孕期补充维生素D3对妊娠期糖尿病T淋巴细胞亚群的影响  

Effect of vitamin D supplementation during pregnancy on T lymphocyte subsets in gestational diabetes mellitus

作　　者：邓丽[1] 黄燕[1] 黄玲玲[1] 苏俊友 覃尹 DENG Li;HUANG Yan;HUANG Lingling;SU Junyou;QIN Yin(Department of Obstetrics,the Second Affiliated Hospital of Guangxi Medical University,Nanning,Guangxi 530007,China)

机构地区：[1]广西医科大学第二附属医院产科,广西南宁530007

出　　处：《检验医学与临床》2020年第16期2273-2276,2280,共5页Laboratory Medicine and Clinic

基　　金：国家卫生和计划生育委员会医药卫生科技发展研究中心项目(W2016CWGX06)。

摘　　要：目的探讨妊娠期糖尿病(GDM)患者在孕期补充维生素D3对其T淋巴细胞亚群的影响。方法选取2019年1—12月该院收治的孕周为24~28周的60例GDM患者作为研究对象,随机分为观察组和对照组。对照组采取合理控制饮食、运动和胰岛素降糖等常规治疗,观察组在对照组的基础上补充维生素D3400U/d,为期14d。同时选取30例健康孕妇作为健康组。常规血生化检测各组孕妇空腹血糖(FBG),使用同位素稀释超高效液相色谱-串联质谱法测定25-羟基维生素D[25(OH)D]水平;采用酶联免疫吸附测定法检测血清肿瘤坏死因子-α(TNF-α)、干扰素-γ(IFN-γ)、白细胞介素(IL)-4和IL-10水平;采用流式细胞术测定CD3+、CD4+、CD8+、CD4+/CD8+、Th1、Th2、Th1/Th2的细胞数。结果观察组治疗后25(OH)D水平明显高于对照组治疗后25(OH)D水平,差异有统计学意义(P<0.05)。补充维生素D3后,观察组、对照组治疗后CD3+、CD4+、CD4+/CD8+T淋巴细胞比例均显著高于同组治疗前,而CD8+T淋巴细胞比例均显著低于同组治疗前,差异有统计学意义(P<0.05);观察组、对照组治疗后Th1、Th1/Th2细胞比例均低于同组治疗前,Th2细胞数均高于同组治疗前,差异有统计学意义(P<0.05);观察组、对照组治疗后血清TNF-α、IFN-γ水平均显著低于同组治疗前,血清IL-4、IL-10水平均显著高于同组治疗前,差异有统计学意义(P<0.05)。结论 GDM患者补充维生素D3可有效调节CD4+/CD8+T淋巴细胞及Th1和Th2细胞比例,维持T淋巴细胞亚群平衡,防止免疫功能紊乱。Objective To explore the influence mechanism of vitamin D3 supplementation on T lymphocyte subsets in patients with gestational diabetes mellitus(GDM)during pregnancy.Methods A total of 60 patients with GDM from 24 to 28 weeks gestational age admitted to the hospital from January to December 2019 were selected as study subjects and randomly divided into observation group and control group.The control group received conventional hypoglycemic treatment such as reasonable control diet,exercise and insulin injection.The observation group was supplemented with vitamin D3 400 U/d on the basis of the control group for a period of 14 days.At the same time,30 normal pregnant women were selected as the normal group.Routine blood biochemical tests for fasting blood glucose(FBG),the expression of 25(OH)D was measured by ID-UPLC/MS/MS,the expression of tumor necrosis factor-α(TNF-α),interferon-γ(IFN-γ),interleukin-4 and IL-10 were measured by ELISA,and CD3+,CD4+,CD8+,CD4+/CD8+,Th1,Th2,Th1/Th2 cell numbers were measured by flow cytometry.Results The 25(OH)D level of the observation group after treatment was significantly higher than that of the control group,with statistically significant difference(P<0.05).After vitamin D3 supplementation,the proportion of CD3+,CD4+,CD4+/CD8+T lymphocytes in the observation group and the control group was significantly higher than that before treatment,while the proportion of CD8+T lymphocytes was significantly lower than that before treatment,with statistically significant difference(P<0.05).The proportion of Th1 and Th1/Th2 cells in the observation group and the control group after treatment was lower than that before treatment,and the number of Th2 cells was higher than that before treatment,with statistically significant differences(P<0.05).The levels of TNF-αand IFN-γin the observation group and the control group after treatment were significantly lower than those before treatment,and the levels of IL-4 and IL-10 were significantly higher than those before treatment,with statistica

关 键 词：维生素D3 妊娠期糖尿病 T淋巴细胞 细胞因子 

分 类 号：R714.2[医药卫生—妇产科学]