标题：妊娠期糖尿病胰岛素抵抗与维生素D3、雌二醇、超敏C反应蛋白水平的关系

      作者：刘成云，马姣荣    榆林市中医医院妇产科，陕西 榆林 719000

      卷次： 2019年30卷15期

      【摘要】 目的 探讨妊娠期糖尿病(GDM)胰岛素抵抗与维生素D3、雌二醇、超敏C反应蛋白(hs-CRP)水平的关系。方法 选择2017年1月至2018年12月期间榆林市中医医院妇产科收治的40例GDM患者作为观察组，同期40例正常孕妇作为对照组。比较两组孕妇胰岛素抵抗指数(HOMA-IR)及血清25-羟维生素D3 [25-(OH)D3]、超敏C反应蛋白(hs-CRP)、雌二醇(E2)水平，分析血清25-(OH)D3、hs-CRP、E2水平与HOMA-IR的相关性。结果 观察组孕妇的HOMA-IR及血清 hs-CRP、E2水平分别为 3.37±1.42、(7.93±2.61) mg/L、(1 128.4±314.7) μmol/mL，明显高于对照组的1.59±0.51、(2.38±0.72) mg/L、(846.3±242.5) μmol/mL，血清25-(OH)D3水平为(70.35±21.88) nmol/L，明显低于对照组的(86.62±28.41) nmol/L，差异均有统计学意义(P<0.05)；相关性分析结果显示，血清 25-(OH)D3水平与HOMA-IR呈负相关(r=-0.382，P<0.05)，血清E2、hs-CRP与HOMA-IR呈正相关(r=0.415、0.387，P<0.05)。结论 胰岛素抵抗在GDM的发病中具有重要作用，维生素D3、E2及hs-CRP水平与胰岛素抵抗的发生关系密切。
      【关键词】 妊娠期糖尿病；胰岛素抵抗；维生素D3；超敏C反应蛋白；性激素
      【中图分类号】 R714.256 【文献标识码】 A 【文章编号】 1003—6350（2019）15—1921—03

Relationship between insulin resistance and vitamin D3, E2, and hs-CRP in gestational diabetes mellitus.
LIUCheng-yun, MA Jiao-rong. Department of Gynecology, Yulin Hospital of Traditional Chinese Medicine, Yulin 719000,Shaanxi, CHINA
【Abstract】 Objective To investigate the relationship between insulin resistance and levels of vitamin D3, estra-diol (E2), and hs-CRP in gestational diabetes mellitus (GDM). Methods Forty patients with GDM treated in Depart-ment of Gynecology, Yulin Hospital of Traditional Chinese Medicine from January 2017 to December 2018 were select-ed as the study subjects, and 40 normal pregnant women were included into the control group during the same period.The insulin resistance index (HOMA-IR), serum 25-hydroxyvitamin D3 [25-(OH)D3], hypersensitive C-reactive protein(hs-CRP), E2 levels were compared between the two groups, and the correlation between serum 25-(OH)D3, hs-CRP, E2levels and HOMA-IR was analyzed. Results The levels of HOMA-IR and serum hs-CRP and E2 in the observationgroup were 3.37±1.42, (7.93±2.61) mg/L, (1 128.4±314.7) μmol/mL, respectively, which were significantly higher than1.59±0.51, (2.38±0.72) mg/L, (846.3±242.5) μmol/mL in the control group (P<0.05), and the level of serum 25-(OH)D3was (70.35±21.88) nmol/mL, which was significantly lower than (86.62±28.41) nmol/mL in the control group (P<0.05).Correlation analysis showed that serum 25-(OH)D3 level was negatively correlated with HOMA-IR (r=-0.382, P<0.05),and serum E2 and hs-CRP were positively correlated with HOMA-IR (r=0.415, 0.387, P<0.05). Conclusion Insulin re-sistance is of important role in GDM. The levels of vitamin D3 and E2, hs-CRP are closely related to the occurrence of in-sulin resistance.
      【Key words】 Gestational diabetes mellitus; Insulin resistance; Vitamin D3; Hypersensitive C-reactive protein;Sex hormones