Heterogeneity of insulin resistance and beta cell dysfunction in gestational diabetes mellitus: a prospective cohort study of perinatal outcomes.
Heterogeneity of insulin resistance and beta cell dysfunction in gestational diabetes mellitus: a prospective cohort study of perinatal outcomes.
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妊娠期糖尿病胰岛素抵抗和β细胞功能障碍的异质性：围产期结局的前瞻性队列研究
DOI：
10.1186/s12967-018-1666-5
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发表时间：
2018-10-24
影响因子：
7.4
通讯作者：
Liu F
中科院分区：
文献类型：
--
作者：
Liu Y;Hou W;Meng X;Zhao W;Pan J;Tang J;Huang Y;Tao M;Liu F
背景胰岛素抵抗和β细胞功能障碍是妊娠期糖尿病（GDM）的重要原因.然而，很少有人知道这些因素的异质性及其对围产期结局的影响。我们调查是否亚型的胰岛素抵抗和β细胞功能障碍在妊娠期糖尿病有不同的影响围产期outcomes.MethodsIn这个前瞻性队列研究中，我们遵循554名孕妇和葡萄糖激发试验，在24- 28周的妊娠。将纳入血糖≥ 7.8 mmol/L的女性，并建议进行诊断性75 g，3 h口服葡萄糖耐量试验。根据胰岛素抵抗或β细胞功能指标低于正常糖耐量（NGT）妇女的第25百分位数，将GDM分为3个亚型：GDM伴β细胞功能障碍、GDM伴胰岛素抵抗缺陷或GDM伴上述两种特征（GDM混合型）。结果GDM混合组的孕前和母亲BMI水平均高于NGT组（分别为23.2 ± 4.0 vs 20.8 ± 3.7 kg/m2，P< 0.001; 24.5 ± 4.3 vs 21.8 ± 3.4 kg/m2，P< 0.001）。此外，GDM混合组的妇女更容易遭受LGA（P= 0.008）不良围产期结局（P= 0.005），尽管这些差异在调整年龄、孕前和母亲BMI后标准化（GDM混合组与NGT组：LGA P= 0.141，不良结局P = 0.186）。另一方面，所有的围产期结局之间的其他两个GDM亚组和NGT group.ConclusionsWomen与GDM显示各自的特点代谢紊乱，并赋予歧视的风险，因为这种异质性的不良围产期结局。
BackgroundInsulin resistance and beta cell dysfunction were reported to be responsible for gestational diabetes mellitus (GDM). However, little is known about the heterogeneity of these factors and its influences on perinatal outcomes. We investigated whether subtypes of insulin resistance and beta cell dysfunction in gestational diabetes mellitus have different impacts on perinatal outcomes.MethodsIn this prospective cohort study, we followed 554 pregnant women and glucose challenge test was performed at 24–28th weeks of their gestation. Women with plasma glucose ≥ 7.8 mmol/L would be included and advised to undergo the diagnostic 75-g, 3-h oral glucose tolerance test. According to indices of measuring insulin resistance or beta cell function were below the 25th percentile of women with normal glucose tolerance (NGT), women with GDM were defined as three subtypes: GDM with the beta cell dysfunction, GDM with the insulin resistance defect or GDM with both traits mentioned above (GDM-mixed). Perinatal outcomes were documented.ResultsThe levels of prepregnancy and maternal BMI in the GDM-mix group were higher compared to women in the NGT group (23.2 ± 4.0 vs 20.8 ± 3.7 kg/m2,P< 0.001; 24.5 ± 4.3 vs 21.8 ± 3.4 kg/m2,P< 0.001, respectively). Furthermore, women in GDM-mix group more likely to be subjected to LGA (P= 0.008) adverse perinatal outcomes (P= 0.005), although these differences were normalized after adjusting age, prepregnancy and maternal BMI (GDM-mix vs. NGT:P= 0.141 for LGA andP= 0.186 for adverse outcomes). On the other hand, all perinatal outcomes were similar between other two GDM subgroups and NGT group.ConclusionsWomen with GDM display respective characteristics on metabolism disorders and confer discriminating risks of adverse perinatal outcomes because of this heterogeneity.
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影响因子：
16.2
作者：
Black MH;Sacks DA;Xiang AH;Lawrence JM
通讯作者：
Lawrence JM
影响因子：
3.7
作者：
Dai L;Deng C;Li Y;Zhu J;Mu Y;Deng Y;Mao M;Wang Y;Li Q;Ma S;Ma X;Zhang Y
通讯作者：
Zhang Y
DOI：
10.1530/rep-10-0088
发表时间：
2010-09
期刊：
Reproduction (Cambridge, England)
影响因子：
--
作者：
Catalano PM
通讯作者：
Catalano PM
影响因子：
8.2
作者：
MATTHEWS, DR;HOSKER, JP;TURNER, RC
通讯作者：
TURNER, RC
影响因子：
3.1
作者：
Wendland EM;Torloni MR;Falavigna M;Trujillo J;Dode MA;Campos MA;Duncan BB;Schmidt MI
通讯作者：
Schmidt MI