Abstract：
OBJECTIVE: 25-hydroxyvitamin D (25(OH)D) affects glucose metabolism by increasing insulin secretion and insulin receptor expression. However, whether 25(OH)D deficiency will increase the risk of gestational diabetes mellitus (GDM) has not been clearly reported. The purpose of this study is to assess the relationship between vitamin D levels in the second trimester of pregnancy and the risk of GDM.
METHODS: According to the inclusion and exclusion criteria, 247 pregnant women came to the fourth hospital of Shijiazhuang (The affiliated obstetrics and gynecology hospital of Hebei Medical University) for obstetrics were investigated during the period of January 1, 2019 to December 31, 2020. The levels of 25(OH)D in the second trimester (16-20 weeks) and oral 75 g glucose tolerance test (OGTT) at 24-28 weeks of pregnancy were reviewed. The sociodemographic data were collected from questionnaire. Multivariate logistic regression was used to analyze the relationship between vitamin D levels and GDM.
RESULTS: The incidence of GDM in the observation group (25(OH)D ≤ 26 ng/ml) was higher than that in the control group (25(OH)D > 26 ng/ml) (p = 0.039). Compared with control group, the observation group had significantly higher level of fasting plasma glucose (FPG) (4.7 [4.5-5.0] mmol/L vs. 4.6 [4.4-4.8] mmol/L, p = 0.012). In the whole study, the level of 25(OH)D was negatively correlated with FPG (r = - 0.164，p = 0.010). After adjusting for age, pre-pregnancy BMI, parity and adverse pregnancy history, compared with the observation group (25 (OH) D ≤ 26 ng/ml), the risk of developing GDM decreased by 50.9% in control group (25(OH)D > 26 ng/ml) (odds ratio [OR] = 0.491, 95% confidence interval [CI] = 0.243-0.989, p = 0.047).
CONCLUSIONS: Adequate vitamin D levels during the second trimester of pregnancy may reduce the risk of GDM.
METHODS: According to the inclusion and exclusion criteria, 247 pregnant women came to the fourth hospital of Shijiazhuang (The affiliated obstetrics and gynecology hospital of Hebei Medical University) for obstetrics were investigated during the period of January 1, 2019 to December 31, 2020. The levels of 25(OH)D in the second trimester (16-20 weeks) and oral 75 g glucose tolerance test (OGTT) at 24-28 weeks of pregnancy were reviewed. The sociodemographic data were collected from questionnaire. Multivariate logistic regression was used to analyze the relationship between vitamin D levels and GDM.
RESULTS: The incidence of GDM in the observation group (25(OH)D ≤ 26 ng/ml) was higher than that in the control group (25(OH)D > 26 ng/ml) (p = 0.039). Compared with control group, the observation group had significantly higher level of fasting plasma glucose (FPG) (4.7 [4.5-5.0] mmol/L vs. 4.6 [4.4-4.8] mmol/L, p = 0.012). In the whole study, the level of 25(OH)D was negatively correlated with FPG (r = - 0.164，p = 0.010). After adjusting for age, pre-pregnancy BMI, parity and adverse pregnancy history, compared with the observation group (25 (OH) D ≤ 26 ng/ml), the risk of developing GDM decreased by 50.9% in control group (25(OH)D > 26 ng/ml) (odds ratio [OR] = 0.491, 95% confidence interval [CI] = 0.243-0.989, p = 0.047).
CONCLUSIONS: Adequate vitamin D levels during the second trimester of pregnancy may reduce the risk of GDM.
摘要：
目的：25-羟基维生素D（25（OH）D）通过增加胰岛素分泌和胰岛素受体表达来影响糖代谢。然而,25(OH)D缺乏是否会增加妊娠期糖尿病(GDM)风险尚未明确报道.这项研究的目的是评估妊娠中期维生素D水平与GDM风险之间的关系。
方法：根据纳入和排除标准，在2019年1月1日至2020年12月31日期间，到石家庄市第四医院（河北医科大学附属妇产科医院）进行产科检查的247名孕妇。回顾了妊娠中期（16-20周）的25（OH）D水平和妊娠24-28周的口服75g葡萄糖耐量试验（OGTT）。社会人口统计学数据来自问卷调查。采用多因素logistic回归分析维生素D水平与GDM的关系。
结果：观察组(25(OH)D≤26ng/ml)GDM发生率高于对照组(25(OH)D>26ng/ml)(p=0.039)。与对照组相比,观察组空腹血糖(FPG)水平明显高于对照组(4.7[4.5-5.0]mmol/Lvs.4.6[4.4-4.8]mmol/L,p=0.012)。在整个研究中,25(OH)D水平与FPG呈负相关(r=-0.164，p=0.010)。在调整了年龄之后,孕前BMI,产次和不良妊娠史，与观察组（25（OH）D≤26ng/ml）相比，对照组发生GDM的风险降低了50.9%(25(OH)D>26ng/ml)(比值比[OR]=0.491,95%置信区间[CI]=0.243-0.989,p=0.047).
结论：妊娠中期充足的维生素D水平可以降低GDM的风险。
方法：根据纳入和排除标准，在2019年1月1日至2020年12月31日期间，到石家庄市第四医院（河北医科大学附属妇产科医院）进行产科检查的247名孕妇。回顾了妊娠中期（16-20周）的25（OH）D水平和妊娠24-28周的口服75g葡萄糖耐量试验（OGTT）。社会人口统计学数据来自问卷调查。采用多因素logistic回归分析维生素D水平与GDM的关系。
结果：观察组(25(OH)D≤26ng/ml)GDM发生率高于对照组(25(OH)D>26ng/ml)(p=0.039)。与对照组相比,观察组空腹血糖(FPG)水平明显高于对照组(4.7[4.5-5.0]mmol/Lvs.4.6[4.4-4.8]mmol/L,p=0.012)。在整个研究中,25(OH)D水平与FPG呈负相关(r=-0.164，p=0.010)。在调整了年龄之后,孕前BMI,产次和不良妊娠史，与观察组（25（OH）D≤26ng/ml）相比，对照组发生GDM的风险降低了50.9%(25(OH)D>26ng/ml)(比值比[OR]=0.491,95%置信区间[CI]=0.243-0.989,p=0.047).
结论：妊娠中期充足的维生素D水平可以降低GDM的风险。
