摘要
Abstract
Objective To explore the relationship between vitamin D level and glucose and lipid metabolism in patients with preeclampsia(PE)and their relationship in pregnancy outcome.Methods A total of 256 pregnant women with PE admitted to the Heping Hospital Affiliated to Changzhi Medical College from January 2021 to January 2023 were selected as the study subjects,and they were divided into normal vitamin D group(n=41),vitamin D deficiency group(n=87)and vitamin D deficiency group(n=128)according to vitamin D levels.The general data,glucose and lipid metabolism levels,and pregnancy outcomes of all pregnant women were compared.Pregnant women were followed up to delivery,and the pregnancy outcomes of all pregnant women were observed,evaluated and statistically counted.A hierarchical interaction test was used to analyze the relationship between serum vitamin D level and glycolipid level.The additive and multiplicative interaction models were used to analyze the risk factors.Results The weight gain of PE pregnant women in the normal vitamin D group,insufficient group and deficient group increased in pregnancy,the proportion of hypertension,diabetes and hyperlipidemia increased,and the outdoor activities and daily sun exposure duration decreased in turn,and the differences were statistically significant(x2/F values ranged from 12.595 to 192.598,P＜0.05).The glycemic parameters of vitamin D-deficient group and vitamin D-deficient group were glycosylated hemoglobin(HbA1c),fasting blood glucose(FPG),fasting serum insulin(FINS),mean blood glucose(MBG),standard deviation of blood glucose(SDBG),frequency of blood glucose fluctuations(NEGE),homeostatic mode assessment of insulin resistance index(HOMA-IR),and blood lipid parameters of total cholesterol(TC),triglyceride(TG),low-density lipoprotein cholesterol(LDL-C),free fatty acids(FFA)and apolipoprotein B(ApoB)were higher than those of the normal vitamin D group,and the HbA1c,MBG,SDBG,NEGE,FFA,and ApoB levels of the vitamin D deficiency group were higher than those of the vitamin D deficiency group,and the difference was statistically significant(F values ranged from 2.041 to 14.967,P＜0.05).The results of stratified interaction test showed that the relationship between serum vitamin D and glucose and lipid metabolism indexes was stable(Pinteraction＜0.05).The incidence of adverse pregnancy outcomes in the normal vitamin D group,vitamin D insufficiency group and vitamin D deficiency group increased in sequence,and the difference was statistically significant(x2=74.395,P＜0.001).The incidence of adverse pregnancy outcomes in PE pregnant women with abnormal glucose and lipid metabolism was higher than that in the normal glucose and lipid metabolism group,and the difference was statistically significant(x2=97.480,P＜0.001).The results of additive interaction model analysis showed that when vitamin D insufficiency and abnormal glucose and lipid metabolism coexisted,the risk of adverse pregnancy outcomes in pregnant women with PE was 2.206 times higher than that of both normal factors,which was greater than the sum of the two factors alone,and the results of multiplicative interaction model analysis showed that there was a multipliative interaction between different vitamin D levels and different glucose and lipid metabolism(OR values ranged from 2.323 to 4.780,P＜0.01).Conclusion Low vitamin D levels in PE patients are associated with abnormal glucose and lipid metabolism,and the risk of adverse pregnancy outcomes in pregnant women with PE is significantly increased when both are present.关键词
子痫前期/维生素D/糖脂代谢/妊娠结局Key words
preeclampsia/vitamin D/glycolipid metabolism/pregnancy outcome分类
预防医学
