妊娠期糖尿病女性骨密度及骨代谢干预研究

Study on bone mineral density and bone metabolism in gestational diabetes mellitus

目的研究妊娠期糖尿病(gestational diabetes mellitus,GDM)女性骨密度、骨代谢变化及药物干预后的变化。方法比较经骨化三醇干预后妊娠期GDM女性与未经骨化三醇干预的妊娠期GDM女性的骨代谢和骨密度改变,研究的骨代谢指标主要包括以下几项:双羟基维生素D[1, 25-(OH)2-VD3],甲状旁腺素(parathyroid hormone,PTH),骨钙素(bone gamma-carboxyglutamic-acid-containing proteins,BGP),Ⅰ型前胶原羧基末端肽(procollagen type I carboxy-terminal peptide,PICP),糖化血红蛋白(hemoglobin A1c,HbA1c),血清钙(calcium,Ca)。骨密度指标为超声骨密度测量值。结果补充骨化三醇的GDM女性与未补充的GDM女性在孕中期和孕晚期的1, 25-(OH)2-VD3、BGP与PICP均有统计学意义,孕晚期的骨密度有统计学意义。两组间的Ca及血糖水平无统计学意义。结论给妊娠期GDM女性补充骨化三醇不会影响妊娠期血糖,且有助于改善妊娠期GDM女性骨密度。

Objective To study the changes in bone mineral density and bone metabolism in pregnant women with gestational diabetes mellitus(GDM)and the changes after drug intervention.Methods Bone metabolism and bone mineral density of GDM women who had been treated with calcitriol or did not undergo calcitriol intervention were compared.The indexes of bone metabolism assessed were as follows:1,25-dihydroxyvitamin D[1,25-(OH)2-VD3],parathyroid hormone(PTH),bone gamma-carboxyglutamic-acid-containing proteins(BGP),procollagen type I carboxy-terminal peptide(PICP),glycated hemoglobin(hemoglobin A1 c,HbA1 c)and blood calcium(Ca).Bone mineral density was measured using ultrasound bone densitometer.Results There were significant differences in 1,25-(OH)2-VD3,BGP and PICP between GDM and GDM women supplemented with calcitriol in the second trimester of pregnancy and late pregnancy.There was a significant difference in bone mineral density in late pregnancy between GDM women and GDM women supplemented with calcitriol.There were no significant differences in blood levels of glucose and Ca between the two groups.Conclusion Calcitriol did not affect blood glucose level during pregnancy and could help to improve bone mineral density in pregnant women with GDM.