目的 分析妊娠中期血清25(OH)D₃水平对妊娠期糖尿病(gestational diabetes mellitus,GDM)的预测价值。方法 选取2019年7月—2020年3月在广州市妇女儿童医疗中心及广东省计划生育专科医院进行产前检查的孕中期妇女,根据孕妇的空腹血糖(FBG)水平和口服糖耐量试验(OGTT)结果分为GDM组(100例)和对照组(320例)。分别测定两组孕妇的年龄、孕前BMI、空腹血糖、服糖后l h血糖、服糖后2 h血糖、空腹胰岛素及25(OH)D₃等指标,进行统计分析与比较。结果 GDM组维生素D不足及缺乏的发病率高于对照组(P＜0.05)。年龄、空腹胰岛素在两组之间无统计学差异(P＞0.05);GDM组25(OH)D₃水平低于对照组(P＜0.05);GDM组空腹血糖、服糖后1 h、2 h血糖及孕前BMI均高于对照组(P＜0.05)。血清25(OH)D₃水平与空腹血糖、服糖后1 h、2 h血糖呈负相关(P＜0.05),而与年龄、BMI及空腹胰岛素无显著相关性(P＞0.05)。25(OH)D₃水平与妊娠期糖尿病发生风险呈负相关。结论 妊娠中期血清25(OH)D₃水平降低可能增加GDM的发生风险,联合检测妊娠中期血清25(OH)D₃水平有助于GDM的早期预测。

Objective To analyze the predictive value of serum 25(OH)D₃ level in the second trimester of pregnancy for gestational diabetes mellitus. Methods From July 2019 to March 2020, pregnant women who had prenatal examinations in Guangzhou Women and Children's Medical Center and Guangdong Family Planning Hospital were selected and divided into GDM group (100 cases) and control group (320 cases) according to FBG level and oral glucose tolerance test (OGTT) results.The age, pre-pregnancy BMI, fasting blood glucose, l h blood glucose after taking sugar, 2 h blood glucose after taking sugar, fasting insulin, 25(OH)D₃ and other indicators of the two groups of pregnant women were measured, respectively, for statistical analysis and comparison. Results The incidence of vitamin D deficiency and deficiency in GDM group was higher than that in control group (P<0.05).There was no significant difference in age and fasting insulin between the two groups (P>0.05).The level of 25(OH)D₃ in the GDM group was lower than that in the control group (P<0.05).Fasting blood glucose, blood glucose at 1 h and 2 h after taking sugar and BMI before pregnancy were all higher in the GDM group than in the control group (P<0.05).Serum 25(OH)D₃ level was negatively correlated with fasting blood glucose and blood glucose at 1 h and 2 h after taking sugar (P<0.05), but not significantly correlated with age, BMI and fasting insulin (P>0.05).The level of 25(OH)D₃ was negatively correlated with the risk of gestational diabetes. Conclusion Reduced serum 25(OH)D₃ levels in the second trimester may increase the risk of GDM, and combined detection of serum 25(OH)D₃ levels in the second trimester is helpful for early prediction of GDM.