孕早期补充维生素D对妊娠期糖尿病高危人群的干预作用

目的探讨孕早期补充维生素D(VD)对血清25-羟维生素D水平(25-OH-D)与妊娠期糖尿病(GDM)发病风险的影响。方法选取2017年10月至12月,在海淀区妇幼保健院营养门诊进行第一次早孕咨询的孕妇中招募101例具有GDM高危因素的孕妇,随机分为干预组与对照组。干预组从孕早期补充700 U VD和100 mg钙剂,对照组同一时间开始补充100 U VD和100 mg钙剂,干预时间至分娩。结果经干预后,干预组孕中期血清25-OH-D水平为(92.08±29.69)nmol/L,对照组为(69.99±25.10)nmol/L。干预组孕妇孕中期、孕晚期及脐带血血清25-OH-D水平均高于对照组(P<0.05)。干预组GDM发病率为18.37%,对照组发病率为28.85%(P>0.05);与对照组相比,干预组的GDM发病风险OR=0.56(95%CI 0.22～1.42)(P>0.05)。结论孕早期补充VD可明显改善孕期妇女VD营养水平,但并未显著降低GDM的发病率。

Effects of vitamin D supplementation in early pregnancy on high-risk groups of gestational diabetes mellitus

OBJECTIVE To investigate the effect of vitamin D supplementation(VD)in early pregnancy on the serum 25-hydroxyvitamin D(25-OH-D)level and the risk of gestational diabetes mellitus(GDM).METHODS From October to December 2017,a total of 101 pregnant women with high risk factors for GDM were enrolled in the first pregnancy consultation at the nutrition clinic of Haidian Maternal and Child Health Hospital,and were randomly divided into intervention group and control group.The intervention group was supplemented with 700 U VD and 100 mg of calcium at the beginning of pregnancy,and the control group was supplemented with 100 U VD and 100 mg of calcium at the same time,and the intervention time was until delivery.RESULTS After intervention,the mean serum 25-OH-D level in the intervention group was(92.08±29.69)nmol/L,and that in the control group was(69.99±25.10)nmol/L.The serum levels of 25-OH-D in the pregnant women,gestational age and cord blood were higher than those in the control group(P<0.05).The incidence of GDM in the intervention group was 18.37%,and the incidence rate in the control group was 28.85%(P>0.05).Compared with the control group,the OR value of the risk of GDM in the intervention group was 0.56(95%CI 0.22-1.42)(P<0.05).CONCLUSION The supplementation of VD in early pregnancy can significantly improve the VD nutrition level of pregnant women,but does not significantly reduce the incidence of GDM.