1.Effects and mechanism of asperuloside on the pyroptosis of intestinal epithelial cells in rats with ulcerative colitis
Chao XU ; Xiaoping TAN ; Jie LI ; Minghua AI ; Yueyue LU ; Chaoyong LIU
China Pharmacy 2025;36(2):166-171
OBJECTIVE To investigate the effects and mechanism of asperuloside (Asp) on the pyroptosis of intestinal epithelial cells in rats with ulcerative colitis (UC). METHODS The male SD rats were randomly divided into Control group, model group (UC group), ASP low-dose and high-dose groups [Asp-L, Asp-H groups, Asp 35, 70 mg/(kg·d)], ASP high-dose group+AMPK inhibitor Compound C group [Asp-H+Compound C group, Asp 70 mg/(kg·d)+Compound C 0.2 mg/(kg·d)], with 12 rats in each group. Except for Control group, the other groups were injected with 50% ethanol (0.25 mL)+5% 2,4, 6- trinitrobenzene sulfonic acid solution (2 mL/kg) into the intestinal cavity to construct UC model. After modeling, the rats in each drug group were given corresponding drug solution by gavage or (and) tail vein injection, once a day, for 14 consecutive days. After the last administration, the weight of rats in each group was measured, and the length of their colons was measured; disease activity index (DAI) score and colonic mucosal damage index (CMDI) score were performed, and the serum levels of inflammatory factors (interleukin-18, -1β, -6) were detected. The pathological changes of the colon tissue were observed. The expressions of pyroptosis-related proteins [caspase-1, gasdermin D (GSDMD)] in colon tissue, and pathway-related proteins such as adenosine monophosphate-activated protein kinase (AMPK), thioredoxin-interacting protein (TXNIP), NOD-like receptor protein 3 (NLRP3) and apoptosis-associated speck-like protein containing a CARD (ASC) were all detected. RESULTS Compared with Control group, the colon tissue structure of rats in UC group was damaged, with obvious infiltration of inflammatory cells and edema. Their body weight, colon length and phosphorylation level of AMPK protein were significantly reduced or shortened; DAI and CMDI scores, serum levels of inflammatory factors, and the protein expressions of caspase-1, GSDMD, TXNIP, NLRP3 and ASC in colon tissue were increased or upregulated significantly (P<0.05). Compared with UC group, the pathological damage of colon tissue in rats was relieved in Asp-L and Asp-H groups, and all quantitative indicators were significantly improved (P<0.05); the improvement effect of Asp-H group was more significant (P<0.05). Compound C could significantly reverse the improvement effect of high-dose of Asp on the above indicators in UC rats (P<0.05). CONCLUSIONS Asp can improve inflammatory damage in colon tissue and inhibit pyroptosis of intestinal epithelial cells in UC rats, which is associated with the activation of AMPK and inhibition of TXNIP/NLRP3 signaling pathway.
