叶酸对妊娠期糖尿病患者血清同型半胱氨酸、游离脂肪酸的影响及其相关性研究

Effect and correlation of folic acid on serum homocysteine and free fatty acid in patients with gestational diabetes mellitus

目的探讨妊娠期孕妇补充叶酸(FA)对妊娠期糖尿病患者(GDM)血清同型半胱氨酸(Hcy)、游离脂肪酸(FFA)的影响及其相关性。方法测定40例GDM患者、40例正常孕妇及40例非孕育龄妇女(非孕组)的空腹Hcy、FFA、FA水平。其中GDM患者、正常孕妇孕期补充叶酸,正常非孕组(非孕育龄妇女)近期未补充叶酸。结果 GDM组的FFA水平高于正常孕妇组、正常非孕组;正常孕妇组与GDM组比较差异有统计学意义(P<0.05);正常非孕组与正常孕妇组、GDM组比较差异有统计学意义(P<0.01)。正常非孕组的Hcy水平高于正常孕妇组、GDM组,正常非孕组与正常孕妇组、GDM组比较,差异有统计学意义(P<0.01);正常孕妇组与GDM组比较,差异无统计学意义(P>0.05)。GDM组的FA与正常非孕组、正常孕妇组比较有统计学差异(P<0.05)。GDM组患者血清FA与Hcy之间存在负相关(r=-0.669,P<0.01);FA、Hcy与FFA之间均无相关性(r值分别为0.182、0.079,P>0.05)。结论孕妇GDM患者血清FA水平与Hcy呈负相关,与FFA水平无相关性;孕期补充叶酸可以降低Hcy浓度,改善GDM患者的胰岛素抵抗,预防糖尿病并发症的发生和发展。

Objective To investigate the effects of folic acid supplementation(FA)in pregnant women on serum homocysteine(Hcy)and free fatty acid(FFA)in gestational diabetes mellitus(GDM)and their correlation.Methods Hcy,FFA,FA levels of 40 patients with GDM and 40 cases of normal pregnancy and 40 cases of non pregnant women(non pregnant group)were determined.Among them,GDM patients,normal pregnant women supplemented with folic acid during pregnancy,and normal non-pregnant women(non-pregnant women of reproductive age)didn’t accept the supplement of folic acid.Results The FFA level of the GDM group was higher than that of the normal pregnant group and the normal non-pregnant group;There was a statistically significant difference between the normal pregnant women group and the GDM group(P<0.05).There was statistically significant difference between the normal non-pregnant group and the normal pregnant group and GDM group(P<0.01).The level of Hcy in normal non-pregnant group is higher than pregnant group and GDM group.The difference between normal non-pregnant group and pregnant group and GDM group is statistically significant(P<0.01).There was no statistical significance on the difference between normal pregnant group and GDM group(P>0.05).The difference of FA level was a statistically significant between the GDM group and the normal non-pregnant group and the normal pregnant group(P<0.05).There was a negative correlation between serum FA and Hcy in patients with GDM(r=-0.669,P<0.01).There was no correlation between FA,Hcy and FFA(r=0.182,r=0.079,P>0.05).Conclusion Serum FA levels in pregnant women with GDM were negatively correlated with Hcy,and had no correlation with FFA levels.Folic acid supplementation during pregnancy reduced Hcy concentration,improved insulin resistance in GDM patients,and prevented the occurrence and development of diabetic complications.