维生素D联合诺和锐特冲治疗GDM对糖脂代谢、胰岛素抵抗影响  

Effects of vitamin D combined with insulin aspart for treating pregnant women with gestational diabetes mellitus on their glycolipid metabolism and insulin resistance

作　　者：刘炳东[1] 李黎梅[1] 曹国蓉 LIU Bingdong;LI Limei;CAO Guorong(Yaan People's Hospital,Sichuan Province,625000)

机构地区：[1]四川省雅安市人民医院,625000

出　　处：《中国计划生育学杂志》2023年第11期2601-2605,共5页Chinese Journal of Family Planning

摘　　要：目的:探究维生素D2联合诺和锐特冲治疗妊娠期糖尿病(GDM)对患者糖脂代谢、胰岛素抵抗的影响。方法:选取2020年5月-2022年5月本院收治的126例GDM患者,随机数值表法分为观察组和对照组各63例。对照组接受锐特充治疗,观察组接受维生素D2联合诺和锐特充治疗。检测两组治疗前、治疗8周后糖脂代谢指标,包括空腹血糖(FBG)、糖化血红蛋白(HbA1c)、空腹胰岛素(FINS)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C),计算胰岛素抵抗指数(HOMA-IR)。记录两组围生结局及用药期间药物不良反应。结果:治疗后观察组与对照组血清FBG(5.03±0.64 mmol/L、5.87±0.70 mmol/L)、HbA1c(5.27±0.63、7.20±0.78)%、FINS(12.37±2.46μU/ml、18.22±3.63μU/ml)、HOMA-IR(2.76±0.45、4.75±0.58)、TC(5.02±0.48 mmol/L、5.53±0.51 mmol/L)、TG(1.73±0.33 mmol/L、2.08±0.35 mmol/L)及LDL-C(2.39±0.28 mmol/L、2.71±0.30 mmol/L)均下降,且观察组低于对照组,HDL-C均上升且观察组(1.34±0.21 mmol/L)高于对照组(1.06±0.20 mmol/L)(均P<0.05)。观察组新生儿早产发生率(4.8%)低于对照组(15.0%)(P<0.05),两组新生儿呼吸窘迫、巨大儿、新生儿低血糖发生率无差异(P>0.05)。治疗期间两组均无严重不良反应,两组低血糖、胃肠不适及头晕头痛发生率无差异(P>0.05)。结论:维生素D2联合锐特充治疗GDM可更有效改善患者糖脂代谢情况,改善胰岛素抵抗及围生结局,治疗安全性较高。Objective:To explore the effects of vitamin D combined with insulin aspart for treating pregnant women with gestational diabetes mellitus(GDM)on their glycolipid metabolism and insulin resistance.Methods:A total of 126 pregnant women with GDM were enrolled and were divided into observation group(63 cases)and control group(63 cases)according to random number table method between May 2020 and May 2022.The women in the control group were treated with insulin aspart,and the women in the observation group were treated with vitamin D_2 combined with insulin aspart.The glucose-lipid metabolism indexes of the women in the two groups before treatment and in 8 weeks after treatment were detected,including fasting blood glucose(FBG),glycosylated hemoglobin A1c(HbA1c),fasting insulin(FINS),total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C),and high-density lipoprotein cholesterol(HDL-C).The homeostatic model assessment for insulin resistance(HOMA-IR)of the women in the two groups was calculated.The perinatal outcomes and the adverse drug reactions during medication of the women in both groups were recorded.Results:The levels of serum FBG,HbA1c,FINS,TC,TG,and LDL-C,and the HOMA-IR value of the women in the two groups after treatment had decreased significantly,and which(5.03±0.64 mmol/L,5.27±0.63%,12.37±2.46μU/ml,5.02±0.48 mmol/L,1.73±0.33 mmol/L,2.39±0.28 mmol/L,and 2.76±0.45)of the women in the observation group were significantly lower than those(5.87±0.70 mmol/L,7.20±0.78%,18.22±3.63μU/ml,5.53±0.51 mmol/L,2.08±0.35 mmol/L,2.71±0.30 mmol/L,and 4.75±0.58)of the women in the control group.The level of HDL-C of the women in the two groups had increased significantly,and which(1.34±0.21 mmol/L)of the women in the observation group was significantly higher than that(1.06±0.20mmol/L)of the women in the control group(all P<0.05).The incidence of the premature birth(4.8%)of the women in the observation group was significantly lower than that(15.0%)of the women in the control group(P

关 键 词：妊娠期糖尿病 诺和锐特充 维生素D2 糖脂代谢 胰岛素抵抗 围生结局 

分 类 号：R714.256[医药卫生—妇产科学]