国际妇产科学杂志

国际妇产科学杂志 ›› 2013, Vol. 40 ›› Issue (4): 379-381.

• 论著 • 上一篇    下一篇

妊娠中期妇女血25-羟维生素D3与妊娠期糖尿病的关系

黄一颖, 应 豪   

  1. 200040 上海，同济大学附属第一妇婴保健院产科
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2013-08-15 发布日期:2013-08-15
  • 通讯作者: 应 豪

The Relationship between Maternal Serum 25-hydroxyvitamin D3 and Gestational Diabetes Mellitus in Mid-term Pregnant Women

HUANG Yi-ying，YING Hao   

  1. Department of Obstetrics，Shanghai First Maternity and Infant Hospital，Tongji University School of Medicine，Shanghai 200040，China.
  • Received:1900-01-01 Revised:1900-01-01 Published:2013-08-15 Online:2013-08-15
  • Contact: YING Hao

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摘要： 目的：探讨妊娠13～16周妇女血25-羟维生素D3水平和妊娠期糖尿病发病的关系。方法：选择2011年9月在同济医科大学附属第一妇婴保健院产科产检并分娩的妊娠期糖尿病患者44例，正常妊娠妇女88例，除外双胎妊娠、经产妇、子痫前期和妊娠前糖尿病等。测定妊娠13～16周妇女血25-羟维生素D3水平。按百分位数法进行分析，分别计算25-羟维生素D3值在不同百分位时妊娠期糖尿病发生率、敏感度、特异度、约登（Youden’s）指数、阴性预测值（PPV）、阳性预测值（NPV）、OR值（95% CI）。结果：①妊娠期糖尿病妇女血25-羟维生素D3水平低于对照组[（49.8±22.0） nmol/L vs. （63.1±22.4） nmol/L，P＜0.01]。②血25-羟维生素D3处于P35时（25-羟维生素D3值45.201 0 nmol/L），Youden’s指数最高（22.73），OR值0.375（95% CI： 0.176～0.797）。③妊娠期糖尿病组中，糖耐量试验1 h血糖异常的妇女25-羟维生素D3值低于糖耐量试验1 h血糖正常者[（42.56±17.04） nmol/L vs.（55.32±23.93） nmol/L，P＜0.05]。结论：妊娠13～16周血25-羟维生素D3水平低下的妇女发生糖尿病的风险增加，25-羟维生素D3水平低下与糖耐量试验后1 h血糖升高有明显的相关性。

关键词: 胆骨化醇, 糖尿病, 妊娠, 葡糖耐量试验

Abstract: Objective： This study investigated the relationship between 25-hydroxyvitamin D3 concentrations and gestational diabetes mellitus at 13-16 gestational weeks. Methods： A nested case-control study of 132 cases was conducted in September 2011 at Shanghai First Maternity and Infant Hospital， Tongji University School of Medicine. Among them， 44 GDM cases were ascertained and 88 women who were not diagnosed with GDM， preeclampsia， multiple pregnancy， multiparas were selected as the control group. The concentration of serum 25-hydroxyvitamin D3 was measured at 13-16 gestational weeks. Percentiles of 25-hydroxyvitamin D3 was calculated. The corresponding mobidity of GDM was determined for each percentile cut-off point. The sensitivity， specificity， Youden index， positive predictive value， and negative predictive value were also estimated. Results：①Maternal serum 25-hydroxyvitamin D3 concentrations in GDM were significantly lower than that in the control gruop[（49.8±22.0） nmol/L vs. （63.1±22.4） nmol/L， P＜0.01].② The Youden index was the highest（22.73） when the concentrations of 25-hydroxyvitamin D3 was 45.201 0 nmol/L（P35）， OR=0.375（95% CI： 0.176-0.797）. ③ Among GDM cases， 25-hydroxyvitamin D3 difficiency were significantly correlated with hyperglycemia at 1-hour OGTT [（42.56±17.04） nmol/L vs. （55.32±23.93） nmol/L， P＜0.05]. Conclusions： The study suggest that maternal 25-hydroxyvitamin D3 deficiency at 13-16 gestational weeks is significantly associated with an elevated risk for GDM. 25-hydroxyvitamin D3 difficiency is obviously correlated with hyperglycemia at 1-hour OGTT.

Key words: Cholecalciferol, Diabetes, gestational, Glucose tolerance test