Relationship Between Serum 25-Hydroxy vitamin D3 Level in First Trimester and Insulin Resistance and Gestaional Diabetes Mellitus
Objective To explore the relationship between serum 25-hydroxyvitamin D3[25-(OH)D3]level in first trimester and insulin resistance and gestaional diabetes mellitus(GDM).Methods Retrospective analysis of the clinical medical records of 560 early pregnant women(5-12 weeks of pregnancy)who underwent physical examinations in the First Affiliated Hospital of Zhengzhou University from January to December 2022,they were divided into GDM group and control group based on the OGTT test results at 24-28+6 weeks of pregnancy.The nutritional status of vitamin D in early pregnancy and the incidence of GDM were calculated.The serum levels of 25-(OH)D3 and homeostasis model assessment of insulin resistance index(HOMA-IR)between the GDM group and the control group were compared.Pearson correlation was used to analyze the correlation between serum levels of 25-(OH)D3 and HOMA-IR in early pregnancy.Logistic regression was used to analyze the relationship between serum levels of 25-(OH)D3,HOMA-IR and GDM in early pregnancy.Results The incidence of GDM among the 560 pregnant women included was 7.86％,among which the incidence of GDM was 81.82％for those with vitamin D deficiency in early pregnancy,there was statistically significant difference in the incidence of GDM among pregnant women with different levels of vitamin D nutrition in the early pregnancy(P＜0.05).The serum levels of 25-(OH)D3 in pregnant women in the GDM group were lower than those in the control group,and HOMA-IR was higher than that in the control group,the differences were statistically significant(P＜0.05).Pearson correlation analysis showed that there was a negative correlation between serum 25-(OH)D3 levels and HOMA-IR in early pregnancy(r=-0.674,P＜0.05).Logistic regression analysis showed that the serum 25-(OH)D3 levels and HOMA-IR in early pregnancy were independent risk factor for GDM(P＜0.05).Conclusion The serum 25-(OH)D3 levels in early pregnancy is negatively correlated with HOMA-IR,and it is an independent risk factor for the occurrence of GDM.Vitamin D deficiency in early pregnancy can increase the risk of GDM in pregnant women to a certain extent,so vitamin D preparations should be supplemented appropriately during pregnancy to reduce the risk of GDM.
early pregnancy25-hydroxyvitamin D3insulin resistancegestaional diabetes mellituscorrelation
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