Ramírez-Torres Maria Aurora, Rodríguez-Pezino Jorge, Zambrana-Castañeda Marcela, Lira-Plascencia Josefina, Parra Adalberto
Department of Endocrinology, Instituto Nacional de Perinatología, México City, Mexico.
J Pediatr Endocrinol Metab. 2003 Mar;16(3):401-5. doi: 10.1515/jpem.2003.16.3.401.
There is an increasing incidence of type 2 diabetes mellitus (DM) among adolescents (especially females), and the serum glucose concentrations in pregnant women <25 years during a 3-h oral glucose tolerance test (3-h OGTT) seem to be lower than those of pregnant women >25 years. Among 115 Mexican pregnant adolescents (<18 years) we analyzed their serum glucose concentrations during: a) 1-h 50-g glucose challenge test (GCT) performed at 24-28 weeks of gestation (n = 103) or at 29-35 weeks of gestation (n = 12); b) A standard 3-h OGTT performed 3-5 days later. Eight adolescents had an abnormal GCT, three of whom also had an abnormal 3-h OGTT. Sixteen adolescents (13 with previously normal GCT) had an abnormal 3-h OGTT, 15 classified as GGI and one as gestational DM (GDM). Serum glucose concentrations in adolescents with GGI were higher than in adolescents with normal 3-h OGTT: a) at 60 and 120 min during the 3-h OGTT (p < 0.001); and b) when expressed as the area under the glucose curve (p < 0.001). Adolescents with GGI had serum glucose concentrations during the 3-h OGTT similar to adult, non-diabetic pregnant Mexican women. It is suggested that GGI in pregnant adolescents may represent an early sign of a future deterioration in glucose metabolism, leading to a higher risk for GDM in future pregnancies and/or type 2 DM in adulthood. Thus, the current criteria to diagnose GDM in adults may not completely apply to adolescents, especially in ethnic groups with high risk for glucose abnormalities and considering the frequency of multiparous adolescents, especially in developing countries.
青少年（尤其是女性）中2型糖尿病（DM）的发病率呈上升趋势，25岁以下孕妇在3小时口服葡萄糖耐量试验（3-h OGTT）期间的血糖浓度似乎低于25岁以上孕妇。在115名墨西哥怀孕青少年（<18岁）中，我们分析了她们在以下情况下的血糖浓度：a）在妊娠24 - 28周（n = 103）或29 - 35周（n = 12）进行的1小时50克葡萄糖筛查试验（GCT）；b）3 - 5天后进行的标准3小时OGTT。8名青少年GCT异常，其中3人3小时OGTT也异常。16名青少年（13名之前GCT正常）3小时OGTT异常，15名归类为葡萄糖耐量受损（GGI），1名诊断为妊娠期糖尿病（GDM）。GGI青少年的血糖浓度高于3小时OGTT正常的青少年：a）在3小时OGTT期间的60分钟和120分钟时（p < 0.001）；b）以葡萄糖曲线下面积表示时（p < 0.001）。GGI青少年在3小时OGTT期间的血糖浓度与成年非糖尿病墨西哥孕妇相似。提示怀孕青少年中的GGI可能是未来糖代谢恶化的早期迹象，导致未来妊娠中患GDM和/或成年后患2型糖尿病的风险更高。因此，目前成人诊断GDM的标准可能并不完全适用于青少年，尤其是在葡萄糖异常风险较高的种族群体中，并且考虑到多产青少年的比例，特别是在发展中国家。
