妊娠糖尿病孕妇血清维生素D水平与妊娠结局的相关性研究

摘要

目的 探讨妊娠糖尿病孕妇血清25羟维生素D水平与妊娠结局的相关性.方法 选取我院2015年1月至2016年8月收治的妊娠糖尿病孕妇58例作为妊娠糖尿病组,另选取同期我院孕检正常孕妇60例作为糖耐量正常组,根据患者有无认知障碍,将患者分为认知功能正常组及认知功能障碍组.比较两组患者生化指标水平.根据患者有无补充维生素D,将妊娠糖尿病组分为两组,比较两组孕妇并发症及围产儿并发症发生情况.结果 妊娠糖尿病组患者FPG、FINS、C肽、TG3、HOMA-β、HOMA-IR水平明显高于糖耐量正常组,差异有统计学意义(P<0.05);妊娠糖尿病组维生素D水平明显低于糖耐量正常组,差异有统计学意义(P <0.05);妊娠糖尿病组维生素缺乏率明显高于糖耐量正常组(94.82% vs.55.00%),差异有统计学意义(P<0.05);观察组治疗后FPG、FINS、P2HPG、HOMA-IR、HOMA-β水平较治疗出现明显变化,在同一治疗时间内对照组生化指标变化幅度低于观察组,差异有统计学意义(P<0.05);观察组患者妊娠期高血压、羊水过多、胎膜早破、剖宫产及胎儿窘迫发生率均低于对照组,差异有统计学意义(P<0.05).结论 妊娠糖尿病孕妇血清维生素D水平低于正常孕妇,积极补充维生素D水平可降低不良妊娠结局的发生率.%Objective To investigate the correlation between serum 25-hydroxyvitamin D level and pregnancy outcome in pregnant women with gestational diabetes mellitus.Methods 58 pregnant women with gestational diabetes mellitus treated in our hospital from January 2015 to August 2016 were chose as gestational diabetes mellitus group,and 60 normal pregnant women in our hospital were chose as normal glucose tolerance group.According to the patients'cognitive impairment,the patients were divided into cognitive functional group and cognitive dysfunction group,comparing the biochemical indexes of the two groups.According to the pa-tients with vitamin D supplementation,the gestational diabetes mellitus group was divided into two groups,comparing the prevalence of pregnant women complications and perinatal complications in the two groups.Results The levels of FPG,FINS,C-peptide,TG3,HO-MA-β and HOMA-IR in patients in gestational diabetes mellitus group were significantly higher than those in normal glucose tolerance group,and the difference was statistically significant(P<0.05).The vitamin D level in gestational diabetes mellitus group was signifi-cantly lower than those in normal glucose tolerance group,and the difference was statistically significant(P<0.05).The vitamin defi-ciency rate in gestational diabetes mellitus group was significantly higher than that in glucose tolerance group(94.82% vs.55%),and the difference was statistically significant(P<0.05).The levels of FPG,FINS,P2HPG,HOMA-IR and HOMA-β were significantly changed after treatment;In the same treatment time,the change of biochemical index in control group was lower than that in the obser-vation group,and the difference was statistically significant(P<0.05).In the observation group,hypertension,amniotic fluid,prema-ture rupture of membranes,cesarean section and fetal distress were lower than that in the control group,and the difference was statisti-cally significant(P<0.05).Conclusion The level of serum vitamin D in gestational diabetes mellitus is lower than that in normal pregnant women,and positive vitamin D supplementation can reduce the incidence of adverse pregnancy outcomes.