Sleep duration and disorders in pregnancy: implications for glucose metabolism and pregnancy outcomes.
Sleep duration and disorders in pregnancy: implications for glucose metabolism and pregnancy outcomes.
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DOI：
10.1038/ijo.2012.142
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发表时间：
2013-06
影响因子：
4.9
通讯作者：
St-Onge, M-P
中科院分区：
文献类型：
--
作者：
O'Keeffe, M.;St-Onge, M-P
人类对睡眠有一种天生的需求，这种需求本质上是由昼夜节律和内分泌系统控制的。最近，睡眠时间减少因其可能导致代谢功能障碍而受到极大关注。大量证据表明，睡眠时间减少可能会增加葡萄糖功能受损、胰岛素抵抗和2型糖尿病的风险。然而，到目前为止，很少有研究确定睡眠时间减少对妊娠期间血糖控制的影响。随着育龄妇女超重和肥胖的高发，妊娠期糖尿病（GDM）的发生率也在不断增加。GDM导致母体和胎儿并发症的风险增加，以及产后2型糖尿病的风险增加。患有GDM的妇女所生的婴儿也有终身肥胖和2型糖尿病的风险。睡眠减少对妊娠期血糖管理的影响尚未得到充分评估，目前缺乏文献。在此，我们回顾了睡眠减少和碳水化合物代谢受损之间的关系，并提出了怀孕期间睡眠减少如何可能导致碳水化合物轴的进一步功能障碍。一个特别的重点将给予睡眠呼吸障碍，以及GDM复杂的怀孕。假定的行动机制，减少睡眠可能会对产妇和婴儿的结果产生不利影响进行了讨论。最后，我们将概述需要解决的重要研究问题。
Humans have an innate requirement for sleep that is intrinsically governed by circadian and endocrine systems. More recently, reduced sleep duration has gained significant attention for its possible contribution to metabolic dysfunction. Significant evidence suggests that reduced sleep duration may elevate the risk for impaired glucose functioning, insulin resistance and type 2 diabetes. However, to date, few studies have determined the implications of reduced sleep duration with regard to glucose control during pregnancy. With the high prevalence of overweight and obesity in women of reproductive age, the occurrence of gestational diabetes mellitus (GDM) is increasing. GDM results in elevated risk of maternal and fetal complications, as well as increased risk of type 2 diabetes postpartum. Infants born to women with GDM also carry a life-long risk of obesity and type 2 diabetes. The impact of reduced sleep on glucose management during pregnancy has not yet been fully assessed and a paucity of literature currently exits. Herein, we review the association between reduced sleep and impaired carbohydrate metabolism and propose how reduced sleep during pregnancy may result in further dysfunction of the carbohydrate axis. A particular focus will be given to sleep-disordered breathing, as well as GDM-complicated pregnancies. Putative mechanisms of action by which reduced sleep may adversely affect maternal and infant outcomes are also discussed. Finally, we will outline important research questions that need to be addressed.
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