妊娠期糖尿病孕妇25-羟维生素D水平与糖脂代谢及产褥感染的相关性

Association of 25 hydroxyvitamin D with glucolipid metabolism and puerperal infection in pregnant women with gestational diabetes mellitus

目的 分析不同血清25-羟维生素D(25(OH)D)水平妊娠期糖尿病(GDM)孕妇糖脂代谢指标及产褥感染发生率。方法 选取2021年1月-2022年12月在铜陵市妇幼保健院妇产科行产检并住院分娩的94例GDM孕妇作为研究组,选取同期住院分娩的100名正常产妇作为对照组。分析两组及GDM孕妇25 (OH)D水平、糖脂代谢指标和产褥感染发生率。结果 研究组体质量指数水平、妊娠期生殖道感染史比例、剖宫产比例均高于对照组(P<0.05),25(OH)D水平低于对照组(P<0.05);以25(OH)D水平中位数为划分界值,将研究组分为高VD水平组和低VD水平组,对照组、高VD水平组、低VD水平组糖脂代谢指标比较差异有统计学意义(P<0.05),其中空腹血糖(FBG)、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)和糖化血红蛋白(HbA1c)依次逐渐升高(P<0.05),高密度脂蛋白胆固醇(HDL-C)依次逐渐降低(P<0.05);低VD水平组患者的产褥感染发生率高于高VD水平组和对照组(P<0.05);GDM孕妇产褥感染的发生与HbA1c、TG及25(OH)D水平具有相关性(P<0.05)。结论 GDM孕妇表现为25(OH)D水平降低,其降低程度与糖脂代谢紊乱程度和产褥感染风险有关,临床可考虑针对低25(OH)D水平给予干预,以期达到减少产褥感染的目的。

OBJECTIVE To observe the serum 25 hydroxyvitamin D(25(OH)D)level,glucolipid metabolism inde-xes and incidence of puerperal infection in the pregnant women with gestational diabetes mellitus(GDM).METHODS A total of 94 pregnant women with GDM who received prenatal examinations and gave birth in obstet-rics and gynecology department of Tongling Maternal and Child Health Hospital from Jan 2021 to Dec 2022 were assigned as the study group,meanwhile,100 normal puerpera who gave birth in the hospital were chosen as the control group.The 25(OH)D level,glucolipid metabolism indexes and incidence of puerperal infection were ob-served and compared between the two groups.RESULTS The body mass index,the proportion of puerpera with history of genital tract infection and the proportion of puerpera undergoing cesarean section were higher in the study group than in the control group(P<0.05),while the 25(OH)D level of the study group was lower than that of the control group(P<0.05).The puerpera of the study group were divided into the high VD group and the low VD group based on the median of 25(OH)D level.There were significant differences in the glucolipid me-tabolism indexes among the control group,the high VD group and the low VD group(P<0.05);the levels of fasting blood glucose(FBG),triglyceride(TG),total cholesterol(TC),low density lipoprotein cholesterol(LDL-C)and glycosylated hemoglobin(HbAlc)were in turn elevated(P<0.05),while the high density lipopro-tein cholesterol(HDL-C)level was in turn reduced(P<0.05).The incidence of puerperal infection of the low VD group was higher than that of the high VD group and the control group(P<0.05).The incidence of puerperal infection in the puerpera with GDM was associated with the HbA1c,TG and 25(OH)D levels(P<0.05).CONCLUSION The puerpera with GDM show the reduction of 25(OH)D level,which is associated with the degree of glucolipid metabolism disorder and the risk of puerperal infection.It is necessary for the hospital to take inter-vention measures to the puerpera with low 25(OH)D so as to reduce the incidence of puerperal infection.