ارتباط بین سطح سرمی ویتامین D با دیابت بارداری: یک مطالعه مورد- شاهدی

نوع مقاله : اصیل پژوهشی

نویسندگان

1 متخصص زنان و نازایی، مرکز تحقیقات سلامت و بیماری‌های زنان، دانشکده پزشکی، دانشگاه علوم پزشکی جهرم، جهرم، ایران.

2 دانشجوی پزشکی، کمیته تحقیقات دانشجویی، دانشکده پزشکی، دانشگاه علوم پزشکی جهرم، جهرم، ایران.

3 مربی گروه بیهوشی، مرکز تحقیقات مؤلفه‌های اجتماعی نظام سلامت، دانشکده پزشکی، دانشگاه علوم پزشکی جهرم، جهرم، ایران.

چکیده

مقدمه: دیابت بارداری (GDM) به‌عنوان عدم تحمل گلوکز و مقاومت به انسولین تعریف می­شود. کاهش سطح ویتامین D منجر به افزایش خطر دیابت بارداری تا 45% می­شود. مطالعه حاضر با هدف تعیین ارتباط بین سطح سرمی ویتامین D با دیابت بارداری در زنان باردار مبتلا و غیرمبتلا به دیابت بارداری مراجعه کننده به کلینیک زنان شهرستان جهرم انجام گرفت.
روش‌کار: این مطالعه موردی شاهدی در سال 1400 بر روی 110 نفر از زنان باردار مراجعه کننده به کلینیک زنان شهرستان جهرم انجام گرفت. تست GTT با 4 بار خون‌گیری برای غربالگری دیابت بارداری و اندازه‌گیری HbA1C انجام شد. در کسانی که از 4 معیار اندازه‌گیری گلوکز خون وریدی در تست تحمل قند، 2 معیار یا بیشتر غیرطبیعی بود، به‌عنوان مبتلا به دیابت بارداری شناخته شده و وارد گروه مورد شدند و کسانی که GTT طبیعی داشتند، با گروه مورد همسان‌سازی شده و در گروه کنترل یا شاهد قرار گرفتند. تجزیه و تحلیل داده‌ها با استفاده از نرم‌افزار SPSS (نسخه 21) و آزمون‌های آماری تی‌تست، من‌ویتنی و ضریب همبستگی اسپیرمن انجام شد. میزان p کمتر از 05/0 معنی‌دار در نظر گرفته شد.
یافته­ ها: بین زنان مبتلا به دیابت بارداری و زنان باردار غیرمبتلا به دیابت بارداری از نظر سطح سرمی ویتامین D تفاوت معنی‌داری وجود نداشت (37/0=p)، ولی از نظر متغیرهای آزمایشگاهی Total.Ca، FBSو HbA1C تفاوت معنی‌داری وجود داشت (05/0>p).
نتیجه­ گیری: اگرچه بین زنان باردار مبتلا و غیرمبتلا به دیابت بارداری از نظر سطح سرمی ویتامین D تفاوت معنی‌داری وجود نداشت، اما میزان ویتامین D در زنان با دیابت بارداری پایین‌تر از زنان بدون دیابت بارداری گزارش شد. همچنین تجویز ویتامین D می‌تواند باعث بهبود متغیرها گردد که افزایش آنها می‌تواند در بروز عوارض بارداری از جمله تشدید دیابت نقش داشته باشد. 

کلیدواژه‌ها

عنوان مقاله [English]

The relationship between serum vitamin D levels and gestational diabetes: A case-control study

نویسندگان [English]

  • Athar Rasekhjahromi 1
  • Zahra Paymard 2
  • Navid Kalani 3
1 Obstetrician and Gynecologist, Women's Health and Diseases Research Center, Faculty of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran.
2 Student of Medicine, Student Research Committee, Faculty of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran.
3 Instructor, Department of Anesthesia, Research Center for Social Determinants of Health, Faculty of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran.
چکیده [English]

Introduction: Gestational diabetes mellitus (GDM) is defined as glucose intolerance and insulin resistance. Decreased vitamin D levels increase the risk of gestational diabetes up to 45%. The present study was performed aimed to compare the relationship between serum level of vitamin D with gestational diabetes in pregnant women with and without gestational diabetes referred to the gynecology clinic in Jahrom.
Methods: This case-control study was performed in 2021 on 110 pregnant women referred to Jahrom gynecology clinic. GTT was performed with 4 blood samples for screening for gestational diabetes and measurement of HbA1C. Those with four or more abnormalities in the intravenous blood glucose test were identified as having gestational diabetes and were included in the case group, and those with normal GTT were matched with the case group and were placed in the control group. Data were analyzed by SPSS software (version 21) and T-test, Mann-Whitney and Spearman Correlation Coefficient. P<0.05 was considered statistically significant.
Results: There was no significant difference between women with gestational diabetes and pregnant women without gestational diabetes in terms of serum levels of vitamin D (P = 0.37). However, there was a significant difference between the two groups in terms of laboratory variables of Total.Ca, FBS and HbA1C (P <0.05).
Conclusion: Although there was no significant difference between pregnant women with and without gestational diabetes in serum levels of vitamin D, the level of vitamin D in women with gestational diabetes was lower than women without diabetes. Vitamin D administration can also improve variables that can increase the risk of pregnancy complications, including exacerbation of diabetes.

کلیدواژه‌ها [English]

  • Gestational diabetes
  • Pregnant women
  • Vitamin D

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مجله زنان، مامایی و نازایی ایران
دوره 25، شماره 8
آبان 1401
صفحه 33-41

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