Continuous glucose profiles in obese and normal-weight pregnant women on a controlled diet: metabolic determinants of fetal growth.
Continuous glucose profiles in obese and normal-weight pregnant women on a controlled diet: metabolic determinants of fetal growth.
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受控饮食中肥胖和正常体重孕妇的连续葡萄糖谱：胎儿生长的代谢决定因素。
DOI：
10.2337/dc11-0723
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发表时间：
2011-10
期刊：
影响因子：
16.2
通讯作者：
Bessesen DH
中科院分区：
文献类型：
--
作者：
Harmon KA;Gerard L;Jensen DR;Kealey EH;Hernandez TL;Reece MS;Barbour LA;Bessesen DH
我们试图使用连续血糖监测(CGM)来确定正常体重和肥胖孕妇在怀孕早期和晚期都摄入习惯性和控制性饮食时的24小时血糖。对22例正常体重(n=22)和16例肥胖(n=16)的妊娠早期(15.7±2.0周)和晚期(27.7±1.7周)的血糖进行了前瞻性测量。还检测了空腹血糖、甘油三酯(仅限妊娠早期)、非酯化脂肪酸(FFAs)和胰岛素。尽管控制饮食，肥胖女性在怀孕早期和晚期的24小时血糖曲线下面积都高于正常体重女性。肥胖女性在怀孕后期几乎所有的空腹和餐后血糖参数都较高，空腹胰岛素、甘油三酯和游离脂肪酸也较高。肥胖母亲所生的婴儿肥胖程度更高。母体质量指数(r=0.54，P=0.01)、夜间平均血糖(r=0.48，P<；0.05)、晚期空腹胰岛素(r=0.49，P<；0.05)与婴儿体脂百分比相关。然而，早期空腹甘油三酯(r=0.67，P<；0.001)和晚期空腹游离脂肪酸(r=0.54，P<；0.01)的相关性更强。这是第一项研究表明，没有糖尿病的肥胖女性比正常体重的女性白天和夜间的血糖水平更高，尽管怀孕早期和晚期都控制了饮食。婴儿的体脂，而不是出生体重，与母亲的BMI、血糖、胰岛素和脂肪酸有关，但甘油三酯是最强的预测因子。这些代谢发现可能解释了肥胖女性婴儿巨大儿发生率较高的原因，这可能是防止胎儿过度生长的试验的目标。
We sought to define 24-h glycemia in normal-weight and obese pregnant women using continuous glucose monitoring (CGM) while they consumed a habitual and controlled diet both early and late in pregnancy. Glycemia was prospectively measured in early (15.7 ± 2.0 weeks’ gestation) and late (27.7 ± 1.7 weeks’ gestation) pregnancy in normal-weight (n = 22) and obese (n = 16) pregnant women on an ad libitum and controlled diet. Fasting glucose, triglycerides (early pregnancy only), nonesterified fatty acids (FFAs), and insulin also were measured. The 24-h glucose area under the curve was higher in obese women than in normal-weight women both early and late in pregnancy despite controlled diets. Nearly all fasting and postprandial glycemic parameters were higher in the obese women later in pregnancy, as were fasting insulin, triglycerides, and FFAs. Infants born to obese mothers had greater adiposity. Maternal BMI (r = 0.54, P = 0.01), late average daytime glucose (r = 0.48, P < 0.05), and late fasting insulin (r = 0.49, P < 0.05) correlated with infant percentage body fat. However, early fasting triglycerides (r = 0.67, P < 0.001) and late fasting FFAs (r = 0.54, P < 0.01) were even stronger correlates. This is the first study to demonstrate that obese women without diabetes have higher daytime and nocturnal glucose profiles than normal-weight women despite a controlled diet both early and late in gestation. Body fat in infants, not birth weight, was related to maternal BMI, glucose, insulin, and FFAs, but triglycerides were the strongest predictor. These metabolic findings may explain higher rates of infant macrosomia in obese women, which might be targeted in trials to prevent excess fetal growth.
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DOI：
10.1016/j.ejogrb.2007.12.006
发表时间：
2008-07-01
影响因子：
2.6
作者：
Siegmund, Tina;Rad, Neda Talai;Buhling, Kai J.
通讯作者：
Buhling, Kai J.
影响因子：
16.2
作者：
Schaefer-Graf UM;Graf K;Kulbacka I;Kjos SL;Dudenhausen J;Vetter K;Herrera E
通讯作者：
Herrera E
影响因子：
3.5
作者：
Di Cianni, G;Miccoli, R;Del Prato, S
通讯作者：
Del Prato, S
影响因子：
7.7
作者：
PETERSON, CM;JOVANOVICPETERSON, L
通讯作者：
JOVANOVICPETERSON, L
影响因子：
158.5
作者：
Metzger, Boyd E.;Lowe, Lynn P.;Sacks, David A.
通讯作者：
Sacks, David A.