2.Effects and mechanism of asperuloside on the pyroptosis of intestinal epithelial cells in rats with ulcerative colitis
Chao XU ; Xiaoping TAN ; Jie LI ; Minghua AI ; Yueyue LU ; Chaoyong LIU
China Pharmacy 2025;36(2):166-171
OBJECTIVE To investigate the effects and mechanism of asperuloside (Asp) on the pyroptosis of intestinal epithelial cells in rats with ulcerative colitis (UC). METHODS The male SD rats were randomly divided into Control group, model group (UC group), ASP low-dose and high-dose groups [Asp-L, Asp-H groups, Asp 35, 70 mg/(kg·d)], ASP high-dose group+AMPK inhibitor Compound C group [Asp-H+Compound C group, Asp 70 mg/(kg·d)+Compound C 0.2 mg/(kg·d)], with 12 rats in each group. Except for Control group, the other groups were injected with 50% ethanol (0.25 mL)+5% 2,4, 6- trinitrobenzene sulfonic acid solution (2 mL/kg) into the intestinal cavity to construct UC model. After modeling, the rats in each drug group were given corresponding drug solution by gavage or (and) tail vein injection, once a day, for 14 consecutive days. After the last administration, the weight of rats in each group was measured, and the length of their colons was measured; disease activity index (DAI) score and colonic mucosal damage index (CMDI) score were performed, and the serum levels of inflammatory factors (interleukin-18, -1β, -6) were detected. The pathological changes of the colon tissue were observed. The expressions of pyroptosis-related proteins [caspase-1, gasdermin D (GSDMD)] in colon tissue, and pathway-related proteins such as adenosine monophosphate-activated protein kinase (AMPK), thioredoxin-interacting protein (TXNIP), NOD-like receptor protein 3 (NLRP3) and apoptosis-associated speck-like protein containing a CARD (ASC) were all detected. RESULTS Compared with Control group, the colon tissue structure of rats in UC group was damaged, with obvious infiltration of inflammatory cells and edema. Their body weight, colon length and phosphorylation level of AMPK protein were significantly reduced or shortened; DAI and CMDI scores, serum levels of inflammatory factors, and the protein expressions of caspase-1, GSDMD, TXNIP, NLRP3 and ASC in colon tissue were increased or upregulated significantly (P<0.05). Compared with UC group, the pathological damage of colon tissue in rats was relieved in Asp-L and Asp-H groups, and all quantitative indicators were significantly improved (P<0.05); the improvement effect of Asp-H group was more significant (P<0.05). Compound C could significantly reverse the improvement effect of high-dose of Asp on the above indicators in UC rats (P<0.05). CONCLUSIONS Asp can improve inflammatory damage in colon tissue and inhibit pyroptosis of intestinal epithelial cells in UC rats, which is associated with the activation of AMPK and inhibition of TXNIP/NLRP3 signaling pathway.
3.Exploring Detoxication Mechanism of Dioscoreae Bulbiferae Rhizoma Processed with Phaseoli Radiati Semen Juice Based on Target Organ Ferroptosis
Yaqian DUAN ; Lingling SONG ; Yueyue ZHANG ; Junming WANG ; Minghao LIU ; Yamin LI ; Bingyin LI ; Xiaohui WU ; Yanmei WANG
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(10):70-76
ObjectiveTo investigate the attenuating effect of Dioscoreae Bulbiferae Rhizoma(DBR) processed with Phaseoli Radiati Semen(PRS) juice, and explore the attenuating mechanism based on ferroptosis of the main toxic target organ. MethodSixty male ICR mice were randomly divided into blank group, DBR group, water roasted DBR group(hereinafter referred to as water group), PRS juice-roasted DBR group 1(DBR-PRS 10∶1, stuffy moistening for 40 min, stir-fried at 130 ℃ for 18 min, hereinafter referred to as group 1), PRS juice-roasted DBR group 2(DBR-PRS 10∶1, stuffy moistening for 80 min, stir-fried at 100 ℃ for 14 min, hereinafter referred to as group 2), PRS juice-roasted DBR group 3(DBR-PRS=20∶3, stuffy moistening for 40 min, stir-fried at 160 ℃ for 14 min, hereinafter referred to as group 3). The raw and processed groups of DBR were gavaged with their corresponding 95% ethanol extract at a dose of 3 g·kg-1·d-1, while the blank group was gavaged with an equal volume of 0.5% sodium