怀孕期间的血糖状况根据禁食和负载后的葡萄糖值:与不良妊娠结果的关联. 一个观察性研究研究
Emmanuel Cosson1, Sopio Tatulashvili1, Eric Vicaut2
1AP-HP, Avicenne Hospital, Paris 13 University, Sorbonne Paris Cité, Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, 125 route de Stalingrad, Hôpital Avicenne, Bobigny 93009, France; Paris 13 University, Sorbonne Paris Cité, UMR U557 INSERM/U11125 INRAE/CNAM/Université Paris13, Unité de Recherche Epidémiologique Nutritionnelle, Bobigny, France.
Diabetes & metabolism
|August 30, 2023
概括
怀孕期高血糖症 (HIP) 通过禁食葡萄糖水平来诊断,增加了怀孕年龄较大的婴儿的风险. 负载后血糖升高与早产和NICU入院有关,即使有治疗.
科学领域:
- 产科和妇科 产科和妇科
- 内分泌学 在内分泌学.
- 围产儿医学 围产儿医学
背景情况:
- 怀孕期高血糖症 (HIP) 诊断可以基于口服葡萄糖耐受性测试 (OGTT) 的禁食或负载后葡萄糖值.
- 这些不同诊断标准对妊娠不良结果的预后影响尚未完全理解.
研究的目的:
- 调查妊娠时明显高血糖 (HIP) 诊断标准 (禁食,后负荷或两者) 与不良妊娠结果之间的关联.
- 为了确定葡萄糖不耐受性的特定模式是否会影响婴儿大小和分娩并发症.
主要方法:
- 一项多民族前性研究包括8339名孕妇,在怀孕22周后接受了HIP查.
- 女性被分为四组:没有HIP,孤立的禁食HIP,孤立的负载后HIP,以及联合的禁食和负载后HIP.
- 评估了对妊娠年龄大 (LGA) 婴儿,早产和新生儿重症监护室入院的风险,并对混因素进行了调整.
主要成果:
- 与没有HIP的女性相比,那些孤立的禁食HIP或联合的禁食和负载后HIP的妇女的孕期婴儿 (LGA) 产生的风险明显更高.
- 怀孕期高血糖症 (HIP) 通过后负载葡萄糖水平 (单独或组合) 确定,与早产和新生儿重症监护室 (NICU) 住院率的增加有关.
- 孤立的负载后HIP并没有显著增加LGA婴儿的风险.
结论:
- 孕期禁食高血糖 (HIP) 是分娩大胎儿的重要风险因素,独立于负载后的葡萄糖水平.
- 孕期负荷后高血糖症 (HIP) 与早产和新生儿重症监护室入院的风险增加有关,这凸显了监测这些结果的重要性.
- 这些发现强调了禁食与负载后葡萄糖升高在HIP对特定不良妊娠结果的差异性影响,即使在治疗和调整混因素后.
相关概念视频
Pathophysiology of Diabetes
986
Diabetes mellitus is a chronic metabolic disorder characterized by hyperglycemia. The four categories of diabetes are type 1 diabetes, type 2 diabetes, other specific types of diabetes, and gestational diabetes.
Type 1 diabetes is characterized by autoimmune-mediated destruction of pancreatic β cells, with environmental factors potentially triggering this process in genetically susceptible individuals. Despite many not having a family history, certain genes increase susceptibility,...
Type 1 diabetes is characterized by autoimmune-mediated destruction of pancreatic β cells, with environmental factors potentially triggering this process in genetically susceptible individuals. Despite many not having a family history, certain genes increase susceptibility,...
986
Diabetes Mellitus: Type 2 and Gestational
2.5K
Type 2 diabetes, characterized by insulin resistance, arises when the insulin receptors on cells lose responsiveness to insulin, diminishing the cell's capacity to take up glucose, resulting in elevated blood glucose levels. To receive a diagnosis of Type 2 diabetes, a series of blood glucose tests are necessary to assess whether the blood glucose falls within normal parameters. If the result is out of the normal range, a patient may be diagnosed as prediabetic or diabetic, depending on the...
2.5K
Diabetes: Symptoms, Diagnosis, and Complications
588
For most patients, experiencing several weeks of polyuria, polydipsia, fatigue, and significant weight loss may indicate the presence of diabetes. Furthermore, adults displaying the phenotypic appearance of type 2 diabetes (particularly those who are obese and not initially insulin-requiring), may have islet cell autoantibodies, suggesting autoimmune-mediated β cell destruction and a diagnosis of latent autoimmune diabetes of adults (LADA). The categorization of glucose homeostasis is...
588
Hypoglycemia and Glucagon
295
Without prolonged fasting, healthy individuals maintain blood glucose levels above 3.5 mM due to a well-adapted neuroendocrine counterregulatory system that effectively prevents acute hypoglycemia, a potentially life-threatening condition. The primary clinical scenarios for hypoglycemia encompass diabetes treatment, inappropriate production of endogenous insulin or insulin-like substances by tumors, and the use of glucose-lowering agents in non-diabetic individuals. Notably, hypoglycemia in the...
295
Overview of Carbohydrate Metabolism
1.1K
Carbohydrate metabolism is a fundamental biochemical process that ensures a constant supply of energy to living cells. The most important carbohydrate is glucose, which can be broken down via glycolysis to enter into the Krebs cycle and eventually lead to the production of ATP through oxidative phosphorylation.
Glucose transport into cells is facilitated by a family of transport proteins called GLUT (Glucose Transporters). GLUT4 is the primary glucose transporter for insulin-stimulated glucose...
Glucose transport into cells is facilitated by a family of transport proteins called GLUT (Glucose Transporters). GLUT4 is the primary glucose transporter for insulin-stimulated glucose...
1.1K
Glucose Homeostasis: Regulation of Blood Glucose
1.7K
Carbohydrates consumed through foods are converted into glucose, a crucial energy source for the body. In the prandial state, high blood glucose levels stimulate the secretion of insulin from the pancreas. Insulin inhibits hepatic glucose production and stimulates glucose uptake and metabolism by muscle and adipose tissue. The excess glucose is converted into glycogen and stored in the liver and muscles.
During fasting, when blood glucose levels are low, the pancreas secretes glucagon. it...
During fasting, when blood glucose levels are low, the pancreas secretes glucagon. it...
1.7K


