Effects of the high-dose vitamin D combined with insulin for treating pregnant women with gestational diabetes mellitus on the levels of their serum visceral adipose-specific serine protease inhibitor and visfatin and their pregnancy outcomes
Objective:To study the effects of the high-dose vitamin D combined with insulin for treating pregnant women with gestational diabetes mellitus(GDM)on the levels of their serum visceral adipose-specific serine protease inhibitor(vaspin)and visfatin,and their pregnancy outcomes.Methods:A total of 105 pregnant women with GDM admitted to the hospital were divided into study group(53 cases)and control group(52 cases)according to the random number table method from December 2021 to March 2023.In addition to adjusting the diet and exercising,the women in both groups received insulin aspartate therapy for 4 weeks,and the women in the study group were given high-dose vitamin D supplement therapy for 4 weeks additionally.The changes of the glucose and lipid metabolism,the insulin resistance,and the levels of the blood 25 hydroxyvitamin D3[25(OH)D3]and the adipokine of the women before and 4 weeks after treatment were compared between the two groups.The women in both groups were followed up until the end of their pregnancy,and the pregnancy outcomes and the adverse reactions rate of the women were compared be-tween the two groups.Results:The levels of the fasting blood glucose(5.26±0.53 mmol/L),the 2h postprandial blood glucose(6.62±0.78 mmol/L),the glycosylated hemoglobin(5.12±0.6％),the total cholesterol(3.24±0.56 mmol/L),the triglyceride(2.96±0.53 mmol/L),the low density lipoprotein cholesterol(2.51±0.55 mmol/L),the fasting insulin(12.52±2.63 mU/L),the vaspin(23.15±2.74 ng/ml)and the visfatin(102.56±20.27 ng/ml),and the insulin resistance index value(2.12±0.14)of the women in the study group after treatment were significantly low-er than those of the women in the control group,but the 25(OH)D3 level(26.52±5.71 ng/ml)of the women in the study group was significantly higher than that of the women in the control group(all P＜0.05).The natural delivery rate(75.5％)of the women in the study group was significantly higher than that(55.8％)of the women in the control group,and the incidences of the cesarean section(15.1％)and the macrosomia(3.8％)of the women in the study group were significantly lower than those(32.7％and 15.4％)of the women in the control group(all P＜0.05).There was no significant difference in the adverse reactions rate(7.5％vs.5.8％)of the women between the two groups(P＞0.05).Conclusion:The insulin combined with the high-dose vitamin D for treating the pregnant women with GDM has a significant effect on regulating their glucose and lipid metabolism,and it is speculated that which can reduce insu-lin resistance and improve pregnancy outcomes of the women by down-regulating their vaspin and visfatin levels and by increasing their 25(OH)D3 level.
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