不同血糖控制情况下妊娠期糖尿病患者的维生素D及血脂水平

Vitamin D and plasma lipid levels in patients with gestational diabetes mellitus during different blood glucose control stages

目的探究不同血糖控制情况下,妊娠期糖尿病患者(GDM)的维生素D及血脂水平变化及差异。方法选取2017年5月至2018年7月间来我院产前检查的孕妇,对孕期24～28周的孕妇行口服葡萄糖耐量试验(OGTT)的检测及筛查。随机选取健康孕妇作为对照组(300例),妊娠期糖尿病孕妇作为试验组(194例),其中根据不同糖化血红蛋白(Hb A1c)水平将试验组分为两组,血糖控制达标组与血糖控制未达标组。分别与对照组比较其维生素D及血脂水平。结果与对照组比较,妊娠期糖尿病组甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白(LDL)均升高,高密度脂蛋白(HDL)、维生素D水平降低,其中血糖控制达标组TG明显升高(P<0.01),TC、LDL升高及维生素D降低无统计学意义(P>0.05);而血糖控制未达标组,四项血脂指标及维生素D水平均有明显差异(P<0.05)。在不同糖化血红蛋白水平的两组间比较,Hb A1c>7.0%组较Hb A1c<7.0%组TG、TC、LDL水平明显升高及HDL、维生素D水平明显降低(P<0.05)。结论妊娠期糖尿病患者常伴有脂代谢紊乱及维生素D的不足,血糖控制不好更会加剧脂质代谢异常及维生素D缺乏。对GDM患者而言,孕期定期、及时监测血糖、糖化血红蛋白、血脂、维生素D尤为重要,谨遵医嘱日常科学合理饮食更是必不可少。

Objective To explore the characteristics and differences of vitamin D and lipid levels in different blood glucose control conditions stages of gestational diabetes mellitus (GDM) patients.Methods Healthy pregnant women were selected as normal control group, and GDM patients received antenatal examination in our hospital from May 2017 to July 2018 were selected as experimental group.According to the different level of hemoglobin A1c (HbA1c), the experimental group were divided into two groups, well-controlled and poorly-controlled.Vitamin D and lipid levels in the experimental group were compared with the control group.Results Compared with the normal control group, triglycerides (TG), total cholesterol (TC) and low-density lipoprotein (LDL) were significantly increased in the GDM group, and vitamin D decreased.Compared with the normal group, TG was significantly increased in the well-controlled group ( P <0.01), while TC, LDL and vitamin D were not statistically significant ( P >0.05).However, there were significant differences in serum lipid index and vitamin D in the poorly-controlled group ( P <0.05).There was also a significant difference with TG, TC, LDL, HDL, Vitamin D between the two groups with different levels of HbA1c ( P <0.05).Conclusion GDM patients are accompanied by lipid metabolism disorder and vitamin D deficiency, and poor blood glucose control will aggravate the abnormality of lipid metabolism and vitamin D deficiency.For patients with GDM, regular and timely monitoring of blood glucose, HbA1c, blood lipids and vitamin D during pregnancy is particularly important.It is also essential to follow the doctor's advice to have a scientific and reasonable diet.