西安地区妊娠妇女不同孕期血清铁蛋白、叶酸和维生素B12的水平及临床意义

目的：探讨西安地区妊娠妇女不同孕期血清铁蛋白、叶酸和维生素B12的水平及临床意义。方法：收集2012 年8 月至2013年1 月在本院进行产前检查的750 例妊娠期妇女及86 例健康非妊娠妇女的血清标本。采用全自动化学发光免疫分析法测定其血清铁蛋白、叶酸和维生素B12的含量。结果：孕妇血清铁蛋白、叶酸和维生素B12的含量随孕期的增长而逐渐降低。早、中、晚孕期妇女叶酸的含量较对照组相比,并无显著差异（P〉0.05）。中、晚孕期妇女血清铁蛋白和维生素B12含量均显著低于对照组,差异有统计学意义（P〈0.05）。结论：西安地区中、晚孕期的孕妇体内存在铁蛋白和维生素B12缺乏,但并不缺乏叶酸。在重视补充叶酸的同时,也应该重视对铁和维生素B12的补充。     

不同孕期GDM孕妇CRP水平、HbA1c和维生素B12相关性研究

摘要 目的：对不同孕期妊娠期糖尿病(gestational diabetes mellitus,GDM)孕妇的全血C反应蛋白(C-reactive protein,CRP)水平、糖化血红蛋白(glycosylated hemoglobin,Hb A1c)和血清维生素B12水平进行检测,并对其相关性进行分析。方法：以妊娠期孕妇为研究对象,根据OGTT试验结果分为对照组和研究组,对照组为健康孕妇,研究组为GDM孕妇,对两组中孕期和晚孕期孕妇的全血CRP、HbA1c和血清维生素B12进行检测。结果：研究组中孕期和晚孕期GDM的全血CRP和HbA1c水平均显著高于对照组（P＜0.05）。与中孕期相比,两组晚孕期全血CRP水平均无明显变化(P＞0.05),对照组孕妇全血HbA1c水平无明显变化(P＞0.05),而研究组晚孕期全血HbA1c水平显著升高(P＜0.05)。与对照组相比,研究组中孕期和晚孕期的血清维生素B12水平显著降低(P＜0.05);与中孕期相比,对照组孕妇血清维生素B12水平无明显变化(P＞0.05),而研究组晚孕期血清维生素B12水平显著降低(P＜0.05)。研究组中孕期和晚孕期CRP水平与HbA1c呈显著的正相关,与维生素B12呈显著的负相关(P＜0.05)。正常孕妇中孕期和晚孕期的CRP水平和HbA1c、维生素B12水平均未呈现相关性（P＞0.05）。结论：GDM孕妇中孕期和晚孕期的全血CRP、HbA1c和血清维生素B12均存在异常,且CRP水平与HbA1c显著正相关,与维生素B12水平显著负相关。     

湘潭地区不同孕期、不同年龄孕妇微量元素变化分析

目的:了解湘潭地区妊娠期妇女不同孕期、不同年龄微量元素的变化规律及缺乏情况,为孕妇合理地补充血清微量元素提供理论依据,从而达到提高孕期保健,减少不良妊娠事件发生的目的.方法:将255例观察组孕妇按妊娠时间分成早孕组(≤12周),中孕组(＞12～＜28周),晚孕组(≥28周),同时选取45例的健康非妊娠妇女作对照;并且根据年龄将观察组孕妇分为30岁以上组(年龄≥30岁)和30岁以下组(年龄＜30岁),采用原子吸收分光光度法测定不同孕期、不同年龄孕妇血清铁、钙、锌、镁、铜5种元素的含量,并统计出不同孕期、不同年龄孕妇5种元素的缺乏情况.结果:不同孕期、不同年龄孕妇各种微量元素均值比较有显著性差异(P＜0.05),表明微量元素的失衡程度与年龄和孕期有关.各孕期铁锌钙的缺乏率与对照组比较有统计学差异(P＜0.05);30岁以上组中铁、钙、锌与30岁以下组有明显差异(P＜0.05).结论:湘潭地区妊娠期孕妇不同孕期、不同年龄间微量元素含量存在着一定差异,孕妇应根据孕周和年龄的不同合理加强对铁、钙、锌等微量元素的补充,以避免孕期不良妊娠结局的发生,提高优生优育.     

