Correlation between the levels of serum 25-hydroxyvitamin D,homocysteine and glycosylated hemoglobin of pregnant women with gestational diabetes mellitus during the first trimester of pregnancy and their insulin resistance
Objective:To explore the correlation between the levels of serum 25-hydroxyvitamin D(25-OH-D),homo-cysteine(Hcy)and glycosylated hemoglobin(HbA1c)of pregnant women with gestational diabetes mellitus(GDM)during the first trimester of pregnancy and their insulin resistance.Methods:134 pregnant women with GDM in hospi-tal were included in study group from December 2019 to December 2022,and 76 normal pregnant women with the sim-ilar age and gestational weeks were selected in control group during the same period.The levels of blood lipids indica-tors,such as triglyceride(TG),total cholesterol(TC),high density lipoprotein cholesterol(HDL-C)and low density lipoprotein cholesterol(LDL-C),the levels of 25-OH-D,Hcy and HbA1c,and the values of insulin resistance indica-tors,such as fasting insulin(FINS),homeostasis model assessment of insulin resistance(HOMA-IR)and homeosta-sis model assessment of islet β cell function index(HOMA-β),of the women during 8-12 gestational weeks were com-pared between the two groups.Multivariate logistic regression was used to screen the risk factors of GDM occurrence.Pearson correlation analysis was adopted to analyze the correlation between the levels of 25-OH-D,Hcy and HbA1c of the pregnant women with GDM and their insulin resistance.Results:The levels of TG,TC and LDL-C of the women in the study group were significantly higher than those of the women in the control group,but the HDL-C level of the women in the study group was significantly lower.The 25(OH)D level(25.89±2.67 nmmol/L)of the women in the study group was significantly lower than that(34.26±3.19 nmmol/L)of the women in the control group.The levels of Hcy(20.96±3.48μmol/L)and HbA1c(6.19％±0.31％)of the women in the study group were significantly higher than those(11.03±2.56μmol/L and 5.67％±0.97％)of the women in the control group,The values of FINS and HO-MA-IR of the women in the study group were significantly higher than those of the women in the control group,but the HOMA-β value of the women in the study group was significantly lower.Multivariate analysis showed that the de-crease of 25(OH)D level,and the increases of Hcy,HbA1c and FINS level and HOMA-IR value of the women were the independent risk factors for their GDM occurrence.Pearson correlation analysis showed that the 25-OH-D level of the women with GDM was negatively correlated with their FINS level and HOMA-IR value,and was positively corre-lated with their HOMA-βvalue.The levels of Hcy and HbA1c of the women with GDM were positively correlated with their FINS level and HOMA-IR value,and were negatively correlated with their HOMA-β value(all P＜0.05).Con-clusion:The levels of the serum 25-OH-D,Hcy and HbA1c of the pregnant women with GDM are closely related to their insulin resistance.Clinical monitoring the levels of 25-OH-D,Hcy and HbA1c and the insulin resistance situation of the pregnant women is beneficial to the prevention and treatment of their GDM during the first trimester of pregnan-cy.
The first trimescer of pregnancyGestational diabetes mellitus25-hydroxyvitamin DHomocysteineGlycosylated hemoglobinInsulin resistanceCorrelationInfluence factor
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