摘要
目的:探究维生素D结合个体化运动、饮食干预对妊娠期糖尿病(GDM)患者胰岛β细胞及妊娠结局的影响。方法:对本院2016年1月—2017年12月本中心产科收治的GDM患者86例进行前瞻性研究,随机数字表法分为对照组(43例)及观察组(43例),两组均给予门冬胰岛素皮下注射治疗,观察组辅以口服维生素D3及运动饮食干预,比较两组血糖相关指标、炎性因子水平、缺血缺氧相关指标、同型半胱氨酸(HCY)、血清胱抑素C(Cys-C)、胰岛β细胞相关指标、不良妊娠和胎儿结局。结果:治疗前两组血糖相关指标、炎性因子水平、缺血缺氧指标相关指标、HCY、Cys-C及胰岛β细胞相关指标无差异(P>0.05),治疗后,观察组FPG、2hPG、HbAlc、hs-CRP、TNF-α、HIF-1α、ET-1、Bax、Caspase-3、HCY、Cys-C、FINS、HOMA-IR水平及不良妊娠结局(23.3%)、不良胎儿结局(23.3%)均低于对照组(58.1%、44.2%),NO、HOMA-β、ISI水平均高于对照组(P<0.05)。结论:维生素D结合个体化运动、饮食干预能更好地提高GDM患者血糖控制效果,降低血清炎症因子水平,缓解患者胎盘缺血缺氧状态,提高胰岛β细胞功能,改善妊娠及胎儿结局。
Objective:To investigate the influence of vitamin D combined with individualized exercise and dietary intervention on isletβ-cells and pregnancy outcomes of pregnant women with gestational diabetes mellitus(GDM).Methods:From January 2016 to December 2017,86 pregnant women with GDM were included in this prospective study,and they were divided into control group and observation group(43 cases in each group)by random number table method.All women in the two groups were given insulin aspart subcutaneous injection,and the women in the observation group were given oral vitamin D3,individualized exercise and dietary intervention additionally.The related parameters of blood sugar,the inflammatory factor levels,the ischemia and hypoxia related indicators,the levels of serum homocysteine(HCY)and serum cystatin C(Cys-C),the indicators related to islet beta cells,and the rates of adverse pregnancy and fetal outcomes were compared between the two groups.Results:There were no significant different in related blood glucose indicators,inflammatory factor levels,ischemia and hypoxia related indicators,levels of HCY and Cys-C,and related indicators of isletβcell before treatment between the two groups(P>0.05).After treatment,the levels of FPG,2 hPG,HbAlc,hs-CRP,TNF-α,HIF-1α,ET-1,Bax,Caspase-3,HCY,Cys-C,FINS,and HOMA-IR of women in the observation group were significant lower than those of women in the control group,but the levels of NO,HOMA-βand ISI were significant higher than those of women in the control group(P<0.05).And the rates of adverse pregnancy outcomes and adverse fetal outcomes of the observation group were 23.3%and 23.3%,which were significant lower than those(58.1%and 44.2%)of the control group(P<0.05).Conclusion:Vitamin D combined with individualized exercise and dietary intervention can effectively improve the blood glucose control effect of pregnant women with GDM,can decrease their level of serum inflammatory factors,can relieve their placental ischemia and hypoxia,can enhance their isletβcell function,and can improve their pregnancy and fetal outcomes.
作者
郭巍
肇雅娟
赵聆
GUO Wei;YAN Yajuan;ZHAO Ling(Zhongshan District Maternal and Child Health Care and Family planning Service Center of Dalian,Liaoning Province,116013)
出处
《中国计划生育学杂志》
2020年第7期1048-1052,1059,共6页
Chinese Journal of Family Planning