孕妇维生素D缺乏与妊娠期糖尿病的相关性分析

目的:调查孕妇妊娠早期维生素D水平及其影响因素,探讨维生素D缺乏与妊娠期糖尿病的相关性。方法:选取2012年7月至2013年4月在上海交通大学医学院附属新华医院产科正规产检并分娩的非孕前糖尿病孕妇,在其建卡初检时采用电化学发光免疫技术测定血清25(OH)D3水平;妊娠24-28周行糖筛查及糖耐量试验,诊断是否为妊娠期糖尿病GDM。收集并整理孕妇年龄,孕前体重指数BMI、维生素D测定孕周与测定季节、孕期维生素D补充情况等信息。结果:1000例孕妇中,GDM发病率为11.5%,维生素D缺乏比例占67.4%;其中,约有54%孕妇常规补充复合维生素,约含维生素400 IU/天,10%孕妇常规补充维生素D。GDM孕妇25(OH)D3水平显著低于正常对照组(P=0.007)。维生素D缺乏孕妇发生GDM的风险是维生素D水平较高组的1.944倍,且在秋冬季更易发生GDM。可以考虑在孕14-16周进行维生素D水平的早期测定。结论:孕妇维生素D缺乏十分普遍。妊娠早期孕妇低维生素D水平可能增加孕妇胰岛素抵抗及孕期发生GDM的发生风险。     

孕早期妇女血清25-羟维生素D水平的表达及与甲状腺功能的相关性研究

目的:探讨孕早期妇女血清25-羟维生素D[25(OH)D]水平及与甲状腺功能的相关性。方法:选取2015年12月至2016年12月期间来我院进行常规产前检查的孕早期(≤12周)妇女90例为观察组,根据妊娠时间将观察组分为A组(4-6周)、B组(7-9周)和C组(10-12周),另选取同期在我院进行健康体检的妇女30例为对照组。采用电化学发光免疫分析法测定所有研究对象血清中的25(OH)D、促甲状腺激素(TSH)、游离甲状腺素(FT4)、游离三碘甲状腺原氨酸(FT3)水平,并分析观察组妇女血清25(OH)D水平与TSH、FT4、FT3之间的相关性。结果:A组、B组、C组出现维生素D缺乏的比例高于对照组,维生素D充足的比例低于对照组,C组出现维生素D不足的比例高于对照组,差异均有统计学意义(P0.05)。A组、B组、C组维生素D缺乏、维生素D不足、维生素D充足的比例之间差异无统计学意义(P0.05)。A组、B组、C组出现甲状腺功能异常的比例比较差异无统计学意义(P0.05)。三种甲状腺功能减退的患病率由低到高分别为临床甲减、亚临床甲减、低T4血症,且A组、B组、C组临床甲减、亚临床甲减及低T4血症组间整体比较差异无统计学意义(P0.05)。不同血清25(OH)D水平的观察组孕妇血清中TSH、FT4、FT3水平之间的差异无统计学意义(P0.05)。直线回归分析显示,观察组血清中25(OH)D水平与TSH、FT4无明显相关性(P0.05),与FT3呈正相关关系(P0.05),多元线性回归模型分析显示血清中25(OH)D水平与TSH、FT4、FT3均无相关性(P0.05)。结论:孕早期妇女普遍存在维生素D缺乏的现象,血清25(OH)D水平及与甲状腺功能无明显相关性,但仍应注意加强维生素D的补充。     

