بررسی ارتباط بین کمبود ویتامین D و بروز دیابت بارداری

نوع مقاله : اصیل پژوهشی

نویسندگان

1 دانشیار گروه زنان و مامایی، دانشکده پزشکی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

2 رزیدنت گروه زنان و مامایی، دانشکده پزشکی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

3 استادیار گروه طب اورژانس، دانشکده پزشکی، دانشگاه علوم پزشکی خراسان شمالی، بجنورد، ایران.

4 کارشناس کتابداری، دانشکده پزشکی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

چکیده

مقدمه: دیابت شیرین بارداری شایع‌ترین مشکل بارداری است و حدود 20-1% از زنان باردار مبتلا به دیابت بارداری هستند، بنابراین جلوگیری و درمان دیابت بارداری اهمیت زیادی دارد. تحقیقات متعددی به ارزیابی ریسک فاکتورهای دیابت بارداری پرداخته‌اند. کمبود ویتامین D یکی از این ریسک فاکتورهاست که دارای نتایج دو پهلو می‌باشد، از این رو مطالعه حاضر با بررسی ارتباط بین سطح سرمی ویتامین D و دیابت بارداری انجام شد.
روش‌کار: این مطالعه آینده‌نگر در سال 97-1396 بر روی زنان باردار 40-15 ساله که در تریمستر اول بارداری برای مراقبت‌های پره‌ناتال به مراکز خدمات جامع سلامت شهر مشهد مراجعه کردند و معیارهای ورود را داشتند، انجام شد. اطلاعات مربوط به سن و شاخص توده بدنی واحدهای پژوهش ثبت شد. سپس از تمامی شرکت‌کنندگان 5 سی‌سی خون به‌منظور اندازه‌گیری سطح 25- هیدروکسی ویتامین D3 گرفته شد. در هفته 28-24 بارداری تمامی شرکت‌کنندگان آزمون تحمل خوراکی گلوکز (OGTT) را انجام دادند. تجزیه و تحلیل داده‌ها با استفاده از نرم‌افزار آماری  SPSS(نسخه 16) و آزمون‌های تی مستقل، من‌ویتنی، کای اسکوئر و دقیق فیشر انجام شد. میزان p کمتر از 05/0 معنی‌دار در نظر
 گرفته شد.
یافته‌ها: از 449 فرد شرکت‌کننده، 320 نفر (2/71%) دارای سطح کمتر از حد طبیعی ویتامین D بودند که 68 نفر (1/15%) کمبود و 252 نفر (1/56%) سطح ناکافی ویتامین D داشتند. 7 نفر (6/1%) سطح بالاتری از ویتامین D و 122 نفر (27%) سطح نرمال ویتامین D داشتند. از بین واحدهای پژوهش، 41 نفر (1/9%) مبتلا به دیابت بارداری شدند. میانه سطح سرمی ویتامین D در افراد بدون دیابت بارداری 22 و در افراد با دیابت بارداری 18 نانو‌گرم بر سی‌سی بود که هرچند متفاوت بود، ولی تفاوت معناداری بین سطح ویتامین D در دو گروه وجود نداشت (555/0=p).
نتیجه‌گیری: هرچند میزان ویتامین D در افراد مبتلا به دیابت بارداری پایین‌تر بود، اما ارتباط معنی‌داری بین سطح ویتامین D و دیابت بارداری وجود نداشت و هر دو گروه سطح کمتر از حد طبیعی ویتامین D را داشتند.

کلیدواژه‌ها

عنوان مقاله [English]

The relationship between vitamin D deficiency and gestational diabetes mellitus

نویسندگان [English]

  • Marzieh Lotfalizadeh 1
  • Negar Ramezanpour 2
  • Kosar Deldar 3
  • Mansoureh Mohammadnezhad 4
1 Associate Professor, Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
2 Resident, Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
3 Assistant professor, Department of Emergency Medicine, Faculty of Medicine, North Khorasan University of Medical Sciences, Bojnord, Iran.
4 Librarian, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
چکیده [English]

Introduction: Gestational diabetes mellitus (GDM) is the most common problem in pregnancy and about 1-20% of pregnant women have GDM. Therefore, it is significantly importance to prevent and treat GDM. Numerous researchers have explored the possible risk factors of GDM. Vitamin D deficiency is one of these risk factors that has ambiguous results, therefore, this study was performed with aim to investigate the relationship between serum vitamin D levels and gestational diabetes.
Methods: This prospective study was conducted in 2017-2018 on pregnant women aged 15-40 years with inclusion criteria who referred to health services centers in Mashhad in first trimester of pregnancy for prenatal care. Data related to age and BMI was recorded. Then, 5 cc of blood was taken from all participants to measure 25-hydroxyvitamin D3. All participants underwent the Oral Glucose Tolerance Test (OGTT) at 24-28 weeks of gestation. Data were analyzed by SPSS software (version 16) and Independent t-test, Mann-Whitney, Chi-square and Fisher's exact test. P<0.05 was considered statistically significant
Results: From 449 participants, 320 (71.2%) had lower than normal levels of vitamin D that 68 (15.1%) of participants suffered from vitamin D deficiency and 252 (56.1%) suffered from vitamin D insufficiency. In addition, 7 participants (1.6%) had the higher levels of vitamin D and 122 (27%) had normal vitamin D. Among the subjects, 41 (9.1%) developed gestational diabetes. The median of vitamin D levels within non-diabetic group was 22 ng/cc and 18 ng/cc for diabetic group, although there was difference, but the difference was not significant between the two groups (p=0.555).
Conclusion: Although vitamin D level was lower in GDM patients, but there was no relationship between vitamin D and gestational diabetes and both groups had vitamin D level lower than normal range.

کلیدواژه‌ها [English]

  • Gestational Diabetes
  • Vitamin D

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مجله زنان، مامایی و نازایی ایران
دوره 25، شماره 1
فروردین 1401
صفحه 1-9

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