A study on association of serum vitamin D level in early pregnancy and GDM in Nanchong region
Objective To investigate serum level of 25-hydroxyvitamin D[25(OH)D]in early pregnancy in Nanchong region,Sichuan and association between serum 25(OH)D and gestational diabetes mellitus(GDM).Methods 3491pregnant women who received regular prenatal examination in our hospital from January 2019 to December 2022 were selected as study subjects.The information such as maternal age,BMIs before pregnancy and at early pregnancy registration,past pregnancy and delivery histories,as well as serum 25(OH)D level at 11-13+6 weeks of gestation and 75g glucose OGTT results at 24-28 weeks of gestation were collected.The pregnant women were divided into normal group(n=2926)and GDM group(n=575)according to their OGTT results.Further,they received stratified grouping:① According to OGTT fasting blood glucose level,they were divided into normal OGTT fasting blood glucose level subgroup(n=3 201)and abnormal OGTT fasting blood glucose level subgroup(n=290);② According to OGTT 1-hour blood glucose level,they were divided into normal OGTT 1-hour blood glucose level subgroup(n=3 254)and abnormal OGTT 1-hour blood glucose level subgroup(n=237);③ According to OGTT 2-hour blood glucose level,they were divided into normal OGTT 2-hour blood glucose level subgroup(n=3 296)and abnormal OGTT 2-hour blood glucose level subgroup(n=195);④ Among 575 pregnant women with GDM,450 pregnant women with GDM were divided into single abnormal item subgroup(they met GDM diagnosis criteria due to one abnormal item of all 3 items OGTT),and 125 pregnant women with GDM were divided into multi-items abnormal subgroup(they met GDM diagnosis criteria due to abnormal two or above items).The serum 25(OH)D levels of all pregnant women were detected.SPSS 22.0 statistical software was used to process the data.Spearman correlation analysis was employed to analyze relationship between serum 25(OH)D level in early pregnancy and blood glucose level(OGTT 1-hour and OGTT 2-hour)in the second trimester of pregnancy.Logistic regression analysis was used to analyze relationship between serum 25(OH)D level in early pregnancy and development of GDM.Results A total of 3 491 pregnant women were enrolled,including 2 916(83.5％)in the normal group and 575(16.5％)in the GDM group.The incidence of GDM was 16.5％.There were 1 569(44.9％)cases of severe 25(OH)D deficiency,1 192(34.2％)of mild 25(OH)D deficiency and 730(20.9％)of normal serum 25(OH)D level respectively.The medians of concentrations of serum 25(OH)D of the pregnant women in the normal group and the GDM group were 32.3(22.3,46.4)nmol/L and 30.5(19.8,43.0)nmol/L respectively,there was a significant difference between the two groups(Z=-3.713,P＜0.001).The stratified analysis for OGTT results showed that in the serum 25(OH)D level,there was no significant difference between the normal OGTT fasting blood glucose group and abnormal OGTT fasting blood glucose group(Z=0.746,P＞0.05),while between the normal OGTT 1-hour blood glucose level subgroup and the abnormal OGTT 1-hour blood glucose level subgroup,there was a significant difference(Z=21.509,P＜0.001).So did between the normal OGTT 2-hour blood glucose level subgroup and the abnormal OGTT 2-hour blood glucose level subgroup(Z=44.924,P＜0.001).Among 575 pregnant women with GDM,in serum 25(OH)D level there was a significant difference between the abnormal single item OGTT subgroup and the abnormal multi-item OGTT subgroup(Z=58.717,P＜0.001).The serum 25(OH)D level was not correlated with the OGTT fasting blood glucose(r=0.009,P＞0.05),while the serum 25(OH)D level was negatively correlated with OGTT 1-hour/2-hour fasting blood glucose(r=-0.070 and-0.085 respectively,both P＜0.05).The risk of GDM of the pregnant women with severe 25(OH)D deficiency in the first trimester of pregnancy was 1,299 times of the risk of GDM of the pregnant women with normal serum 25(OH)D level(OR=1.299,95％CI:1.018-1.657,P＜0.05).Conclusion The serum 25(OH)D level of the pregnant women in the first trimester of pregnancy is generally low in Nanchong region,and the risk of GDM is significantly increased in those pregnant women with severe 25(OH)D deficiency in the first trimester of pregnancy.
万方数据
维普
