血清叶酸和维生素B12与GDM风险关系的分析  

Analysis of the correlation between the serum folic acid and vitamin B12levels of pregnant women and their risk of gestational diabetes mellitus

作　　者：王尽轶 马春星 高月月 张亚明 王凤英[1] 刘训涛 刘云春[1] WANG Zhiyi;MA Chunxing;GAO Yueyue;ZHANG Yaming;WANG Fengying;LIU Xuntao;LIU Yunchun(The First Affiliated Hospital of Hebei North University,Zhangjiakou,Hebei Province,075000)

机构地区：[1]河北北方学院附属第一医院,张家口075000

出　　处：《中国计划生育学杂志》2023年第12期2942-2946,共5页Chinese Journal of Family Planning

基　　金：河北省医学科学研究项目(20231408)。

摘　　要：目的:探讨血清叶酸和维生素B12与妊娠期糖尿病(GDM)的风险关系。方法:回顾性分析2021年1月-2023年1月于本院就诊的妊娠24~28周妇女临床资料,其中GDM组143例,健康对照组589例。分别比较两组患者血清叶酸、维生素B12等临床数据差异。并根据全部受试者血清叶酸、维生素B12的四分位数将患者分为4组。使用logistic回归分析和限制性立方样条(RCS)分析血清叶酸和维生素B12与GDM风险关系。结果:高血清叶酸浓度组GDM风险显著升高(OR=1.716,95%CI 1.123~2.620),低维生素B12浓度组GDM风险增加(OR=2.517,95%CI 1.720~3.681)。叶酸与GDM风险呈显著的非线性关系(χ^(2)=7.413,P=0.025),维生素B12与GDM的风险呈线性关系(χ^(2)=4.856,P=0.089)。较低或较高水平叶酸孕妇均具有较高GDM发生风险,当叶酸达到19.03ng/ml时,GDM风险开始呈现上升趋势。GDM发生风险随着维生素B12浓度的增加呈现降低趋势。结论:血清叶酸与GDM发生并非线性关系,较低或较高水平叶酸均增加GDM发生风险,维生素B12水平越低GDM风险增加。Objective:To explore the risk correlation between the serum folic acid and vitamin B12levels of pregnant women and their risk of gestational diabetes(GDM).Methods:The clinical data of the pregnant women during 24-28 gestational weeks from January 2021to January 2023were analyzed retrospectively,including 143cases with GDM in study group and 589healthy women in control group.The differences of clinical data,such as serum folic acid and vitamin B12levels,of the women were compared between the two groups.The women in the two groups were divided into 4groups according to the quartile of their serum folic acid and vitamin B12levels.Logistic regression analysis and restricted cubic spline(RCS)were used to analyze the correlation between the levels of serum folic acid and vitamin B12 of the women and their GDM risk.Results:The risk of GDM of the women with high serum folic acid level(OR=1.716,95%CI 1.123-2.620)or with low vitamin B12level(OR=2.517,95%CI 1.720-3.681)increased significantly.There was a significant nonlinear correlation between the folic acid level of the women and their GDM risk(χ^(2)=7.413,P=0.025),and there was a significant linear correlation between the vitamin B12level of the women and their GDM risk(χ^(2)=4.856,P=0.089).The women with lower or higher levels of folic acid level had the higher risk of GDM.When the folic acid level of the women was 19.03ng/mL,the risk of GDM of the women began to rise.The risk of GDM of the women had decreased with the increase of their vitamin B12level.Conclusion:There is a nonlinear correlation between the serum folic acid level of the pregnant women and their GDM.The low or high level of folic acid of the pregnant women can increase the risk of their GDM occurrence.The lower level of vitamin B12of the pregnant women,the higher risk of their GDM.

关 键 词：妊娠期糖尿病 叶酸 维生素B12 非线性分析 

分 类 号：R714.256[医药卫生—妇产科学]