中文摘要：

目的观察妊娠糖尿病（gestationaldiabetesmellitus,GDM）孕妇孕中晚期维生素D的营养状态并分析其成因.方法以液相色谱串联质谱的方法检测2013年10月至2015年7月北京协和医院营养科门诊GDM孕妇血清中25羟维生素D（25-OHVkD）浓度,根据是否服用含有维生素D制剂分为服用组和未服用组,服用组调查含维生素D的膳食补充剂应用情况,并根据患者膳食记录统计富含维生素D的食物消费频率.结果共纳入98例GDM孕妇,孕周（29.0±3.3）周,血清总25-OH VitD浓度为（72.03±26.18）nmol/L,缺乏率.服用含维生素0制剂的孕妇血清25-OH VitD高于未服用组[（74.35±26.13）nmol/L比（60.45±23.63）nmol/L,P=0.031],两组缺乏率分别为17.9%和35.7%.血清25-OH VitD2检出率为19.4%（19/98）,检出者平均水平为（11.61±6.71）nmol/1〉（6.05-24.71nmol/L）,均服用维生素D制剂,未服用组均未检出.分季节比较发现,秋、冬季节孕妇维生素D水平显著低于春、夏两季,缺乏率显著高于春、夏季节.在四季中,仅在秋季服用组的血清25-OHVkD浓度显著高于未服用组[（78.59±27.54）nmol/L比（46.18±18.77）nmol/L,P=0.045],其他3个季节两组无统计学差异;夏季两组缺乏率均为0.膳食记录显示,观察对象奶、蛋的消费频率分别为（7.5±3.8）？欠/周（不饮奶4例）和（5.6±2.2）次/周.结论本研究纳人的GDM孕妇孕中晚期维生素D秋冬季节缺乏较为严重,血清维生素D2检出率高,对维持该群体血清维生素D水平有贡献.膳食中较高的奶、蛋制品消费频率或许有助于维持维生素D水平.

英文摘要：

Objective To observe the vitamin D nutritional status and its influencing factors among women with gestational diabetes mellitus （GDM） in the last two trimesters of pregnancy. Methods The high-performance liquid chromatography-tandem mass spectrometry method was adopted for the 25-OH vitamin D （25-OH VitD） de-tection in pregnant women with GDM visiting the outpatient nutrition clinic in Peking Union Medical College Hospi-tal between October 2013 and July 2015. The women were divided into two groups based on whether they were tak-ing vitamin D supplements. We surveyed vitamin D containing dietary supplements use in the vitamin D intake group, and the frequency of consumption of food high in vitamin D based on the patients, diet records. Results A total of 98 pregnant women with GDM were included, with the gestational age of （29. 0 ±3. 3） weeks. The total serum 25-OH VitD was （72.03 ±26. 18） nmol/L. The incidence of vitamin D deficiency （ 〈50 nmol/L） was 20.4% （20/98）. The serum 25-OH VitD level in the pregnant women was higher in the vitamin D intake group than in the non-intake group [ （74 35 ±26. 13） nmol/L （60. 45 ±23. 63） nmol/L, P =0.031 ]. The vitamin D deficiency rate was 17. 9% and 35. 7% in the vitamin D intake group and the non-intake group, respectively. The level of ser-um 25-OH VitD2 was （11. 61 ±6. 71） （6. 05 - 24 71） nmol/L, with the detection rate of 19. 4 % （19/98） , all in the vitamin D intake group. Serum 25-OH VitD2 was not detected in the non-intake group. Analysis by season showed that the level of serum 25-OH VitD in pregnant women in fall/winter was significantly lower than that in spring/summer; and the vitamin D deficiency rate was significantly higher in fall/winter. The serum 25-OH VitD level in pregnant women in the vitamin D intake group was significantly higher than in the non-intake group in fall only [ （78. 59 ±27. 54） nmol/L vs（46.18 ± 18.