carboxymethyl cellulose, once a day for 14 consecutive days. Hematoxylin-eosin(HE) staining was used to observe the histopathological changes of mouse liver. Alanine aminotransferase(ALT) and aspartate aminotransferase(AST) levels in serum, as well as malondialdehyde(MDA), ferrous ions(Fe2+), reduced glutathione(GSH) and superoxide dismutase(SOD) levels in liver tissue were detected by the biochemical detection. Western blot was used to detect the expression of iron key proteins such as ferritin heavy chain 1(FTH1) and glutathione peroxidase 4(GPX4). ResultHE staining results showed that the liver tissue structure of the blank group was clear, the morphology of hepatocytes was normal, the cytoplasms of hepatocytes in the DBR group and water group were loose and vacuolar, with obvious pathological damages, and the pathologic damages of mice in the group 1-3 were significantly improved. Compared with the blank group, the levels of ALT, AST, MDA and Fe2+ in mice from the DBR group were significantly increased(P<0.01), while GSH and SOD levels were significantly reduced(P<0.01), and the protein expression levels of FTH1 and GPX4 were significantly decreased(P<0.01). Compared with the DBR group, the ALT, AST,MDA and Fe2+ levels of mice in the group 1-3 were significantly reduced(P<0.05, P<0.01), the GSH and SOD levels and the protein expression levels of FTH1 and GPX4 were significantly increased(P<0.01). Compared with the water group, the AST and MDA levels of mice in the group 1-3 were significantly reduced(P<0.05, P<0.01), the SOD level significantly increased(P<0.05, P<0.01), the FTH1 protein expression significantly increased(P<0.01), and the serum ALT level of mice in the group 2-3 significantly reduce(P<0.01), Fe2+ level significantly reduced(P<0.01), GSH level significantly increased(P<0.05, P<0.01), and GPX4 protein expression significantly increased(P<0.05, P<0.01). Among the group 1-3, the group 3 had the best detoxification effect. ConclutionProcessing with PRS juice can reduce the liver injury induced by DBR, and the mechanism may be related to the inhibition of ferroptosis in the liver.
4.Research Progress in the Treatment of Ulcerative Colitis with Sishen Pills
Kaiyang LI ; Mei YANG ; Qi ZHAO ; Jing HUANG ; Xiaoyuan LIN ; Jiemin LIU ; Zhenfan GUO ; Hui SHI ; Yueyue YANG
Chinese Journal of Information on Traditional Chinese Medicine 2024;31(3):180-185
Sishen Pills is a classic prescription for the treatment of spleen and kidney diarrhea,which has the effect of warming the kidney and the spleen,astringent intestine and antidiarrheal.In modern clinical application,the modified prescriptions based on Sishen Pills,combined with other treatments of TCM and integrated traditional Chinese and Western medicine are often used to treat ulcerative colitis with spleen-kidney yang deficiency syndrome,and the curative effect is remarkable.Experimental pharmacological studies have shown that Sishen Pills may achieve the purpose of ulcerative colitis by regulating the expression of related signaling pathway proteins,regulating inflammatory factors,inhibiting inflammatory response,regulating autophagy,regulating intestinal flora,improving intestinal mucosal permeability,repairing intestinal mucosal barrier,regulating cellular energy metabolism,anti-oxidative stress,regulating cellular immune function,etc.In this article,the research status of Sishen Pills in the treatment of ulcerative colitis was sorted out and summarized,in order to provide reference for further study of its mechanism and clinical application.
5.Evaluation of the safety and efficacy of mitomycin C-perfluorooctyl bromide liposome nanoparticles in the treatment of human pterygium fibroblasts
Tao LI ; Lingshan LIAO ; Shenglan ZHU ; Juan TANG ; Xiaoli WU ; Qilin FANG ; Ying LI ; Biao LI ; Qin TIAN ; Junmei WAN ; Yi YANG ; Yueyue TAN ; Jiaqian LI ; Juan DU ; Yan ZHOU ; Dan ZHANG ; Xingde LIU
Recent Advances in Ophthalmology 2024;44(2):100-105
