双歧杆菌联合维生素D对肥胖合并妊娠期糖尿病患者糖脂代谢水平及妊娠结局的影响

Effects of bifidobacteria combined with vitamin D on glucose and lipid metabolism and pregnancy outcomes in obese patients with gestational diabetes mellitus

摘要:

目的 探究双歧杆菌联合维生素D对肥胖合并妊娠期糖尿病（GDM）患者糖脂代谢水平及妊娠结局的影响。方法 选取2023年2月—2024年12月三二〇一医院收治的120例肥胖合并GDM患者，按信封抽签法随机分为常规组和联合组，每组60例。常规组给予常规治疗；联合组在常规组基础上，给予双歧杆菌联合维生素D干预。比较两组糖脂代谢水平、胰岛β细胞功能、体质量指数（BMI）、腰臀比及不良妊娠结局。结果 联合组治疗前后空腹血糖、餐后2 h血糖、糖化血红蛋白的差值均大于常规组（P <0.05）；联合组治疗前后甘油三酯、总胆固醇、低密度脂蛋白胆固醇的差值均大于常规组（P <0.05）；联合组治疗前后胰岛β细胞功能指数、胰岛素抵抗指数、空腹胰岛素的差值均大于常规组（P <0.05）；联合组治疗前后BMI、腰臀比的差值均大于常规组（P <0.05）；联合组不良妊娠结局总发生率低于常规组（P <0.05）。结论 双歧杆菌联合维生素D可改善肥胖合并GDM患者糖脂代谢和胰岛β细胞功能，降低胰岛素抵抗，优化体重管理，并降低不良妊娠结局发生率。

Abstract:

Objective To investigate the effects of bifidobacteria combined with vitamin D supplementation on glucose and lipid metabolism and pregnancy outcomes in obese patients with gestational diabetes mellitus (GDM).Methods One hundred and twenty obese women with GDM admitted to the 3201 Hospital between February 2023 and December 2024 were selected and randomly assigned by the envelope method to either a conventional group or a combined group, with 60 cases in each group. The conventional group received standard care, while the combined group received bifidobacteria plus vitamin D supplementation in addition to conventional treatment. The glucose and lipid metabolism, pancreatic β-cell function, body mass index (BMI), waist-to-hip ratio, and adverse pregnancy outcomes were compared between groups.Results The combined group exhibited greater differences in fasting blood glucose, 2-hour postprandial glucose, and glycated hemoglobin levels before and after treatment compared to the conventional group (P < 0.05). The differences in triglycerides, total cholesterol, and low-density lipoprotein cholesterol levels before and after treatment in the combined group were greater than those in the conventional group (P < 0.05). The differences in the pancreatic β-cell function index, insulin resistance index, and fasting insulin levels before and after treatment in the combined group were greater than those in the conventional group (P < 0.05). The differences in BMI and the waist-to-hip ratio before and after treatment in the combined group were also greater than those in the conventional group (P < 0.05). The overall incidence of adverse pregnancy outcomes was lower in the combined group than in the conventional group (P < 0.05).Conclusion Bifidobacteria combined with vitamin D improves glucose and lipid metabolism, enhances pancreatic β-cell function, reduces insulin resistance, optimizes weight management, and lowers the incidence of adverse pregnancy outcomes in obese patients with GDM.