目的 探究1,25-二羟基维生素D3和微量元素水平与妊娠期糖尿病的之间的关系。方法 随机选取2016年1月至2018年1月之间在本院妇产科产检的254名GDM妊娠女性纳入GDM组，同时选取437名健康妊娠女性作为对照组。分别测定两组对象在孕早期、孕中期和孕晚期Ca、Fe、Zn、Cu、Mg、Gr含量及1,25-二羟基维生素D3水平。结果 GDM组孕前体重和孕前BMI均显著高于对照组（P<0.01），而两组年龄，身高未见统计学差异；组内比较：两组对象孕中期及晚期Fe、Zn、Cu含量低于孕早期（P<0.05），GDM组1,25-二羟基维生素D3随着孕期增加水平降低（P<0.05），而两组Ca、Mg、Gr含量随孕期增加无变化。组间比较：GDM组孕中期及晚期Fe、Zn及1,25-二羟基维生素D3水平显著低于同期对照组孕妇而血铜含量高于对照组（P<0.05），Ca、Mg、Gr含量无差异，两组对象孕早期微量元素含量及1,25-二羟基维生素D3水平无差异。结论 妊娠期健康女性体内铁锌铜含量随孕期增加而降低，而GDM妊娠女性体内铁锌含量随孕期增加下降尤为显著，此外GDM组维生素D水平随孕期增加而降低。
Objective To explore the relationship between the levels of 1,25-dihydroxyvitomin D3[1,25-(OH)2D3] and trace elements and gestational diabetes mellitus during pregnancy. Method During January 2016 to January 2018, 254 gestational diabetes mellitus (GDM) pregnant women were randomly selected from the department of obstetrics and gynecology in our hospital in GDM group, while 437 healthy pregnant women were selected as the control group. The levels of Ca, Fe, Zn, Cu, Mg, Gr and 1,25-dihydroxyvitomin D3 levels in two groups were measured respectively in the first trimester, second trimester and third trimester. Results Pre-pregnancy weight and pre-pregnancy BMI in GDM group were significantly higher than those in control group (P<0.01), but there was no significant difference in age and height between the two groups; Intra group comparison: the levels of Fe, Zn and Cu in the two groups in second trimester and third trimester were lower than those in first trimester (P<0.05). In GDM group, and 1,25- two hydroxyvitamin D3 decreased with the increase of pregnancy(P<0.05), while the levels of Ca, Mg and Gr in two groups didn’t change with the increase of pregnancy. Inter group comparison: the levels of Fe, Zn and 1,25- two hydroxyvitamin D3 of GDM group were significantly lower than those in the control group at the second and third trimester but the level of Cu was higher than that of control group(P<0.05), besides, there is no difference in the levels of Ca, Mg and Gr. What’s more, there was no difference in trace element content and 1,25- two hydroxyvitamin D3 level between two groups of pregnant women in the first trimester. Conclusions The content of Fe, Zn and Cu in the healthy pregnant women decreased with the increase of pregnancy, while the content of Zn and Fe in GDM pregnant women apparently decreased with the increase of pregnancy. In addition, vitamin D level in group GDM decreased with the increase of pregnancy.