叶酸联合维生素B12对儿童癫痫患者同型半胱氨酸水平的影响

目的：观察叶酸联合维生素B12对儿童癫痫患者同型半胱氨酸（Hcy）水平的影响。方法：选取我院2017年1月—2020年12月就诊,接受治疗的98例儿童癫痫患者为研究对象。按照随机数字表,将98例患者随机分为干预组和对照组各49例,两组患者性别、年龄、病程、发病频率间均无差异（P>0.05）,具有可比性。对照组患者选择临床一线治疗药物进行抗癫痫治疗,干预组患者在对照组用药基础上,添加0.4 mg叶酸+100 μg维生素B12进行辅助治疗,对患者进行为期3个月的跟踪随访。测定两组患者干预前、干预1个月、干预3个月后血清Hcy、叶酸和维生素B12水平,比较两者患者干预前后血清Hcy、叶酸和维生素B12水平变化,同时记录患者癫痫发作次数和每次发作持续时间,比较两者患者发作次数和持续时间的差异。结果：治疗前,两组患者血清Hcy、叶酸和维生素B12水平比较均无统计学差异。经叶酸联合维生素B12干预1个月、3个月后,干预组患者血清Hcy水平均显著降低（P<0.05）,叶酸及维生素B12水平均显著增高（P<0.05）,而对照组患者血清Hcy水平出现增高现象（P<0.05）,叶酸及维生素B12水平未观察到差异（P>0.05）,干预组与对照组相比,血清Hcy、叶酸和维生素B12水平均有差异（P<0.05）;干预组患者癫痫发作频率显著低于对照组患者,发作持续时间显著短于对照组患者（P<0.001）。结论：叶酸联合维生素B12对儿童癫痫患者进行辅助治疗,可显著降低血清Hcy水平,降低癫痫发作频率,缩短癫痫发作时间,值得在临床推广应用。     

全反式维甲酸对急性早幼粒细胞白血病患者血清学的影响

目的：探讨全反式维甲酸（All trans retinoic acid,ATRA）作为辅助剂在急性早幼粒细胞白血病（Acute promyelocytic leukemia, APL）治疗中,对患者血清促红细胞生成素（Erythropoietin,EPO）、血清铁蛋白、叶酸和维生素B12水平的影响。方法：回顾性分析 我院2011 年6 月-2015 年6 月接诊的50 例急性早幼粒细胞白血病患者的临床资料。根据患者的治疗方法不同将患者分为两组, A 组（亚砷酸钠治疗组）和B 组（亚砷酸钠联合ATRA）。对比两组患者治疗后血清铁蛋白、EPO、叶酸和维生素B12 恢复情况。结 果：两组患者入院时所有血清EPO、铁蛋白等比较,差异无统计学意义（P>0.05）;治疗后两组患者血清各指标均有所改善（P<0. 05）;治疗后B 组患者中EPO、血清B12、血清铁蛋白和叶酸恢复正常水平者明显多于A 组,差异具有统计学意义（P<0.05）。结论： 全反式维甲酸辅助治疗急性早幼粒细胞白血病患者能够更好的改善患者血清EPO、铁蛋白、叶酸和维生素B12 的异常,对于疾病 的治疗有一定的效果。     

左旋多巴治疗帕金森病时测定血同型半胱氨酸水平的临床意义

目的:探讨左旋多巴治疗帕金森病(PD)时测定血同型半胱氨酸水平的临床意义。方法:收集我院内科2012年3月到2014年3月住院和门诊的PD患者50例(病例组),选取健康体检者50例作为对照组,比较两组同型半胱氨酸、叶酸以及维生素B12差异以及同型半胱氨酸与叶酸、维生素B12和左旋多巴剂量和PD患者评分(UPDRS评分)相关性。结果:病例组血浆同型半胱氨酸水平显著高于对照组、差异具有的统计学意义(P0.05),叶酸以及维生素B12低于对照组,两组之间的差异具有统计学意义(P0.05);按照血浆同型半胱氨酸剂量将病例组分为两个亚组,高剂量组(≥14μmol/L)和低剂量组(14μmol/L),两亚组叶酸、维生素B12、左旋多巴剂量和UPDRS评分之间差异均无统计学意义(P0.05);相关性分析发现,同型半胱氨酸与叶酸、维生素B12以及UPDRS评分呈负相关(r=-0.545,-0.337,-0.233,P=0.001,0.009,0.013),与左旋多巴剂量呈正相关(r=0.518,P=0.001)。结论:左旋多巴治疗PD可使血同型半胱氨酸水平升高并降低叶酸、维生素B12的含量,临床上应加强叶酸、维生素B12等营养支持治疗。     

