完善妊娠糖尿病的诊断:一个系统的审查和元分析
Ellen C Francis1, Camille E Powe2, William L Lowe3
1Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, NJ, USA. ellen.francis@rutgers.edu.
Communications medicine
|December 18, 2023
概括
孕产妇超重/肥胖和胰岛素耐药性增加了妊娠糖尿病 (GDM) 中不良围产期结果的风险. 为了准确的GDM诊断和管理,需要对非血糖标记物进行进一步的研究.
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:
- 在孕期糖尿病 (GDM) 的妇女中,围产期结局不同.
- 除了血糖控制之外的因素来完善GDM诊断还没有得到很好的定义.
- 这项研究系统地审查了GDM的潜在精度标记.
研究的目的:
- 对妊娠糖尿病 (GDM) 的潜在精确标记进行系统审查和元分析.
- 为了确定除了血糖状况之外的因素,可以完善GDM诊断并预测围产期结果.
- 评估母性特征和生化标志物与GDM中不良产周结局的关联.
主要方法:
- 在PubMed和EMBASE (开始至2022年3月) 进行系统的文献搜索.
- 包括比较患有GDM的女性产周期结局的研究.
- 对母亲的体重指数 (BMI) 和后代的宏观/LGA进行元分析;对其他精确标记的审查 (人体测量,生物化学,遗传学,生态学,胎儿生物识别).
主要成果:
- 在GDM中,母亲的超重/肥胖与后代宏观症 (OR 2.65) 和大孕年龄 (LGA) (OR 2.23) 的更高风险有关.
- 在GDM中,增加的甘油三和胰岛素抵抗与较大的宏观性或LGA风险有关.
- 其他评估的标志物显示在GDM中准确使用的结果不一致.
结论:
- 孕产妇超重/肥胖会显著增加患有GDM的女性患有宏观症或LGA的风险.
- 孕期胰岛素耐药性和高甘油三血症可能有助于GDM风险分层.
- 建议对GDM的非血糖生化,遗传,基因和社会文化标志物进行进一步的研究.
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