[ABSTRACT]Objective:To detect vitamin D levels in patients with gestational diabetes mellitus and the influence and clin-ical effect of Vitamin D supplement on insulin resistance,fatty factors and TNF-α.Methods:A total of 100 patients with GDM from September 2014 to May 201 5 in our hospital were selected as object of observation (GDM Group).A total of 52 cases pa-tients with vitamin D deficiency were randomly divided into two groups,the treatment group (n=26)and the control group (n =26).At the same time,50 cases of healthy pregnant women were selected as normal group.Biochemical indexes of observa-tion group and normal group were detected.Biosynthetic Human insulin injection was given to the patients in the control group. The patients in the observation group were supplemented with vitamin D drops on the basis of the treatment of control group. The level of insulin resistance,adipokines and TNF-αwere detected in the 2 groups.Results:FBG,PBG,FINS,TG,visfatin, TNF-αand HOMA-IR in GDM group were significantly higher compared with that in normal group (P <0.05 ).25 (OH)D3 and APN in GDM group decreased significantly compared with that in normal group (P <0.05).The comparison of TC,HDL-C and LDL-C in the two groups were not statistically significant (P >0.05).PBG,FINS,HOMA-IR,visfatin and TNF-α in both groups after treatment significantly decreased compared with that before treatment.PBG,visfatin and TNF-αin treatment group after treatment decreased more significantly than that in control group (P <0.05).FINS and HOMA-IR in treatment group after treatment increased more significantly than that in control group (P <0.05).The decrease of FBG was not obvious and there was no significant difference between the two groups after treatment (P >0.05).APN and 25(OH)D3 in both groups after treatment significantly increased compared with that before treatment.And they in treatment group after treatment in-creased more significantly than that in control group(P <0.05.In the correlation analysis,25 (OH)D3 in serum was positively correlated to the level of APN(r =0.318,P <0.05).Also,it was negatively correlated to HOMA-IR,visfatin and TNF-α(r =-0.569,-0.325 and -0.282 respectively,all P <0.05).Conclusions:Vitamin D levels in patients with gestational diabetes mellitus decreased more significantly compared with that in healthy pregnamt women.The patients with vitamin D deficiency have higher risk to get GDM.Vitamin D can treat GDM by regulating the degree of insulin resistance and the level of adipo-kines.It has clinical value in the treatment of GDM.%目的：：探讨妊娠期糖尿病(gestational diabetes mellitus,GDM)患者血清维生素 D 水平,及维生素 D 补充对胰岛素抵抗、脂肪细胞因子及 TNF-α水平的影响及临床疗效.方法：选取2014年9月~2015年5月期间住院治疗的100例 GDM 患者为观察对象(GDM 组),将52例维生素 D 缺乏患者随机分为治疗组(n＝26)和对照组(n＝26),同时选取同期健康体检妊娠孕妇50例为正常组,对观察组与正常组的生化指标进行检测,对照组给予患者生物合成人胰岛素注射液治疗,治疗组在对照组基础上辅以维生素 D 滴剂治疗,检测两组患者胰岛素抵抗程度、脂肪细胞因子及 TNF-α水平.结果：GDM 组FBG、PBG、FINS、TG、Visfatin、TNF-α及 HOMA-IR 等水平显著高于正常组(P ＜0．05),25(OH)D3及 APN 水平较正常组明显降低(P ＜0．05),两组 TC、HDL-C 及 LDL-C 水平差异不显著(P 均＞0．05)；两组治疗后 PBG、FINS、HOMA-IR、Visfatin 及 TNF-α水平显著低于治疗前,且治疗组治疗后 PBG、Visfatin 及 TNF-α水平显著低于对照组(P ＜0．05),治疗后 FINS、HOMA-IR 显著高于对照组(P ＜0．05),FBG 水平下降不明显,且两组间治疗后水平无明显差异(P ＞0．05),APN 和25(OH)D3两组治疗后较治疗前水平升高,且治疗组治疗后水平较对照组显著升高(P ＜0．05)；相关性分析中,血清25(OH)D3与 APN 水平呈正相关(r ＝0．318,P ＜0．05),与 HOMA-IR、Visfatin 及 TNF-α水平呈负相关(r 值分别为－0．569、－0．325和－0．282,P 值均＜0．05).结论：妊娠期糖尿病患者血清维生素 D 水平较正常孕妇显著降低,维生素 D 缺乏患者患有 GDM 的风险较高；维生素 D 可以通过调节胰岛素抵抗程度及脂肪细胞因子等水平来治疗 GDM,在 GDM 治疗中有一定的临床价值.
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