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超声骨密度测量联合维生素D缺乏评估妊娠期糖尿病患者的骨密度及影响因素分析

Evaluation of bone mineral density in patients with gestational diabetes mellitus by ultrasonic bone mineral density measurement combined with Vitamin-D deficiency and analysis of influencing factors.

作者信息

Han Lulu, Ma Jingjing, Wang Shenghai, Li Zhihong

机构信息

Lulu Han, Department of Endocrinology, Baoding First Central Hospital, Baoding, Hebei, 071000, China.

Jingjing Ma, Department of Endocrinology, Baoding First Central Hospital, Baoding, Hebei, 071000, China.

出版信息

Pak J Med Sci. 2022 Mar-Apr;38(4Part-II):933-938. doi: 10.12669/pjms.38.4.5090.

Abstract

OBJECTIVES

To investigate the evaluation of bone mineral density (BMD) in patients with gestational diabetes mellitus (GDM) by ultrasonic bone mineral density measurement combined with Vitamin-D deficiency and its influencing factors.

METHODS

A total of 100 patients with gestational diabetes mellitus (GDM) admitted to our hospital from January 2017 to December 2020 were selected as the GDM group, and another 100 pregnant volunteers who underwent physical examination in our hospital were selected as the healthy control group. The levels of triacylglycerol (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), glycated hemoglobin (HbA1c), fasting insulin (FINS), C-peptide, procollagen, parathyroid hormone (PTH), serum calcium, 25-hydroxyvitamin-D3 (25-OH-D) and ultrasonic BMD Z-score were determined and compared between the two groups. Moreover, the effects of different levels of 25-OH-D on the above indexes were compared, and multivariate logistic regression analysis was performed.

RESULTS

Compared with the healthy reference group, the levels of TG, TC, LDL-C, PTH, HbA1c, FINS and C-peptide of GDM group were significantly increased (P < 0.05), while BMD Z-score and 25-OH-D levels were significantly decreased. In the GDM group, the lower the 25-OH-D levels, the higher the FPG, HbA1c and FINS levels and the lower the serum calcium level and BMD Z-score, with statistically significant differences (P < 0.05). Multivariate logistic regression analysis showed that 25-OH-D was an independent risk factor affecting BMD in patients with GDM (P<0.05).

CONCLUSIONS

Patients with GDM have lower BMD and 25-hydroxyVitamin-D3 levels. Measurement of BMD and 25-hydroxyVitamin-D3 levels can help assess the progression of GDM. BMD has a close bearing on Vitamin-D deficiency in patients with GDM.

摘要

目的

通过超声骨密度测量结合维生素D缺乏情况及其影响因素,研究妊娠期糖尿病(GDM)患者的骨密度(BMD)评估。

方法

选取2017年1月至2020年12月在我院收治的100例妊娠期糖尿病患者作为GDM组,另选取100例在我院进行体检的妊娠志愿者作为健康对照组。测定并比较两组的甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、糖化血红蛋白(HbA1c)、空腹胰岛素(FINS)、C肽、前胶原、甲状旁腺激素(PTH)、血清钙、25-羟维生素D3(25-OH-D)水平及超声骨密度Z值。此外,比较不同水平的25-OH-D对上述指标的影响,并进行多因素logistic回归分析。

结果

与健康对照组相比,GDM组的TG、TC、LDL-C、PTH、HbA1c、FINS及C肽水平显著升高(P<0.05),而骨密度Z值和25-OH-D水平显著降低。在GDM组中,25-OH-D水平越低,空腹血糖(FPG)、HbA1c及FINS水平越高,血清钙水平及骨密度Z值越低,差异有统计学意义(P<0.05)。多因素logistic回归分析显示,25-OH-D是影响GDM患者骨密度的独立危险因素(P<0.05)。

结论

GDM患者的骨密度和25-羟维生素D3水平较低。测量骨密度和25-羟维生素D3水平有助于评估GDM的进展。骨密度与GDM患者的维生素D缺乏密切相关。

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