Differences in the implications of maternal lipids on fetal metabolism and growth between gestational diabetes mellitus and control pregnancies
Differences in the implications of maternal lipids on fetal metabolism and growth between gestational diabetes mellitus and control pregnancies
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DOI：
10.1111/j.1464-5491.2011.03346.x
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发表时间：
2011-09-01
影响因子：
3.5
通讯作者：
Herrera, E.
中科院分区：
文献类型：
--
作者：
Schaefer-Graf, U. M.;Meitzner, K.;Herrera, E.
Aims To evaluate the potential contribution of maternal glucose and lipids to fetal metabolic variables and growth in pregnancy with normal glucose tolerance in comparison with pregnancy with well controlled gestational diabetes previously reported by us.Methods在190例口服葡萄糖耐量试验正常的孕妇（对照组）中，测定母体和动脉脐带血血清中的胰岛素、葡萄糖和脂质成分。分娩后测量新生儿体重和新生儿脂肪量。根据孕妇孕前BMI、剖腹产和孕龄调整数值。测量结果进行了比较与妊娠期糖尿病previousreported.Results产妇血清葡萄糖，甘油三酯，游离脂肪酸和胆固醇水平没有显着差异对照妊娠和妊娠期糖尿病，而胰岛素，稳态模型评估和甘油值显着较低，前者（2.6与5.6 μ mol/L和176与193 μ mol/L，分别）。相反，对照组孕妇的脐带血葡萄糖和游离脂肪酸显著低于妊娠期糖尿病孕妇（分别为3.9和4.4 mmol/l，80.7和137 μ mol/l）;胰岛素（0.03和0.05 nmol/l）和稳态模型评估（1.0和1.87）也是如此。在对照妊娠中，母体血清葡萄糖、游离脂肪酸和甘油与脐带血中的相关性，但与新生儿体重和脂肪量无关，如妊娠期糖尿病患者的游离脂肪酸。脐带血甘油三酯和新生儿的体重或脂肪量之间的负相关性，以前报告的妊娠期糖尿病不能被证实在控制怀孕，所有的胎儿脂质表现出正相关的新生儿anthropometrics.Conclusion在正常妊娠，与妊娠期糖尿病，母体脂质不影响新生儿体重。妊娠期糖尿病孕妇和对照组孕妇的母体脂质水平相似，但妊娠期糖尿病孕妇脐带血中游离脂肪酸水平较高，这表明其胎盘转运增强和/或由于胎儿胰岛素反应性降低而引起的脂解增强。
Aims To evaluate the potential contribution of maternal glucose and lipids to fetal metabolic variables and growth in pregnancies with normal glucose tolerance in comparison with pregnancies with well-controlled gestational diabetes previously reported by us.Methods In 190 pregnancies with normal oral glucose tolerance tests (controls), insulin, glucose and lipid components were determined in maternal and arterial cord blood serum. Birthweight and neonatal fat mass were obtained after delivery. Values were adjusted for maternal pre-pregnancy BMI, Caesarean section and gestational age. Measurements were compared with those of gestational diabetes previously reported.Results Maternal serum glucose, triacylglycerol, free fatty acid and cholesterol levels did not differ between control pregnancies and those with gestational diabetes, whereas insulin, homeostasis model assessment and glycerol values were significantly lower in the former (2.6 vs. 5.6 mu mol/l and 176 vs. 193 mu mol/l, respectively). In contrast, cord blood glucose and free fatty acids were significantly lower in control pregnancies than in those with gestational diabetes (3.9 vs. 4.4 mmol/l and 80.7 vs. 137 mu mol/l, respectively); the same was valid for insulin (0.03 vs. 0.05 nmol/l) and homeostasismodel assessment (1.0 vs. 1.87). In control pregnancies, maternal serum glucose, free fatty acids and glycerol correlated with those in cord blood, but not with neonatal weight and fat mass, as seen for free fatty acids in those with gestational diabetes. The negative correlation between cord blood triacylglycerols and neonatal weight or fat mass previously reported in gestational diabetes could not be confirmed in control pregnancies, where all fetal lipids showed a positive correlation to neonatal anthropometrics.Conclusion In normal pregnancies, in contrast to those with gestational diabetes, maternal lipids do not influence neonatal weight. Similar levels of maternal lipids in pregnancies with gestational diabetes and control pregnancies, but higher free fatty acids in the cord blood of those with gestational diabetes, indicate their enhanced placental transport and/or enhanced lipolysis as a result of decreased fetal insulin responsiveness.