Effect of high-dose vitamin D combined with insulin on serum homocysteine, glucose and lipid metabolism and pregnancy outcome in patients with gestational diabetes mellitus
10.3760/cma.j.cn101721-20240126-00022
- VernacularTitle:大剂量维生素D联合胰岛素治疗对妊娠期糖尿病患者血清同型半胱氨酸、血糖、血脂代谢及妊娠结局的影响
- Author:
Caiping GUO
1
;
Jing ZHAO
Author Information
1. 陕西省延安市人民医院妇产科，延安 716000
- Keywords:
Vitamin D;
Insulin;
Gestational diabetes mellitus;
Serum homocysteine;
Lipid metabolism;
Pregnancy outcome
- From:
Clinical Medicine of China
2024;40(4):271-277
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the effect of high-dose vitamin D combined with insulin on serum homocysteine (HCY), glucose and lipid metabolism and pregnancy outcome in patients with gestational diabetes mellitus.Methods:From June 2020 to May 2023, 120 patients with gestational diabetes mellitus in Yan'an People's Hospital were selected as the research object, and they were randomly divided into observation group and control group with 60 cases in each group. The control group was treated with insulin aspart, while the observation group was treated with insulin aspart and large dose of vitamin D. The levels of serum HCY, glucose metabolism, serum 25-hydroxyvitamin D3 and blood lipid metabolism were compared between the two groups before and after treatment. The pregnancy outcomes of the two groups were compared and analyzed through follow-up.Independent sample t-test is used for comparison between two groups of econometric data that conform to normal distribution, while paired t-test is used for comparison within groups. The comparison between the groups was performed by χ2 test. Results:After treatment, fasting blood glucose ((4.67±0.52) mmol/L vs (5.46±0.68) mmol/L), 2-hour postprandial blood glucose ((6.67±0.56) mmol/L vs (8.42±0.78) mmol/L) and homeostasis model insulin resistance index (2.45±0.45 vs 3.87±0.34) in the observation group were significantly lower than those in the control group, and homeostasis model assessment of islets in pre diabetes patients β cell function index (HOMA-β) in the observation group was significantly higher than that in the control group (87.15±10.45 vs 75.92±10.06). The differences were statistically significant (t values were 7.15, 14.12, 19.50, and 6.00; all P<0.001). After treatment, the serum HCY level ((8.72±1.27) μmol/L vs (10.18±1.65) μmol/L), in the observation group was lower than that in the control group and the serum 25-OH-D3 level ((15.05±2.41) μg/L vs (11.25±2.37) μg/L) in the observation group was higher than that in the control group. The differences were statistically significant ( t=5.43, 8.71, P<0.001). After treatment, the serum triglyceride, total cholesterol and low density lipoprotein cholesterol (LDL-C) in the observation group were compared with those in the control group. LDL-C levels were lower than those in the control group ((2.15±0.15) mmol/L vs (3.23±0.18) mmol/L, (5.23±0.14) mmol/L vs (6.34±0.17) mmol/L, (1.53±0.21) mmol/L and (2.21±0.22) mmol/L), serum high density lipoprotein cholesterol (HDL-C), HDL-C levels were significantly higher than those in the control group ((1.18±0.11) mmol/L vs (0.98±0.12) mmol/L), and the differences were statistically significant (t-values were 35.70, 39.04, 17.32, and 9.52, respectively, all P<0.001). The incidence of adverse pregnancy outcome in the observation group was lower than that in the control group (10% (6/60) vs 40% (24/60)), and the difference was statistically significant ( χ2=14.28, P<0.001). Conclusion:High-dose vitamin D combined with insulin therapy can not only effectively improve glucose and lipid metabolism, but also reduce the HCY level and improve the adverse pregnancy outcome in patients with gestational diabetes mellitus.
