上海交通大学学报（医学版）

上海交通大学学报（医学版）

• 论著（临床研究） • 上一篇    下一篇

孕中期血清25-羟维生素D3及血脂水平对妊娠期糖尿病的影响

周晔，顾玮，林婧   

  1. 上海交通大学 医学院附属国际和平妇幼保健院， 上海 200030
  • 出版日期:2016-02-28 发布日期:2016-03-29
  • 作者简介:周晔（1966—）， 女， 副主任医师， 硕士; 电子信箱: victoriazhou66@163.com。

Effects of serum 25(OH)D3 and lipid levels at the second trimester on gestational diabetes mellitus

ZHOU Ye, GU Wei, LIN Jing   

  1. International Peace Maternity and Child Health Hospital， Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
  • Online:2016-02-28 Published:2016-03-29

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1971

摘要：

目的 探讨孕中期血清25-羟维生素D3[25(OH)D3]和血脂水平对妊娠期糖尿病（GDM）的影响。方法 以行产前检查的孕妇作为研究对象,分为正常妊娠组（对照组,n=6 796）和GDM组（n=977），于孕中期（孕12～16周）检测血清25(OH)D3及总胆固醇（TCh）、三酰甘油（TAG）、高密度脂蛋白（HDL）和低密度脂蛋白(LDL)等血脂指标，通过logistic回归分析评价25(OH)D3和血脂水平在GDM发病中的作用。结果 GDM组25(OH)D3和HDL水平均低于对照组；而TAG、TCh、LDL均高于对照组。Logistic回归分析显示除LDL外的所有指标均与GDM致病有关，其中TAG（OR=1.54）和TCh（OR=1.63）是危险因素，而25(OH)D3（OR=0.995）和HDL（OR=0.392）是保护因素。结论 孕中期血清25(OH)D3和血脂水平对GDM的发病有重要作用，其中TAG和TCh是GDM发病的危险因素，而25(OH)D3和HDL是保护因素；可尝试通过调脂及降糖综合治疗降低GDM的患病率。

关键词: 妊娠期糖尿病, 25-羟维生素D3, 血脂, 危险因素

Abstract:

Objective To investigate the effects of serum 25(OH)D3 and lipid levels on the gestational diabetes mellitus (GDM). Methods Pregnant women who underwent prenatal examinations were enrolled and divided into the normal pregnancy group (control group, n=6 796) and GDM group (n=977). Serum 25(OH)D3, total cholesterol (TCh), triglyceride (TAG), high density lipoprotein cholesterol (HDL), and low density lipoprotein (LDL) levels of two groups at the second trimester of pregnancy (12-16 weeks) were detected. The logistic regression analysis was adopted to evaluate the effects of 25(OH)D3 and lipid levels on the pathogenesis of GDM. Results 25(OH)D3 and HDL levels of the GDM group were lower than those of the control group, while TAG, TCh, and LDL levels were higher than those of the control group. Logistic regression analysis showed that all indexes were relevant to the pathogenesis of GDM except LDL. TAG (OR=1.54) and TCh (OR=1.63) were risk factors of GDM, while 25(OH)D3 (OR=0.995) and HDL (OR=0.392) were protective factors of GDM. Conclusion Serum 25(OH)D3 and lipid levels at the second trimester play an important role in the pathogenesis of GDM. TAG and TCh are risk factors of GDM, while 25(OH)D3 and HDL are protective factors of GDM. Therefore, it can be attempted to reduce the incidence of GDM by the combination therapy of lowering lipids and glucose.

Key words: gestational diabetes mellitus, 25 (OH) D3；lipid, risk factor