| 胡国涛,吴军,袁新菊,等.黔东南州孕妇维生素 D水平与妊娠期糖尿病、妊娠期亚临床甲状腺功能减退症的相关性分析[J].安徽医药,2026,30(11):2223-2227. |
| 黔东南州孕妇维生素 D水平与妊娠期糖尿病、妊娠期亚临床甲状腺功能减退症的相关性分析 |
| Correlation between vitamin D levels and gestational diabetes mellitus and subclinical hypothyroidism in pregnant women in Qiandongnan prefecture |
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| DOI：10.3969/j.issn.1009-6469.2026.11.019 |
| 中文关键词: 维生素 D缺乏 妊娠并发症 民族地区 妊娠期糖尿病 妊娠期亚临床甲状腺功能减退 相关性分析 |
| 英文关键词: Vitamin D deficiency Pregnancy complications Ethnic areas Gestational diabetes mellitus Subclinical hypothy-roidism during pregnancy Correlation analysis |
| 基金项目:黔东南州科技计划项目(黔东南科合基础〔2023〕19号) |
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| 中文摘要: |
| 目的探讨黔东南州孕妇维生素 D水平与妊娠期糖尿病、妊娠期亚临床甲状腺功能减退症的相关性。方法选取 2023年 1月至 2024年 1月在黔东南州人民医院就诊的孕妇 210例为研究对象，收集病人年龄、居住地、民族、孕期、现病史、既往病史等资料。根据 25-羟基维生素 D(［25(OH)D］检测结果，分为维生素 D正常组 41例，维生素 D缺乏组 169例。检测空腹血糖(FPG)、糖化血红蛋白( HbA1c)、促甲状腺素( TSH)、游离甲状腺激素( FT4)、钙离子( Ca2+)、 25(OH)D、血肌酐( Scr)等。统计维生素 D缺乏率，对比维生素 D缺乏在各年龄段、城乡居住地、不同民族、不同孕期之间的差异，比较两组病人妊娠期糖尿病、妊娠期亚临床甲状腺功能减退症、妊娠期糖尿病合并亚临床甲状腺功能减退症的发生率，分析维生素 D缺乏与妊娠期并发症之间的相关性。结果维生素 D正常组与维生素 D缺乏组病人的年龄、 Scr等对比差异无统计学意义( P>0.05)，25(OH)D、TSH、 FT4Ca2+、FPG、HbA1c等对比，差异有统计学意义( P<0.05)。所有孕妇中，维生素 D缺乏率为 80.5%，维生素 D水平为( 22.85±9.99)n、mol/L。苗族、侗族、汉族、其他民族维生素 D缺乏率分别为 78.5%、86.8%、78.4%、82.1%，差异无统计学意义( P=0.706)。 21～25岁、 >25～36岁、 >36岁 3个年龄段孕妇维生素 D缺乏率分别为 85.7%、80.4%、74.1%，差异无统计学意义( P=0.518)。城市居住人群、乡镇居住人群维生素 D缺乏率分别为 84.3%、77.7%，差异无统计学意义( P=0.291)。孕早期、孕中期、孕晚期维生素 D缺乏率分别为 92.1%、76.5%、58.5%，差异有统计学意义(P=0.001)。维生素 D正常组与维生素 D缺乏组对比妊娠期糖尿病患病率( 12.2%比 30.2%)妊娠期亚临床甲状腺功能减退症患病率( 7.3%比 24.9%)、妊娠期糖尿病合并亚临床甲状腺功能减退症患病率( 0%比 21.3%)差、异有统计学意义( P<0.05)。 25(OH)D水平与 Ca2+、FT4呈正相关( P<0.05)； 25(OH)D水平与 TSH、 FPG、糖化血红蛋白呈负相，关( P<0.05)。结论在黔东南地区，维生素 D水平与妊娠期糖尿病、妊娠期亚临床甲状腺功能减退症之间存在一定的关系。维生素 D缺乏使妊娠期并发症患病率明显升高。 |
| 英文摘要: |
| Objective To investigate the correlation between maternal vitamin D levels and gestational diabetes mellitus (GDM) aswell as gestational subclinical hypothyroidism (SCH) among pregnant women in Qiandongnan Prefecture. Methods A total of 210 pregnant women who sought medical attention atQiandongnan Prefecture People's Hospital from January 2023 and January 2024 wereenrolled as study subjects. Collected data included age, place of residence (urban/rural), ethnicity, gestational stage, current medicalhistory, and past medical history. The patients were assigned to a normal vitamin D group (n=41) or a vitamin D deficiency group (n= 169) according to serum 25-hydroxyvitamin D[25(OH)D] levels. Measurements included fasting plasma glucose (FPG), glycated hemo-globin (HbA1c), thyroid-stimulating hormone (TSH), free thyroxine (FT4), calcium ions (Ca2.), 25(OH)D, and serum creatinine (Scr). Theprevalence of vitamin D deficiency was calculated and compared across different age groups, urban versus rural residence, ethnicities,and pregnancy trimesters. The prevalence rates of GDM, SCH, and their comorbidity was compared between the two groups, and the cor-relation between 25(OH)D and pregnancy-related complications was analyzed.Results No significant differences were found in age or Scr levels between the normal vitamin D group and the vitamin D deficiency groups (P>0.05). Significant differences were observed in 25(OH)D, TSH, FT4, Ca2., FPG, and HbA1c levels (P<0.05). The overall prevalence of vitamin D deficiency was 80.5%, with a mean vi-tamin D level of (22.85±9.99)nmol/L. The vitamin D deficiency rates did not differ significantly among Miao (78.5%), Dong (86.8%),Han (78.4%), or other ethnic groups (82.1%) (P=0.706), across age groups 21-25 (85.7%),>25-36 (80.4%), or >36 years (74.1%) (P=0.518),or between urban (84.3%) and rural (77.7%) residents (P=0.291).However,significant differences were found across pregnancy trimesters:first(92.1%),second(76.5%),and third(58.5%)(P=0.001).The vitamin D deficiency group had a significantly higher prevalence of GDM(30.2% vs. 12.2%), SCH(24.9% vs. 7.3%),and comorbidity of GDM and SCH(21.3% vs. 0%) compared to the normal vitamin D group(all P<0.05).Serum 25(OH)D levels showed a positive correlation with Ca2. and FT4(P<0.05),and a negative correlation with TSH, FPG,and HbA1c(P<0.05). Conclusions In the Qiandongnan prefecture,lower maternal vitamin D levels are significantly associatedwith an increased risk of GDM and SCH.Vitamin D deficiency is linked to a substantially higher prevalence of these obstetric complica-tions. |
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