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目的探讨妊娠中期血清25-羟维生素D_3[25-(OH)-Vit D_3]与血脂水平在妊娠期糖尿病(GDM)患者发病中的作用。方法将2013年1月-2016年5月于华北理工大学附属医院行产前检查的7 000例孕妇根据产前检查结果,将GDM患者1 012例设为实验组,5 988例未见异常孕妇设为对照组,于孕24~28周检测血清25-(OH)-Vit D_3、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL)及低密度脂蛋白(LDL)水平,应用Logistic逐步回归分析各项指标在GDM发病中的作用。结果与对照组相比,实验组的血清25-(OH)-Vit D_3(t=2.991,P=0.003)和HDL(t=3.644,P<0.001)水平均明显较低,而TG(t=6.263,P<0.001)、TC(t=7.698,P<0.001)和LDL(t=9.045,P<0.001)水平均明显较高,差异均具有统计学意义(均P<0.05)。通过Logistic逐步回归分析可得:25-(OH)-Vit D_3、TG、TC以及HDL水平均与GDM致病有关;GDM发病的危险因素为:TG(OR=1.540,P<0.001)和TC(OR=1.631,P=0.001),OR>1;保护因素为25-(OH)-Vit D_3(OR=0.994,P=0.046)和HDL(OR=0.391,P<0.001)。结论妊娠中期血清25-(OH)-Vit D_3和血脂水平与GDM的发病密切相关,其发病的危险因素为TG和TC,保护因素为25-(OH)-Vit D_3和HDL。
Objective To investigate the role of serum 25-hydroxyvitamin D3 [25- (OH) -Vit D_3] and serum lipids during the second trimester of pregnancy in the pathogenesis of gestational diabetes mellitus (GDM). Methods From January 2013 to May 2016, 7 000 prenatal women undergoing prenatal examinations at the Affiliated Hospital of North China Polytechnic University were enrolled. According to the results of prenatal examinations, 1 012 cases of GDM patients were included as experimental group, and 5 988 pregnant women without abnormalities The serum levels of 25- (OH) -Vit D 3, total cholesterol (TC), triglyceride (TG), high density lipoprotein (HDL) and low density lipoprotein (LDL) Level, using Logistic stepwise regression analysis of the role of various indicators in the pathogenesis of GDM. Results Compared with the control group, the levels of serum 25- (OH) -Vit D 3 (t = 2.991, P = 0.003) and HDL (t = 3.644, 6.263, P <0.001). The levels of TC (t = 7.698, P <0.001) and LDL (t = 9.045, P <0.001) were significantly higher in the two groups (all P <0.05). Logistic regression analysis showed that the levels of 25- (OH) -Vit D_3, TG, TC and HDL were all related to the pathogenesis of GDM. The risk factors of GDM were TG (OR = 1.540, P <0.001) and TC OR = 1.631, P = 0.001). OR> 1. The protective factors were 25- (OH) -Vit D 3 (OR = 0.994, P = 0.046) and HDL (OR = 0.391, P <0.001). Conclusion Serum levels of 25- (OH) -Vit D 3 and blood lipid in the second trimester of pregnancy are closely related to the pathogenesis of GDM. The risk factors for the pathogenesis are TG and TC, and the protective factors are 25- (OH) -Vit D 3 and HDL.