妊娠糖尿病与维生素D的相关性研究
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摘要
目的探讨妊娠期糖尿病与血清维生素D的相关性。方法回顾性分析2016年1月至2017年1月北京市仁和医院收治的200例妊娠期糖尿病孕妇(病例组)的临床资料,并于同期随机选取200例健康妊娠孕妇(对照组)作为对照,所有孕妇均在孕11~13+6周行维生素D检测,在孕24~28+6周行口服葡萄糖耐量试验(OGTT)测定血糖水平。分析妊娠期糖尿病孕妇血糖水平与孕期血清维生素D的相关性。结果病例组孕妇的年龄、体质量指数(BMI)、空腹血糖(FBG)、餐后1 h血糖值(1 h PBG)、餐后2 h血糖值(2 h PBG)、空腹胰岛素(FINS)、低密度脂蛋白(LDL)、HOMA模型胰岛素抵抗指数(HOMA-IR)分别为(27.34±5.58)岁、(23.80±2.24)kg/m2、(6.89±0.82)mmol/L、(12.33±1.05)mmol/L、(9.90±0.78)mmol/L、(14.65±1.94)IU/m L、(3.18±0.44)mmol/L、(5.06±2.24),均高于对照组的(25.51±6.02)岁、(21.38±2.57)kg/m2、(4.21±0.67)mmol/L、(7.34±0.78)mmol/L、(6.12±0.89)mmol/L、(9.76±1.62)IU/m L、(2.76±0.39)mmol/L、(3.11±1.87),差异均有统计学意义(P<0.05);病例组孕妇的维生素D水平、HOMA模型β细胞功能指数(HOMA-IS)分别为(14.24±6.17)mg/L、(134.28±56.22),均低于对照组的(22.58±5.45)mg/L、(289.55±69.13),差异均有统计学意义(P<0.05);维生素D与FBG、1 h PBG、2 h PBG、HOMA-IR呈负相关(P<0.05),与HOMA-IS呈正相关(P<0.05)。结论维生素D水平在妊娠期糖尿病孕妇血清中显著降低;维生素D缺乏参与了妊娠期糖尿病的发生发展过程,其可能的机制为影响胰岛β细胞的功能而增加胰岛素抵抗。
Objective To explore the correlation between gestation diabetes mellitus and serum vitamin D.Methods The clinical data of 200 pregnant women with gestational diabetes mellitus(case group) in Beijing Renhe Hospital from January 2016 to January 2017 were retrospectively analyzed, and 200 healthy pregnant women(control group) were randomly selected at the same time. All the pregnant women were tested for vitamin D at 11-13+ 6 weeks,and the oral glucose tolerance test(OGTT) were used to measure blood glucose levels at 24-28+6 weeks. The relationship between blood glucose levels and serum vitamin D in pregnant women with gestational diabetes mellitus was analyzed.Results The age, body mass index(BMI), fasting blood glucose(FBG), 1 h post blood glucose(PBG), 2 h PBG, fasting insulin(FINS), low-density lipoprotein(LDL) and homeostasis model assessment of IR(HOMA-IR) in the case group were(27.34±5.58) years,(23.80±2.24) kg/m2,(6.89±0.82) mmol/L,(12.33±1.05) mmol/L,(9.90±0.78) mmol/L,(14.65±1.94) IU/m L,(3.18±0.44) mmol/L,(5.06±2.24), respectively, which were significantly higher than corresponding(25.51±6.02) years,(21.38±2.57) kg/m2,(4.21±0.67) mmol/L,(7.34±0.78) mmol/L,(6.12±0.89) mmol/L,(9.76±1.62) IU/m L,(2.76±0.39) mmol/L,(3.11±1.87) in the control group(all P<0.05). The levels of vitamin D and HOMA-IS in the case group was(14.24±6.17) mg/L,(134.28±56.22), respectively, which were significantly lower than(22.58±5.45) mg/L and(289.55±69.13) in the control group(all P<0.05). There were the negative correlation between vitamin D and FBG, 1 h PBG, 2 h PBG, HOMA-IR(P<0.05), and a positive correlation with HOMA-IS(P<0.05). Conclusion The serum of vitamin D is significantly lower in pregnant women with gestational diabetes mellitus. Vitamin D deficiency is involved in the development of gestational diabetes mellitus, in which the mechanism might be increasing the insulin resistance by influencing the pancreatic β cells.