妊娠中晚期孕妇膳食营养及体内叶酸、维生素D等水平与妊高症的关系

目的：了解孕妇在妊娠中晚期的膳食营养状况,分析叶酸、维生素D等水平与妊高症的关系。方法：选取山东大学齐鲁医院青岛市院区2017年8月-2019年8月收治的妊娠期高血压疾病（PIH,简称妊高症）患者106例作为观察组,根据妊高症分型分为三个亚组：妊娠期高血压组（38例）、轻度子痫前期（36例）、重度子痫前期（32例）,选取同期在我院住院的正常孕妇126例为对照组。采用24h回忆法统计孕妇膳食状况,观察和比较两组患者血清叶酸、同型半胱氨酸（Hcy）、维生素D、血清钙、体重指数（BMI）等指标,分析影响PIH的相关因素。结果：孕妇不同膳食结构中,谷类、乳类、蔬菜类、鱼虾类、水果类摄入量均不足,豆类和油脂类摄入量适宜,畜禽肉类和蛋类摄入过量;对照组患者血清中叶酸、维生素D以及血清钙水平明显高于观察组中各亚组患者,随着妊娠高血压程度的不断加重,观察组中各亚组血清中叶酸、维生素D以及血清钙水平呈明显降低趋势,各组间比较差异具有统计学意义（P<0.01）;重度子痫前期组患者血清Hcy水平最高,正常对照组血清Hcy水平最低,各组间比较具有明显差异（P<0.01）;对影响PIH的单因素分析中,两组患者在年龄、BMI、血清叶酸、维生素D、血清Hcy和血清钙水平等方面比较具有统计学意义（P<0.05或P<0.01）。Logistic回归分析显示,孕期BMI、血清Hcy为PIH的独立危险因素,叶酸、维生素D、血清钙为PIH的保护因素。结论：孕妇在妊娠中晚期的膳食营养结构不均衡,谷类、乳类、蔬菜类、鱼虾类、水果类摄入量均不足,畜禽肉类和蛋类摄入过量,营养结构有待改善。PIH的发生与维生素D、叶酸和血清钙水平密切相关,BMI、Hcy是影响PIH发生的独立危险因素,叶酸、维生素D和血清钙是PIH的保护因素。孕妇在妊娠期间补充叶酸、维生素D、血清钙和控制能量过度摄入,对预防和降低PIH的发生具有重要的临床意义。     

血清Hcy，叶酸和维生素B12在胃癌及其癌前疾病中的作用

目的:探讨血清同型半胱氨酸(Hcy)、叶酸以及维生素B12在胃癌及癌前疾病中的水平及临床意义。方法:收集2014年1月至2016年8月我院收治的100例胃癌患者(胃癌组),及100例胃良性病变患者包括41例胃炎、34例胃溃疡、25例胃息肉(癌前病变组),并于同期随机选择200例健康体检者为对照组,采用循环酶法测定三组的血清Hcy,电化学发光免疫分析法测定叶酸及维生素B12水平,并分析各指标与胃癌临床病理特征的关系。结果:胃癌组、癌前病变组血清Hcy水平均高于对照组,叶酸及维生素B12水平均低于对照组,并且胃癌组血清Hcy水平高于癌前病变组,叶酸及维生素B12水平低于癌前病变组,差异有统计学意义(P0.05)。Ⅲ+Ⅳ期胃癌患者Hcy水平高于Ⅰ+Ⅱ期,进展期患者Hcy水平高于早期,有淋巴结转移患者Hcy水平高于无转移者,差异有统计学意义(P0.05);Hcy表达与性别、年龄、病变位置以及分化程度无关,差异无统计学意义(P0.05)。叶酸、维生素B12的表达在胃癌患者中与各临床病理特征(性别、年龄、TNM分期、肿瘤浸润深度、病变位置、有无淋巴结转移、分化程度)无明显关系,差异无统计学意义(P0.05)。结论:血清Hcy在胃癌患者中呈高水平表达,而叶酸及维生素B12呈低水平表达,联合检测三种指标有助于早期区分胃癌及癌前病变,同时血清Hcy还可能参与了胃癌的发生发展过程。Hcy、叶酸及维生素B12可作为早期鉴别诊断胃癌及其癌前病变的重要指标。     

