2020 年第 11 期 第 15 卷

妊娠期糖尿病患者血清维生素D水平与血糖和血脂及妊娠结局的关系

The relationship between serum vitamin D level and blood glucose, blood lipid and pregnancy outcome in patients with gestational diabetes mellitus

作者：梁超王克芳

英文作者：Liang Chao Wang Kefang

单位：首都医科大学附属北京安贞医院妇产科100029

英文单位：Department of Obstetrics and Gynecology Beijing Anzhen Hospital Capital Medical University Beijing 100029 China

关键词：妊娠期糖尿病；维生素D；妊娠结局

英文关键词：Gestationaldiabetesmellitus;VitaminD;Pregnancyoutcome 

• 摘要：

• 目的 探究妊娠期糖尿病（GDM）患者血清维生素D水平与血糖、血脂及妊娠结局的关系。方法 回顾性分析2017年7月至2018年12月于首都医科大学附属北京安贞医院妇产科建档产检且诊断为GDM的209例孕妇的临床资料。依据孕中期血清25-羟基维生素D水平分为维生素D缺乏组（110例）、维生素D不足组（78例）及维生素D正常组（21例），统计并比较3组GDM患者的一般情况、孕中期血脂及口服葡萄糖耐量试验（OGTT）情况以及妊娠结局、分娩方式等方面的差异。结果 3组OGTT空腹、1 h、2 h血糖及三酰甘油、总胆固醇、高密度脂蛋白、低密度脂蛋白水平差异均无统计学意义（均P＞0.05）。维生素D缺乏组及维生素D不足组胎膜早破发生率高于维生素D正常组［38.5%（42/109）、32.5%（25/77）比10.0%（2/20）］，差异均有统计学意义（均P<0.05）。3组在分娩方式方面差异无统计学意义（P＞0.05）。结论 不同维生素D水平的GDM患者胎膜早破发生率方面有差异，低维生素D水平的GDM患者有更多不良妊娠结局的趋势。

• Objective To explore the relationship between serum vitamin D level and blood glucose, blood lipid and pregnancy outcome in patients with gestational diabetes mellitus(GDM). Methods From July 2017 to December 2018，the clinical data of 209 pregnant women with GDM diagnosed by prenatal examination admitted to department of obstetrics and gynecology， Beijing Anzhen Hospital， Capital Medical University were analyzed retrospectively. According to the serum 25-(OH)D level during pregnancy, they were divided into three groups: vitamin D deficiency group （n=110）, vitamin D insufficiency group (n=78) and vitamin D normal group (n=21). The general condition, blood lipid, blood glucose in the oral glucose tolerance test(OGTT) at second trimester, pregnancy outcome and mode of delivery of GDM patients in these three groups were analyzed and compared. Results There was no significant difference in fasting, 1 h, 2 h blood glucose in OGTT, triglyceride, total cholesterol, high-density lipoprotein and low-density lipoprotein levels among the three groups(all P>0.05). The incidence of premature rupture of membranes in vitamin D deficiency group and vitamin D insufficiency group were higher than that in vitamin D normal group［38.5%（42/109）, 32.5%（25/77） vs 10.0%（2/20）］, and the differences were statistically significant (both P<0.05). There was no significant difference in delivery model among the three groups(P>0.05). Conclusions There are differences in the incidence of premature rupture of membranes in GDM patients with different vitamin D levels. GDM patients with low vitamin D levels have more adverse pregnancy outcomes.