妊娠期糖尿病孕妇血清中25-羟维生素D营养状况及与糖代谢指标的关系

The nutritional status of 25-hydroxyvitamin D in pregnant women with gestational diabetes mellitus and its correlation with glycometabolism index

目的分析广州地区妊娠期糖尿病(GDM)孕妇血中25-羟维生素D[25-(OH)-VD]的营养状况,并探讨GDM孕妇血清中25-(OH)-VD与糖代谢指标的相关性。方法选取2019年1—10月在本院门诊诊断为GDM的孕妇120例孕妇为研究对象,根据GDM孕妇血清中25-(OH)-VD水平分为3组,分别为25-(OH)-VD缺乏组、25-(OH)-VD不足组和25-(OH)-VD正常组,计算出各组占比,并分析比较各组空腹血糖(FPG)、糖化血红蛋白(HbA1c)及空腹胰岛素(FINs)水平之间的差异,进一步分析GDM孕妇血清中25-(OH)-VD与这3个指标的相关性。结果120例GDM孕妇血清25-(OH)-VD水平正常者15例(12.50%),血清25-(OH)-VD不足者70例(58.33%),缺乏者35例(29.17%);分析显示,25-(OH)-VD水平正常组中FPG、HbA1c和FINs水平分别为(5.23±0.68)mmol/l、(5.41±0.46)%、(10.39±3.58)μU/ml;25-(OH)-VD缺乏组中FPG、HbA1c和FINs水平分别为(6.33±1.23)mmol/l、(5.97±0.87)%、(16.09±6.37)μU/ml;25-(OH)-VD不足组中FPG、HbA1c和FINs水平分别为(5.97±1.04)mmol/l、(5.78±0.55)%、(15.37±5.56)μU/ml;25-(OH)-VD水平正常组明显低于25-(OH)-VD缺乏组和25-(OH)-VD不足组,差异均有统计学意义(均P<0.05)。25-(OH)-VD缺乏组中FPG水平高于25-(OH)-VD不足组,差异有统计学意义(P<0.05),其余组间比较差异均无统计学意义(均P>0.05);GDM孕妇血清中25-(OH)-VD的水平与FPG、HbA1c及FINS呈负相关(r=-0.537、-0.563、-0.449),差异均有统计学意义(均P<0.05)。结论广州地区GDM孕妇血清25-(OH)-VD营养状况不理想,其缺乏在一定程度上加速GDM病情的恶化。

Objective To analyze the nutritional status of 25-hydroxyvitamin D[25-(OH)-VD]in pregnant women with gestational diabetes mellitus(GDM),and to explore its correlation with glycometabolism index in serum of pregnant women with GDM.Methods 120 cases of pregnant women with GDM from January 2019 to October 2019 were divided into three groups:lack of 25-(OH)-VD group,25-(OH)-VD deficiency group,and 25-(OH)-VD normal group.The differences in fasting blood glucose(FPG),glycosylated hemoglobin(HbA1c),and fasting insulin(FINs)levels among the three groups were compared,their correlation with 25-(OH)-VD were analyzed.Results There were 15 cases(12.50%)of normal serum 25-(OH)-VD level in 120 pregnant women with GDM,70 cases(58.33%)of 25-(OH)-VD deficiency,35 cases(29.17%)of lack of 25-(OH)-VD.The analysis showed that the levels of FPG,HbA1c,and FINs in the normal group of 25-(OH)-VD were(5.23±0.68)mmol/L,(5.41±0.46)%,(10.39±3.58)μU/ml;those in the 25-(OH)-VD deficiency group respectively were(6.33±1.23)mmol/L,(5.97±0.87)%,(16.09±6.37)μU/ml;those in the lack of 25-(OH)-VD group respectively were(5.97±1.04)mmol/L,(5.78±0.55)%,(15.37±5.56)μU/ml.The levels of FPG,HbA1c,and FINs in the normal group of 25-(OH)-VD were significantly lower than those in the 25-(OH)-VD deficiency group and the lack of 25-(OH)-VD group,with statistically significant differences(all P<0.05);the level of FPG in the 25-(OH)-VD deficiency group was significantly higher than that in the lack of 25-(OH)-VD group(P<0.05),but there were no statistically significant differences in the other two(all P>0.05).The level of 25-(OH)-VD in the serum of GDM pregnant women was negatively correlated with FPG,HbA1c,and FINs(r=-0.537,-0.563,-0.449,all P<0.05).Conclusion The nutritional status of 25-(OH)-VD in serum of GDM pregnant women in Guangzhou area is not ideal,and its deficiency accelerates the deterioration of the GDM condition to some extent.