孕中期维生素D缺乏与妊娠期糖尿病女性产后葡萄糖耐量异常风险较高有关。
Vitamin D Deficiency at Mid-Pregnancy Is Associated with a Higher Risk of Postpartum Glucose Intolerance in Women with Gestational Diabetes Mellitus.
作者信息
Kim Kyung Soo, Park Seok Won, Cho Yong Wook, Kim Soo Kyung
机构信息
Department of Internal Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
出版信息
Endocrinol Metab (Seoul). 2020 Mar;35(1):97-105. doi: 10.3803/EnM.2020.35.1.97.
BACKGROUND
To evaluate the association between serum 25-hydroxyvitamin D (25(OH)D) at mid-pregnancy and postpartum glucose intolerance in women with gestational diabetes mellitus (GDM).
METHODS
We enrolled 348 pregnant women diagnosed with GDM from August 2012 to October 2016. We measured serum 25(OH)D levels at mid-pregnancy and carried out a 75-g oral glucose tolerance test at 6 to 12 weeks after delivery. Vitamin D deficiency was defined as serum 25(OH)D <20 ng/mL.
RESULTS
The prevalence of vitamin D deficiency was 76.7% (=267). Women with vitamin D deficiency had a higher prevalence of postpartum glucose intolerance than did those without vitamin D deficiency (48.7% vs. 32.1%, =0.011). Serum 25(OH)D level was negatively correlated with hemoglobin A1c at antepartum and postpartum period (antepartum: =-0.186, =0.001; postpartum: =-0.129, =0.047). Homeostasis model assessment of β-cell function was positively correlated with serum 25(OH)D level only postpartum (=0.138, =0.035). The risk of postpartum glucose intolerance was 2.00 times (95% confidence interval, 1.13 to 3.55) higher in women with vitamin D deficiency than in those without vitamin D deficiency (=0.018).
CONCLUSION
In women with GDM, vitamin D deficiency at mid-pregnancy is associated with an elevated risk of postpartum glucose intolerance.
背景
评估妊娠中期血清25-羟维生素D（25(OH)D）与妊娠期糖尿病（GDM）女性产后葡萄糖耐量异常之间的关联。
方法
我们纳入了2012年8月至2016年10月期间诊断为GDM的348名孕妇。我们测量了妊娠中期的血清25(OH)D水平，并在分娩后6至12周进行了75克口服葡萄糖耐量试验。维生素D缺乏定义为血清25(OH)D<20 ng/mL。
结果
维生素D缺乏的患病率为76.7%（=267）。维生素D缺乏的女性产后葡萄糖耐量异常的患病率高于无维生素D缺乏的女性（48.7%对32.1%，=0.011）。妊娠前后血清25(OH)D水平与糖化血红蛋白呈负相关（妊娠前：=-0.186，=0.001；产后：=-0.129，=0.047）。仅在产后，β细胞功能的稳态模型评估与血清25(OH)D水平呈正相关（=0.138，=0.035）。维生素D缺乏的女性产后葡萄糖耐量异常的风险比无维生素D缺乏的女性高2.00倍（95%置信区间，1.13至3.55）（=0.018）。
结论
在GDM女性中，妊娠中期维生素D缺乏与产后葡萄糖耐量异常风险升高有关。
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