血清高敏C反应蛋白与妊娠糖尿病的相关性研究

目的 探讨血清高敏C反应蛋白(hsC-RP)水平与妊娠糖尿病(GDM)的相关性.方法 在妊娠中晚期检测孕妇的血清hsC-RP水平.将患GDM的306例孕妇作为病例组(GDM组),糖耐量正常的347名孕妇作为对照组(Con组),比较两组的血清hsC-RP水平,再按hsC-RP水平四分位,将研究对象分为4组,进行Logistic回归分析.结果 GDM组的血清hsC-RP中位数水平明显高于Con组(3.01 mg/L vs 2.15 mg/L,P＜0.01).根据hsC-RP水平四分位的结果,将研究对象分为4组,第1组hsC-RP＜1.41 mg/L,第2组hsC-RP 1.41～2.41 mg/L,第3组hsC-RP 2.42～4.60 mg/L,第4组hsC-RP≥4.61 mg/L,相应的GDM的检出率分别为36.81%、42.68%、48.47%、59.51%.调整年龄、孕次、孕前BMI、SBP、DBP及糖尿病家族史等因素,行Logistic回归分析发现,hsC-RP是GDM的独立危险因素(OR值为1.27,95%CI为1.08～1.49,P＜0.01).结论 GDM患者妊娠中晚期hsC-RP水平明显升高,慢性炎症可能参与了GDM的发生.     

CDKAL1基因多态性与妊娠期糖尿病及其临床特点的相关性研究

目的 探讨我国南方人群中CDKAL1基因两个SNP位点rs7754840和rs10448033的多态性与GDM易感性的关系. 方法 采用病例对照研究,分别选取GDM患者(GDM组)153例和正常糖耐量的孕妇(GNGT组)180名.采用聚合酶链反应-限制性片断长度多态性分析法(PCR-RFLP)测定两个SNP位点多态性分布,并进行统计学分析. 结果 GDM组孕前BMI、FPG、TG均高于GNGT组,TC、HDL-C及LDL-C均低于GNGT组(P＜0.05).SNP位点rs7754840基因型(CC,GC,GG)频率和等位基因频率与GNGT组比较,差异均无统计学意义(P=0.937、0.933);而SNP位点rs10440833基因型(AA,AT,TT)与GNGT组比较,差异有统计学意义(P=0.024),且风险基因型TT的频率高于GNGT组(TTvs TC+CC,P=0.032);GDM组A等位基因频率高于GNGT组[OR(95％CI):1.519(1.114～2.071),P=0.008];AA基因型患者的FPG高于其他基因型(P=0.011),TG高于TT基因型(P=0.007),HDL C低于TT基因型(P=0.001). 结论 CDKAL1基因SNP位点rs7754840与GDM无相关性;SNP位点rs10440833与GDM的易感性相关,且该位点多态性可能与血糖、TG及LDL-C的水平有关.     

妊娠糖尿病发病机制研究进展

妊娠糖尿病(GDM)主要指妊娠期首次发现的糖耐量异常.GDM与非妊娠期的糖尿病都是遗传因素与环境因素共同作用所致的多基因复杂疾病,其发病机制涉及遗传易感性、胰岛素抵抗和分泌缺陷、慢性炎性反应等.而且,GDM病史是女性产后发展为糖尿病的高危因素.因此,深入了解GDM的发病机制具有重要意义.     

妊娠糖尿病的药物治疗

妊娠糖尿病是在妊娠过程中首次发现的任何程度的糖耐最异常,其发病机制与多种因素相关.妊娠期间血糖水平对母体、妊娠结局及围产儿的预后有着重要的影响.治疗妊娠糖尿病的药物选择要求能够有效控制血糖,及对胎儿影响小,低血糖事件少,患者依从性好等.目前治疗妊娠糖尿病的药物仍以胰岛素为主,但部分口服降糖药也逐渐进入人们的视野.现就妊娠糖尿病的药物治疗进行概述.     

关注妊娠糖尿病

自1979年世界卫生组织首次将妊娠糖尿病作为糖尿病的一大亚型独立划分出来至今的30．年间,妊娠糖尿病患病率不断增加,其对母婴健康的影响巨大,值得密切关注。妊娠糖尿病的病理机制可能与妊娠期问胰岛素抵抗加剧,以及胰岛素信号转递过程中多个环节受损有关,尚需更多的探索。为了保证母婴健康,对妊娠糖尿病的临床与基础研究仍需进一步加强。     

妊娠糖尿病筛查与诊断的现状

妊娠糖尿病(GDM)在糖尿病的病冈分类中是一个独立的类型.GDM筛杏和诊断的最终目的是改善围产儿预后.高血糖与不良妊娠结局(HAPO)研究提示即使低于GDM诊断标准的高血糖,也与新生儿的出生体重增加及不良孕产结局密切相关.国际上GDM的筛查方法与诊断标准仍未统一,制定全球合理的筛查方法和诊断标准成为国内外学者越来越关注的问题.     