胎盘特异性基因4 mRNA基因在孕妇外周血中的检测及临床价值

目的:应用实时荧光定量PCR(RT-PCR)技术对不同孕周孕妇外周血浆胎盘特异性基因4(PLAC4)m RNA基因进行检测,寻找唐氏综合征产前诊断的可靠生物学标志物,为无创性产前诊断提供新的突破口。方法:按入组标准随机选取健康育龄未妊娠女性5例,正常健康妊娠孕妇60例(早期妊娠20例、中期妊娠20例、晚期妊娠20例),唐氏筛查高危孕妇8例,正常分娩24 h女性5例。共收集外周血浆样本78例。应用RT-PCR技术,检测样本中的PLAC4 m RNA基因含量,并进行相对定量分析。结果:健康育龄未妊娠女性及正常分娩后24 h女性外周血浆中均无游离胎儿PLAC4 m RNA基因的存在;正常健康妊娠孕妇不同孕周标本均检测到PLAC4 m RNA基因,以早期妊娠作为对照,中期妊娠是早期妊娠的1.99倍,晚期妊娠是早期妊娠的3.73倍;唐氏筛查高危孕妇均检出PLAC4 m RNA基因,含量是早期妊娠的6.36倍。结论:PLAC4 m RNA基因有望成为唐氏综合征产前诊断的可靠性生物学标志物。     

Folate and vitamin B12 status of women in Newfoundland at their first prenatal visit

BACKGROUND: Newfoundland has one of the highest rates of neural tube defects in North America. Given the association between low maternal folic acid levels and neural tube defects, a cross-sectional study was conducted to obtain base-line data on the folate and vitamin B12 status of a sample of women in Newfoundland who were pregnant. METHODS: Blood samples were collected between August 1996 and July 1997 from 1424 pregnant women in Newfoundland during the first prenatal visit (at approximately 16 weeks'' gestation); this represented approximately 25% of the women in Newfoundland who were pregnant during this period. The samples were analysed for serum folate, vitamin B12, red blood cell folate and homocysteine. RESULTS: Median values for serum folate, red blood cell folate and serum vitamin B12 were 25 nmol/L, 650 nmol/L and 180 pmol/L, respectively. On the basis of the interpretive criteria used for red blood cell folate status, 157 (11.0%) of the 1424 women were deficient (< 340 nmol/L) and a further 180 (12.6%) were classified as indeterminate (340-420 nmol/L). Serum homocysteine levels, measured in subsets of the red blood cell folate status groups, supported the inadequate folate status. Serum vitamin B12 levels of 621 (43.6%) women were classified as deficient or marginal; however, the validity of the interpretive criteria for pregnant women is questionable. INTERPRETATION: A large proportion of pregnant women surveyed in Newfoundland in 1997 had low red blood cell folate levels.     

Anemia and Dental Caries in Pregnant Women: a Prospective Cohort Study

The objective was to evaluate the effect of anemia during pregnancy on the risk of dental caries development in pregnant women. A prospective cohort including a sample of pregnant women in a prenatal care unit of São Luís, Brazil, was done. The incidence of dental caries during pregnancy, according to Nyvad’s criteria, was the outcome. The main independent variables were serum iron, ferritin, hemoglobin, erythrocyte, hematocrit, mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), and red cell distribution width (RDW). Pregnant women (n = 121) were evaluated at two moments: up to 16th week of gestational age (T1) and in the last trimester of pregnancy (T2). Crude and adjusted associations were estimated by the incidence ratio risk (IRR) and respective 95% confidence intervals (95%CI). After adjustment, higher serum concentrations of ferritin (IRR = 0.97, 95%CI 0.95–0.99) in T1, and Fe (IRR = 0.99, 95%CI 0.98–0.99), ferritin (IRR = 0.99, 95%CI 0.98–0.99), erythrocyte (IRR = 0.71, 95%CI 0.50–0.99), hemoglobin (IRR = 0.84, 95%CI 0.73–0.96), hematocrit (IRR = 0.93, 95%CI 0.88–0.98), MCV (IRR = 0.91, 95%CI 0.86–0.96), and MCH (IRR = 0.83, 95%CI 0.74–0.93) in T2, were associated with fewer incidence of dental caries in pregnant women. Iron deficiency anemia during pregnancy is a risk factor for the incidence of dental caries in these women.     

