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目的:探讨补充维生素D(VitD)对妊娠期糖尿病(GDM)孕妇胰岛素抵抗的影响。方法:将56例GDM孕妇随机分成饮食控制+VitD组(26例)和饮食控制组(30例)。饮食控制+VitD组采取饮食控制的同时口服VitD3400 IU,每日2次;另选择20例健康孕妇作为对照组。1个月后分别检测3组空腹血糖(FBG)、空腹胰岛素(FINS)及血清25-(OH)VitD3含量。根据公式计算胰岛素敏感指数(HOMA-ISI)和胰岛素抵抗指数(HOMA-IRI)来评价胰岛素抵抗程度。结果:饮食控制+VitD组25-(OH)VitD3升高至(49.08±7.36)nmol/L,明显高于饮食控制组(28.82±6.34)nmol/L,P<0.05,与对照组比较差异无统计学意义(P>0.05)。对照组、饮食控制组和饮食控制+VitD组的FINS分别为(9.13±2.96)mU/L、(13.89±5.41)mU/L、(10.24±3.85)mU/L,两组间比较差异均有统计学意义(P<0.05)。饮食控制+VitD组HOMA-IRI明显低于饮食控制组(P<0.05),而高于对照组(P<0.05);HOMA-ISI明显高于饮食控制组(P<0.05),而低于对照组(P<0.05)。饮食控制+VitD组和饮食控制组的FBG均显著高于对照组(P<0.05),但两组之间比较差异无统计学意义(P>0.05)。结论:GDM发生与VitD缺乏有关,GDM孕妇补充VitD后,25-(OH)VitD3水平明显升高,胰岛素抵抗明显改善,但不能恢复至正常孕妇状态。
Objective: To investigate the effect of vitamin D supplementation on insulin resistance in pregnant women with gestational diabetes mellitus (GDM). Methods: 56 pregnant women with GDM were randomly divided into diet control + VitD group (26 cases) and diet control group (30 cases). Diet control + VitD group taking diet control while oral VitD3400 IU, 2 times a day; the other 20 healthy pregnant women as the control group. One month later, the levels of fasting blood glucose (FBG), fasting insulin (FINS) and serum 25- (OH) VitD3 were measured in three groups. Insulin sensitivity index (HOMA-ISI) and insulin resistance index (HOMA-IRI) were calculated according to the formula to evaluate the degree of insulin resistance. Results: The diet-control + VitD group increased 25- (OH) VitD3 to (49.08 ± 7.36) nmol / L, significantly higher than that of the diet control group (28.82 ± 6.34) nmol / L, P < Statistical significance (P> 0.05). FINS were (9.13 ± 2.96) mU / L, (13.89 ± 5.41) mU / L and (10.24 ± 3.85) mU / L in the control group, the diet control group and the diet control + VitD group, respectively Statistical significance (P <0.05). HOMA-IRI in diet control + VitD group was significantly lower than that in control group (P <0.05), but higher than that in control group (P <0.05); HOMA-ISI was significantly higher than that in control group (P <0.05) Group (P <0.05). FBG of diet control + VitD group and diet control group were significantly higher than that of control group (P <0.05), but there was no significant difference between the two groups (P> 0.05). Conclusion: The occurrence of GDM is related to the deficiency of VitD. After vitamin D supplementation in GDM pregnant women, the level of 25- (OH) VitD3 is markedly elevated, insulin resistance is obviously improved, but it can not be recovered to normal pregnant women.