大连地区妊娠期糖尿病孕妇妊娠中期维生素A、E水平研究
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摘要
目的:了解大连地区妊娠期糖尿病孕妇妊娠中期维生素A、E水平,为妊娠期糖尿病孕妇合理补充维生素提供参考。方法:选取2015年7月至2017年11月在大连市妇幼保健院产科门诊就诊检测维生素A、E的孕妇。共6 151例结果纳入分析,其中GDM孕妇5 012例,同期正常孕妇1 139例。采用高效液相色谱法检测血清维生素A、E水平。结果:妊娠期糖尿病孕妇维生素A平均水平(0.41±0.09)mg/L,异常情况以缺乏为主,总体缺乏率8.37%,与正常孕妇比较差异具有统计学意义(P <0.05);维生素E平均水平为(12.03±3.11)mg/L,异常情况以过量为主,总体过量率1.89%,与正常孕妇比较差异不具有统计学意义(P> 0.05)。孕前体质指数正常、超重、肥胖、和消瘦的妊娠期糖尿病孕妇体内维生素A、E水平均存在差异,差异具有统计学意义(P <0.05)。结论:妊娠期糖尿病孕妇较正常孕妇更容易发生维生素A、E水平异常。孕期应及时合理补充,以预防维生素A、E缺乏或过量,从而避免不良妊娠结局发生。
Objective: To learn the serum levels of vitamin A and E in pregnant women with gestational diabetes mellitus(GDM) in Dalian during the second trimester of pregnancy,and to provide a reference for rational vitamin supplements. Methods: A total of 6 151 pregnant women were selected to measure the serum levels of vitamin A and E by high performance liquid chromatography(HPLC) from July 2015 to November 2017 in the obstetrics clinic of dalian maternal and child health hospital, including 5 012 pregnant women with gestational diabetes mellitus and 1139 normal pregnant women. Results: The average level of vitamin A in pregnant women with gestational diabetes mellitus was(0.41 ± 0.09)mg/L,the abnormality was mainly lacking and the total deficiency rate was 8.37%. The difference was statistically significant(P < 0.05) compared with the normal pregnant women. The average vitamin E level was(12.03 +3.11)mg/L, the abnormal condition was mainly excessive and the total overdose rate was 1.89%. The difference was not statistically significant compared with the normal pregnant women(P > 0.05). There were differences in the levels of vitamin A and E in pregnant women with normal pre-pregnancy body mass index, overweight, obesity, and emaciation(P < 0.05). Conclusion: Pregnant women with gestational diabetes mellitus are more likely to have abnormal vitamin A and E levels than normal pregnant women. It should be promptly and reasonably supplemented to prevent vitamin A, E deficiency or excess, so as to avoid adverse pregnancy outcomes.
Objective: To learn the serum levels of vitamin A and E in pregnant women with gestational diabetes mellitus(GDM) in Dalian during the second trimester of pregnancy,and to provide a reference for rational vitamin supplements. Methods: A total of 6 151 pregnant women were selected to measure the serum levels of vitamin A and E by high performance liquid chromatography(HPLC) from July 2015 to November 2017 in the obstetrics clinic of dalian maternal and child health hospital, including 5 012 pregnant women with gestational diabetes mellitus and 1139 normal pregnant women. Results: The average level of vitamin A in pregnant women with gestational diabetes mellitus was(0.41 ± 0.09)mg/L,the abnormality was mainly lacking and the total deficiency rate was 8.37%. The difference was statistically significant(P < 0.05) compared with the normal pregnant women. The average vitamin E level was(12.03 +3.11)mg/L, the abnormal condition was mainly excessive and the total overdose rate was 1.89%. The difference was not statistically significant compared with the normal pregnant women(P > 0.05). There were differences in the levels of vitamin A and E in pregnant women with normal pre-pregnancy body mass index, overweight, obesity, and emaciation(P < 0.05). Conclusion: Pregnant women with gestational diabetes mellitus are more likely to have abnormal vitamin A and E levels than normal pregnant women. It should be promptly and reasonably supplemented to prevent vitamin A, E deficiency or excess, so as to avoid adverse pregnancy outcomes.
引文
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[9] Sun M, Song MM, Wei B, et al. 5-Hydroxymethylcytosinemediated alteration of transposon activity associated with the exposure to adverse in utero environments in human. Hum Mol Genet, 2016, 25(11):2208-2219.
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[11]蒋红清,陈寒,倪君君.北京市孕妇常规保健下血清维生素A、E水平现状.解放军医学院学报, 2015, 36(11):1118-1121.
[12]陈慧敏,吴锦晖,孙静,等.妊娠期糖尿病孕妇的微量营养素特征分析.中国药业, 2016, 25(11):82-85.
[13]杨慧霞,徐先明,王子莲,等.妊娠合并糖尿病诊治指南(2014).糖尿病临床, 2014, 8(11):489-498.
[14] Gopalakrishnan V, Singh R, Pradeep Y, et al. Evaluation of the prevalence of gestational diabetes mellitus in North Indians using the International Association of diabetes and Pregnancy Study groups(IADPSG)criteria. J Postgrad Med, 2015, 61(3):155-158.
