Nilsson Charlotta, Ursing Dag, Törn Carina, Aberg Anders, Landin-Olsson Mona
Department of Endocrinology and Diabetology, Lund University Hospital, S- 221 85 Lund, Sweden.
Diabetes Care. 2007 Aug;30(8):1968-71. doi: 10.2337/dc07-0157. Epub 2007 May 22.
We sought to study the frequency of beta-cell-specific autoantibody markers in women with gestational diabetes mellitus (GDM) and to follow these women to estimate the risk of later development of type 1 diabetes.
Of 385 pregnant women with GDM during 1995-2005 in the district of Lund, 24 (6%) women were found positive for at least one of the following: islet cell antibody (ICA), GAD antibody (GADA), or tyrosine phosphatase antibody (IA-2A). The women were followed and autoantibodies reanalyzed. Those who had not developed diabetes did an oral glucose tolerance test. The frequencies of known risk factors for GDM were compared in women with GDM with and without pancreatic autoantibodies.
Among the autoantibody-positive women, 50% had developed type 1 diabetes compared with none among the GDM control subjects (P = 0.001), 21% had impaired fasting glucose or impaired glucose tolerance compared with 12.5% among control subjects (P = 0.3), and none had developed type 2 diabetes compared with 12.5% among control subjects (P = 0.1).
Autoantibody screening in pregnant women with GDM and follow-up after delivery should be considered for early recognition of type 1 diabetes.
我们试图研究妊娠糖尿病（GDM）女性中β细胞特异性自身抗体标志物的频率，并对这些女性进行随访，以评估其日后发生1型糖尿病的风险。
在1995年至2005年期间，于隆德地区的385名患有GDM的孕妇中，有24名（6%）女性被发现至少对以下一种抗体呈阳性：胰岛细胞抗体（ICA）、谷氨酸脱羧酶抗体（GADA）或酪氨酸磷酸酶抗体（IA - 2A）。对这些女性进行随访并重新分析自身抗体。未患糖尿病的女性进行口服葡萄糖耐量试验。比较了有和没有胰腺自身抗体的GDM女性中已知的GDM风险因素的频率。
在自身抗体阳性的女性中，50%已发展为1型糖尿病，而GDM对照组中无人发展为此病（P = 0.001）；21%有空腹血糖受损或糖耐量受损，而对照组中这一比例为12.5%（P = 0.3）；无人发展为2型糖尿病，而对照组中这一比例为12.5%（P = 0.1）。
对于患有GDM的孕妇，应考虑进行自身抗体筛查及产后随访，以便早期识别1型糖尿病。
