摘要
目的:探究妊娠期糖尿病(GDM)患者孕早期血清25-羟维生素D(25-OH-D)、同型半胱氨酸(Hcy)和糖化血红蛋白(HbA1c)水平与胰岛素抵抗关系。方法:选择本院2019年12月-2022年12月收治的GDM患者134例为GDM组,同期年龄相近孕周匹配的76例正常孕妇为对照组。比较两组孕8~12周时血脂指标[三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)]、25-OH-D、Hcy、HbA1c,胰岛素抵抗指标[空腹胰岛素水平(FINS)、胰岛素抵抗指数(HOMA-IR)、胰岛β细胞功能指数(HOMA-β)],采用多因素logistic回归筛选GDM发生的危险因素,并运用Pearson相关性分析25-OH-D、Hcy、HbA1c与胰岛素抵抗关系。结果:GDM组TG、TC、LDL-C高于对照组,HDL-C低于对照组,25(OH)D(25.89±2.67nmmol/L)低于对照组(34.26±3.19 nmmol/L),Hcy(20.96±3.48μmol/L)、HbA1c(6.19%±0.31%)高于对照组(11.03±2.56μmol/L、5.67%±0.97%),FINS、HOMA-IR高于对照组,HOMA-β低于对照组;多因素分析显示,25(OH)D降低和Hcy、HbA1c、FINS、HOMA-IR上升为GDM发生的独立危险因素;Pearson相关性分析,GDM患者25-OH-D与FINS、HOMA-IR呈负相关,与HOMA-β呈正相关;Hcy及HbA1c与FINS、HOMA-IR均呈正相关,与HOMA-β均呈负相关(均P<0.05)。结论:GDM患者血清25-OH-D、Hcy、HbA1c与胰岛素抵抗密切相关,临床监测25-OH-D、Hcy、HbA1c及胰岛素抵抗情况有利于孕早期GDM防治。
Objective:To explore the correlation between the levels of serum 25-hydroxyvitamin D(25-OH-D),homo-cysteine(Hcy)and glycosylated hemoglobin(HbA1c)of pregnant women with gestational diabetes mellitus(GDM)during the first trimester of pregnancy and their insulin resistance.Methods:134 pregnant women with GDM in hospital were included in study group from December 2019 to December 2022,and 76 normal pregnant women with the sim-ilar age and gestational weeks were selected in control group during the same period.The levels of blood lipids indica-tors,such as triglyceride(TG),total cholesterol(TC),high density lipoprotein cholesterol(HDL-C)and low density lipoprotein cholesterol(LDL-C),the levels of 25-0H-D,Hcy and HbAlc,and the values of insulin resistance indica-tors,such as fasting insulin(FINS),homeostasis model assessment of insulin resistance(HOMA-IR)and homeosta-sis model assessment of isletβcell function index(HOMA-β),of the women during 8-12 gestational weeks were com-pared between the two groups.Multivariate logistic regression was used to screen the risk factors of GDM occurrence.Pearson correlation analysis was adopted to analyze the correlation between the levels of 25-0H-D,Hcy and HbA1c of the pregnant women with GDM and their insulin resistance.Results:The levels of TG,TC and LDL-C of the women in the study group were significantly higher than those of the women in the control group,but the HDL-C level of the women in the study group was significantly lower.The 25(OH)D level(25.89±2.67 nmmol/L)of the women in the study group was significantly lower than that(34.26±3.19 nmmol/L)of the women in the control group.The levels of Hcy(20.96±3.48μmol/L)and HbA1c(6.19%±0.31%)of the women in the study group were significantly higher than those(11.03±2.56pmol/L and 5.67%±0.97%)of the women in the control group,The values of FINS and HO-MA-IR of the women in the study group were significantly higher than those of the women in the control group,but the HOMA-βvalue of the women in the study group was significantly lower.Multivariate analysis showed that the de-crease of 25(OH)D level,and the increases of Hcy,HbAlc and FINS level and HOMA-IR value of the women were the independent risk factors for their GDM occurrence.Pearson correlation analysis showed that the 25-0H-D level of the women with GDM was negatively correlated with their FINS level and HOMA-IR value,and was positively corre-lated with their HOMA-value.The levels of Hcy and HbA1c of the women with GDM were positively correlated with their FINS level and HOMA-IR value,and were negatively correlated with their HOMA-βvalue(all P<0.05).Con-clusion:The levels of the serum 25-0H-D,Hcy and HbA1c of the pregnant women with GDM are closely related to their insulin resistance.Clinical monitoring the levels of 25-0H-D,Hcy and HbA1c and the insulin resistance situation of the pregnant women is beneficial to the prevention and treatment of their GDM during the first trimester of pregnancy.
作者
付朝霞
王朝虎
FU Zhaoxia;WANG Chaohu(Zigong Fourth People's Hospital,Zigong,Sichuan Province,643000)
出处
《中国计划生育学杂志》
2024年第2期421-426,共6页
Chinese Journal of Family Planning
基金
超声医学工程国家重点实验室开发课题(2022KFK7020)。
关键词
孕早期
妊娠期糖尿病
25-羟维生素D
同型半胱氨酸
糖化血红蛋白
胰岛素抵抗
相关性
影响因素
The first trimescer of pregnancy
Gestational diabetes mellitus
25-hydroxyvitamin D
Homocysteine
Glycosylated hemoglobin
Insulin resistance
Correlation
Influence factor