Research On Correlation Between Serum 25-hydroxyvitamin D,Ferritin And Level Of Glucose/Lipid Metabolism In Pregnant Women

Objective: To investigate the changes of serum 25 hydroxyvitamin D(25(OH)D)and ferritin(SF)in patients with gestational diabetes mellitus,and to analyse the correlation between contain of 25(OH)D and SF in serum and level of glucose / lipid metabolism,and insulin resistance in pregnant women.Methods:Pregnant women of childbearing age who have been enrolled in the Affiliated Hospital of Zunyi Medical University for routine antenatal checkups ranging from May2017 to October 2017,underwent oral glucose tolerance test(OGTT)at 24-28 weeks.Among these pregnant women,118 of which were diagnosed with gestational diabetes mellitus(GDM)and listed as the GDM group following the new diagnostic criteria for GDM recommended by the WHO in 2013,and 154 of which were diagnosed as normal glucose tolerance(NGT)and were listed as the NGT group.In addition,154 cases of non-pregnancy childbearing age women from the physical examination department of our hospital were selected as the normal control(NC)group.At the same time,according to the clinical practice guideline for evaluation,treatment,and prevention of vitamin D deficiency recommended by 2011 American Endocrine Society's,118 cases of GDM group was subdivided into three groups,44 cases with VD deficiency,48 cases with VD insufficiency,and 26 cases with VD normal group.The general clinical data of the participants selected was collected.All subjects were tested for fasting plasma glucose(FPG),two hours postprandial blood glucose(2hPG),glycosylated hemoglobin(HbAlc),triglyeride(TG),total cholesterol(Totalcholesterol,TC),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),fasting insulin(FIns),and homeostasis model assessment insulin resistance(HOMA-IR).Serum levels of25(OH)D and SF were determined by enzyme-linked immunosorbent assay(ELISA).Result: There were no significant differences in age,body mass index(BMI)and gestational age among the NC,NGT and GDM groups(P>0.05).Compared with the NGT and NC groups,the FPG,2hPG,HbA1 c,TG,FIns,HOMA-IR and SF levels were significantly increased in the GDM group(P<0.05),while the 25(OH)D level was significantly lower(P< 0.05).Here the SF level in the NGT group was significantly higher than that in the NC group(P<0.05).Further investigation showed that the level of FIns,HOMA-IR and SF of the VD-deficient and VD-insufficient subgroup,and the 2hPG level of the VD-deficient subgroup were significantly increased compared with the normal VD subgroup in the GDM group(P<0.05)In addition,compared with the VD-insufficient subgroup,the level of FPG,HbA1 c,TG,and SF in the VD-deficient group were significantly increased(P<0.05).The correlational analysis between the contain of25(OH)D and SF in serum and level of glucose / lipid metabolism,and insulin resistance showed that serum 25(OH)D was negatively correlated with FPG,2hPG,HbA1 c,TG,FIns,HOMA-IR,and SF(P<0.05),while serum SF was positively correlated with FPG,2hPG,HbA1 c,TG,FIns,and HOMA-IR(P<0.05),and was negatively correlated with 25(OH)D(P<0.05).Both TG and SF were risk factors for pregnant women with GDM,while25(OH)D was a protective factor on the basis of the Logistic regression analysis.Conclusion: In this study,the reduction of VD and SF in pregnant women may be relevant to the pathogenesis of GDM.