范海博

[摘要] 目的 探討胰岛素抵抗与妊娠糖尿病（GDM）患者血清维生素D的相关性。 方法 选择我院2019年1月至2020年1月收治的GDM患者32例作为观察组，选择同期健康体检产妇32例作为对照组。均检测空腹胰岛素、三酰甘油、总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、25-羟维生素D水平、空腹血糖，并分析胰岛素抵抗与血清25-羟维生素D的相关性。 结果 观察组三酰甘油（2.20±0.48）mmol/L、总胆固醇（4.43±0.15）mmol/L、低密度脂蛋白胆固醇（2.39±0.17）mmol/L、高密度脂蛋白胆固醇（1.31±0.29）mmol/L与对照组[（2.17±0.42）mmol/L、（4.46±0.16）mmol/L、（2.43±0.19）mmol/L、（1.29±0.28）mmol/L]比较，差异无统计学意义（P>0.05）;与对照组比较，观察组空腹胰岛素（24.79±2.43）U/L及空腹血糖（7.29±0.81）mmol/L水平均较高，差异有统计学意义（P<0.05）;与对照组比较，观察组胰岛素抵抗指数（6.75±1.32）较高，25-羟维生素D水平（18.86±3.48）nmol/L较低，差异有统计学意义（P<0.05）;经Pearson相关性分析发现，GDM患者血清25-羟维生素D与胰岛素抵抗呈负相关（r=-0.733，P=0.000）。 结论 GDM患者血清维生素D与胰岛素抵抗有关，推测GDM患者的胰岛素抵抗可通过维生素D补充进行调节，临床可根据生素D与胰岛素抵抗情况，积极为患者实施高效的治疗方案。

[关键词] 妊娠糖尿病;维生素D;胰岛素抵抗;相关性

[中图分类号] R714.5          [文献标识码] B          [文章编号] 1673-9701（2021）12-0126-04

Correlation analysis between serum vitamin D and insulin resistance in patients with gestational diabetes mellitus

FAN Haibo

Department of Clinical Laboratory， Jiamusi Maternal and Child Health Hospital in Heilongjiang Province， Jiamusi 154002， China

[Abstract] Objective To explore the correlation between insulin resistance and serum vitamin D in patients with gestational diabetes mellitus （GDM）. Methods A total of 32 patients with GDM admitted to our hospital from January 2019 to January 2020 were selected as the observation group.32 parturients receiving the physical examination in the same period were selected as the control group.The levels of fasting insulin （FI），triglyceride， total cholesterol （TC）， low density lipoprotein cholesterol （LDL-C），high density lipoprotein cholesterol （HDL-C），25- hydroxyvitamin D （25-OH D） and fasting blood glucose （FBG） were measured in both groups， while the correlation between insulin resistance and serum 25-OH D was analyzed. Results The triglyceride [（2.20±0.48）mmol/L]，TC[（4.43±0.15）mmol/L]， LDL-C[（2.39±0.17） mmol/L] and HDL-C[（1.31±0.29） mmol/L] in the observation group were significantly higher than those in the control group [（2.17±0.42）mmol/L， （4.46±0.16）mmol/L， （2.43±0.19）mmol/L and （1.29±0.28）mmol/L]，and there was no significant difference （P>0.05）. Compared with the control group， FI[（24.79±2.43）U/L] and FBG [（7.29±0.81）mmol/L] were higher in the observation group， and the difference was statistically significant （P<0.05）. Compared with the control group， the insulin resistance index of the observation group was higher [（6.75±1.32）]， and the level of 25-OH D was lower [（18.86±3.48）nmol/L]， with statistically significant difference（P<0.05）. Pearson correlation analysis showed that serum 25-OH D in GDM patients was negatively correlated with insulin resistance（r=-0.733， P=0.000）. Conclusion Serum vitamin D in GDM patients is related to insulin resistance. It is speculated that insulin resistance in GDM patients can be regulated by vitamin D supplementation. According to the situation of vitamin D and insulin resistance， effective treatment programs can be actively implemented for patients.

[Key words] Gestational diabetes mellitus; Vitamin D; Insulin resistance; Correlation

妊娠糖尿病（Gestational diabetes mellitus，GDM）是影响孕产妇身心健康的疾病，是指该期间首次出现糖代谢异常情况，因产妇妊娠过程会出现激素变化，进而削弱机体胰岛素敏感度，出现胰岛素抵抗，并干扰糖代谢，不仅降低生活质量，严重者影响妊娠结局，导致新生儿低血糖、巨大儿等发生率增加[1]。作为脂溶性维生素的维生素D，可影响钙磷代谢，调节免疫功能，促进骨代谢，并以25-羟维生素D的形式参与血液循环，其水平的高低可反映维生素D状态[2]。相关研究发现，胰岛素抵抗与维生素D具有联系，而维生素D缺乏会提高GDM发生风险，但目前临床对此类相关应用报道较少[3]。鉴于此，本研究选择我院2019年1月至2020年1月收治的GDM患者32例作为观察组，选择同期健康体检产妇32例作为对照组，旨在探讨胰岛素抵抗与GDM患者血清维生素D的相关性，现报道如下。