Disturbances in lipid metabolism in diabetic pregnancy - Are these the cause of the problem?
Disturbances in lipid metabolism in diabetic pregnancy - Are these the cause of the problem?
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DOI：
10.1016/j.beem.2010.05.006
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发表时间：
2010-08-01
影响因子：
7.4
通讯作者：
Ortega-Senovilla, Henar
中科院分区：
文献类型：
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作者：
Herrera, Emilio;Ortega-Senovilla, Henar
妊娠期糖尿病（GDM）最常见的新生儿并发症是巨大儿。在妊娠早期，发生母体脂肪蓄积，随后是脂肪组织脂解增加和随后的甘油三酯血症，这主要对应于所有循环脂蛋白中甘油三酯（TG）增加。在GDM女性中，胰岛素抵抗增强和雌激素减少是报告的广泛的血脂异常状况的原因。妊娠期糖尿病胎儿血浆中长链多不饱和脂肪酸的比例降低可能是由于供应减少、胎盘转移受损甚至宫内代谢改变所致。妊娠期糖尿病孕妇TG与新生儿体重、脂肪量呈正相关。还发现了氧化应激增强和脂肪因子改变，即使在正常血糖条件下也会产生不良后果。因此，尽管还需要进一步的研究，但总体而言，这些发现表明，母体脂质代谢的改变而不是高脂血症构成了GDM巨大儿的风险。(C)2010爱思唯尔有限公司版权所有。
The most common neonatal complication of gestational diabetes (GDM) is macrosomia. During early pregnancy an accumulation of maternal fat depots occurs followed by increased adipose tissue lipolysis and subsequent hyperlipidaemia, which mainly corresponds to increased triglycerides (TG) in all circulating lipoproteins. In GDM women, the enhanced insulin resistance and decreased oestrogens are responsible for the reported wide range of dyslipidaemic conditions. In GDM, decreased proportion of long chain polyunsaturated fatty acids in fetus plasma could result from decreased supply, impaired placental transfer or even altered intrauterine metabolism. A positive correlation between maternal TG and neonatal body weight or fat mass has been found in GDM. Augmented oxidative stress and altered adipokines have also been found, with an adverse outcome even in normoglycaemic conditions. Thus, although additional studies are required, overall these findings indicate that altered maternal lipid metabolism rather than hyperglycaemia constitutes a risk for macrosomia in GDM. (C) 2010 Elsevier Ltd. All rights reserved.