Intrahepatic cholestasis of pregnancy: Association with glycaemic control in gestational diabetes
Intrahepatic cholestasis of pregnancy: Association with glycaemic control in gestational diabetes
复制标题
DOI：
10.1111/dme.14574
复制
发表时间：
2021-04-07
影响因子：
3.5
通讯作者：
Fuglsang, Jens
中科院分区：
文献类型：
--
作者：
Axelsen, Silja M.;Kampmann, Ulla;Fuglsang, Jens
目的本研究的目的是确定是否代谢葡萄糖的档案，根据血糖控制和胰岛素的要求，是不同的妇女与妊娠期糖尿病（GDM）和妊娠期肝内胆汁淤积症（ICP）相比，妇女只有GDM。方法这项回顾性队列研究，包括妇女与GDM和ICP匹配的妇女只有GDM是在奥胡斯大学医院，丹麦，从2012年到2019年。共46例和184对照进行了比较，在妊娠期间的血糖控制。根据ICP的严重程度，将患有GDM和ICP的女性进一步分为亚组：轻度ICP（空腹胆盐10-39 μ mol/L）和中度/重度ICP结果在基线2小时口服葡萄糖耐量试验值、妊娠中期和妊娠晚期HbA（1c）值、或最大胰岛素需求量之间的GDM与ICP和不。ICP患者在妊娠期间发生先兆子痫的比例明显高于其他患者：23.9%（11/46）vs7.6%（14/184）; p = 0.003。结论本研究首次在临床上探讨了妊娠期糖尿病合并和不合并ICP的妊娠过程。根据目前的治疗指南，ICP与GDM患者血糖控制的临床显著变化无关。妊娠期糖尿病和ICP的妇女发展为先兆子痫的人数明显增多。
Aims The aim of this study was to determine whether the metabolic glucose profile, based on glycaemic control and insulin requirements, was different in women with gestational diabetes mellitus (GDM) and intrahepatic cholestasis of pregnancy (ICP) compared to women with only GDM.Methods This retrospective cohort study comprised women with GDM and ICP matched with women with only GDM was undertaken at Aarhus University hospital, Denmark, from 2012 to 2019. A total of 46 cases and 184 controls were compared in relation to glycaemic control during pregnancy. Women with GDM and ICP were further divided into subgroups according to the severity of ICP: mild ICP (fasting bile salts 10-39 mu mol/L) and moderate/severe ICP (bile salts >= 40 mu mol/L).Results No statistically significant differences were observed in baseline 2-h oral glucose tolerance test values, second and third trimester HbA(1c) values, or maximum insulin requirements during pregnancy between women with GDM with and without ICP. Significantly more women with ICP developed preeclampsia during pregnancy: 23.9% (11/46) versus 7.6% (14/184); p = 0.003.Conclusions This study is the first to address the course of pregnancy in women with GDM with and without ICP in a clinical setting. Under the current treatment guidelines, ICP is not associated with clinically significant changes in glycaemic control in GDM. Significantly more women with both GDM and ICP developed preeclampsia.