孕妇血维生素D水平与妊娠期糖尿病相关性研究

叶瑛瑛; 王金辉; 王丽君; 龚爱敏

doi:10.16766/j.cnki.issn.1674-4152.001735

孕妇血维生素D水平与妊娠期糖尿病相关性研究

doi: 10.16766/j.cnki.issn.1674-4152.001735

玉环市人民医院妇科，浙江玉环 317600

基金项目:

浙江省医药卫生科技计划项目 2018KY922

详细信息

通讯作者:
叶瑛瑛, E-mail：lavenda0916@163.com

中图分类号: R715.3 R977.24
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出版历程
- 收稿日期: 2019-10-21
- 网络出版日期: 2022-02-19

Study on the relationship between serum vitamin D level and gestational diabetes mellitus in pregnant women

Gynaecology, Yuhuan People's Hospital of Zhejiang Province, Yuhuan, Zhejiang 317600, China

摘要

摘要: 目的探讨孕妇血清25-羟维生素D[25-(OH)D]水平与妊娠期糖尿病(gestational diabetes mellitus，GDM)的关系，分析孕妇血清25-(OH)D水平的影响因素。方法采用随机数字表法选取2017年9月—2018年12月在玉环市人民医院产检的300例孕妇，在孕早期、中期、晚期分别检测25-(OH)D水平，根据血清25-(OH)D水平分为缺乏组和不缺乏组，比较2组孕妇妊娠期糖尿病发生率的差别；根据孕晚期血清25-(OH)D水平，分析孕妇血清25-(OH)D水平的影响因素。结果孕早期缺乏组、不缺乏组孕妇妊娠期糖尿病发生率分别为26.32%、12.50%，比较差异无统计学意义(P＞0.05)；孕中期缺乏组、不缺乏组孕妇妊娠期糖尿病发生率分别为28.65%、9.80%，比较差异有统计学意义(P < 0.05)；孕晚期缺乏组、不缺乏组孕妇妊娠期糖尿病发生率分别为27.47%、10.00%，比较差异有统计学意义(P < 0.05)；在单因素分析的基础上经多因素logistic回归分析显示每日户外活动时间少、孕晚期在冬春季、未正规补充维生素D、未及时补充维生素D为孕妇血清25-(OH)D缺乏的独立危险因素(均P < 0.05)。结论孕妇血清25-(OH)D水平下降可能增加妊娠期糖尿病发生的风险，孕早期合理补充维生素D可有效预防孕妇维生素D缺乏，有助于降低妊娠期糖尿病的发生风险。
- 孕妇 /
- 25-羟维生素D /
- 妊娠期糖尿病 /
- 维生素
Abstract: Objective To investigate the relationship between serum 25-hydroxyvitamin D [25-(OH)D] level and gestational diabetes mellitus (GDM) in pregnant women, and to analyze the influencing factors of serum 25-hydroxyvitamin D level in pregnant women. Methods A random number table was used to select 300 pregnant women who were examined in Yuhuan People's Hospital from September 2017 to December 2018. The levels of 25-(OH)D were detected in the early, middle and late stages of pregnancy. According to the serum levels of 25-(OH)D, the pregnant women were divided into two groups: lack group and no lack group, and the incidence of gestational diabetes was compared between the two groups. According to the serum 25-(OH)D level in the third trimester, the influencing factors of serum 25-(OH)D level in pregnant women were analyzed. Results The incidence of gestational diabetes was 26.32% in the lack group and 12.50% in the no lack group, with no statistically significant difference (P>0.05). The incidence of gestational diabetes in the second trimester deficiency group and the no deficiency group were 28.65% and 9.80%, respectively, with statistically significant differences (P < 0.05). The incidence of gestational diabetes was 27.47% and 10.00% in the lack group and no lack group, respectively, with statistically significant differences (P < 0.05). On the basis of univariate analysis, multivariate logistic regression analysis showed that the independent risk factors of serum 25-(OH)D deficiency in pregnant women were less time spent in outdoor activities, winter and spring, no regular vitamin D supplementation, and no timely vitamin D supplementation (all P < 0.05). Conclusion Decreased serum 25-(OH)D level in pregnant women may increase the risk of gestational diabetes. Reasonable vitamin D supplementation in early pregnancy can effectively prevent vitamin D deficiency in pregnant women and help reduce the risk of gestational diabetes.
- Pregnant women /
- 25-hydroxyvitamin D /
- Gestational diabetes mellitus /
- Vitamin

HTML全文

表 1 2组孕妇不同孕期GDM情况比较[例(%)]

孕期	组别	例数	妊娠期糖尿病	χ²值	P值
孕早期	缺乏组	190	50(26.32)	2.840	0.092
	不缺乏组	32	4(12.50)
孕中期	缺乏组	171	49(28.65)	7.584	0.006
	不缺乏组	51	5(9.80)
孕晚期	缺乏组	182	50(27.47)	5.439	0.020
	不缺乏组	40	4(10.00)

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表 2 影响孕妇血清25-(OH)D水平的单因素分析[例(%)]

因素	变量取值	例数	25-(OH)D不缺乏	χ²值	P值
每日户外活动时间(有无>1 h)	有	66	18(27.27)	5.446	0.020
	无	156	22(14.10)
孕晚期季节	夏秋季	82	21(25.61)	5.073	0.024
	冬春季	140	19(13.57)
正规补充维生素D	有	67	20(29.85)	9.096	0.003
	无	155	20(12.90)
及时补充维生素D(孕早期开始补充)	有	82	21(25.61)	5.073	0.024
	无	140	19(13.57)
年龄(是否在30岁以上)	是	118	19(16.10)	0.626	0.429
	否	104	21(20.19)
孕前体质指数(是否>24)	是	42	8(19.05)	0.037	0.847
	否	180	32(17.78)

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表 3 影响孕妇血清25-(OH)D水平的多因素分析

变量	B	SE	Wald ^χ2	P值	OR值	95% CI
每日户外活动时间少	1.480	0.453	10.670	0.001	4.392	1.807~10.673
冬春季	0.806	0.399	4.071	0.044	2.239	1.023~4.898
未正规补充维生素D	1.499	0.446	11.299	0.001	4.476	1.868~10.725
未及时补充维生素D	0.871	0.386	5.079	0.024	2.389	1.120~5.093

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