首页|GDM孕妇血清甲状腺激素、25-羟维生素D水平与新生儿低血糖关系

GDM孕妇血清甲状腺激素、25-羟维生素D水平与新生儿低血糖关系

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目的:探讨妊娠期糖尿病(GDM)孕妇血清甲状腺激素、25-羟基维生素D[25-(OH)D]水平与新生儿低血糖的相关性.方法:选择2021年9月-2022年6月在本院分娩的305例GDM产妇临床资料,根据新生儿是否发生低血糖分为低血糖组58例与血糖正常组247例,检测血清游离三碘甲腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺激素(TSH)、25-(OH)D水平,采用pearson法分析血清FT3、FT4、25-(OH)D水平与血糖指标相关性,logistic回归模型分析影响新生儿发生低血糖的影响因素.结果:血糖正常组与低血糖组年龄、孕前体质指数、确诊时孕周、孕次、分娩方式、新生儿性别及空腹胰岛素、稳态模型胰岛素抵抗指数无差异(P>0.05),低血糖组分娩期血糖控制不佳、早产儿、低出生体重儿、出生1min Apgar评分≤7分患儿占比、空腹血糖(FBG)、糖化血红蛋白(HbA1c)均高于血糖正常组,血清 FT3(6.25±1.47 pmmol/L)、FT4(13.95±1.44 pmmol/L)、25-(OH)D(27.56±3.28 ng/ml)水平均低于血糖正常组(6.76±1.51 pmmol/L、18.43±1.56 pmmol/L、36.42±5.24 ng/ml)(均 P<0.05),两组血清 TSH 水平无差异(P>0.05);相关性分析显示,血清FT3、FT4与FBG、HbA1c呈负相关(P<0.05),与FINS、HOMA-IR无关(P>0.05);25-(OH)D与FBG、HbA1c、FINS、HOMA-IR呈负相关(P<0.05).分娩期血糖控制欠佳、FBG升高、低出生体重儿、HbA1c升高、FT3降低、FT4降低、25-(OH)D降低是GDM孕妇分娩低血糖新生儿的影响因素(均P<0.05).结论:新生儿低血糖与GDM孕妇血清FT3、FT4、25-(OH)D水平降低有关.
Correlation between the serum thyroid hormone and 2 5-hydroxy vitamin D levels of pregnant women with gestational diabe-tes mellitus and their neonatal hypoglycemia
Objective:To investigate the correlation between the serum thyroid hormone and 25-hydroxyvitamin D[25-(OH)D]levels of pregnant women with gestational diabetes mellitus(GDM)and their neonatal hypoglycemia.Meth-ods:The clinical data of 305 women with GDM who had given birth in hospital from September 2021 to June 2022 were selected in this study.According to whether the neonatal hypoglycemia or not,58 cases with the neonatal hypo-glycemia were in study group and 247 cases without the neonatal hypoglycemia were in control group.The levels of ser-um free triiodothyronine(FT3),free thyroxine(FT4),thyroid stimulating hormon(TSH),and 25-(OH)D of the women were detected.Pearson method was used to analyze the correlation between the serum FT3,FT4 and 25-(OH)D levels of the women and their neonatal blood glucose indicators.Logistic regression model was used to analyze the in-fluencing factors of the neonatal hypoglycemia occurrence.Results:There were no significant differences in the age,the pre-pregnancy body mass index,the gestational age at diagnosis,the gravidity,the delivery mode,the neonatal gender,the fasting insulin and the homeostasis model assessment of insulin resistance(HOMA-IR)value of the women between the two groups(P>0.05).The proportions of the poor blood glucose control during delivery and the levels of fasting blood glucose(FBG)and glycosylated hemoglobin(HbA1c)of the women,and the premature in-fants,the low birth weight infants and the infants with Apgar score ≤7 at 1min after birth in the study group were significantly higher than those in the control group.The levels of serum FT3(6.25±1.47 pmmol/L),FT4(13.95± 1.44 pmmol/L)and 25-(OH)D(27.56±3.28 ng/ml)of the women in the study group were significantly lower than those(6.76±1.51 pmmol/L,18.43±1.56 pmmol/L and 36.42±5.24 ng/ml)of the women in the control group(all P<0.05).There was no significant difference in the serum TSH level of the women between the two groups(P>0.05).Correlation analysis showed that the levels of serum FT3 and FT4 of the women were negatively correlated with their FBG and HbA1c levels(P<0.05),but which were no correlated with the FINS level and the HOMA-IR value of the women(P>0.05).The 25-(OH)D level of the women was negatively correlated with their FBG,HbA1c and FINS levels and their HOMA-IR value(P<0.05).The poor blood glucose control during delivery,the increased FBG level,the low-birth-weight infants,the increased HbA1c level,and the decreased levels of FT3,FT4 and 25-(OH)D of the women were the influencing factors of their neonatal hypoglycemia occurrence(all P<0.05).Conclusion:The neonatal hypoglycemia occurrence is related to the decrease of the serum FT3 and FT4 levels of the pregnant women with GDM.

Gestational diabetes mellitusNeonatal hypoglycemiaThyroid hormone25-hydroxyvitamin DInfluen-cing factor

黎国春、周春兰

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湖北省宜昌市夷陵人民医院(443100)

妊娠期糖尿病 新生儿低血糖 甲状腺激素 25-羟维生素D 相关性 影响因素

2024

中国计划生育学杂志
国家人口计生委科学技术研究所

中国计划生育学杂志

CSTPCD
影响因子:1.759
ISSN:1004-8189
年,卷(期):2024.32(2)
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