大连地区冬春季孕早期维生素D水平与妊娠期糖尿病的关系研究

Research of the correlation between vitamin D levels in early pregnancy and Dalian gestational diabetes mellitus in winter and spring

关键词:  维生素 D  妊娠期糖尿病  胰岛素抵抗  孕早期

Key words:  vitamin D  gestational diabetes mellitus  insulin resistance  early pregnancy

摘要:

目的　探讨大连地区冬春季孕早期维生素 D(vitamin D，VD)水平对妊娠期糖尿病发病率的影响。方法　选择2016年10月至2017年5月于大连市妇幼保健院产检的初产、单胎孕妇470例，测定其体内维生素D、空腹静脉血糖水平，根据其体内维生素D水平，分为正常组53例、不足组241例和缺乏组176例。对于不足组及缺乏组随机分为试验组和对照组，试验组（分别记为不足试验组，缺乏试验组）每日给予VD 滴剂胶囊 1200 IU(3 粒)，口服。对照组（分别记为不足对照组，缺乏对照组）及正常组给予每日VD 滴剂胶囊 400 IU(1 粒)，口服。随访各组至孕24~28周妊娠期糖尿病的发生及维生素 D 缺乏的改善情况。结果　正常组GDM发生率低于不足及缺乏组（P<0.05），试验组孕妇 GDM 的发生率较对照组有所降低，但差异不具有统计学意义(P>0.05)。试验组维生素D水平较治疗前显著升高，差异具有统计学意义(P<0.01)。正常组和对照组治疗后维生素D水平有所提高，但与治疗前比较，差异不具有统计学意义(P＞0.05)。结论　孕早期VD水平缺乏、不足孕妇妊娠期糖尿病发生率较高; 每日补充维生素 D 1200 IU，可提高体内维生素D水平，但未降低妊娠期糖尿病发病率。

Abstract:

Objective To explore the correlation between vitamin D levels in early pregnancy in winter and spring and gestational diabetes mellitus in Dalian. Methods 470 cases of primipara and singleton pregnant women from October 2016 to May 2017 in the Dalian obetetrics and gynecology hospital affiliated to Dalian medical university were selected as the research objects. all pregnant women were tested the vitamin D levels and fasting blood glucose, then According to the level of vitamin D in the body, they were divided into normal group 53 cases, insufficiency group 241 cases, and deficient group176 cases.The insufficiency group and the deficient group were randomly divided into the experimental group and the control group. The experimental group (insufficiency experimental group, deficient experimental group) was given VD 1200 IU (3 capsules) orally. The control group ( insufficiency control group,deficient control group) and normal group were given VD 400 IU (1 capsule) orally. Follow-up to 24-28 weeks, all pregnant women were given the OGTT test, The incidence of gestational diabetes mellitus and the improvement of vitamin D level were analyzed statistically. Results The incidence of GDM in the normal group was lower than that in the insufficiency and deficient group (P<0.05).and The incidence of GDM in the experimental group was lower than that in the control group. But the difference was not statistically significant (P>0.05). The level of vitamin D in the experimental group was significantly higher than those before treatment. The difference was statistically significant (P<0.01).compared with prior treatment , The vitamin D level of the normal group and the control group was improved after intervention. but The difference was not statistically significant (P>0.05). Conclusions The incidence of gestational diabetes mellitus was higher in pregnant women with low VD levels in early pregnancy; supplementation of vitamin D 1200 IU/d can improved the level of vitamin D in the body, but not reduced the incidence of gestational diabetes.