Ma Huashu, Qiao Zongxu, Li Na, Zhao Yefang, Zhang Shasha
Department of Obstetrics, Xingtai People's Hospital Affiliated to Hebei Medical University, Xingtai, China.
Ann Palliat Med. 2021 Jun;10(6):6630-6636. doi: 10.21037/apm-21-1036. Epub 2021 Jun 8.
Gestational diabetes mellitus (GDM) is one of the most common complications during pregnancy. This study aims to analyze the relationship between the changes in vitamin A, vitamin E, and oxidative stress levels, and pregnancy outcomes in GDM patients.
A total of 104 GDM patients admitted to our hospital between January 2018 and January 2019 were selected as the study group, and 126 pregnant women who received healthy examinations in the same hospital during the same period were selected as the control group. Vitamin A, E, and oxidative stress [total antioxidant capacity (TAOC), malondialdehyde (MDA), red blood cell glutathione (GSH), and superoxide dismutase (SOD)] between the two groups were compared. Age, pre-pregnancy body mass index (BMI), pre-pregnancy waist-to-hip ratio (waist/hip circumference), parity, gravidity, glycosylated hemoglobin, and other related index levels were collected for the GDM patients. Multivariate logistic regression analysis was used to analyze the risk factors affecting the pregnancy outcomes of the GDM patients.
The levels of vitamin A, SOD, GSH, and TAOC in the study group were significantly lower than those in the control group, and the levels of vitamin E and MDA were significantly higher than those in the control group (P<0.05). Of the 104 GDM patients, 43 had adverse pregnancy outcomes, and 61 had no adverse pregnancy outcomes. There was a significant difference between the adverse and non-adverse pregnancy outcome groups in the levels of glycosylated hemoglobin, vitamin A, vitamin E, MDA, SOD, GSH, and TAOC (P<0.05). Analysis of the unconditional multivariate logistic regression model showed that the expression levels of glycosylated hemoglobin, vitamin A, vitamin E, MDA, SOD, GSH, and TAOC were independent risk factors affecting the pregnancy outcomes of GDM patients (P<0.05).
Vitamin A, E, and oxidative stress levels are abnormally expressed in GDM, and are independent risk factors affecting the pregnancy outcomes in GDM patients. Therefore, the clinical monitoring of oxidative stress levels and vitamin supplementation should be increased, as these may be of great significance in improving pregnancy outcomes in GDM patients.
妊娠期糖尿病（GDM）是孕期最常见的并发症之一。本研究旨在分析维生素A、维生素E及氧化应激水平变化与GDM患者妊娠结局之间的关系。
选取2018年1月至2019年1月在我院收治的104例GDM患者作为研究组，同期在我院进行健康检查的126例孕妇作为对照组。比较两组间维生素A、E及氧化应激指标[总抗氧化能力（TAOC）、丙二醛（MDA）、红细胞谷胱甘肽（GSH）和超氧化物歧化酶（SOD）]。收集GDM患者的年龄、孕前体重指数（BMI）、孕前腰臀比（腰/臀围）、产次、妊娠次数、糖化血红蛋白及其他相关指标水平。采用多因素logistic回归分析影响GDM患者妊娠结局的危险因素。
研究组维生素A、SOD、GSH及TAOC水平显著低于对照组，维生素E及MDA水平显著高于对照组（P<0.05）。104例GDM患者中，43例出现不良妊娠结局，61例未出现不良妊娠结局。不良与非不良妊娠结局组在糖化血红蛋白、维生素A、维生素E、MDA、SOD、GSH及TAOC水平上存在显著差异（P<0.05）。无条件多因素logistic回归模型分析显示，糖化血红蛋白、维生素A、维生素E、MDA、SOD、GSH及TAOC的表达水平是影响GDM患者妊娠结局的独立危险因素（P<0.05）。
GDM患者维生素A、E及氧化应激水平异常表达，是影响GDM患者妊娠结局的独立危险因素。因此，应加强氧化应激水平的临床监测及维生素补充，这对改善GDM患者妊娠结局可能具有重要意义。
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