妊娠早中期维生素D水平动态变化与妊娠糖尿病的关联性分析  

Analysis of the relationship between the dynamic changes of vitamin D levels in early and midterm pregnancy and gestational diabetes mellitus

作　　者：曹志瑞 崔巧婷 陶瑞雪 Cao Zhirui;Cui Qiaoting;Tao Ruixue(Department of Obstetrics and Gynaecology,the Third Affiliated Hospital of Anhui Medical University,Hefei First People′s Hospital,Hefei 230001,China)

机构地区：[1]安徽医科大学第三附属医院合肥市第一人民医院妇产科,合肥230001

出　　处：《中国医药》2024年第9期1388-1392,共5页China Medicine

基　　金：国家自然科学基金(81872631)。

摘　　要：目的探讨妊娠早中期维生素D水平动态变化与妊娠糖尿病(GDM)的关联。方法选取2019年1月至2020年12月于合肥市第一人民医院规律产检并分娩的650例孕妇作为研究对象。检测孕妇妊娠早中期血清25-羟维生素D水平,根据是否合并GDM,将孕妇分为GDM组(67例)和非GDM组(583例)。分析25-羟维生素D水平与GDM的潜在关联。结果2组年龄、妊娠前体重指数、妊娠早期25-羟维生素D水平、妊娠早中期25-羟维生素D平均值比较差异均有统计学意义(均P<0.05)。二元Logistic回归分析结果显示,25-羟维生素D水平最高组(Q_(4)组)的孕妇患GDM的风险为25-羟维生素D水平最低组(Q_(1)组)的0.33倍(比值比:0.33,95%置信区间:0.14~0.74,P<0.05)。调整年龄、妊娠前体重指数、妊娠次数、产次等混杂因素后,这种关联仍然显著(P<0.05)。限制性立方样条图结果显示,妊娠早期25-羟维生素D水平与GDM风险呈负相关(P=0.035)。结论妊娠早中期维生素D水平随孕周的增加有升高趋势,妊娠早期充足的维生素D水平与GDM患病风险降低相关。Objective To investigate the relationship between the dynamic changes of vitamin D levels in early and midterm pregnancy and gestational diabetes mellitus(GDM).Methods A total of 650 pregnant who regular prenatal examination and delivery at Hefei First People′s Hospital from January 2019 to December 2020 was selected for analysis.Serum 25-hydroxy vitamin D levels were measured during early and midterm pregnancy,pregnant women were divided into GDM group(67 cases)and non GDM group(583 cases)based on whether GDM was merged or not.The potential relationship between 25-hydroxy vitamin D level and GDM was explored.Results There were significant differences in age,pre-pregnancy body mass index,the level of 25-hydroxy vitamin D in early pregnancy and the average value of 25-hydroxy vitamin D in early and midterm pregnancy between the two groups(all P<0.05).The results of binary Logistic regression analysis showed that the risk of GDM in the group with the highest level of 25-hydroxy vitamin D(group Q_(4))was 0.33 times(odds ratio=0.33,95%confidence interval:0.14-0.74,P<0.05)to the group with the lowest level of 25-hydroxy vitamin D(group Q_(1)).After adjusting the confounding factors such as age,pre-pregnancy body mass index,number of pregnancies and parturition,the correlation was still significant(P<0.05).The results of restriction cubic spline showed that 25-hydroxy vitamin D in early pregnancy was negatively correlated with the risk of GDM(P=0.035).Conclusion The level of vitamin D in early pregnancy tends to increase with the increase of gestational weeks,and the adequate level of vitamin D in early pregnancy is related to the decreased risk of GDM.

关 键 词：妊娠糖尿病 维生素D 妊娠期结局 

分 类 号：R714.25[医药卫生—妇产科学]