摘要
目的探讨孕早期血清25-羟维生素D_(3)[25-(OH)D_(3)]水平与胰岛素抵抗和妊娠糖尿病(GDM)的关系。方法回顾性分析2022年1—12月在河南省人民医院体检的560例孕早期(孕5~12周)女性临床病历资料,根据孕24~28+6周的口服葡萄糖耐量试验检测结果将患者分为GDM组和对照组。统计孕早期维生素D营养状态与GDM发生率,比较GDM组和对照组孕妇血清25-(OH)D_(3)水平、稳态模型的胰岛素抵抗指数(HOMA-IR),采用Pearson相关性分析孕早期血清25-(OH)D_(3)水平与HOMA-IR的相关性,采用logistic回归分析孕早期血清25-(OH)D_(3)水平及HOMA-IR与GDM的关系。结果纳入的560例孕妇中GDM发生率为7.86%,其中孕早期维生素D缺乏者,GDM发生率达到81.82%,孕早期不同维生素D营养状态的孕妇GDM发生率比较,差异有统计学意义(P<0.05)。GDM组孕妇血清25-(OH)D_(3)水平低于对照组,HOMA-IR高于对照组,差异均有统计学意义(P<0.05)。Pearson相关性分析结果显示,孕早期血清25-(OH)D_(3)水平与HOMA-IR呈负相关(r=-0.674,P<0.05);logistic回归分析结果显示,孕早期血清25-(OH)D_(3)水平低下和HOMA-IR升高是GDM发生的独立危险因素(P<0.05)。结论孕早期血清25-(OH)D_(3)水平与HOMA-IR呈负相关,是GDM发生的独立危险因素。孕早期维生素D缺乏在一定程度上可增加妊娠期妇女GDM发生风险,妊娠期应适当补充维生素D制剂,以降低GDM发生风险。
Objective To explore the relationship between serum 25-hydroxyvitamin D_(3)[25-(OH)D_(3)]level in first trimester and insulin resistance and gestaional diabetes mellitus(GDM).Methods Retrospective analysis of the clinical medical records of 560 early pregnant women(5-12 weeks of pregnancy)who underwent physical examinations in the First Affiliated Hospital of Zhengzhou University from January to December 2022,they were divided into GDM group and control group based on the OGTT test results at 24-28+6 weeks of pregnancy.The nutritional status of vitamin D in early pregnancy and the incidence of GDM were calculated.The serum levels of 25-(OH)D_(3)and homeostasis model assessment of insulin resistance index(HOMA-IR)between the GDM group and the control group were compared.Pearson correlation was used to analyze the correlation between serum levels of 25-(OH)D_(3)and HOMA-IR in early pregnancy.Logistic regression was used to analyze the relationship between serum levels of 25-(OH)D_(3),HOMA-IR and GDM in early pregnancy.Results The incidence of GDM among the 560 pregnant women included was 7.86%,among which the incidence of GDM was 81.82%for those with vitamin D deficiency in early pregnancy,there was statistically significant difference in the incidence of GDM among pregnant women with different levels of vitamin D nutrition in the early pregnancy(P<0.05).The serum levels of 25-(OH)D_(3)in pregnant women in the GDM group were lower than those in the control group,and HOMA-IR was higher than that in the control group,the differences were statistically significant(P<0.05).Pearson correlation analysis showed that there was a negative correlation between serum 25-(OH)D_(3)levels and HOMA-IR in early pregnancy(r=-0.674,P<0.05).Logistic regression analysis showed that the serum 25-(OH)D_(3)levels and HOMA-IR in early pregnancy were independent risk factor for GDM(P<0.05).Conclusion The serum 25-(OH)D_(3)levels in early pregnancy is negatively correlated with HOMA-IR,and it is an independent risk factor for the occurrence of GDM.Vitamin D deficiency in early pregnancy can increase the risk of GDM in pregnant women to a certain extent,so vitamin D preparations should be supplemented appropriately during pregnancy to reduce the risk of GDM.
作者
杜小婉
吕英华
杨俊朋
史晓阳
DU Xiaowan;LU Yinghua;YANG Junpeng;SHI Xiaoyang(Department of International Medicine,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China;Department of Endocrinology,Henan Provincial People’s Hospital,Zhengzhou 450000,China)
出处
《河南医学研究》
CAS
2024年第8期1426-1429,共4页
Henan Medical Research
