血清25羟维生素D与妊娠期糖尿病胰岛素抵抗的相关性分析

Correlation Analysis of Serum 25-Hydroxy-Vitamin D and Insulin Resistance in Gestational Diabetes Mellitus

目的探讨血清25-羟维生素D(25-hydroxy-vitamin D,25-OH-VD)水平与妊娠期糖尿病患者胰岛素抵抗的相关性。方法选择2021年3月—2023年3月淄博市妇幼保健院接收的65例妊娠期糖尿病孕妇作为观察组,选择同时期医院接收的65名健康孕妇作为对照组。采集空腹静脉血进行血清25-OH-VD、血糖、胰岛素指标检测,比较2组各指标水平。采取Pearson相关性分析25-OH-VD与血糖、胰岛素指标的关系,采取多因素logistic回归分析妊娠期糖尿病的独立危险因素。结果观察组糖化血红蛋白(glycosylated hemoglobin,HbAlc)、空腹血糖(fasting blood glucose,FBG)、餐后2 h血糖(2 hour postprandial blood glucose,2 hPBG)、空腹胰岛素(fasting insulin,FINS)、稳态模型评估-胰岛素抵抗指数(homeostasis model assessment-insulin resistance index,Homa-IR)水平高于对照组,胰岛B细胞功能指数(homeostasismodel assessmentβcell function,Homa-β)、25-OH-VD水平低于对照组(P<0.05)。观察组维生素D营养状态缺乏占36.92%、不足占58.46%、充足占4.62%,对照组维生素D营养状态缺乏占15.38%、不足占53.85%、充足占30.77%,差异有统计学意义(P<0.05)。25-OH-VD与HbAlc、FBG、2 hPBG、FINS、Homa-IR呈负相关(P<0.05),与Homa-β呈正相关(P<0.05)。25-OH-VD缺乏为妊娠期糖尿病发病的独立危险因素(P<0.05)。结论妊娠期糖尿病患者血清25-OH-VD与血糖、胰岛素抵抗密切相关,25-OH-VD缺乏是引发妊娠期糖尿病的独立危险因素,研究价值较高。

Objective To investigate the correlation between serum 25-hydroxy-vitamin D(25-OH-VD)level and insulin resistance in patients with gestational diabetes mellitus.Methods A total of 65 pregnant women with gestational diabetes mellitus admitted to Zibo Maternal and Child Health Hospital from March 2021 to March 2023 were selected as the observation group,and 65 healthy pregnant women admitted to the hospital during the same period were selected as the control group.Fasting venous blood was collected to detect serum 25-OH-VD,blood glucose,and insulin index,and the levels of each index were compared between the two groups.Pearson correlation analysis was used to analyze the relationship between 25-OH-VD and blood glucose and insulin index.Multivariate logistic regression analysis was used to analyze the independent risk factors for gestational diabetes mellitus.Results The levels of glycosylated hemoglobin(HbAlc),fasting blood glucose(FBG),2 hour postprandial blood glucose(2 hPBG),fasting insulin(FINS)and homeostasis model assessment-insulin resistance index(Homa-IR)in observation group were higher than those in control group,while the levels of homeostasismodel assessmentβcell function(Homa-β)and 25-OH-VD in observation group were lower than those in control group(P<0.05).The nutritional status of vitamin D in the observation group was 36.92%deficient,58.46%insufficient and 4.62%adequate,while that in the control group was 15.38%deficient,53.85%insufficient and 30.77%adequate,the difference was statistically significant(P<0.05).25-OH-VD was negatively correlated with HbAlc,FBG,2 hPBG,FINS and Homa-IR(P<0.05),and positively correlated with Homa-β(P<0.05).25-OH-VD deficiency was an independent risk factor for gestational diabetes mellitus(P<0.05).Conclusion Serum 25-OH-VD is closely related to blood glucose and insulin resistance in patients with gestational diabetes mellitus,and deficiency of 25-OH-VD is an independent risk factor for gestational diabetes mellitus,which has high research value.