指数(HOMA-β)低于正常组,差异均有统计学意义(P<0.05)。(2)餐后1、2 h血糖异常值孕妇25羟维生素D水平均低于血糖值正常的孕妇,差异有统计学意义(P<0.05)。(3)25羟维生素D水平与HOMA-IR呈负相关(r=-0.186,P=0.003)。结论孕早期25羟维生素D缺乏增加胰岛素抵抗及糖尿病的发生风险,在妊娠早期检测能有效预测GDM的发生,具有一定的临床价值。
Objective To explore the predictive value of 25 hydroxy vitamin D deficiency in gestational diabetes mellitus(GDM)during early pregnancy. Methods 835 pregnant women in first trimester were selected as the research object from March 2017-May2017(spring) in Lishui maternity and child health care hospital. The selected objects are local household registration of Lishui city.Fasting blood glucose(FBG),fasting insulin(FINS),25 hydroxy vitamin D,and oral glucose tolerance test(OGTT) in 24-28 weeks of the subjects were tested. The relationship between 25 hydroxy vitamin D levels and the incidence of GDM,insulin and glycemic index was analyzed. Results(1) The level of 25 hydroxy vitamin D of the subjects was(38. 03 ± 12. 67) nmol/L. Among the835 pregnant women,145 were 25 hydroxy vitamin D deficient,and the deficiency rate was 82. 6%. 95 cases of pregnant women were confirmed as diabetes,with an incidence of 11. 38%. The incidence of GDM and HOMA-IR in 25 hydroxy vitamin D deficiency group were higher than those in the normal group,while HOMA-βwas lower than normal group(P 〈0. 05).(2) For pregnant women with blood glucose abnormality of 1,2 h after meal,the level of 25 hydroxy vitamin D was lower than the normal pregnant woman(P 〈0. 05).(3)The level of 25 hydroxy vitamin D was negatively correlated with HOMA-IR(r =-0. 186,P = 0. 003). Conclusion The deficiency of 25 hydroxy vitamin D can increased the risk of insulin resistance and diabetes mellitus. Early pregnancy tested can effectively predict the occurrence of GDM,and it has certain clinical value.
作者
靳春雷
朱焕勉
谭晓霞
翁梅芬
JIN Chun Lei;ZHU Huan Mian;TAN Xiao Xia;WENG Mei Fen(Lishui Maternity and Child Health Care Hospital, Lishui, Zhejiang 323000, Chin)
出处
《中国妇幼卫生杂志》
2018年第4期70-73,共4页
Chinese Journal of Women and Children Health
基金
中国疾病预防控制中心妇幼保健中心合生元母婴营养与健康研究项目(2016FYH005)
关键词
妊娠期糖尿病
25羟维生素D
胰岛素抵抗
gestational diabetes mellitus
25 hydroxy vitamin D
insulin resistance