北京城区健康育龄妇女血清25-羟维生素D水平及胰岛素抵抗的关系  

The relationship between serum 25-hydroxyvitamin D levels and insulin resistance of healthy childbearing age women in Beijing city

作　　者：杨立颖[1] 张巍[1] 范玲[2] 李娜[1] 刘韬[1] 贾晓[1] 

机构地区：[1]首都医科大学附属北京妇产医院新生儿科,北京100026 [2]首都医科大学附属北京妇产医院产科,北京100026

出　　处：《中国妇产科临床杂志》2012年第4期263-266,共4页Chinese Journal of Clinical Obstetrics and Gynecology

基　　金：首都医科大学附属北京妇产医院科研基金资助项目(201111)

摘　　要：目的了解北京城区正常育龄妇女25-羟维生素D[25-hydroxyvitamin D,25(OH)D]水平及胰岛素抵抗状态,并分析两者的关系。方法于2010年12月1—20日北京妇产医院招募北京市城区23～30岁健康未育妇女170例,采用酶联免疫吸附试验测定其空腹血25(OH)D及甲状旁腺素(parathyroid hormone,PTH)、糖代谢相关指标(空腹血糖、胰岛素和糖化血红蛋白)及血清钙、磷、碱性磷酸酶及血酯水平。结果①170例妇女平均25(OH)D水平为(27.28±6.64)nmol/L,其中25(OH)D缺乏和不足者169例(99.4%),25(OH)D适宜者1例(0.6%)。②25(OH)D缺乏组PTH[(178.27±78.65)ng/L]与25(OH)D不足组[(172.89±78.52)ng/L]比较,差异无统计学意义(P>0.05),但两组PTH均高于正常水平;血清25(OH)D与PTH无线性关系(r=-0.061,P>0.05)。③血清25(OH)D与血钙、磷、碱性磷酸酶、甘油三酯、总胆固醇、空腹血糖、糖化血红蛋白、体质指数、胰岛素及胰岛素抵抗指数无相关性(P>0.05)。④170例未育妇女存在胰岛素抵抗者30例(17.6%),其25(OH)D水平[(24.22±5.44)nmol/L]与无胰岛素抵抗组[(27.93±6.71)nmol/L]比较,差异有统计学意义(P<0.01)。结论北京城区冬季健康育龄妇女普遍存在维生素D缺乏;其低维生素D水平可能与胰岛素抵抗增加有关,并可能成为妊娠期糖尿病的危险因素。Objective To investigate the serum level of 25-hydroxyvitamin D（25（OH）D）and insulin resistance of women in childbearing age in the urban area of Beijing city,and to analyze the relationship between the two.Methods 170healthy women （23～30years old）in Beijing city recruited in this study in December 2010.Serum levels of 25（OH）D and parathyroid hormone（PTH）,indicators of glucose metabolism,serum calcium,phosphorus,alkaline phosphatase,triglycerides and total cholesterol were determined by enzyme-linked immu-nosorbent assay.Results ① The average level of 25（OH）D was（27.28±6.64）nmol/L.169cases（99.4%） were 25 （OH）D deficiency or insufficient（≤50nmol/L）,among them 70cases（41.2%）were 25（OH）D deficiency（≤25nmol/L）.There was only 1case（0.6%）with 25 （OH）D expedient（50nmol/L〈25 （OH）D≤75 nmol/L）,none of the 170women was 25 （OH）D adequated（〉75nmol/L）.②The difference of the level of PTH in 25 （OH）D deficiency group[（178.27±78.65）ng/L]and 25 （OH）insufficient group[（172.89±78.52）ng/L] was not significant（P〉0.05）,but both were higher than the normal level（8.8～68.0ng/mL）;the relationship between serum 25 （OH）D and PTH was wireless regression （r=-0.061,P〉0.05）.③ The level of serum 25（OH）D had no correlation with levels of calcium,phosphorus,alkaline phosphatase,triglycerides,total choles-terol,blood glucose,glycosylated hemoglobin,body mass index （BMI）,insulin and insulin resistance indices （P〉0.05）.④There were 3 0cases（1 7.6% ）had insulin resistance,the level of 2 5（OH）D in these cases wassignificantly lower than that in those who had no insulin resistance[（24.22±5.44）nmol/L and（27.93±6.71）nmol/L, P〈0.01）].Conclusion Women of childbearing age in Beijing urban were lack of vitamin D in winter;the insulin resistance may be related to low vitamin D levels.Low vitamin D level may be one of the risk factors of gestational diabetes.

关 键 词：维生素D 胰岛素抵抗 甲状旁腺素 25-羟维生素D 

分 类 号：R587.1[医药卫生—内分泌]