ارتباط بین وضعیت ویتامین D و دیابت بارداری: یک مطالعه مورد- شاهدی

نوع مقاله : اصیل پژوهشی

نویسندگان

1 استادیار گروه زنان و مامایی، دانشکده پزشکی، دانشگاه علوم پزشکی آبادان، آبادان، ایران.

2 دکترای پزشکی، دانشکده پزشکی، دانشگاه علوم پزشکی آبادان، آبادان، ایران.

3 استادیار گروه آمار زیستی، دانشکده پزشکی، دانشگاه علوم پزشکی آبادان، آبادان، ایران.

4 استادیار گروه داخلی، دانشکده پزشکی، دانشگاه علوم پزشکی آبادان، آبادان، ایران.

10.22038/ijogi.2024.74814.5860

چکیده

مقدمه: دیابت بارداری (GDM) از مهم‌ترین علل بروز عوارض در طول بارداری است که شیوع بالایی دارد و شناسایی عوامل مؤثر بر فیزیوپاتولوژی آن به‌عنوان راهکاری جهت پیشگیری و درمان، امری ضروری است، لذا مطالعه حاضر با هدف بررسی سطح سرمی ویتامین D در زنان باردار مبتلا به دیابت بارداری و سالم انجام شد.
روش‌کار: این مطالعه موردی شاهدی 1402-1401 بر روی 198 زن باردار (99 نفر مبتلا به دیابت بارداری و 99 نفر در گروه شاهد بدون دیابت بارداری) مراجعه کننده به مراکز درمانی دانشگاه علوم پزشکی آبادان انجام گرفت. پس از اخذ رضایت از افراد و ثبت اطلاعات دموگرافیک، سطح سرمی ویتامین D افراد ثبت شد. تجزیه و تحلیل داده­ ها با استفاده از نرم‌افزار آماری SPSS (نسخه 24) و آزمون‌های تی مستقل و آزمون همبستگی پیرسون انجام شد. میزان p کمتر از 05/0 معنی‌دار در نظر گرفته شد.
یافته ­ها: میانگین سطح ویتامین D در زنان دارای GDM به‌صورت معناداری کمتر از زنان باردار گروه شاهد بود (97/16 در مقابل 76/26 نانوگرم بر میلی‌لیتر). با گروه‌بندی زنان باردار بر اساس سن، سن بارداری، گروید و BMI، زنان مبتلا به GDM از میانگین سطح ویتامین D کمتری نسبت به زنان باردار گروه شاهد برخوردار بودند (05/0>p). در بررسی همبستگی در زنان دارای GDM، سطح ویتامین D ارتباط معکوس و معناداری با قند 1 ساعته (212/0- =r، 035/0=p) و قند 2 ساعته (223/0- =r، 026/0=p) داشت، اما ارتباط معناداری با سطح FBS مشاهده نشد. حساسیت و ویژگی ویتامین D در تشخیص GDM در نقطه برش 05/18 برابر با 7/69% و 7/74%، ارزش اخباری مثبت و منفی برابر با 4/73% و 2/71% و دقت کل برابر با 2/72 % بود و میزان توافق نیز در حد متوسط بود.
نتیجه ­گیری: زنان مبتلا به GDM به‌طور قابل توجهی ویتامین D کمتری داشتند که می‌تواند یک عامل خطر برای ابتلاء به GDM در دوران بارداری در نظر گرفته ­شود.

کلیدواژه‌ها

موضوعات

عنوان مقاله [English]

The relationship between vitamin D status and gestational diabetes mellitus: a case-control study

نویسندگان [English]

  • Somayeh Fallahnezhad 1
  • Aram Bahari 2
  • Bagher Pahlavanzade 3
  • Samaneh Hashemi 4
  • Davood Mosavat 4
1 Assistant professor, Department of Obstetrics and Gynecology, Faculty of Medicine, Abadan University of Medical Sciences, Abadan, Iran.
2 PhD in Medicine, Faculty of Medicine, Abadan University of Medical Sciences, Abadan, Iran.
3 Assistant professor, Department of Biostatistics, Faculty of Medicine, Abadan University of Medical Sciences, Abadan, Iran.
4 Assistant professor, Department of Internal, Faculty of Medicine, Abadan University of Medical Sciences, Abadan, Iran.
چکیده [English]

Introduction: Gestational diabetes (GDM) is one of the most important causes of complications during pregnancy and has a high prevalence, so it is essential to identify the factors affecting its physiopathology as a way to prevent and treat it. Therefore, the present study was performed with aim to investigate the serum level of vitamin D in healthy and diabetic pregnant women.
Methods: This case-control study was conducted in 2022-2023 on 198 pregnant women (99 with gestational diabetes and 99 without gestational diabetes in the control group) referred to the treatment centers of Abadan University of Medical Sciences. After obtaining consent from the subjects and recording demographic information, serum vitamin D levels were also recorded. Data were analyzed by SPSS software (version 24) and Independent T and Pearson correlation tests. P<0.05 was considered statistically significant.
Results: The mean serum level of vitamin D in women with GDM was significantly lower than pregnant women in the control group (16.97 vs. 26.76 ng/ml). By grouping pregnant women based on age, gestational age, gravid and BMI, women with GDM had lower mean vitamin D levels than pregnant women in the control group (P<0.05). In the correlation analysis of women with GDM, vitamin D level had an inverse and significant relationship with 1-hour sugar (r=-0.212 and P=0.035) and 2-hour sugar (r=-0.223 and P=0.026), but no significant relationship with FBS level was observed. The sensitivity and specificity of vitamin D in the diagnosis of GDM at the cut-off point of 18.05 were 69.7% and 74.7%, and the positive and negative predictive value were 73.4% and 71.2%, and the overall accuracy was 72.2% and the level of agreement was moderate.
Conclusion: Women with GDM had significantly less vitamin D, which can be considered a risk factor for GDM during pregnancy.

کلیدواژه‌ها [English]

  • Gestational diabetes
  • Vitamin D
  • Fasting blood sugar

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مجله زنان، مامایی و نازایی ایران
دوره 26، شماره 11
بهمن 1402
صفحه 44-56

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