川东北地区妊娠期糖尿病孕妇妊娠中期维生素B5、B6水平研究

张利平 陈国栋

【摘要】 目的：探讨川东北地区妊娠期糖尿病孕妇妊娠中期维生素B5、B6水平。方法：选择2018年9月-2020年4月在本院进行产检的川东北地区孕妇330例为研究对象。所有孕妇于孕24～28周进行75 g葡萄糖口服糖耐量检查，将检测结果为妊娠期糖尿病的孕妇40例纳入GDM组，检测结果正常的孕妇290例纳入对照组。检测后比较两组糖脂代谢、炎性因子与维生素B5、B6水平。结果：GDM组的空腹血糖、餐后2 h血糖、TG、TC、LDL-C水平均高于对照组，HDL-C水平低于对照组，差异均有统计学意义（P<0.05）。GDM组的血清IL-6、TNF-α水平均高于对照组，APN低于对照组，差异均有统计学意义（P<0.05）。GDM组的维生素B5、B6水平均低于对照组，差异均有统计学意义（P<0.05）。Pearson分析顯示妊娠期糖尿病孕妇的维生素B5、B6水平与IL-6、TNF-α、空腹血糖、餐后2 h血糖、TG、TC、LDL-C均呈负相关性（P<0.05），与APN、HDL-C均呈正相关性（P<0.05）。GDM组的巨大儿、早产、羊水异常、新生儿窒息发生率均高于对照组，差异均有统计学意义（P<0.05）。结论：川东北地区妊娠期糖尿病孕妇妊娠中期维生素B5、B6水平相对较低，与孕妇的糖脂代谢紊乱、炎性因子异常分泌存在相关性。

【关键词】 川东北地区 妊娠期糖尿病 维生素B5 维生素B6 炎性因子

Study on the Levels of Vitamin B5 and B6 in the Second Trimester of Pregnant Women with Gestational Diabetes in Northeastern Sichuan/ZHANG Liping， CHEN Guodong. //Medical Innovation of China， 2021， 18（16）： 171-175

[Abstract] Objective： To investigate the levels of vitamin B5 and B6 in the second trimester of pregnant women with gestational diabetes in northeastern Sichuan. Method： A total of 330 pregnant women in northeastern Sichuan who underwent obstetric examination in our hospital from September 2018 to April 2020 were selected as the research subjects. All the pregnant women received oral glucose tolerance test of 75 g glucose at 24 to 28 weeks of gestation. 40 pregnant women with GDM test results were included in the GDM group， and 290 pregnant women with normal test results were included in the control group. After detection， glucose and lipid metabolism， inflammatory factors and vitamin B5 and B6 levels were compared between the two groups. Result： The levels of fasting blood glucose， 2 h postprandial blood glucose， TG， TC and LDL-C in GDM group were higher than those in control group， while the level of HDL-C was lower than that in control group， the differences were statistically significant （P<0.05）. Serum IL-6 and TNF-α levels in GDM group were higher than those in control group， and APN was lower than that in control group， the differences were statistically significant （P<0.05）. The levels of vitamin B5 and B6 in GDM group were lower than those in the control group， the differences were statistically significant （P<0.05）. Pearson analysis showed that the levels of vitamin B5 and B6 in pregnant women with gestational diabetes mellitus were negatively correlated with IL-6， TNF-α， fasting blood glucose， 2 h postprandial blood glucose， TG， TC， LDL-C （P<0.05）， and positively correlated with APN and HDL-C （P<0.05）. The incidence of macrosomia， premature delivery， abnormal amniotic fluid and neonatal asphyxia in GDM group were higher than those in the control group， the differences were statistically significant （P<0.05）. Conclusion： The levels of vitamin B5 and B6 in pregnant women with gestational diabetes mellitus in northeast Sichuan are relatively low in the second trimester， which are correlate with the disorder of glucose and lipid metabolism and abnormal secretion of inflammatory factors in pregnant women.

[Key words] Northeastern Sichuan Gestational diabetes mellitus Vitamin B5 Vitamin B6 Inflammatory cytokines

First-author’s address： Nanchong Central Hospital， Nanchong 637000， China

doi：10.3969/j.issn.1674-4985.2021.16.041

妊娠期糖尿病（gestational diabetes mellitus， GDM）指孕妇在妊娠后首次发病的特殊类型糖尿病，多发病于黄种人群[1]。妊娠期糖尿病孕妇体内存在与2型糖尿病患者相似的脂代谢紊乱、胰岛素抵抗、微炎症反应激活[2-3]，但是具体的发病机制还不明确。四川省东北部简称川东北，包括南充、达州、广元、广安、巴中等地区，由于地理环境与居民习惯的问题，糖尿病的流行程度一直比较高，也使得妊娠期糖尿病的发病率一直居高不下。……