The Metabolic Profile of Intrahepatic Cholestasis of Pregnancy Is Associated With Impaired Glucose Tolerance, Dyslipidemia, and Increased Fetal Growth
The Metabolic Profile of Intrahepatic Cholestasis of Pregnancy Is Associated With Impaired Glucose Tolerance, Dyslipidemia, and Increased Fetal Growth
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DOI：
10.2337/dc14-2143
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发表时间：
2015-02-01
期刊：
影响因子：
16.2
通讯作者：
Williamson, Catherine
中科院分区：
文献类型：
--
作者：
Martineau, Marcus G.;Raker, Christina;Williamson, Catherine
目的量化妊娠期肝内胆汁淤积 (ICP) 和无并发症妊娠妇女的葡萄糖和脂质浓度变化，并研究其对胎儿生长的影响。 研究设计和方法 2011-2014 年，英国和美国的两所大学医院进行了比较胆汁淤积和无并发症单胎妊娠代谢结果的前瞻性研究。从门诊产前服务中招募了 26 名 ICP 妇女和 27 名既往无妊娠糖尿病史的对照妊娠妇女，并进行随访直至分娩。使用连续血糖监测 (CGM) 系统和/或标准葡萄糖耐量试验 (GTT) 结合 GLP-1 和空腹血脂谱来研究葡萄糖、肠降血糖素、胆固醇和甘油三酯的变化。使用调整后的出生百分位数对胎儿生长进行量化。结果在动态 CGM 期间（P < 0.005）和 GTT 后（P < 0.005），ICP 中产妇血糖浓度显着增加。 ICP 的特点是空腹甘油三酯升高 (P < 0.005) 和 HDL 胆固醇降低 (P < 0.005)，类似于代谢综合征中观察到的变化。经种族、性别和胎龄调整后，患有 ICP 的母亲的后代具有显着更大的定制出生体重百分位 (P < 0.005)。结论 ICP 与糖耐量受损、血脂异常和胎儿生长加快有关。这些发现可能对受影响后代的未来健康产生影响。
OBJECTIVEQuantification of changes in glucose and lipid concentrations in women with intrahepatic cholestasis of pregnancy (ICP) and uncomplicated pregnancy and study of their influence on fetal growth.RESEARCH DESIGN AND METHODSA prospective study comparing metabolic outcomes in cholestastic and uncomplicated singleton pregnancies was undertaken at two university hospitals in the U.K. and U.S. from 2011-2014. A total of 26 women with ICP and 27 control pregnancies with no prior history of gestational diabetes mellitus were recruited from outpatient antenatal services and followed until delivery. Alterations in glucose, incretins, cholesterol, and triglycerides were studied using a continuous glucose monitoring (CGM) system and/or a standard glucose tolerance test (GTT) in conjunction with GLP-1 and a fasting lipid profile. Fetal growth was quantified using adjusted birth centiles.RESULTSMaternal blood glucose concentrations were significantly increased in ICP during ambulatory CGM (P < 0.005) and following a GTT (P < 0.005). ICP is characterized by increased fasting triglycerides (P < 0.005) and reduced HDL cholesterol (P < 0.005), similar to changes observed in metabolic syndrome. The offspring of mothers with ICP had significantly larger customized birth weight centiles, adjusted for ethnicity, sex, and gestational age (P < 0.005).CONCLUSIONSICP is associated with impaired glucose tolerance, dyslipidemia, and increased fetal growth. These findings may have implications regarding the future health of affected offspring.