不同剂量维生素D预防妊娠期糖尿病的临床效果比较

Comparison of clinical effects of different doses of vitamin D on preventing gestational diabetes mellitus

目的比较不同剂量维生素D预防妊娠期糖尿病的临床效果。方法选择2019年6月至2020年5月在本院接受产检的孕周<12周的210例孕妇为研究对象,依据电脑数字表法随机将其分为对照组和观察组,每组105例。妊娠12周起,予以对照组孕妇低剂量(400 IU)维生素D口服,予以观察组孕妇高剂量(1200 IU)维生素D口服。比较两组妊娠24周口服葡萄糖耐量试验结果、妊娠期糖尿病发生情况及糖、脂代谢指标水平。结果妊娠24周口服葡萄糖耐量试验结果显示,观察组服糖前及服糖后1、2 h的血糖水平均低于对照组(P<0.05)。观察组妊娠期糖尿病发生率为5.71%,低于对照组的14.29%(P<0.05)。妊娠24周时,观察组的FBG、FINS、HOMA-IR、TC、TG、LDL-C水平低于对照组,HDL-C水平高于对照组(P<0.05)。结论在妊娠期糖尿病预防中,相较于低剂量(400 IU)维生素D口服,高剂量(1200 IU)维生素D口服对孕妇血糖水平的控制效果更佳,可进一步降低妊娠期糖尿病发生率,并且有助于改善其糖、脂代谢状况。

Objective To compare the clinical effects of different doses of vitamin D on preventing gestational diabetes mellitus.Methods A total of 210 pregnant women with gestational week<12 weeks who received prenatal examination in our hospital from June 2019 to May 2020 were selected as the research objects.The pregnant women were randomly divided into control group and observation group according to the method of computer digital table,with 105 cases in each group.From 12 weeks of gestation,the control group was given low-dose(400 IU)vitamin D orally,while the observation group was given high-dose(1200 IU)vitamin D orally.The results of oral glucose tolerance test at 24 weeks of gestation,the occurrence of gestational diabetes mellitus and the levels of glucose and lipid metabolism indexes were compared between the two groups.Results The results of oral glucose tolerance test at 24 weeks of gestation showed that the blood glucose level of the observation group before,1 h and 2 h after taking sugar was lower than that of the control group(P<0.05).The incidence of gestational diabetes mellitus in the observation group was 5.71%,which was lower than 14.29%in the control group(P<0.05).At 24 weeks of gestation,the levels of FBG,FINS,HOMA-IR,TC,TG and LDL-C in the observation group were lower than those in the control group,and the level of HDL-C was higher than that in the control group(P<0.05).Conclusion In the prevention of gestational diabetes mellitus,high-dose(1200 IU)vitamin D orally has a better control effect on the blood glucose level of pregnant women than low-dose(400 IU)vitamin D orally,it can further reduce the incidence of gestational diabetes mellitus and help to improve the glucose and lipid metabolism.