2024 年第 9 期 第 0 卷

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

英文作者：Cao Zhirui Cui Qiaoting Tao Ruixue

单位：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

英文单位：Department of Obstetrics and Gynaecology the Third Affiliated Hospital of Anhui Medical University Hefei First People′s Hospital Hefei 230001 China

关键词：妊娠糖尿病；维生素D；妊娠期结局

英文关键词：Gestationaldiabetesmellitus;VitaminD;Pregnancyoutcomes

• 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（Q4组）的孕妇患GDM的风险为25-羟维生素D水平最低组（Q1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 Q4) 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 Q1). 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.