The Effect Of Vitamin D On Prognosis Of Mothers And Their Infants In Patients With Gestational Diabetes Mellitus

Backgrounds and Objective:In recent years, a large number of studies have shown that the correlation between vitamin D levels and glucose metabolism in patients with gestational diabetes mellitus. Studies also have shown that vitamin D levels of maternal and infant affected the outcomes of gestational diabetes mellitus.Our study is mean to detect the changes of serum vitamin D levels in patients with gestational diabetes mellitus(GDM) and analyze its effects on their infants. Subjects and Methods:1. 160 cases GDM women were investigated from January 2013 to May 2014 at 24-28 weeks. All participants have received the oral glucose tolerance test(OGTT) in Luoyang Central Hospital maternity clinic and endocrine clinic. According to the criteria of the American Diabetes Association(ADA) for the gestational diabetes, 60 patients with GDM and 60 patients with normal glucose tolerance group(NGT) were detected biochemical indices and 25(OH) D3. Then, 20 GDM cases of the treatment group and 20 GDM cases in the control group were randomly selected among vitamin D deficiency. Then, vitamin D was given by oral for one month, after which their biochemical indices were checked and compared the complications of maternal and perinatal infants between the two groups.2. Using questionnaire survey method to record participants. Record the name, age, family history, lifestyle, pre-pregnancy weight, pregnancies, reproductive history, measured height, weight, calculate pre-pregnancy body mass index and gained weight index during pregnancy of the GDM women.3. All participants were excluded to suffer from diabetes, hypertension, thyroid disease, polycystic ovary syndrome, liver and kidney dysfunction, other organs of chronic diseases, acute and chronic inflammation before pregnancy.4. All participants were fasting for 8-12 hours, then they were extracted venous blood 5ml in the morning. The samples were measured in Luoyang Central Hospital laboratory, glucose oxidase measured fasting plasma glucose(FPG), measured ECL fasting insulin(FINS) and fasting C-peptide, measured of glycosylated hemoglobin(HbA1c) with HPLC, measured serum ECLIA 25-(OH) D, calcium enzymatic assay, total cholesterol(TC), triglyceride(TG3), high density lipoprotein(HDL-C), low density lipoprotein(LDL-C). Calculated the insulin resistance index(HOMA-IR) =(fasting glucose × fasting insulin 22.5) to evaluate insulin resistance; insulin secretion index(HOMA-B) = 20 × fasting insulin(FINS) /(fasting glucose(FPG)-3.5), to evaluate the early insulin secretion according to the fasting blood glucose and insulin levels.5. Statistical analysis: SPSS17.0 statistical software was used for data analysis, measurement data was expressed as mean ± standard deviation(a) representation. Two independent samples were used to compare the mean difference between the two groups, with P <0.05 was considered statistically significant. Results:1. For GDM group, the 25-(OH) D3 levels were significantly lower than that in the NGT group(P <0.05). Insulin resistance index was significantly higher than that in the NGT group, the difference was with statistically significant(P <0.001);2.For GDM group, results of FPG, FINS, fasting C-peptide, HbA1 c, TG3 were higher than that in the NGT group, the difference was statistically significant(P <0.001, P <0.001, P <0.001, P <0.001, P <0.001);3. GDM group of pregnant women suffered from higher complications risk than NGT group, with statistical significance(P<0.05); the proportion of after the treatment with vitamin D, maternal and perinatal complications was significantly decreased compared with the control group, which was statistically significant(P < 0.05). Conclusions:1. 25-(OH) D levels were significantly lower in the GDM group than that in the group with normal glucose tolerance. Insulin resistance index was significantly higher in the GDM group than that in the NGT group, vitamin D deficiency increase insulin resistance.2. Maternal and fetal complications were significantly higher in the GDM group than that in the NGT group. Replenishing vitamin D could improve insulin resistance, which was statistically significant in reducing maternal complications and perinatal morbidity.