| Objective To explore the correlation and clinical significance between serum levels of25 hydroxyvitamin D(25-OH-VD),leptin(LP)and interleukin-6(IL-6)with gestational diabetes mellitus(GDM)and subclinical pothyroidism(SCH),so as to provide reference for the prognosis and clinical treatment of GDM patients with SCH.Methods In this study,pregnant women at 24-28 gestational weeks who underwent obstetric examination in the Maternal and Child Health Hospital of Zaozhuang from April 2018 to April 2020 were selected as the research objects.The Chinese Guidelines for the Prevention and Treatment of Type 2 diabetes and Guidelines for the Diagnosis and Treatment of Thyroid Diseases in Pregnancy and Postpartum were used as diagnostic criteria to determine the inclusion of the group.The subjects were divided into 4 groups: group I(GDM combined with SCH group,n=86),group II(GDM alone group,n=104),group III(SCH alone group,n=98)and group IV(normal pregnant women control group,n=110).Collect the basic demographic data,related detection indicators,previous pregnancy and childbirth history,related family history and other information of the subjects,and detect the levels of 25-OH-VD,LP and IL-6 in the blood of the subjects by electrochemiluminescence,enzyme-linked immunosorbent assay and ELISA double antibody sandwich method.SPSS.22.0software was used for statistical analysis,and P<0.05 was considered as statistically significant difference.The study was approved by the hospital ethics committee and academic committee.During the study,the informed consent of the patients or their families was obtained and signed.Results(1)The age,body mass index(BMI),weight gain during pregnancy and fasting blood glucose(FBG)levels of GDM patients with SCH were higher than those of normal pregnant women(P<0.05);The prenatal BMI,pregnancy weight gain and FBG level of GDM group were higher than those of normal pregnant women(P<0.05);There was no significant difference between the patients with simple SCH and the control group of normal pregnant women(P>0.05).(2)The level of serum 25-OH-VD in Group I,Group II and Group III was significantly lower than that in Group IV(P<0.05),and the level in Group I was significantly lower than that in Group II and Group III(P<0.05);(3)The level of LP in each group was significantly higher than that in Group IV(P<0.05),and that in Group I and Group II was higher than that in Group III(P<0.05);(4)The level of IL-6 in Group I and Group II was significantly higher than that in Group IV(P<0.05).There was no significant difference between Group III and Group IV(P>0.05).The level of IL-6 in Group I and Group II was higher than that in Group III(P<0.05).(5)The correlation analysis between serum 25-OH-VD,LP,IL-6 levels and blood glucose levels showed that the three serum markers had no significant correlation with FBG,1-hour postprandial blood glucose(1h PBG),2-hour postprandial blood glucose(2h PBG)of normal pregnant women in Group IV(P>0.05);In group I,II and III25-OH-VD was negatively correlated with 1h PBG and 2h PBG(r=-0.58,and r=-0.61),(r=-0.49 and r=-0.51),(r=-0.44 and r=-0.47).In group I,II and III serum LP level was positively correlated with 1h PBG and 2h PBG(r=0.52 and r=0.44),(r=0.46 and r=0.40),(r=0.32 and r=0.34).In group I,II serum IL-6 level was positively correlated with 1h PBG(r=0.53),(r=0.46)(6)The high risk factors of GDM complicated with SCH are older,higher prenatal BMI,family history of diabetes,pregnancy induced hypertension,thyroid dysfunction,polycystic ovary syndrome(PCOS),25-OH-VD deficiency,high levels of LP and IL-6.The possibility of premature rupture of membranes and premature delivery in GDM with SCH was higher than that in normal pregnant women.Conclusion(1)The deficiency of serum 25-OH-VD and the increase of LP and IL-6levels are correlated with the occurrence and development of GDM complicated with SCH,which has important reference value for the prediction of adverse pregnancy outcome.(2)The probability of premature rupture of membranes and preterm delivery in GDM with SCH is higher than that in normal pregnant women,and active treatment for complications can avoid adverse pregnancy outcomes. |
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