维生素D对妊娠糖尿病胰岛素敏感性、TNF-α及氧化应激的影响

Effects of Vitamin D on Insulin Sensitivity,TNF-αand Oxidative Stress in Patients with Gestational Diabetes Mellitus

目的探讨血清维生素D水平对妊娠糖尿病(GDM)患者糖代谢、胰岛素抵抗、肿瘤坏死因子(TNF-α)及氧化应激生物标志物的影响。方法选择妊娠糖尿病患者70例(GDM组)和同期产检的血糖正常孕妇70例(对照组),检测两组患者空腹血糖(FBG)、空腹胰岛素(FINS)、糖化血红蛋白(HbA1c)、25羟维生素D[25(OH)D]、TNF-α、还原型谷胱甘肽(GSH)和超氧化物歧化酶(SOD)水平。结果与对照组相比,GDM组患者FBG、HbA1c、胰岛素抵抗指数(HOMA-IR)、TNF-α升高,胰岛β细胞分泌指数(HOMA-β)、血清25(OH)D、GSH水平降低(均P<0.05)。25(OH)D与FBG、HOMA-IR、HbA1c、TNF-α呈负相关,与HOMA-β、GSH呈正相关,与FINS、SOD无相关性。结论维生素缺乏或不足与GDM患者的空腹血糖升高和胰岛素抵抗相关,25(OH)D缺乏可能通过增加炎症反应和氧化应激影响GDM患者的糖代谢和胰岛素敏感性。

Objective To investigate the effects of serum vitamin D levels on glucose metabolism,insulin resistance,tumor necrosis factor(TNF-α)and oxidative stress biomarkers in gestational diabetes mellitus(GDM)patients.Methods A total of 70 patients with gestational diabetes mellitus(GDM group)and 70 pregnant women with normal blood glucose(control group)were recruited to detect fasting blood glucose(FBG),fasting insulin(FINS),glycosylated hemoglobin(HbA1c),25 hydroxyvitamin D[25(OH)D],TNF-α,reduced glutathione(GSH)and superoxide dismutase(SOD)levels.Results Compared with the control group,the FBG,HbA1c,insulin resistance index(HOMA-IR),TNF-αincreased,and the levels of islet beta cell secretion index(HOMA-β),serum 25(OH)D and GSH decreased in GDM group(all P<0.05).25(OH)D was negatively correlated with FBG,HOMA-IR,HbA1c and TNF-α,while it was positively correlated with HOMA-βand GSH.Conclusion 25(OH)D deficiency or insufficiency in GDM patients is associated with increased fasting blood glucose and insulin resistance,which is closely related to increased inflammatory reaction and oxidative stress.