Maternal nutrition: opportunities in the prevention of gestational diabetes.
Maternal nutrition: opportunities in the prevention of gestational diabetes.
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DOI：
10.1093/nutrit/nuw033
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发表时间：
2017-01
影响因子：
6.1
通讯作者：
Spieldenner J
中科院分区：
文献类型：
--
作者：
Silva-Zolezzi I;Samuel TM;Spieldenner J
妊娠期糖尿病（GDM）目前被定义为葡萄糖耐受不良，其严重程度不同，在妊娠期间发病或首次发现。高血压和不良妊娠结局研究包括全球15个中心的25000名非糖尿病孕妇，报告称，根据国际糖尿病和妊娠研究组协会的标准，平均17.8%的妊娠受GDM影响，在某些国家其频率可高达25.5%。然而，由于筛查方法、诊断标准的高度异质性以及所研究人群特征的差异，目前缺乏GDM的真实全球患病率估计。妊娠期全身性高血糖水平的存在导致不利的宫内环境，这已被证明对母亲及其后代的短期和长期健康结果具有负面影响，包括婴儿患肥胖症的风险增加以及母亲和孩子在以后的生活中患2型糖尿病的风险增加。受环境因素（包括营养）直接影响的表观遗传机制可能在形成这些未来的健康风险方面发挥关键作用，并可能是这种恶性循环的一部分。本文回顾了GDM的负担和目前的证据，支持产妇营养干预作为一个有前途的战略，以打破周期，解决与GDM相关的危险因素。
Gestational diabetes mellitus (GDM) is currently defined as glucose intolerance that is of variable severity with onset or first recognition during pregnancy. The Hyperglycemia and Adverse Pregnancy Outcome Study, including 25 000 nondiabetic pregnant women in 15 centers across the world, reported that an average of 17.8% of pregnancies are affected by GDM and its frequency can be as high as 25.5% in some countries, based on the International Association of Diabetes and Pregnancy Study Groups criteria. Nevertheless, true global prevalence estimates of GDM are currently lacking due to the high level of heterogeneity in screening approaches, diagnostic criteria, and differences in the characteristics of the populations that were studied. The presence of systemic high blood glucose levels in pregnancy results in an adverse intrauterine environment, which has been shown to have a negative impact on short- and long-term health outcomes for both the mother and her offspring, including increased risks for the infant to develop obesity and for both mother and child to develop type 2 diabetes mellitus later in life. Epigenetic mechanisms that are directly influenced by environmental factors, including nutrition, may play a key role in shaping these future health risks and may be part of this vicious cycle. This article reviews the burden of GDM and the current evidence that supports maternal nutritional interventions as a promising strategy to break the cycle by addressing risk factors associated with GDM.