[15] Bayril T, Yildiz AS, Akdemir F, et al. The Technical and Financial Effects of Parenteral Supplementation with Selenium and Vitamin E during Late Pregnancy and the Early Lactation Period on the Productivity of Dairy Cattle. Asian-Australas J Anim Sci, 2015,28(8):1133-1139.
[16] Li H,Yin Q,Li N,et al. Plasma markers of oxidative stress in patients with gestational diabetes mellitus in the second and third trimester. Obstet Gynecol Int,2016:3865454.
[17] Roberts JM, Myatt L, Spong CY, et al. Vitamins C and E to prevent complications of pregnancy-associated hypertension. N Engl J Med, 2010, 362(14):1282-1291.
[18] Wangkheimayum S, Kumar S, Suri V. Effect of Vitamin E on s PSelectin Levels in Pre-Eclampsia. Indian J Clin Biochem, 2011,26(2):169-171.
[19]中国营养学会.中国居民膳食营养素参考摄入量2013版.北京:科学出版社, 2014:89.
[20] Maged AM, Torky H, Fouad MA, et al. Role of antioxidants in gestational diabetes mellitus and relation to fetal outcome:a randomized controlled trial. J Matern Fetal Neonatal Med, 2016,29(24):4049-4054.
[21]汤庆娅,陶晔璇,冯一,等.成人不同体重指数对血清抗氧化维生素水平的影响研究.上海医学, 2007, 30(2):77-80.
[2] Thorne-Lyman AL,Fawzi WW. Vitamin A and carotenoids during pregnancy and maternal, neonatal and infant health outcomes:a systematic review and meta-analysis. Paediatr Perinat Epidemiol,2012, 26 Suppl:36-54.
[3] Lira LQ,Dimenstein R. Vitamin A and gestational diabetes. Rev Assoc Med Bras(1992), 2010, 56(3):355-359.
[4]丁丽丽,朱明炜.脂溶性维生素对多种慢性疾病治疗作用的研究进展.中国食物与营养, 2013, 19(1):85-87.
[5]鲍扬,李维勤,黎介寿.维生素E与营养.肠外与肠内营养,2004, 11(1):51-54.
[6]中国肥胖问题工作组数据汇总分析协作组.我国成人体重指数和腰围对相关疾病危险因素异常的预测价值:适宜体重指数和腰围切点的研究.中华流行病学杂志, 2002, 23(1):10-15.
[7] Bastani P, Hamdi K, Abasalizadeh F, et al. Effects of vitamin E supplementation on some pregnancy health indices:a randomized clinical trial. Int J Gen Med, 2011, 4:461-464.
[8]董彩霞,荫士安.中国孕妇营养与健康状况十年回顾.中华预防医学杂志, 2018, 52(1):94-100.
[9] Sun M, Song MM, Wei B, et al. 5-Hydroxymethylcytosinemediated alteration of transposon activity associated with the exposure to adverse in utero environments in human. Hum Mol Genet, 2016, 25(11):2208-2219.
[10]胡贻椿,陈竞,李敏,等. 2010-2012年中国城市孕妇贫血及维生素A、维生素D营养状况.中华预防医学杂志, 2017, 51(2):125-131.
[11]蒋红清,陈寒,倪君君.北京市孕妇常规保健下血清维生素A、E水平现状.解放军医学院学报, 2015, 36(11):1118-1121.
[12]陈慧敏,吴锦晖,孙静,等.妊娠期糖尿病孕妇的微量营养素特征分析.中国药业, 2016, 25(11):82-85.
[13]杨慧霞,徐先明,王子莲,等.妊娠合并糖尿病诊治指南(2014).糖尿病临床, 2014, 8(11):489-498.
[14] Gopalakrishnan V, Singh R, Pradeep Y, et al. Evaluation of the prevalence of gestational diabetes mellitus in North Indians using the International Association of diabetes and Pregnancy Study groups(IADPSG)criteria. J Postgrad Med, 2015, 61(3):155-158.
[15] Bayril T, Yildiz AS, Akdemir F, et al. The Technical and Financial Effects of Parenteral Supplementation with Selenium and Vitamin E during Late Pregnancy and the Early Lactation Period on the Productivity of Dairy Cattle. Asian-Australas J Anim Sci, 2015,28(8):1133-1139.
[16] Li H,Yin Q,Li N,et al. Plasma markers of oxidative stress in patients with gestational diabetes mellitus in the second and third trimester. Obstet Gynecol Int,2016:3865454.
[17] Roberts JM, Myatt L, Spong CY, et al. Vitamins C and E to prevent complications of pregnancy-associated hypertension. N Engl J Med, 2010, 362(14):1282-1291.
[18] Wangkheimayum S, Kumar S, Suri V. Effect of Vitamin E on s PSelectin Levels in Pre-Eclampsia. Indian J Clin Biochem, 2011,26(2):169-171.
[19]中国营养学会.中国居民膳食营养素参考摄入量2013版.北京:科学出版社, 2014:89.
[20] Maged AM, Torky H, Fouad MA, et al. Role of antioxidants in gestational diabetes mellitus and relation to fetal outcome:a randomized controlled trial. J Matern Fetal Neonatal Med, 2016,29(24):4049-4054.
[21]汤庆娅,陶晔璇,冯一,等.成人不同体重指数对血清抗氧化维生素水平的影响研究.上海医学, 2007, 30(2):77-80.