血清妊娠相关血浆蛋白A在诊断异常妊娠中的临床意义

目的:探讨血清妊娠相关血浆蛋白A(PAPP-A)在诊断异常妊娠中的临床意义,分析其与异常妊振的关系。方法:选取299例5~13周的正常早孕妇为正常早孕组,同期选取稽留流产86例,先兆流产54例,异位妊娠76例为异常妊娠组,用酶联免疫吸附试验(ELASA)测定两组受试者的血清PAPP-A水平,分析两组受试者各个孕周内的血清PAPP-A水平的差异。结果:稽留流产孕妇在各个孕周内(9~13周)的血清PAPP-A水平显著低于同孕周内正常早孕孕妇(t值分别为9.500,8.113,3.511,9.538,8.504,P值均0.05);稽留流产孕妇总的平均血清PAPP-A水平亦低于常早孕孕妇(t=3.651,P值均0.05);异位妊娠孕妇在各个孕周内(9~13周)的血清PAPP-A水平显著低于同孕周内正常早孕孕妇(t值分别为7.976,9.030,9.941,11.625,14.079,12.569,P值均0.05),异位妊娠孕妇总的平均血清PAPP-A水平亦低于常早孕孕妇(t=28.168,P值均0.05);先兆流产孕妇(除孕8周)与正常早孕妊娠血清PAPP-A水平比较无显著统计学意义。结论:血清PAPP-A水平在异常妊娠如异位妊娠、稽留流产中显著降低,可作为诊断异位妊娠、稽留流产及先兆流产辅助诊断的生物学指标。     

Association between Perfluorinated Compound Exposure and Miscarriage in Danish Pregnant Women

Perfluorinated alkylated substances (PFAS) have been extensively used in consumer products and humans are widely exposed to these persistent compounds. A recent study found no association between exposure to perfluorooctanoic acid (PFOA) and perfluorooctanesulfonic acid (PFOS) and miscarriage, but no studies have examined adverse effect of the more recently introduced PFASs. We therefore conducted a case-control study within a population-based, prospective cohort during 2010-2012. Newly pregnant women residing in the Municipality of Odense, Denmark were invited to enroll in the Odense Child Cohort at their first antenatal visit before pregnancy week 12. Among a total of 2,874 participating women, 88 suffered a miscarriage and 59 had stored serum samples, of which 56 occurred before gestational week 12. They were compared to a random sample (N=336) of delivering women, who had also donated serum samples before week 12. Using a case-control design, 51 of the women suffering a miscarriage were matched on parity and gestational day of serum sampling with 204 delivering women. In a multiple logistic regression with adjustment for age, BMI, parity and gestational age at serum sampling, women with the highest tertile of exposure to perfluorononanoic acid (PFNA) and perfluorodecanoic acid (PFDA) in pregnancy had odds ratios for miscarriage of 16.5 (95% CI 7.4-36.6-36.5) and 2.67 (1.31-5.44), respectively, as compared to the lowest tertile. In the matched data set, the OR were 37.9 (9.9-145.2) and 3.71 (1.60-8.60), respectively. The association with perfluorohexane sulfonic acid (PFHxS) was in the same direction, but not statistically significant, while no association was found with PFOA and PFOS. Our findings require confirmation due to the possible public health importance, given that all pregnant women are exposed to these widely used compounds.     

