妊娠维生素 D 缺乏与妊娠糖尿病。
Vitamin D deficiency in pregnancy and gestational diabetes mellitus.
机构信息
Department of Neonatology, Beth Israel Deaconess Medical Center, Boston, MA, USA.
出版信息
Am J Obstet Gynecol. 2012 Sep;207(3):182.e1-8. doi: 10.1016/j.ajog.2012.05.022. Epub 2012 Jun 1.
OBJECTIVE
We examined the association of second-trimester maternal plasma 25-hydroxyvitamin D (25[OH]D) during pregnancy with gestational diabetes mellitus (GDM).
STUDY DESIGN
Among 1314 pregnant women who participated in Project Viva, a birth cohort study, we measured 25(OH)D levels at 26-28 weeks gestation during GDM screening using a 1-hour 50-g glucose challenge test.
RESULTS
We found 25(OH)D levels of <25 nmol/L in 44 of 1087 women (4.0%) with normal glucose tolerance, 9 of 159 women (5.7%) with impaired glucose tolerance, and 9 of 68 women (13.2%) with GDM. Analyses that were adjusted for sociodemographics, season, maternal body mass index, gestational weight gain, and dietary factors suggested that women with 25(OH)D levels of <25 vs ≥25 nmol/L may have higher odds of experiencing GDM (odds ratio, 2.2; 95% confidence interval, 0.8-5.5). Glucose levels after the glucose challenge test were associated inversely with 25(OH)D levels (P < .01).
CONCLUSION
Second-trimester 25(OH)D levels were associated inversely with glucose levels after 1-hour 50-g glucose challenge test; low 25(OH)D levels may be associated with increased risk of GDM.
目的
我们研究了妊娠中期母体血浆 25-羟维生素 D（25[OH]D）与妊娠期糖尿病（GDM）的关系。
研究设计
在参与 Viva 项目的 1314 名孕妇中，我们在 GDM 筛查期间（使用 1 小时 50g 葡萄糖挑战试验），在妊娠 26-28 周时测量了 25（OH）D 水平。
结果
我们发现 1087 名糖耐量正常的女性中有 44 名（4.0%）、159 名糖耐量受损的女性中有 9 名（5.7%）和 68 名 GDM 女性的 25（OH）D 水平<25nmol/L。经社会人口统计学、季节、母体体重指数、妊娠体重增加和饮食因素调整的分析表明，25（OH）D 水平<25 与≥25nmol/L 的女性发生 GDM 的可能性更高（比值比，2.2；95%置信区间，0.8-5.5）。葡萄糖挑战试验后血糖水平与 25（OH）D 水平呈负相关（P<0.01）。
结论
妊娠中期 25（OH）D 水平与 1 小时 50g 葡萄糖挑战试验后血糖水平呈负相关；低 25（OH）D 水平可能与 GDM 风险增加有关。
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