妊娠糖尿病患者血清25(OH)D_3水平及其相关因素分析

Serum 25(OH) D_3 Level and Related Factors in Patients with Gestational Diabetes

目的了解妊娠糖尿病(GDM)患者不同孕周血清25(OH)D3水平及其相关因素。方法 2012年1月至2013年12月在宁夏医科大学总医院就诊的妊娠妇女433例,按照美国ADA标准进行糖尿病筛查,根据妊娠糖尿病诊断标准将孕妇分为正常妊娠(NGRG)组和GDM组。433例孕妇孕20~22周时进行血清25(OH)D3含量的检测,其中NGRG组36例、GDM组中42例动态检测孕20周、孕28周、孕36周时血清25(OH)D3水平,比较两组数据,并对相关因素采用Logistic回归分析。结果孕妇血清25(OH)D3水平均明显低于正常值(P<0.05),而GDM组变化更显著(P<0.05)。但NGRG组和GDM组孕妇未显现出随孕周变化有明显改变情况。孕妇的血清25(OH)D3水平与年龄、基础体重指数、日照时间、空腹血糖、餐后1h血糖水平有相关性(P<0.05),而与餐后2h血糖水平、餐后3h血糖水平无相关性(P>0.05)。结论低维生素D状态在孕妇中普遍存在,GDM患者血清25(OH)D3水平降低更为明显。孕妇年龄、体重增加、基础体重指数、日照时间、空腹血糖、餐后1h血糖可能是GDM发生的危险因素。

Objective To investigate the serum 25( OH) D3 levels and related factors of gestational diabetes with different gestational age. Methods 433 pregnant women from January 2012 to December 2013 in the general hospital of Ningxia medical university were divided into normal pregnancy( NGRG) group and gestational diabetes( GDM) group based on the diagnostic criteria for gestational diabetes,according to the american ADA standards for diabetes screening. Serum 25( OH) D3 in 433 cases of pregnant women at 20 to 22 weeks of pregnancy were detected,of which 36 cases in NGRG group,42 cases in GDM group were dynamically tested at 20 th week,28 th week,36 th week of pregnancy,then compared two sets of data,and processed relevant factors using Logistic regression analysis. Results Maternal serum 25( OH) D3 levels were significantly lower than normal levels( P < 0. 05),while the changes in GDM group were more significant( P <0. 05). Pregnant women of NGRG and GDM group did not show a significant change as the gestational age changed. Maternal serum 25( OH) D3 had significant relevance to age,underlying body mass index,duration of sunshine,fasting blood glucose,1h postprandial blood glucose levels( P < 0. 05) while had no correlation with 2h postprandial blood glucose levels,3h postprandial glucose levels( P > 0. 05). Conclusion Low vitamin D status in pregnant women is prevalent. Decreasing of serum 25( OH) D3 levels in GDM patients are more apparent. Maternal age,weight gain,basic body mass index,duration of sunshine,fasting blood glucose and 1h postprandial blood glucose may be risk factors for the occurrence of GDM.