Objective To prepare a nano drug(PFOB@Lip-MMC)with liposome as the carrier,liquid perfluorooc-tyl bromide(PFOB)as core and mitomycin C(MMC)loading on the liposome shell and study its inhibitory effect on the proliferation of human pterygium fibroblasts(HPFs).Methods The thin film dispersion-hydration ultrasonic method was used to prepare PFOB@Lip-MMC and detect its physical and chemical properties.Cell Counting Kit-8,Cam-PI cell viability staining and flow cytometry were employed to detect the impact of different concentrations of PFOB@Lip-MMC on the via-bility of HPFs.DiI fluorescence labeled PFOB@Lip-MMC was used to observe the permeability of the nano drug to HPFs under a laser confocal microscope.After establishing HPF inflammatory cell models,they were divided into the control group(with sterile phosphate-buffered saline solution added),PFOB@Lip group(with PFOB@Lip added),MMC group(with MMC added),PFOB@Lip-MMC group(with PFOB@Lip-MMC added)and normal group(with fresh culture medi-um added)according to the experimental requirements.After co-incubation for 24 h,flow cytometer was used to detect the apoptosis rate of inflammatory cells,and the gene expression levels of interleukin(IL)-1β,prostaglandin E2(PGE2),tumor necrosis factor(TNF)-α and vascular endothelial growth factor(VEGF)in cells were analyzed by PCR.Results The average particle size and Zeta potential of PFOB@Lip-MMC were(103.45±2.17)nm and(27.34±1.03)mV,respec-tively,and its entrapped efficiency and drug loading rate were(72.85±3.28)%and(34.27±2.04)%,respectively.The sustained-release MMC of drug-loaded nanospheres reached(78.34±2.92)%in vitro in a 24-hour ocular surface environ-ment.The biological safety of PFOB@Lip-MMC significantly improved compared to MMC.In terms of the DiI fluorescence labeled PFOB@Lip-MMC,after co-incubation with inflammatory HPFs for 2 h,DiI fluorescence labeling was diffusely dis-tributed in the cytoplasm of inflammatory HPFs.The apoptosis rate of inflammatory HPFs in the PFOB@Lip-MMC group[(77.23±4.93)%]was significantly higher than that in the MMC group[(51.62±3.28)%].The PCR examination results showed that the gene transcription levels of IL-1 β,PGE2,TNF-α and VEGF in other groups were significantly reduced com-pared to the control group and PFOB@Lip group,with the most significant decrease in the PFOB@Lip-MMC group(all P<0.05).Conclusion In this study,a novel nano drug(PFOB@LIP-MMC)that inhibited the proliferation of HPFs was successfully synthesized,and its cytotoxicity was significantly reduced compared to the original drugs.It has good bio-compatibility and anti-inflammatory effects,providing a new treatment approach for reducing the recurrence rate after pte-rygium surgery.
6.Point application (invigorate the spleen and kidney and circulation of blood formula) combined with five-animal exercise on improving the nutritional status for asthenia of patients with dialysis
Ruqin ZHAO ; Shengfeng LIU ; Xiangmin BO ; Ling YIN ; Min XIE ; Jihong CHEN ; Yueyue GUO
Chinese Journal of Practical Nursing 2024;40(2):81-89
Objective:To observe the effect of point application-invigorate the spleen and kidney, circulation of blood formula (PA) combined with five-animal exercise (FAE) on improving the nutritional status for asthenia of patients with dialysis, and provide evidence for the rehabilitation treatment of dialysis patients.Methods:According to the random number table method, a total of 80 patients treated with regular dialysis at Department of Nephrology, the Affiliated Hospital of Nanjing University of Chinese Medicine from April 2020 to December 2021 were randomly divided into experimental group and control group, with 40 cases in each group. Participants in the control group received regular dialysis, basic treatment and diet nursing (RBD). Participants in the experimental group received RBD plus PA+FAE. Labaratory test results, Subjective Global Assessment scale score and Traditional Chinese medicine symptom score were measured at baseline and 12-weeks after the intervention. The Fried Frailty scale score was measured at baseline, 4, 8, and 12 weeks after the intervention.Results:The control group aged (54.08 ± 11.34) years old, 23 males, 17 females; the experimental group aged (57.38±9.89) years old, 19 males, 21 females. After 4, 8 and 12 weeks of intervention, the Fried Frailty Scale scores of the