目的 探索妇女妊娠早期维生素D营养状况与妊娠期糖尿病(GDM)发病风险关系。方法 选取2016年6月至2017年12月在本院产检且早孕期空腹血糖正常并住院分娩的单胎孕妇300例为基础建立妊娠妇女队列,于妊娠早期检测孕妇空腹血糖及血清25-羟基维生素D (25-OH-D),依据维生素D(VitD)水平分为三组,分别为VitD缺乏组52例、VitD不足组172例及VitD正常组76例,随访到分娩。比较各组GDM发病率,GDM患者口服葡萄糖耐量试验(OGTT)诊断GDM的血糖异常点数量、需要应用胰岛素治疗比例及糖化血红蛋白水平。结果 VitD正常组、VitD不足组和VitD缺乏组的GDM发生率分别为9.2%、20.3%和38.5%,差异有统计学意义,GDM发生率随VitD水平降低呈升高趋势。 三组的GDM患病孕妇中需要应用胰岛素治疗的妇女所占比例和OGTT异常点数≥2的妇女所占比例差异均有统计学意义。结论 妇女孕早期血清维生素D营养状况与GDM发病风险和严重程度有关,孕早期监测血清维生素D水平,并适当补充VitD有可能降低妊娠期糖尿病的发生风险及病情严重程度、提高孕产妇健康水平。
Abstract
Objective To prospectively study the relationship between vitamin D (VitD) deficiency during the early pregnancy and onset risk of gestational diabetes mellitus (GDM). Methods We recruited 300 early-pregnant women from the patients of the Haidian Maternal and Child Health Hospital, and measured their fasting blood glucose and serum 25-hydroxyvitamin (D25-OH-D). According to the D25-OH-D levels, the subjects were divided into 3 groups:VitD lack (n=52), VitD insufficient (n=172), and VitD normal (n=76), and were followed up to the date of delivery. We statistically tested the between-group differences in terms of GDM incidence, oral glucose tolerance test (OGTT) result, rate of insulin treatment, and levels of glycosylated hemoglobin. Results Between the three groups, the GDM incidence was significantly different, and was decreased with the D25-OH-D levels (VitD lack:38.5%; insufficient:20.3%; and normal:9.2%). Among the GDM patients, the rates of insulin treatment and abnormal OGTT results were also significantly varied with VitD levels. Conclusion Low level of serum 25-OH-D in early pregnancy was associated to the increased incidence and severity of GDM. The findings suggest that VitD supplement may reduce the risk of GDM, and thus improve the maternal health.
关键词
妊娠期糖尿病 /
25-羟基维生素D /
葡萄糖耐量试验
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Key words
gestational diabetes mellitus /
25-OH-D /
oral glucose tolerance test
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参考文献
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脚注
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基金
首都卫生发展科研专项项目(2016-4-7042)
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