同型半胱氨酸、叶酸浓度与妊娠期糖尿病的关联研究

Study on the associations of homocysteine and folic acid concentrations with gestational diabetes mellitus

目的探讨血浆同型半胱氨酸(Hcy)、叶酸水平与妊娠期糖尿病(GDM)的相关性。方法选取2012年4月至2015年2月在陕西省汉中市三二〇一医院产科确诊的314例GDM患者作为GDM组,随机选取同期健康孕妇347例作为对照组。通过标准化问卷收集孕妇的一般资料,血浆Hcy水平检测采用循环酶法,血浆叶酸水平检测采用电化学发光法。结果GDM组Hcy水平高于对照组(t=23.301),叶酸水平低于对照组(t=22.811),差异均有统计学意义(均P<0.05)。GDM组孕24~26^(+6)周、孕27~29^(+6)周、孕30~32^(+6)周Hcy水平均高于对照组(t值分别为14.123、16.039、9.277),叶酸水平均低于对照组(t值分别为12.650、15.842、10.608),差异均有统计学意义(均P<0.05)。Pearson相关性分析发现,GDM孕妇血浆Hcy水平与叶酸水平呈显著性负相关(r=-0.431,P<0.05)。结论血浆Hcy和叶酸水平可能与GDM密切相关,并且Hcy水平和叶酸水平呈负相关。

Objective To explore the associations of homocysteine(Hcy)and folic acid concentrations with gestational diabetes mellitus(GDM).Methods From April 2012 to February 2015,314 cases of gestational diabetes mellitus in obstetrics department of 3201 Hospital of Hanzhong of Shaanxi Province were selected as the GDM group,and 347 matched healthy pregnant women in the same periods and area were randomly selected as control group.The general data of pregnant women was collected by standardized questionnaire.Hcy concentration in plasma was detected by circulating enzyme method,while folic acid was detected by electrochemiluminescence method.Results The levels of Hcy and plasma folic acid in GDM group were significantly higher than the control group(t=23.301 and 22.811,respectively,both P<0.05).The Hcy levels of pregnant women at 24-26^(+6)week,27-29^(+6)week,30-32^(+6)week of gestation in GDM group were significantly higher than those in the control group(t=14.123,16.039 and 9.277,respectively,all P<0.05),while the folic acid level at those periods in GDM group were lower than control group(t=12.650,15.842 and 10.608,respectively,all P<0.05).Pearson correlation analysis showed a significant negative correlation between plasma Hcy level and folic acid level in pregnant women with GDM(r=-0.431,P<0.05).Conclusion Plasma homocysteine and folic acid levels may be closely associated with GDM,and plasma homocysteine level is negatively correlated with folic acid level.