Objective To explore the correlation between gestation diabetes mellitus and serum vitamin D.Methods The clinical data of 200 pregnant women with gestational diabetes mellitus(case group) in Beijing Renhe Hospital from January 2016 to January 2017 were retrospectively analyzed, and 200 healthy pregnant women(control group) were randomly selected at the same time. All the pregnant women were tested for vitamin D at 11-13+ 6 weeks,and the oral glucose tolerance test(OGTT) were used to measure blood glucose levels at 24-28+6 weeks. The relationship between blood glucose levels and serum vitamin D in pregnant women with gestational diabetes mellitus was analyzed.Results The age, body mass index(BMI), fasting blood glucose(FBG), 1 h post blood glucose(PBG), 2 h PBG, fasting insulin(FINS), low-density lipoprotein(LDL) and homeostasis model assessment of IR(HOMA-IR) in the case group were(27.34±5.58) years,(23.80±2.24) kg/m2,(6.89±0.82) mmol/L,(12.33±1.05) mmol/L,(9.90±0.78) mmol/L,(14.65±1.94) IU/m L,(3.18±0.44) mmol/L,(5.06±2.24), respectively, which were significantly higher than corresponding(25.51±6.02) years,(21.38±2.57) kg/m2,(4.21±0.67) mmol/L,(7.34±0.78) mmol/L,(6.12±0.89) mmol/L,(9.76±1.62) IU/m L,(2.76±0.39) mmol/L,(3.11±1.87) in the control group(all P<0.05). The levels of vitamin D and HOMA-IS in the case group was(14.24±6.17) mg/L,(134.28±56.22), respectively, which were significantly lower than(22.58±5.45) mg/L and(289.55±69.13) in the control group(all P<0.05). There were the negative correlation between vitamin D and FBG, 1 h PBG, 2 h PBG, HOMA-IR(P<0.05), and a positive correlation with HOMA-IS(P<0.05). Conclusion The serum of vitamin D is significantly lower in pregnant women with gestational diabetes mellitus. Vitamin D deficiency is involved in the development of gestational diabetes mellitus, in which the mechanism might be increasing the insulin resistance by influencing the pancreatic β cells.
引文
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[12]Lu M,Xu Y,Lv L,et al.Association between-vitamin D status and the risk of gestational diabetes mellitus:a meta-analysis[J].Arch Gynecol Obstet,2016,293(5):959-966.
[13]Al-Aissa Z,Hadarits O,Rosta K,et al.A brief of gestational diabetes mellitus,risk factors and current criteria of diagnosis[J].Orv Hetil,2017,158(8):283-290.
[14]安娜,权莉,曹婷,等.血清维生素D与2型糖尿病相关性研究[J].临床合理用药杂志,2012,5(21):3-5.
[15]黄一颖,应豪.妊娠中期妇女血25-羟维生素D3与妊娠期糖尿病的关系[J].国际妇产科学杂志,2013,40(4):379-381,389.
[16]王薇,杨慧霞.维生素D与妊娠期糖尿病[J].中华围产医学杂志,2015,18(2):140-144.
[17]陈龙丁,牛建民,周宇恒,等.妊娠早期血清25-羟基维生素D3与妊娠期糖尿病的相关研究[J].中华糖尿病杂志,2015,6(3):152-155.
[2]神雪,杨祖菁,张琳,等.孕妇维生素D缺乏与妊娠期糖尿病的相关性分析[J].现代生物医学进展,2015,15(1):76-79,113.
[3]Wielgos M,Bomba-Opon D,Czajkowski K,et al.Towards a European Consensus on Gestational Diabetes Mellitus:A Pragmatic Guide for Diagnosis,Management,and Care.The Polish Diabetes in Pregnancy Study Group and FIGO[J].Ginekol Pol,2017,88(1):46-49.
[4]Zhang Q,Cheng Y,He M,et al.Effect of various doses of vitamin Dsupplementation on pregnant women with gestational diabetes mellitus:A randomized controlled trial[J].Exp Ther Med,2016,12(3):1889-1895.
[5]王凯航,向菲.血清25-羟维生素D与妊娠期糖尿病相关性分析[J].重庆医学,2015,44(17):2362-2364.
[6]American Diabetes Association.Standards of medical care in diabetes-2011[J].Diabetes Care,2011,34(S1):S11-S61.
[7]Alptekin H,?izmecioglu A,I??k H,et al.Predicting gestational diabetes mellitus during the first trimester using anthropometric measurements and HOMA-IR[J].J Endocrinol Invest,2016,39(5):577-583.
[8]姚建平,郑淑莺.血清25-羟维生素D水平与妊娠糖尿病的相关性[J].中华临床营养杂志,2013,21(6):359-361.
[9]Yazdchi R,Gargari BP,Asghari-Jafarabadi M,et al.Effects of vitamin D supplementation on metabolic indices and hs-CRP levels in gestational diabetes mellitus patients:a randomized,double-blinded,placebo-controlled clinical trial[J].Nutr Res Pract,2016,10(3):328-335.
[10]薛红艳,吴明媛,赵远,等.妊娠期糖尿病的影响因素分析[J].中国当代医药,2013,20(12):68-70.
[11]王爽,杨慧霞.妊娠期糖尿病发病的危险因素分析[J].中华妇产科杂志,2014,49(5):321-324.
[12]Lu M,Xu Y,Lv L,et al.Association between-vitamin D status and the risk of gestational diabetes mellitus:a meta-analysis[J].Arch Gynecol Obstet,2016,293(5):959-966.
[13]Al-Aissa Z,Hadarits O,Rosta K,et al.A brief of gestational diabetes mellitus,risk factors and current criteria of diagnosis[J].Orv Hetil,2017,158(8):283-290.
[14]安娜,权莉,曹婷,等.血清维生素D与2型糖尿病相关性研究[J].临床合理用药杂志,2012,5(21):3-5.
[15]黄一颖,应豪.妊娠中期妇女血25-羟维生素D3与妊娠期糖尿病的关系[J].国际妇产科学杂志,2013,40(4):379-381,389.
[16]王薇,杨慧霞.维生素D与妊娠期糖尿病[J].中华围产医学杂志,2015,18(2):140-144.
[17]陈龙丁,牛建民,周宇恒,等.妊娠早期血清25-羟基维生素D3与妊娠期糖尿病的相关研究[J].中华糖尿病杂志,2015,6(3):152-155.