妊娠晚期糖尿病患者维生素B12缺乏状况及其影响因素分析

Vitamin B12 deficiency and its influencing factors in patients with third⁃trimester diabetes

目的 调查妊娠晚期糖尿病患者维生素B12缺乏状况,探讨维生素B12缺乏的影响因素。方法 以2018年6月至2022年6月于无锡某医院产检的妊娠晚期糖尿病患者作为研究对象,妊娠28周时调查维生素B12缺乏状况,采用描述性分析方法对结果进行分析,采用单、多因素分析方法对妊娠晚期糖尿病患者维生素B12缺乏的影响因素进行分析。结果 共1 355例妊娠晚期糖尿病患者参与调查,最终纳入1 235份有效数据,有效率为91.14%。1 235例患者共有260例发生维生素B12缺乏,发生率为21.05%。多因素logistic回归分析结果显示,使用二甲双胍治疗(OR=3.862)、1年以上素食经历(OR=2.002)、畜肉摄入不足(OR=2.357)、甲状腺功能减退(OR=1.549)、幽门螺杆菌感染(OR=1.551)、偶尔或从不补充复合维生素(OR=8.575、2.276)是妊娠晚期糖尿病患者维生素B12缺乏的影响因素。结论 妊娠晚期糖尿病患者维生素B12缺乏发生率较高,使用二甲双胍治疗、1年以上素食经历、畜肉摄入不足、甲状腺功能减退、幽门螺杆菌感染、孕期未充分补充复合维生素均是维生素B12缺乏的影响因素,建议临床可根据上述因素制定对策,以帮助患者提高维生素B12水平、改善妊娠结局。

Objective To investigate the status of vitamin B12 deficiency in patients with third‐trimester diabetes and explore its influencing factors.Methods Patients with third‐trimester diabetes who underwent prenatal examination at a hospital in Wuxi from June 2018 to June 2022 were selected as the study subjects.Vitamin B12 deficiency was investigated at 28 weeks of gestation.Descriptive analysis method was used to analyze the results,and univariate and multivariate analysis methods was used to analyze the influencing factors of vitamin B12 deficiency in patients with third‐trimester diabetes.Results A total of 1355 patients with third‐trimester diabetes participated in the survey,and 1235 valid data were included,with an effective rate of 91.14%.Vitamin B12 deficiency occurred in 260 of 1235 patients(21.05%).Multivariate logistic regression analysis showed that metformin treatment(OR=3.862),vegetarian experience for more than one year(OR=2.002),inadequate livestock meat intake(OR=2.357),hypothyroidism(OR=1.549),Helicobacter pylo⁃ri infection(OR=1.551),and occasional or no multivitamin supplementation(OR=8.575,2.276)were the influencing factors of Vitamin B12 deficiency in patients with third‐trimester diabetes.Conclusions The prevalence of vitamin B12 deficiency is elevated among patients with third‐trimester diabetes.Factors such as metformin treatment,vegetarian experience for more than one year,inadequate livestock meat intake,hypothyroidism,Helicobacter pylori infection,and prenatal insufficiency multivitamin supplementation all contribute to the development of vitamin B12 deficiency.It is recommended that clinical interventions be tailored based on these factors to assist patients in elevating their vitamin B12 levels and en-hancing pregnancy outcomes.