ZINC ABSORPTION IN DIABETIC PREGNANT WOMEN

先天性异常、早产和产程延长的发生率更高 在患有糖尿病的孕妇和缺锌的动物中。 在 非妊娠糖尿病患者的能量和锌代谢似乎 糖尿病患者的尿锌损失通常是 提升了好几倍。 目前尚不清楚尿锌损失是否也是 妊娠糖尿病女性中，当需要增加 锌。 我们的研究目的有两个：（1）确定尿锌是否 糖尿病妇女在怀孕期间的排泄持续升高， 这是当他们没有怀孕，（2）以找出如果这增加 尿排泄与锌的其他方面的变化有关 体内平衡，即，吸收和循环。 三组20名妇女 每种都将进行研究：胰岛素依赖型糖尿病女性、非胰岛素- 依赖性糖尿病妇女和对照妇女。 将进行测量 所有妇女在早期（9-10周）、中期（24-26周）和晚期（34-36周） 周）妊娠、哺乳期第12周和6个月后 月经的开始 尽可能多的女性也会 在怀孕前就应该研究。 每次测量时血糖控制 将通过测量糖化血红蛋白进行评估， 糖化白蛋白（蛋白质）、空腹血糖和尿 葡萄糖 尿排泄、吸收和血浆中总 将测定锌和锌分数。 70 Zn，稳定的锌 同位素，将被用作示踪剂来测量锌的量 从标准饮食中吸收。 目前尚不清楚尿锌丢失的原因 在糖尿病患者中过量。 糖基化蛋白的量和 将测量血清和尿液中的糖基化氨基酸， 确定这些水平之间是否存在任何关系 糖基化产物和过量锌损失。 还有血清胰岛素 将测量胰高血糖素和胰岛素/胰高血糖素比率，并与 尿锌丢失。 糖尿病对血清、红细胞、 动脉脐带血和尿金属硫蛋白水平也将 测定了 怀孕期间尿中锌的持续流失 如果没有吸收的可比增加来平衡这些损失， 使糖尿病母亲面临锌耗竭的风险。 既然如此， 母亲锌营养状况与 糖尿病患者的妊娠结局是有保证的。

Congenital anomalies, pre-term and prolonged labor occur more frequently in both pregnant women with diabetes and in zinc deficient animals. In nonpregnant diabetics both fuel and zinc metabolism seem to be disturbed; the urinary zinc losses of diabetic patients are usually elevated several fold. It is not known if urinary zinc losses are also elevated in pregnant diabetic women when there is an increased need for zinc. Our research goal is twofold: (1) to determine if urinary zinc excretion continues to be elevated in diabetic women during pregnancy as it is when they are not pregnant, and (2) to find out if this increased urinary excretion is associated with changes in other aspects of zinc homeostasis, i.e., absorption and circulation. Three groups of 20 women each will be studied: insulin-dependent diabetic women, noninsulin- dependent diabetic women, and control women. Measurements will be made in all women at early (9-10 weeks), mid (24-26 weeks) and late (34-36 weeks) gestation, at the 12th week of lactation, and 6 months following the onset of menstruation. As many of the women as possible will also be studied prior to conception. At each measurement glycemic control will be assessed from measurements of glycosylated hemoglobin, glycosylated albumin (protein), fasting plasma glucose, and urinary glucose. The urinary excretion, absorption, and plasma levels of total zinc and zinc fractions will be determined. 70Zn, a stable zinc isotope, will be used as a tracer to measure the quantity of zinc absorbed from a standard diet. It is not known why urinary zinc losses are excessive in diabetics. The amount of glycosylated protein and glycosylated amino acids in the serum and urine will be measured to determine if there is any relationship between the levels of these glycosylated products and the excess zinc loss. Also, serum insulin, glucagon, and insulin/glucagon ratios will be measured and related to urinary zinc losses. The effect of diabetes on serum, erythrocyte, arterial cord blood, and urinary metallothionein levels will also be measured. Continued losses of zinc in the urine during pregnancy without comparable increases in absorption to balance these losses may place the diabetic mother at risk for zinc depletion. In that case, further studies of the relationship between maternal zinc status and pregnancy outcome in the diabetic would be warranted.