维生素D联合二甲双胍治疗妊娠期糖尿病患者的效果

Effects of Vitamin D combined with Metformin in treatment of gestational diabetes mellitus

目的:观察维生素D联合二甲双胍治疗妊娠期糖尿病(GDM)患者的效果。方法:选取2019年3月至2022年3月该院收治的76例GDM患者进行前瞻性研究,按照随机数字表法将其分为对照组和观察组各38例。对照组予以二甲双胍治疗,观察组在对照组基础上联合维生素D治疗。比较两组治疗前后血糖指标[空腹血糖(FBG)、餐后2 h血糖(2hPG)、糖化血红蛋白(HbA1c)、胰岛素抵抗指数(HOMA-IR)]水平、氧化应激指标[超氧化物歧化酶(SOD)、丙二醛(MDA)]水平、25-羟维生素D[25(OH)D]水平、脂肪酸结合蛋白4(FABP4)水平,以及不良分娩结局发生率。结果:治疗后,观察组2hPG、FBG、HbA1c、HOMA-IR、MDA、FABP4水平均低于对照组,SOD、25(OH)D水平均高于对照组,差异有统计学意义(P<0.05);观察组不良分娩结局发生率为5.26%(2/38),低于对照组的23.68%(9/38),差异有统计学意义(P<0.05)。结论:维生素D联合二甲双胍治疗GDM患者可降低血糖指标水平、FABP4水平和不良分娩结局发生率,升高25(OH)D水平,改善氧化应激指标水平,效果优于单纯二甲双胍治疗。

Objective:To observe effects of Vitamin D combined with Metformin in the treatment of patients with gestational diabetes mellitus(GDM).Methods:A prospective study was conducted on 76 GDM patients admitted to the hospital from March 2019 to March 2022.They were divided into control group and observation group according to the random number table method,38 cases in each.The control group was treated with Metformin,while the observation group was treated with Vitamin D on the basis of that of the control group.The levels of blood glucose indexes[fasting blood glucose(FBG),2 h postprandial blood glucose(2hPG),glycosylated hemoglobin(HbA1c),insulin resistance index(HOMA-IR)],the oxidation stress index levels[superoxide dismutase(SOD),malondialdehyde(MDA)],25-hydroxyVitamin D[25(OH)D],the fatty acid binding protein 4(FABP4)level,and the incidence of adverse delivery outcomes were compared between the two groups before and after the treatment.Results:After the treatment,the levels of 2hPG,FBG,HbA1c,HOMA-IR,MDA and FABP4 in the observation group were lower than those in the control group,the levels of SOD and 25(OH)D were higher than those in the control group,and the differences were statistically significant(P<0.05).Further,the incidence of adverse delivery outcomes in the observation group was 5.26%(2/38),which was lower than 23.68%(9/38)in the control group,and the difference was statistically significant(P<0.05).Conclusions:Vitamin D combined with Metformin in the treatment of the GDM patients can reduce the levels of blood glucose indexes,the FABP4 level and the incidence of adverse delivery outcomes,increase the 25(OH)D level,and improve the levels of oxidation stress indexes.Moreover,it is superior to single Metformin treatment.