妊娠糖尿病伴亚临床甲减对孕妇骨密度及骨钙素、25-羟基维生素D的影响

Effect of disease of pregnant women with gestational diabetes mellitus and subclinical hypothyroidism on their bone mineral density,and levels of osteocalcin and 25-hydroxyvitamin D

目的:探讨妊娠糖尿病伴亚临床甲减对孕妇骨密度及骨钙素、25-羟基维生素D的影响。方法:以本院内分泌科确诊的妊娠期糖尿病伴亚临床甲减孕妇120例为观察组,同期产前检查健康孕妇120例为对照组,检测两组孕妇骨密度(BMD)及骨钙素(OC)、25-羟基维生素D3(25-OH-VD3),并观察母婴妊娠结局。结果:观察组骨量正常率(72.5%)低于对照组(85.0%),骨量减少发生率(20.0%)和OC(9.86±0.13μg/L)高于对照组(5.0%、7.21±0.15μg/L),25-OH-VD(16.09±5.34μg/L)和跟骨BMD水平(0.91±0.18 g/cm2)低于对照组(18.96±6.36μg/L、1.14±0.21g/cm2)(均P<0.05);观察组新生儿低出生体质量(20.0%)和新生儿窒息发生率(10.0%)高于对照组(5.0%、1.7%)。结论:妊娠糖尿病伴亚临床甲减可降低孕妇的骨密度,影响骨钙素、25-羟基维生素D表达水平,增加新生儿窒息、低体重风险,应引起临床重视。

Objective:To explore the effect of disease of pregnant women with gestational diabetes mellitus(GDM)and subclinical hypothyroidism on their bone mineral density,and levels of osteocalcin(OC)and 25-hydroxyvitamin D3(25-OH-VD3).Methods:120 pregnant women with GDM and subclinical hypothyroidism were selected in experimental group,and 120 healthy pregnant women were selected in control group during the same period.The bone mineral density,and levels of OC and 25-OH-VD3 of all women were detected.And maternal and infant pregnancy outcomes of all women were observed.Results:The rate of normal bone mineral density of women in the experimental group was 72.5%,which was significant lower than that(85.0%)of women in the control group.The incidence of bone mineral density decreased and OC level of women in the experimental group were 20.0%and 9.86±0.13μg/L,which were significant higher than those(5.0%and 7.21±0.15μg/L)of women in the control group.The level of 25-OH-VD and calcaneus BMD value of women in the experimental group were 16.09±5.34μg/L and 0.91±0.18 g/cm,which were significant lower than those(18.96±6.36μg/L and 1.14±0.21 g/cm2)of women in the control group(P<0.05).The incidence of low birth weight and neonatal asphyxia in the experimental group were 20.0%and 10.0%,which were significant lower than those(5.0%and 1.7%)in the control group(P<0.05).Conclusion:The diseases of pregnant women with GDM and subclinical hypothyroidism can reduce the expression levels of bone mineral density,and levels of osteocalcin and 25-hydroxyvitamin D,which can increase the risk of neonatal asphyxia and low body weight,so it is should be paid attention to in clinical practice.