Study On The Relationship Between Serum Vitamin D Level And Glucose Metabolism During Pregnancy

Objective:To understand the serum vitamin D nutritional status of pregnant women in Hefei,analyze the relationship between serum vitamin D level during pregnancy and the related indexes of glucose metabolism during pregnancy,guide the rational supplement of vitamin D during pregnancy,and improve glucose metabolism,to provide clinical evidence for preventing hyperglycemia during pregnancy.Methods:A total of 5690 pregnant women aged 24-28 weeks were enrolled in the study from January 1,2016,to December 31,2019 at the outpatient clinic of the Anhui Medical University,all participants voluntarily signed an informed consentform.Inclusive criteria:（1）single child;（2）age 18-45 years;（3）living in Hefei during pregnancy.Exclusion criteria:（1）mental illness;（2）artificial assisted reproductive conception;（3）clear acute inflammatory disease;（4）pre-pregnancy with clearly diagnosed diseases,such as pre-pregnancy diabetes,thyroid disease,abnormal liver and kidney function,multiple pregnancy;（5）incomplete information.All pregnant women recorded their age,pre-pregnancy height,pre-pregnancy weight,pregnancy times,birth times,fasting blood glucose,fasting insulin,and 25-hydroxyvitamin D were also measured,blood glucose 1hour after taking 75 g Glucose,blood glucose 2 hours after taking 75 g glucose,insulin resistance index was calculated.The serum vitamin D level was divided into deficiency group（vitamin D < 20ng/ml）and control group（vitamin D ≥20ng/ml）,the influential factors of serum vitamin D level and its relationship with related indexes of glucose metabolism were analyzed by statistical methods.Research results:（1）Vitamin D level was（15.33 ± 6.39）ng/ml in 5690 pregnant women,vitamin D deficiency was 4517 cases（79.42%）,vitamin D level was（12.82 ± 3.78）ng/ml.（2）The differences of age,BMI before pregnancy and season between the two groups were statistically significant（P<0.05）;Logistic regression analysis showed that age,BMI before pregnancy and season were the influencing factors of vitamin D（or =1.027;1.074;1.10,P<0.05）.（3）Deficiency group fasting blood glucose（4.60±0.50）mmol/l,fasting insulin（8.52±4.13）u U/ml,HOMA-IR（1.77±1.01）were higher than control group fasting blood glucose（4.56±0.46）mmol/l,fasting insulin（8.18±4.03）u U/ml,HOMA-IR（1.68±0.96）;linear regression showed that vitamin D level was negatively correlated with fasting blood glucose,fasting insulin and HOMA-IR（P<0.05）;the association of vitamin D level fasting blood glucose,fasting insulin,HOMA-IR remained after controlling age,pre-pregnancy BMI,season,duration of pregnancy,and postpartum confounding factors by multiple linear regression（P<0.05）.（4）Vitamin D deficiency was the influential factor of GDM（or = 1.191,P<0.05）.Conclusion:1.Vitamin D deficiency is common in the second trimester of pregnancy in Hefei area,among which age,pre-pregnancy BMI,season the influencing factors.2.Vitamin D levels were negatively correlated with fasting blood glucose,fasting insulin,and HOMA-IR,Vitamin D deficiency increases the risk of GDM in pregnant women.