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目的:研究孕前、孕期维生素D水平与妊娠期糖尿病关系。方法:选取我院孕前优生门诊备孕妇女138例,测定138例研究对象孕前、孕期外周血清维生素D、血糖、空腹胰岛素、胰岛素抵抗水平,并对维生素D水平低于正常指标的部分入组患者补充适量维生素D作为实验干预,分组随访维生素D缺乏干预组(简称干预组)、维生素D缺乏未干预组(简称未干预组)、维生素D正常组(简称正常组))妇女妊娠后糖尿病发病率及以上各指标的变化。结果:维生素D缺乏组孕妇妊娠糖尿病发病率为82.61%(76/92),维生素D正常组孕后妊娠糖尿病发病率为34.78%(16/46),组间差异有统计学意义(P<0.05);干预组与未干预组空腹血糖水平分别为(5.29±0.51)mmol·L~(-1)和(5.42±0.71)mmol·L~(-1),高于正常组空腹血糖水平[(4.32±0.28)mmol·L~(-1)],差异具有统计学意义(P<0.05);干预组空腹胰岛素水平为(11.07±3.24)μU·ml~(-1),未干预组空腹胰岛素水平为(12.93±5.76)μU·ml~(-1),两者均明显高于正常组[(9.22±2.19)μU·ml~(-1)],干预组患者空腹胰岛素水平显著低于未干预组(P<0.05)。结论:在临床实际诊治中,孕前、孕期维生素D水平在一定程度上与妊娠期糖尿病具有相关性,通过监测维生素D、血糖以及胰岛素抵抗水平,适当地补充维生素D,可降低妊娠期糖尿病的患病率、减少妊娠期糖尿病带来的诸多并发症以及不良反应。
Objective: To study the relationship between vitamin D levels during pregnancy and gestational diabetes mellitus. Methods: 138 pregnant women with preeclampsia in our hospital were enrolled in this study. The serum levels of vitamin D, blood glucose, fasting insulin and insulin resistance were measured in 138 subjects before and during pregnancy. Some patients with vitamin D levels below the normal level were enrolled in this study. The amount of vitamin D as experimental intervention, group follow-up vitamin D deficiency intervention group (referred to as intervention group), vitamin D deficiency without intervention group (referred to as non-intervention group), vitamin D normal group (normal group) The above indicators of change. Results: The incidence of gestational diabetes mellitus was 82.61% (76/92) in the vitamin D deficiency group and 34.78% (16/46) in the normal vitamin D group, the difference was statistically significant (P <0.05 (5.29 ± 0.51) mmol·L -1 and (5.42 ± 0.71) mmol·L -1, respectively, higher than the fasting blood glucose level in normal group [( 4.32 ± 0.28 mmol·L -1], the difference was statistically significant (P <0.05). The fasting insulin level in the intervention group was (11.07 ± 3.24) μU · ml -1, and the level of fasting insulin (12.93 ± 5.76) μU · ml -1, both of which were significantly higher than that of the normal group [(9.22 ± 2.19) μU · ml -1]. The fasting insulin level of the intervention group was significantly lower than that of the normal group Intervention group (P <0.05). Conclusion: In the actual clinical diagnosis and treatment, the level of vitamin D before pregnancy and during pregnancy is related to the degree of gestational diabetes mellitus to a certain extent. By monitoring vitamin D, blood glucose and insulin resistance, proper vitamin D supplementation can reduce the risk of gestational diabetes mellitus Prevalence, reduce the complications caused by gestational diabetes and adverse reactions.