孕妇基础25-羟维生素D水平与孕中期血脂代谢及妊娠期糖尿病相关性研究

Correlation between the serum levels of 25-hydroxyvitamin D of pregnant women at early pregnancy and blood lipids metabolism as well as gestational diabetes mellitus at mid-gestation

目的探讨孕妇基础25-羟维生素D水平与妊娠24～28周血糖、血脂代谢异常的相关性。方法选取就诊的876例初次孕检的健康孕妇,依据维生素D水平分组,分为维生素D充足组39例、维生素D不足组429例、维生素D缺乏组和维生素D严重缺乏组187例。收集受试者年龄、身高、体重、血压,计算体重指数(BMI),测定25-羟维生素D水平,并于妊娠24～28周测定三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、糖化血红蛋白A1c(Hb A1c),同时行口服葡萄糖耐量试验(OGTT);分析不同维生素D水平状态血脂及血糖水平的差异,并对血清25-羟维生素D水平与血糖、血脂的相关性进行分析。结果维生素D缺乏导致GDM和血脂代谢紊乱的发生风险分别增加2. 101倍和2. 272倍,维生素严重缺乏导致妊娠糖尿病(GDM)和血脂代谢紊乱发生的风险分别增加2. 878倍和2. 534倍。结论孕妇基础25-羟维生素D水平与妊娠24～28周血脂紊乱及GDM的发生有关。

Objective To investigate the correlation between the serum levels of 25-hydroxyvitamin D at early pregnancy and blood glucose,blood lipid metabolic disorder as well as gestational diabetes mellitus(GMD)at mid-gestation.Methods A total of 876 pregnant women who underwent pregnancy examination for the first time in our hospital from July 2014 to July 2017 were enrolled in the study,According to the levels of vitamin D,these pregnant women were divided into four groups:sufficient vitamin D group(n=39),insufficient vitamin D group(n=429),vitamin D deficiency group(n=221)and vitamin D severe deficiency group(n=187).The subject’s age,height and body weight,blood pressure were recorded,BMI was calculated,and the levels of 25-hydroxyl vitamin D were measured at early pregnancy,and riglyceride,total cholesterol,high-density lipoprotein cholesterol,low density lipoprotein cholesterol,glycosylated hemoglobin A1c were detected.Moreover the oral glucose tolerance test(OGTT)was performed at 24~28th weeks gestation.The differences of serum lipids and blood glucose levels at different vitamin D levels were analyzed,and the relationships between serum 25-hydroxyvitamin D levels and blood glucose,lipids were analyzed.Results The risk of gestational diabetes mellitus(GDM)and dyslipidemia caused by vitamin D deficiency was increased as high as 2.101 and 2.272 times,respectively,and the risk of GDM and dyslipidemia caused by severe vitamin D deficiency was increased as high as 2.878 times and 2.534 times,respectively.Conclusion The levels of 25-hydroxyvitamin D in pregnant women at early pregnancy(24~28 weeks)are correlated with the occurrence of GDM and dyslipidemia.