Effects of inositol supplementation in a cohort of mothers at risk of producing an NTD pregnancy

Neural tube defects (NTDs), most commonly spina bifida and anencephaly, can be prevented with periconceptional intake of folic acid in about 70% of cases. Recurrence of NTDs despite supplementation of high dose of folic acid further suggests that a proportion of NTD cases might be resistant to folic acid. Moreover, heterogeneity of NTDs has been suggested in animal studies, indicating that only some sub-type of NTDs should be considered sensitive to folate intake. Inositol isomers (particularly myo- and chiro-inositol) can prevent folate-resistant NTDs in the curly-tail mutant mouse, suggesting that some cases of human NTDs might benefit from inositol supplementation. In humans, lower inositol blood concentration was found in pregnant women carrying NTD fetuses, whereas a periconceptional combination therapy with folic acid associated with inositol has been linked to normal live births, despite high NTD recurrence risk. Fifteen pregnancies from 12 Caucasian women from different parts of Italy with at least one previous NTD-affected pregnancy underwent periconceptional combined myo-inositol and folic acid supplementation. Maternal serum α-feto-protein levels were found in the normal range, and normal results on ultrasound examination were found in all the pregnancies that followed. No collateral effects or intense uterine contractions were demonstrated in this pilot study in any of the pregnancies after inositol supplementation, and seventeen babies were born without any type of NTD.     

Elemental contents in serum of pregnant women with gestational diabetes mellitus

Diabetes mellitus is characterized by hyperglycemia and is closely related to trace elements. Quite a few pregnant women suffer from impaired glucose tolerance (IGT) or gestational diabetes mellitus (GDM). Investigation of the changes of elemental contents in serum of the pregnant women with IGT and GDM is significant in the etiological research and cure of the diseases. In the present work, the elements Cu, Zn, Ca, Sr, Mg, P, Fe, and Al in the serum of pregnant women were determined. The elemental contents in different experimental groups were compared. Also, the correlation between elemental contents and gestational period was observed. The results showed that compared with normal pregnant women, the Cu contents in serum of pregnant women with GDM increased, but Zn contents had a decreasing trend. In addition, for all pregnant women, the Ca contents in serum had an obvious inverse correlation with gestational period.     

饮食疗法对妊娠期糖尿病孕妇血脂代谢动态变化的研究

目的:探讨脂代谢紊乱在妊娠期糖尿病(GDM)中的作用,为妊娠期糖尿病的预防及指导临床干预提供理论依据。方法:观察妊娠期糖尿病患者和糖耐量正常孕妇血脂水平及胰岛素抵抗程度差异,分析妊娠期糖尿病患者饮食治疗前后的血脂及炎症标志物的动态变化,于孕12W、24W及36W分别抽取两组孕妇空腹静脉血,测定糖、脂代谢指标及炎症标志物水平,计算血浆致动脉粥样硬化指数(atherogenic index of the plasma,AIP);应用稳态模型胰岛素抵抗指数(HOMA-IR)及胰岛分泌功能指数(HBCI),评价胰岛素抵抗指数(IR)程度及胰岛功能。结果:(1)GDM组的C肽、FINS、HOMA-IR明显高于糖耐量正常组(normal glucose tolerance,NGT)组(p0.05),GDM组HBCI指数低于NGT组(p0.05)。(2)干预组与对照组比较,12W时,TC、TG、HDL、LDL差异均无统计学意义(p0.05);24W及32W差异均有统计学意义(p0.05),均较对照组高。(3)对GDM组中TC、TG、HDL、LDL、AIP、hs-CRP、N及WBC值进行分析,TG、TC、LDL、AIP、hs-CRP、N及WBC值24W较36W及12W高(p0.05);HDL水平24W较36W及12W低(p0.05)。(4)NGT组中TG、TC、LDL、AIP、hs-CRP、N及WBC值36W较24W及12W高(p0.05);HDL水平36W较24W及12W高(p0.05)。结论:GDM孕妇存在着明显的胰岛素抵抗和胰岛β细胞分泌功能受损。GDM孕妇合并较正常妊娠更为严重的炎症反应,血脂水平明显升高,饮食治疗后对改善IR有益,提示在妊娠期糖尿病患者中,通过适当的饮食治疗进而对血糖及血脂的调整可以显著减少母儿并发症。