experimental group at different time points were 2 (2, 2), 1 (1, 2) and 1 (0, 1), respectively, lower than 3 (2, 4), 2 (2, 3) and 2 (2, 3) of the control group, and the differences in time effect, inter-group effect and interaction effect were statistically significant ( F=105.76, 18.38, 46.67, all P<0.01). Further pairwise comparisons within groups indicated significant differences of Fried Frailty scale scores at different time points ( Z=-2.78, -4.01, -6.08, all P<0.01). After 12-week of intervention, the results of hemoglobin, serum albumin and serum prealbumin were (107.88 ± 15.58) g/L, (39.10 ± 4.92) g/L, and (289.36 ± 72.05) mg/L in the experimental group, respectively, higher than (100.15 ± 17.62) g/L, (36.93 ± 4.72) g/L, (255.63 ± 75.35) mg/L in the control group ( t=-2.08, -2.01, -2.05, all P<0.05). Subjective Overall Assessment scale was found a significant difference between the 2 groups ( χ2=10.91, P<0.01): the number of grade A (good nutrition) and B (mild to moderate malnutrition) were 36 and 4 in the experimental group and 23 and 17 in the control group. Traditional Chinese medicine symptom score was (4.68 ± 2.50) in the experimental group, lower than (9.58 ± 4.40) in the control group ( t=6.13, P<0.01). Conclusions:Point application-invigorate the spleen and kidney and circulation of blood formula combined with five-animal exercise can effectively improve the nutritional status of dialysis patients and reduce the weakness of patients
7.The Relationship between the Duration of Folic Acid Supplementation,Gesta-tional Diabetes Mellitus and Adverse Perinatal Outcomes
Jinyi WANG ; Chunxing MA ; Yueyue GAO ; Yaming ZHANG ; Fengying WANG ; Xuntao LIU ; Yunchun LIU
Journal of Practical Obstetrics and Gynecology 2024;40(8):664-669
Objective:To investigate the relationship between the duration of folic acid supplementation,gesta-tional diabetes mellitus(GDM)and adverse perinatal outcomes based on generalized linear mixed model.Meth-ods:Clinical data was collected of 759 pairs of mothers and children who delivered at the First Affiliated Hospital of Hebei North University from January 2021 to December 2022.The adverse perinatal outcomes of this study in-cluded cesarean section,premature birth,macrosomia,low birth weight(LBW),large for gestational age(LGA),and small for gestational age infant(SGA).Generalized linear mixed model was used to analyze the impact of GDM and supplementation with folic acid for a duration of ≥3 months on the risk of adverse perinatal outcomes.A stratified analysis of the duration of folic acid supplementation was conducted to determine whether it was a con-founding factor or influencing factor of GDM and adverse birth outcomes.Results:A total of 748 patients(98.55%)received folic acid supplementation before and during pregnancy,with a total of 743 patients(97.89%)receiving folic acid supplementation during pregnancy and 496 patients(65.35%)receiving folic acid supplementation before pregnancy.77 mothers were diagnosed with GDM,with an incidence rate of 10.14%.Compared with those who received folic acid supplementation before pregnancy for<3 months,those who re-ceived folic acid supplementation before pregnancy for ≥ 3 months were associated with an increased risk of GDM.The adjusted RR(aRR)was 1.72(95%CI 1.17-2.53).The GDM patients who received folic acid sup-plementation for≥3 months before pregnancy was associated with a reduced risk of SGA,with an aRR of 0.40(95%CI 0.18-0.89).In the subgroup of pregnant women who received folic acid supplementation for≥3 months,GDM was associated with an increased risk of cesarean section(aRR 1.36,95%CI 1.06-1.75))and macrosomia(aRR2.11,95%CI 1.06-4.20),but both aRR were lower than fixed effect RR of 1.53(95%CI 1.01-2.34)and 2.43(95%CI 12.7-4.66),respectively.and the above differences were statistically signifi-cant(P<0.01).Conclusions:Supplementing folic acid for≥3 months before pregnancy increases the risk of GDM,but reduces the risk of SGA birth in patients with GDM.Supplementing folic acid during pregnancy for≥3 months has a reducing effect on the risk of adverse perinataloutcomes of cesarean section and macrosomia in women with GDM.
