目的 研究孕中期妊娠期糖尿病孕妇血清铁、锌和铁蛋白的变化情况,探讨其与妊娠期糖尿病发病的关系.方法 选择2014年1月-2015年12月该院24～28周妊娠期糖尿病孕妇200例作为妊娠期糖尿病组,血糖正常孕妇200例作为对照组.观察两组孕妇血清铁蛋白、血清铁、血清锌水平及其与糖代谢指标的相关性,比较两组妊娠期铁缺乏、缺铁性贫血及胎儿发育情况.结果 妊娠期糖尿病组孕妇空腹血糖(5.25±3.21)mmol/L、1h血糖(10.56±1.73)mmol/L、2h血糖(8.51±0.87)mmol/L、空腹胰岛素(13.12±2.24) mmol/L、糖化血红蛋白(6.97％)、胰岛素抵抗指数(2.98)均高于对照组(4.29±1.05)mmol/L、(8.72±1.24)mmol/L、(6.98±0.82)mmol/L、(6.46±1.87)mmol/L、(4.26％)、(1.19)(P＜0.05),妊娠期糖尿病组胰岛β细胞分泌功能(147.87)低于对照组(164.50)(P ＜0.05).妊娠期糖尿病组患者血清铁(27.34±7.12)μmol/L和铁蛋白(59.16±5.78)ng/ml水平高于对照组(20.98±6.01)μmol/L和(40.43±4.87)ng/ml(P ＜0.05),妊娠期糖尿病组患者血清锌(10.59±2.23)μmol/L水平低于对照组(14.02±2.43)μmol/L(P ＜0.05).血清铁蛋白和血清铁与空腹血糖、空腹胰岛素、糖化血红蛋白、胰岛素抵抗指数均呈正相关(P＜0.05).血清锌和空腹血糖、空腹胰岛素、糖化血红蛋白、胰岛素抵抗指数均呈负相关(P＜0.05).两组妊娠期铁缺乏、缺铁性贫血的发生率差异无统计学意义(P＞0.05),两组胎儿双顶径、股骨长、头围、腹围差异无统计学意义(P＞0.05).结论 孕中期妊娠期糖尿病孕妇血清铁和铁蛋白水平升高,血清锌水平下降,血清铁、锌、铁蛋白水平与妊娠期糖尿病孕妇的糖代谢指标有相关性,和妊娠期糖尿病的发病有关.%Objective To study the changes of serum iron,zinc and ferritin in pregnant women with gestational diabetes in the second trimester,and to explore their correlations with gestational diabetes.Methods Totally 200 cases of pregnant women with gestational diabetes in the 24-28 gestational weeks in our hospital from January 2014 to December 2015 were selected as gestational diabetes group,while 200 pregnant women with normal blood glucose in the same gestational weeks as control group.Serum ferritin,iron and zinc levels and their correlations to sugar metabolism indexes were observed.Pregnancy iron deficiency,iron-deficiency anemia and fetal development were compared between the two groups.Results The fasting blood glucose,1-h glucose,2-h glucose,fasting insulin,glycated hemoglobin,insulin resistance index of the gestational diabetes group were higher than those of the control group (P ＜ 0.05).The pancreatic β cell function of the gestational diabetes group was significantly lower than that of the control group (P ＜ 0.05).The serum iron and ferritin levels in the gestational diabetes group were higher than those in the control group (P ＜ 0.05),while the serum zinc level was lower than that in the control group (P ＜ 0.05).The serum ferritin and iron levels were positively correlated with fasting glucose,fasting insulin,glycated hemoglobin and insulin resistance index (P ＜ 0.05).The serum zinc level was negatively correlated to serum fasting glucose,fasting insulin,glycated hemoglobin and insulin resistance index (P ＜ 0.05).There was no significant difference in the incidence of pregnancy iron deficiency or iron-deficiency anemia between the two groups (P ＞ 0.05).There was no significant difference in the fetal biparietal diameter,femur length,head circumference or abdominal circumference between the two groups (P ＞ 0.05).Conclusions During the second trimester of pregnancy,the levels of serum iron and ferritin increase and the level of serum zinc decreases in the pregnant women with gestational diabetes.The levels of serum iron,zinc and ferritin are significantly correlated to the sugar metabolism indexes in pregnant women with gestational diabetes,and to the incidence of gestational diabetes.
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