Diagnosis and therapy of gestational diabetes mellitus

In 1999-2000 at the Medical Clinic Motol Faculty Hospital in collaboration with the Gynaecological Clinic of the Hospital a group of 55 pregnant women with the diagnosis of gestational diabetes (GDM) were followed up. The objective of the investigation was to find out how in the investigated area (detachment area of the Gynaecological and Obstetric Clinic Motol Faculty Hospital) GDM is diagnosed at present, how it is treated and what is the percentage of perinatal morbidity in the investigated group. The mean age of the investigated women was 32.3 +/- 4.5 years. The presence of risk factors for the development of GDM was found in 59.8% of the examined women. 65.7% women had a positive gynaecological case-history. GDM was detected most frequently during the 30th week of pregnancy, in 25% women in the 35th and later week of gestation. In 52% the diagnosis of GDM was established only on hospital admission on account of complications of pregnancy. The mean HbA1C level during detection of gestational diabetes was 6.81 +/- 0.41%. The majority of women -91.1%--were treated by diet, 8.9% women had insulin treatment. The prevalence of diabetic foctopathy was 48.3%. The mean weight of the offspring of diabetic mothers was 3350 g +/- 248 g, the mean length was 49.6 +/- 6.3 cm. No stillbirth was recorded. One infant suffered from an inborn developmental defect (morbus Down). The results provide evidence not only of late diagnosis of GDM (after the 28th week of gestation) but also of inadequate screening in the field, as GDM is frequently detected only during complications of pregnancy.     

Association between maternal alcohol use during pregnancy and gestational diabetes mellitus: a meta-analysis

International Journal of Diabetes in Developing Countries - Maternal alcohol use and gestational diabetes mellitus (GDM) have been serious public health issues worldwide. This study aimed to...     

多囊卵巢综合征与妊娠糖尿病

多囊卵巢综合征(PCOS)是女性最常见的内分泌紊乱疾病,而妊娠糖尿病(GDM)是妊娠期最常见的代谢紊乱性疾病,众多研究表明,PCOS患者妊娠后发生糖尿病的几率明显增高.胰岛素抵抗、肥胖以及血浆内脂素(visfatin)、视黄醇结合蛋白4浓度升高等是联系两者的可能机制.通过改变生活方式、减重及应用二甲双胍等,可以明显改善...     

脂肪因子与妊娠糖尿病

人体脂肪细胞可分泌多种具有生物活性的脂肪因子,且在妊娠糖尿病(GDM)患者中存在分泌失调的现象.研究发现,妊娠早期瘦素的增加和脂联素的下降可能预示着GDM的发生;脂联素通过影响胰岛素信号转导改变胰岛素敏感性,调节血糖和胰岛素水平;视黄醇结合蛋白4(RBP4)可能通过调节血脂间接调节血糖;内脂素和vaspin的表达受多种因素影响,可能是发生胰岛素抵抗的中心环节;抵抗素基因多态性亦在不同方面对人体产生影响.综上,脂肪因子作用机制复杂,其分泌失调与GDM患者胰岛素抵抗及糖、脂代谢密切相关,并影响其病理生理学变化及预后.     

Hemostatic changes in gestational diabetes mellitus

The purpose was to characterize the hemostatic changes in women with gestational diabetes mellitus (GDM). In this case–control study, 50 women with newly diagnosed GDM at 24–28 weeks of pregnancy and 41 normal pregnant women, matched for age, body mass index, and gestational age, were enrolled. Anthropometric, metabolic patterns, coagulation parameters, and plasminogen were measured in each subject. Plasma fibrinogen levels, plasminogen, and von Willebrand factor (vWF) activities were significantly higher in patients with GDM as compared to normal pregnant women (p < 0.001, p < 0.001, and p < 0.05, respectively). Although protein S was significantly elevated in diabetic group (p < 0.05), free protein S was similar in both groups. Coagulation factors VIII and IXa were significantly higher in patients with GDM (p < 0.001 and p < 0.01, respectively). In the group with GDM, factor VIII was positively correlated with HbA1c (r = 0.192, p < 0.001). A weak but significant negative correlation was observed between protein S and fasting glucose (r =−0.006, p < 0.05). GDM potentiates the alteration in coagulation and fibrinolysis during normal pregnancy. The question of whether the hemostatic balance is unchanged or shifts toward a hypercoagulable status remains unanswered.

     

Circulating Pro-Neurotensin in gestational diabetes mellitus

Background and aims

Pro-Neurotensin (NT), a stable surrogate parameter of NT, has recently been introduced as a peptide predicting the development of obesity, diabetes mellitus, cardiovascular diseases, and cardiovascular mortality. However, regulation of Pro-NT in gestational diabetes mellitus (GDM) remains uninvestigated.

妊娠糖尿病的危险因素

妊娠糖尿病是糖尿病分型中的一种独立类型.目前,妊娠糖尿病公认的危险因素包括年龄大于25岁、孕前体重指数大于25 kg/m2、非高加索白人、糖尿病家族史等.近年研究证实,妊娠糖尿病还与其他一些因素相关,如多囊卵巢综合征、身高偏矮、携带HBsAg、高血压等.及早的发现和干预这些高危因素,对于改善孕妇及子代的预后,减少人群中糖尿病的发病率有深远影响.     

1,5 Anhydroglucitol in gestational diabetes mellitus

Objective

1,5 Anhydroglucitol (1,5 AG) is reported to be a more sensitive marker of glucose variability and short-term glycemic control (1–2?weeks) in patients with type1 and type 2 diabetes. However, the role of 1,5 AG in gestational diabetes mellitus (GDM) is not clear. We estimated the serum levels of 1,5 AG in pregnant women with and without GDM.