8.The Relationship between the Duration of Folic Acid Supplementation,Gesta-tional Diabetes Mellitus and Adverse Perinatal Outcomes
Jinyi WANG ; Chunxing MA ; Yueyue GAO ; Yaming ZHANG ; Fengying WANG ; Xuntao LIU ; Yunchun LIU
Journal of Practical Obstetrics and Gynecology 2024;40(8):664-669
Objective:To investigate the relationship between the duration of folic acid supplementation,gesta-tional diabetes mellitus(GDM)and adverse perinatal outcomes based on generalized linear mixed model.Meth-ods:Clinical data was collected of 759 pairs of mothers and children who delivered at the First Affiliated Hospital of Hebei North University from January 2021 to December 2022.The adverse perinatal outcomes of this study in-cluded cesarean section,premature birth,macrosomia,low birth weight(LBW),large for gestational age(LGA),and small for gestational age infant(SGA).Generalized linear mixed model was used to analyze the impact of GDM and supplementation with folic acid for a duration of ≥3 months on the risk of adverse perinatal outcomes.A stratified analysis of the duration of folic acid supplementation was conducted to determine whether it was a con-founding factor or influencing factor of GDM and adverse birth outcomes.Results:A total of 748 patients(98.55%)received folic acid supplementation before and during pregnancy,with a total of 743 patients(97.89%)receiving folic acid supplementation during pregnancy and 496 patients(65.35%)receiving folic acid supplementation before pregnancy.77 mothers were diagnosed with GDM,with an incidence rate of 10.14%.Compared with those who received folic acid supplementation before pregnancy for<3 months,those who re-ceived folic acid supplementation before pregnancy for ≥ 3 months were associated with an increased risk of GDM.The adjusted RR(aRR)was 1.72(95%CI 1.17-2.53).The GDM patients who received folic acid sup-plementation for≥3 months before pregnancy was associated with a reduced risk of SGA,with an aRR of 0.40(95%CI 0.18-0.89).In the subgroup of pregnant women who received folic acid supplementation for≥3 months,GDM was associated with an increased risk of cesarean section(aRR 1.36,95%CI 1.06-1.75))and macrosomia(aRR2.11,95%CI 1.06-4.20),but both aRR were lower than fixed effect RR of 1.53(95%CI 1.01-2.34)and 2.43(95%CI 12.7-4.66),respectively.and the above differences were statistically signifi-cant(P<0.01).Conclusions:Supplementing folic acid for≥3 months before pregnancy increases the risk of GDM,but reduces the risk of SGA birth in patients with GDM.Supplementing folic acid during pregnancy for≥3 months has a reducing effect on the risk of adverse perinataloutcomes of cesarean section and macrosomia in women with GDM.
9.The Relationship between the Duration of Folic Acid Supplementation,Gesta-tional Diabetes Mellitus and Adverse Perinatal Outcomes
Jinyi WANG ; Chunxing MA ; Yueyue GAO ; Yaming ZHANG ; Fengying WANG ; Xuntao LIU ; Yunchun LIU
Journal of Practical Obstetrics and Gynecology 2024;40(8):664-669
Objective:To investigate the relationship between the duration of folic acid supplementation,gesta-tional diabetes mellitus(GDM)and adverse perinatal outcomes based on generalized linear mixed model.Meth-ods:Clinical data was collected of 759 pairs of mothers and children who delivered at the First Affiliated Hospital of Hebei North University from January 2021 to December 2022.The adverse perinatal outcomes of this study in-cluded cesarean section,premature birth,macrosomia,low birth weight(LBW),large for gestational age(LGA),and small for gestational age infant(SGA).Generalized linear mixed model was used to analyze the impact of GDM and supplementation with folic acid for a duration of ≥3 months on the risk of adverse perinatal outcomes.A stratified analysis of the duration of folic acid supplementation was conducted to determine whether it was a con-founding factor or influencing factor of GDM and adverse birth outcomes.Results:A total of 748 patients(98.55%)received folic acid supplementation before and during pregnancy,with a total of 743 patients(97.89%)receiving