孕妇血维生素D水平与妊娠期糖尿病相关性研究

Study on the relationship between serum vitamin D level and gestational diabetes mellitus in pregnant women

目的探讨孕妇血清25-羟维生素D[25-(OH)D]水平与妊娠期糖尿病(gestational diabetes mellitus,GDM)的关系,分析孕妇血清25-(OH)D水平的影响因素。方法采用随机数字表法选取2017年9月—2018年12月在玉环市人民医院产检的300例孕妇,在孕早期、中期、晚期分别检测25-(OH)D水平,根据血清25-(OH)D水平分为缺乏组和不缺乏组,比较2组孕妇妊娠期糖尿病发生率的差别;根据孕晚期血清25-(OH)D水平,分析孕妇血清25-(OH)D水平的影响因素。结果孕早期缺乏组、不缺乏组孕妇妊娠期糖尿病发生率分别为26.32%、12.50%,比较差异无统计学意义(P>0.05);孕中期缺乏组、不缺乏组孕妇妊娠期糖尿病发生率分别为28.65%、9.80%,比较差异有统计学意义(P<0.05);孕晚期缺乏组、不缺乏组孕妇妊娠期糖尿病发生率分别为27.47%、10.00%,比较差异有统计学意义(P<0.05);在单因素分析的基础上经多因素logistic回归分析显示每日户外活动时间少、孕晚期在冬春季、未正规补充维生素D、未及时补充维生素D为孕妇血清25-(OH)D缺乏的独立危险因素(均P<0.05)。结论孕妇血清25-(OH)D水平下降可能增加妊娠期糖尿病发生的风险,孕早期合理补充维生素D可有效预防孕妇维生素D缺乏,有助于降低妊娠期糖尿病的发生风险。

Objective To investigate the relationship between serum 25-hydroxyvitamin D[25-(OH)D]level and gestational diabetes mellitus(GDM)in pregnant women,and to analyze the influencing factors of serum 25-hydroxyvitamin D level in pregnant women.Methods A random number table was used to select 300 pregnant women who were examined in Yuhuan People’s Hospital from September 2017 to December 2018.The levels of 25-(OH)D were detected in the early,middle and late stages of pregnancy.According to the serum levels of 25-(OH)D,the pregnant women were divided into two groups:lack group and no lack group,and the incidence of gestational diabetes was compared between the two groups.According to the serum 25-(OH)D level in the third trimester,the influencing factors of serum 25-(OH)D level in pregnant women were analyzed.Results The incidence of gestational diabetes was 26.32%in the lack group and 12.50%in the no lack group,with no statistically significant difference(P>0.05).The incidence of gestational diabetes in the second trimester deficiency group and the no deficiency group were 28.65%and 9.80%,respectively,with statistically significant differences(P<0.05).The incidence of gestational diabetes was 27.47%and 10.00%in the lack group and no lack group,respectively,with statistically significant differences(P<0.05).On the basis of univariate analysis,multivariate logistic regression analysis showed that the independent risk factors of serum 25-(OH)D deficiency in pregnant women were less time spent in outdoor activities,winter and spring,no regular vitamin D supplementation,and no timely vitamin D supplementation(all P<0.05).Conclusion Decreased serum 25-(OH)D level in pregnant women may increase the risk of gestational diabetes.Reasonable vitamin D supplementation in early pregnancy can effectively prevent vitamin D deficiency in pregnant women and help reduce the risk of gestational diabetes.