Screening for biomarkers predictive of gestational diabetes mellitus
Screening for biomarkers predictive of gestational diabetes mellitus
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DOI：
10.1007/s00592-008-0037-8
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发表时间：
2008-09-01
影响因子：
3.8
通讯作者：
Rice, Gregory E.
中科院分区：
文献类型：
--
作者：
Georgiou, Harry M.;Lappas, Martha;Rice, Gregory E.
妊娠期葡萄糖耐受不良筛查为诊断为妊娠期糖尿病的妇女提供了一个管理的机会。然而，有必要及早诊断妊娠糖尿病，以尽量减少发育中的胎儿暴露于次优条件下，并预防围产期并发症及其后遗症。本研究的目的是确定在糖耐量受损之前血浆中出现的妊娠糖尿病的潜在生物标志物。前瞻性地招募孕妇参加研究，并在第一次产前检查和常规口服葡萄糖耐量试验时采集血液。诊断为妊娠糖尿病的妇女与相同数量的正常妊娠（对照）妇女配对。研究的生物标志物包括内分泌和代谢激素、细胞因子和趋化因子以及氧化应激的替代标志物。与对照组相比，妊娠糖尿病患者在妊娠28周表现出血浆胰岛素升高和血浆脂联素浓度降低。妊娠11周时血浆中胰岛素和脂联素浓度也有显著差异。双变量logistic回归分析显示胰岛素和脂联素与妊娠期糖尿病的后续发展相关。血浆胰岛素和脂联素浓度，当在11周时测量，可能预测即将发生的妊娠糖尿病。需要进一步的研究来确定这些生物标志物的可靠性。
Screening for glucose intolerance during pregnancy provides an opportunity to offer management to those women diagnosed with gestational diabetes mellitus. However, there is a need to diagnose gestational diabetes early to minimize exposure of the developing fetus to suboptimal conditions and prevent perinatal complications and their sequelae. The purpose of this study was to identify potential biomarkers for impending gestational diabetes that appear in the plasma before impaired glucose tolerance. Pregnant women were prospectively recruited to the study and blood was collected at the first antenatal visit and at the time of routine oral glucose tolerance test. Women diagnosed with gestational diabetes were matched with an equal number of normal pregnant (control) women. Biomarkers under investigation included endocrine and metabolic hormones, cytokines and chemokines, and surrogate markers of oxidative stress. Compared to controls, women with gestational diabetes exhibited elevated plasma insulin and reduced plasma adiponectin concentrations at 28 weeks gestation. Significant differences in insulin and adiponectin concentrations were also observed in plasma at 11 weeks gestation. Bivariate logistic regression analysis showed that both insulin and adiponectin are associated with subsequent development of gestational diabetes. Plasma insulin and adiponectin concentrations, when measured at 11 weeks, may be predictive of impending gestational diabetes. Further studies are warranted to determine the reliability of these biomarkers.