folic acid supplementation during pregnancy and 496 patients(65.35%)receiving folic acid supplementation before pregnancy.77 mothers were diagnosed with GDM,with an incidence rate of 10.14%.Compared with those who received folic acid supplementation before pregnancy for<3 months,those who re-ceived folic acid supplementation before pregnancy for ≥ 3 months were associated with an increased risk of GDM.The adjusted RR(aRR)was 1.72(95%CI 1.17-2.53).The GDM patients who received folic acid sup-plementation for≥3 months before pregnancy was associated with a reduced risk of SGA,with an aRR of 0.40(95%CI 0.18-0.89).In the subgroup of pregnant women who received folic acid supplementation for≥3 months,GDM was associated with an increased risk of cesarean section(aRR 1.36,95%CI 1.06-1.75))and macrosomia(aRR2.11,95%CI 1.06-4.20),but both aRR were lower than fixed effect RR of 1.53(95%CI 1.01-2.34)and 2.43(95%CI 12.7-4.66),respectively.and the above differences were statistically signifi-cant(P<0.01).Conclusions:Supplementing folic acid for≥3 months before pregnancy increases the risk of GDM,but reduces the risk of SGA birth in patients with GDM.Supplementing folic acid during pregnancy for≥3 months has a reducing effect on the risk of adverse perinataloutcomes of cesarean section and macrosomia in women with GDM.
10.The Relationship between the Duration of Folic Acid Supplementation,Gesta-tional Diabetes Mellitus and Adverse Perinatal Outcomes
Jinyi WANG ; Chunxing MA ; Yueyue GAO ; Yaming ZHANG ; Fengying WANG ; Xuntao LIU ; Yunchun LIU
Journal of Practical Obstetrics and Gynecology 2024;40(8):664-669
Objective:To investigate the relationship between the duration of folic acid supplementation,gesta-tional diabetes mellitus(GDM)and adverse perinatal outcomes based on generalized linear mixed model.Meth-ods:Clinical data was collected of 759 pairs of mothers and children who delivered at the First Affiliated Hospital of Hebei North University from January 2021 to December 2022.The adverse perinatal outcomes of this study in-cluded cesarean section,premature birth,macrosomia,low birth weight(LBW),large for gestational age(LGA),and small for gestational age infant(SGA).Generalized linear mixed model was used to analyze the impact of GDM and supplementation with folic acid for a duration of ≥3 months on the risk of adverse perinatal outcomes.A stratified analysis of the duration of folic acid supplementation was conducted to determine whether it was a con-founding factor or influencing factor of GDM and adverse birth outcomes.Results:A total of 748 patients(98.55%)received folic acid supplementation before and during pregnancy,with a total of 743 patients(97.89%)receiving folic acid supplementation during pregnancy and 496 patients(65.35%)receiving folic acid supplementation before pregnancy.77 mothers were diagnosed with GDM,with an incidence rate of 10.14%.Compared with those who received folic acid supplementation before pregnancy for<3 months,those who re-ceived folic acid supplementation before pregnancy for ≥ 3 months were associated with an increased risk of GDM.The adjusted RR(aRR)was 1.72(95%CI 1.17-2.53).The GDM patients who received folic acid sup-plementation for≥3 months before pregnancy was associated with a reduced risk of SGA,with an aRR of 0.40(95%CI 0.18-0.89).In the subgroup of pregnant women who received folic acid supplementation for≥3 months,GDM was associated with an increased risk of cesarean section(aRR 1.36,95%CI 1.06-1.75))and macrosomia(aRR2.11,95%CI 1.06-4.20),but both aRR were lower than fixed effect RR of 1.53(95%CI 1.01-2.34)and 2.43(95%CI 12.7-4.66),respectively.and the above differences were statistically signifi-cant(P<0.01).Conclusions:Supplementing folic acid for≥3 months before pregnancy increases the risk of GDM,but reduces the risk of SGA birth in patients with GDM.Supplementing folic acid during pregnancy for≥3 months has a reducing effect on the risk of adverse perinataloutcomes of cesarean section and macrosomia in women with GDM.

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