妊娠糖尿病远期并发症风险预测的研究进展  

Progress in the risk prediction of long term of gestational diabetes millitus complication

作　　者：苑程鲲[1] 王萌影[1] 彭丽敏 马琳琳[1] 鲁彩霞[1] Yuan Chengkun;Wang Mengying;Peng Limin;Ma Linlin;Lu Caixia(Department of Obstetrics,the First Affiliated Hospital of Heilongjiang University of Chinese Medicine,Harbin 150040,China)

机构地区：[1]黑龙江中医药大学附属第一医院产科,哈尔滨150040

出　　处：《中国临床保健杂志》2021年第3期428-432,共5页Chinese Journal of Clinical Healthcare

基　　金：国家卫生计生委医药卫生科技发展研究中心科研项目(W2015CAE110);黑龙江中医药管理局科研项目(ZHY2020-113,ZHY18-055)。

摘　　要：妊娠糖尿病(GDM)是孕期发生的葡萄糖不耐受,GDM的发生可能由于胰岛β细胞功能受损或影响机体血糖稳态平衡的激素、多肽水平的变化,远期并发慢性代谢疾病和心血管疾病的风险大大增加。更早、更准确地诊断GDM可预测GDM远期不良结局。妊娠早中期母体血清中的与脂肪有关的物质(脂联素、内脂素、脂肪酸结合蛋白4、视黄醇结合蛋白4等)及与胎盘有关的物质(性激素结合球蛋白、胎球蛋白A、成纤维细胞因子21/23、卵泡抑素等)的水平与GDM的发病密切相关。此外尿的代谢物(酮体、非极性氨基酸)能够很好的成为GDM的早期诊断生物标志物。Gestational diabetes mellitus(GDM)is a glucose intolerance that occurs during pregnancy.GDM may be induced by dys-regulation of pancreaticβ-cell function and/or by alteration of secreted gestational hormones and peptides related with glucose homeostasis.It may affect one out of five pregnancies,leading to perinatal morbidity and adverse neonatal outcomes,and high risk of chronic metabolic and cardiovascular injuries in both mother and offspring.In addition,an earlier and more specific detection of GDM with associated metabolic and cardiovascular risk could improve GDM development and outcomes.In this sense,1st-2nd trimester-released biomarkers found in maternal plasma including adipose tissue-derived factors such as adiponectin,visfatin,omentin-1,fatty acid-binding protein-4 and retinol binding-protein-4 have shown correlations with GDM development.Moreover,placenta-related factors such as sex hormone-binding globulin,afamin,fetuin-A,fibroblast growth factors-21/23,ficolin-3 and follistatin,or specific micro-RNAs may participate in GDM progression and be useful for its recognition.Finally,urine-excreted metabolites such as those related with serotonin system,non-polar amino-acids and ketone bodies,may complete a predictive or early-diagnostic panel of biomarkers for GDM.

关 键 词：糖尿病 妊娠 危险性评估 生物标记 早期诊断 综述 

分 类 号：R714.256[医药卫生—妇产科学]