胰岛素联合大剂量维生素D治疗GDM对患者血清vaspin、Visfatin水平及妊娠结局的影响  

Effects of the high-dose vitamin D combined with insulin for treating pregnant women with gestational diabetes mellitus on the levels of their serum visceral adipose-specific serine protease inhibitor and visfatin and their pregnancy outcomes

作　　者：刘筱佳 周春娜 LIU Xiaojia;ZHOU Chunna(Daqing Longnan Hospital,Daqing,Heilongjiang Province,163000)

机构地区：[1]黑龙江省大庆市龙南医院,163000

出　　处：《中国计划生育学杂志》2024年第4期804-810,共7页Chinese Journal of Family Planning

摘　　要：目的:研究大剂量维生素D联合胰岛素对妊娠期糖尿病(GDM)孕妇血清内脏脂肪特异性丝氨酸蛋白酶抑制因子(vaspin)、内脏脂肪素(Visfatin)水平及妊娠结局的影响。方法:将本院2021年12月-2023年3月收治的GDM孕妇105例随机数字表法分为联合组(n=53例)与对照组(n=52例),除调整饮食、运动外,两组均接受门冬胰岛素治疗,联合组联合大剂量维生素D补充治疗,持续4周,比较治疗前、治疗4周后两组糖脂代谢、胰岛素抵抗、血25羟基维生素D3[25(OH)D3]、脂肪因子变化,均随访至妊娠结束,比较两组妊娠结局及不良反应。结果:治疗后,联合组空腹血糖(5.26±0.53 mmol/L)、餐后2h血糖(6.62±0.78 mmol/L)、糖化血红蛋白(5.12±0.6)%、总胆固醇(3.24±0.56 mmol/L)、甘油三酯(2.96±0.53 mmol/L)、低密度脂蛋白胆固醇(2.51±0.55 mmol/L)、空腹胰岛素(12.52±2.63 mU/L)、胰岛素抵抗指数(2.12±0.14)、vaspin(23.15±2.74 ng/ml)和Visfatin(102.56±20.27 ng/ml)均低于对照组,25(OH)D3(26.52±5.71 ng/ml)高于对照组(均P <0.05)。联合组自然分娩率(75.5%)高于对照组(55.8%),剖宫产率(15.1%)、巨大儿发生率(3.8%)均低于对照组(32.7%、15.4%)(均P<0.05);两组不良反应(7.5%比5.8%)无差异(P>0.05)。结论:胰岛素联合大剂量维生素D治疗GDM对患者调节糖脂代谢作用显著,推测其可通过下调vaspin、Visfatin,升高25(OH)D3水平,减轻胰岛素抵抗,改善妊娠结局。Objective:To study the effects of the high-dose vitamin D combined with insulin for treating pregnant women with gestational diabetes mellitus(GDM)on the levels of their serum visceral adipose-specific serine protease inhibitor(vaspin)and visfatin,and their pregnancy outcomes.Methods:A total of 105 pregnant women with GDM admitted to the hospital were divided into study group(53 cases)and control group(52 cases)according to the random number table method from December 2021 to March 2023.In addition to adjusting the diet and exercising,the women in both groups received insulin aspartate therapy for 4 weeks,and the women in the study group were given high-dose vitamin D supplement therapy for 4 weeks additionally.The changes of the glucose and lipid metabolism,the insulin resistance,and the levels of the blood 25 hydroxyvitamin D3[25(OH)D3]and the adipokine of the women before and 4 weeks after treatment were compared between the two groups.The women in both groups were followed up until the end of their pregnancy,and the pregnancy outcomes and the adverse reactions rate of the women were compared between the two groups.Results:The levels of the fasting blood glucose(5.26±0.53 mmol/L),the 2h postprandial blood glucose(6.62±0.78 mmol/L),the glycosylated hemoglobin(5.12±0.6%),the total cholesterol(3.24±0.56 mmol/L),the triglyceride(2.96±0.53 mmol/L),the low density lipoprotein cholesterol(2.51±0.55 mmol/L),the fasting insulin(12.52±2.63 mU/L),the vaspin(23.15±2.74ng/ml)and the visfatin(102.56±20.27 ng/ml),and the insulin resistance index value(2.12±0.14)of the women in the study group after treatment were significantly lower than those of the women in the control group,but the 25(OH)D3 level(26.52±5.71 ng/ml)of the women in the study group was significantly higher than that of the women in the control group(all P<0.05).The natural delivery rate(75.5%)of the women in the study group was significantly higher than that(55.8%)of the women in the control group,and the incidences of the cesarean section(15.1%)an

关 键 词：妊娠期糖尿病 大剂量维生素D 门冬胰岛素 内脏脂肪素 内脏脂肪特异性丝氨酸蛋白酶抑制因子 血糖控制 妊娠结局 

分 类 号：R714.256[医药卫生—妇产科学]