Continuous glucose monitoring during pregnancy in women with polycystic ovary syndrome.
Continuous glucose monitoring during pregnancy in women with polycystic ovary syndrome.
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DOI：
10.1097/aog.0b013e31822c887f
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发表时间：
2011-10
影响因子：
7.2
通讯作者：
Legro RS
中科院分区：
文献类型：
--
作者：
Dmitrovic R;Katcher HI;Kunselman AR;Legro RS
评估多囊卵巢综合征（PCOS）女性是否会在妊娠早期显示环境高血糖（通过连续血糖监测测量），并随着妊娠的进展而逐渐加重。这是一项单胎妊娠的病例对照研究，包括17名PCOS妇女和17名健康妇女。在整个妊娠期间进行4次75 g口服葡萄糖耐量试验（OGTT），随后进行24小时连续葡萄糖监测（访视1：-6-10周;访视2：12-16周;访视3：24-28周;访视4：34-38周）。根据世界卫生组织（WHO）的标准，8名PCOS妇女（47%）和2名对照妇女（12%）发生了妊娠期糖尿病（GDM）。与对照组相比，PCOS女性在访视1、访视2和访视3的OGTT期间的葡萄糖曲线下面积（AUC）以及访视1的胰岛素曲线下面积（AUC）较高。两组间研究的任何动态血糖监测参数均无差异。在研究过程中，两组的游离雄激素指数（FAI）均显著降低，PCOS组在访视1（p=0.003）、访视2（p=0.07）和访视3（p=0.04）时降低幅度更大。两组的出生体重差异不显著：PCOS组为3346 g，对照组为3633 g，无围产期发病率。患有PCOS的女性患GDM的风险增加，GDM在妊娠早期表现出来，可以通过OGTT检测到。连续24小时血糖监测没有显示葡萄糖代谢的变化，尽管我们的样本量很小。多囊卵巢综合征患者高雄激素血症随妊娠进展而改善。
To estimate whether women with polycystic ovary syndrome (PCOS) will display ambient hyperglycemia (as measured by continuous glucose monitoring) early in pregnancy that progressively exacerbates with advancing pregnancy. This was a case-control study during singleton pregnancies of 17 women with PCOS and 17 healthy women. A 75-g oral glucose tolerance test (OGTT) followed by 24-h continuous glucose monitoring was obtained four times throughout the pregnancy (Visit 1: –6–10 weeks; Visit 2: 12–16 weeks; Visit 3: 24–28 weeks; Visit 4: 34–38 weeks). Eight women with PCOS (47%) and 2 controls(12%) developed gestational diabetes mellitus (GDM) as defined by World Health Organization (WHO) criteria. Women with PCOS had a higher area under the curve (AUC) for glucose during the OGTT at Visit 1, Visit 2 and Visit 3, and for insulin at Visit 1, compared to the control group. No differences were found between groups for any of the continuous glucose monitoring parameters studied. The free androgen index (FAI) significantly decreased over the course of the study in both groups, with a stronger decrease in the PCOS group at Visit 1 (p=0.003), Visit 2 (p=0.07) and Visit 3 (p=0.04). The difference in birth weight between groups was not significant: 3346g in PCOS and 3633g in controls, and there was no perinatal morbidity. Women with PCOS are at increased risk for GDM, which manifests early in pregnancy and is detectable by OGTT. Serial 24-hour glucose monitoring did not reveal changes in glucose metabolism, although our sample size was small. Hyperandrogenemia improves with progressive pregnancy in women with PCOS.