呼伦贝尔地区孕妇基础25-羟维生素D水平与孕中期血脂代谢及妊娠期糖尿病相关性分析

Correlation between basic 25-hydroxyvitamin D level and blood lipid metabolism in the second trimester and gestational diabetes mellitus in pregnant women in Hulun Buir

目的探讨呼伦贝尔地区孕妇基础25-羟维生素D水平与孕中期血脂代谢及妊娠期糖尿病相关性。方法选择2017年1月至2019年8月呼伦贝尔市人民医院孕妇792例作为研究对象,采用电化学发光法(ECL)测定基础25-羟维生素D水平,根据测定结果分为维生素D缺乏组、维生素D不足组和维生素D充足组。于孕中期采用全自动生化分析仪测定各组总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白(HDL-C)及低密度脂蛋白(LDL-C)水平;采用血糖测定仪测定患者空腹血糖(FPG)、餐后2 h血糖(2h PG)水平;对孕妇进行随访,记录妊娠期糖尿病发生率;采用Pearson相关性分析软件对呼伦贝尔孕妇基础25-羟维生素D水平与孕中期血脂水平、妊娠期糖尿病发生率进行相关性分析。结果792例呼伦贝尔孕妇中维生素D缺乏组231例,维生素D不足组412例,维生素D充足组149例。三组TC及HDL-C水平比较,差异无统计意义(P>0.05);维生素D缺乏组TG和LDL-C、FPG、2h PG水平均高于维生素D不足组和维生素D充足组(P<0.05);入组孕妇随访过程中确诊妊娠期糖尿病患者75例,占8.84%,且患者均为维生素D缺乏孕妇。Pearson相关性分析结果表明,孕妇25-羟维生素D水平与妊娠期糖尿病发生率、TG和LDL-C水平呈负相关性(P<0.05);与TC及HDL-C水平无相关性(P>0.05)。结论呼伦贝尔地区孕妇基础25-羟维生素D水平与孕中期血脂代谢及妊娠期糖尿病发生率存在相关性,应采取有效措施干预,改善孕妇糖脂代谢,降低妊娠期糖尿病发生率。

Objective To investigate the correlation between basic 25-hydroxyvitamin D[25(OH)D]level and blood lipid metabolism in the second trimester and gestational diabetes mellitus(GDM)in pregnant women in Hulun Buir.Methods A total of 792 pregnant women in Hulunbei'er People's Hospital from January 2017 to August 2019 were selected as research objects.The level of basic 25(OH)D was measured by electrochemiluminescence(ECL).According to the measurement results,they were divided into the vitamin D deficiency group,vitamin D insufficiency and vitamin D sufficiency group.The levels of total cholesterol(TC),triglyceride(TG),high density lipoprotein cholesterol(HDL-C)and low density lipoprotein cholesterol(LDL-C)in each group were measured by the automatic biochemical analyzer in the second trimester of pregnancy.Fasting blood glucose(FPG)and 2-hour postprandial blood glucose(2h PG)were measured by blood glucose meter.The pregnant women were followed up and the incidence of GDM was recorded.SPSS Pearson correlation analysis software was used to analyze the correlation between the level of basic 25(OH)D,blood lipid level in the second trimester,and the incidence of GDM in pregnant women in Hulun Buir.Results Among 792 pregnant women in Hulun Buir,there were 231 cases in the vitamin D deficiency group,412 cases in the vitamin D insufficiency group and 149 cases in the vitamin D sufficiency group.The levels of TC and HDL-C showed no statistically significant differences among three groups(P>0.05).The levels of TG,LDL-C,FPG and 2h PG in the vitamin D deficiency group were higher than those in the vitamin D insufficiency and the vitamin D sufficiency group(P<0.05).During the follow-up,75 patients were diagnosed as GDM,accounting for 8.84%,and all the patients were pregnant women with vitamin D deficiency.The results of SPSS Pearson correlation analysis showed that the level of basic 25(OH)D in pregnant women was negatively correlated with the incidence of GDM and the levels of TG and LDL-C(P<0.05).There was no correlation with TC and HDL-C(P>0.05).Conclusion The level of basic 25(OH)D is correlated with blood lipid metabolism and the incidence of GDM in the second trimester of pregnancy of pregnant women in Hulun Buir.Effective measures should be taken to improve the glucose and lipid metabolism of pregnant women and reduce the incidence of GDM.