Georgiou Harry M, Lappas Martha, Georgiou George M, Marita Adinda, Bryant Valerie J, Hiscock Richard, Permezel Michael, Khalil Zeinab, Rice Gregory E
Department of Obstetrics and Gynecology, University of Melbourne, Parkville, VIC, Australia.
Acta Diabetol. 2008 Sep;45(3):157-65. doi: 10.1007/s00592-008-0037-8. Epub 2008 May 22.
Screening for glucose intolerance during pregnancy provides an opportunity to offer management to those women diagnosed with gestational diabetes mellitus. However, there is a need to diagnose gestational diabetes early to minimize exposure of the developing fetus to suboptimal conditions and prevent perinatal complications and their sequelae. The purpose of this study was to identify potential biomarkers for impending gestational diabetes that appear in the plasma before impaired glucose tolerance. Pregnant women were prospectively recruited to the study and blood was collected at the first antenatal visit and at the time of routine oral glucose tolerance test. Women diagnosed with gestational diabetes were matched with an equal number of normal pregnant (control) women. Biomarkers under investigation included endocrine and metabolic hormones, cytokines and chemokines, and surrogate markers of oxidative stress. Compared to controls, women with gestational diabetes exhibited elevated plasma insulin and reduced plasma adiponectin concentrations at 28 weeks gestation. Significant differences in insulin and adiponectin concentrations were also observed in plasma at 11 weeks gestation. Bivariate logistic regression analysis showed that both insulin and adiponectin are associated with subsequent development of gestational diabetes. Plasma insulin and adiponectin concentrations, when measured at 11 weeks, may be predictive of impending gestational diabetes. Further studies are warranted to determine the reliability of these biomarkers.
孕期筛查糖耐量异常为那些被诊断为妊娠期糖尿病的女性提供了进行管理的机会。然而，有必要尽早诊断妊娠期糖尿病，以尽量减少发育中的胎儿暴露于不理想的状况，并预防围产期并发症及其后遗症。本研究的目的是确定在糖耐量受损之前出现在血浆中的、即将发生的妊娠期糖尿病的潜在生物标志物。前瞻性招募孕妇参与本研究，并在首次产前检查时以及进行常规口服葡萄糖耐量试验时采集血液。被诊断为妊娠期糖尿病的女性与数量相等的正常怀孕（对照）女性进行匹配。所研究的生物标志物包括内分泌和代谢激素、细胞因子和趋化因子，以及氧化应激的替代标志物。与对照组相比，患有妊娠期糖尿病的女性在妊娠28周时血浆胰岛素升高，血浆脂联素浓度降低。在妊娠11周时血浆中也观察到胰岛素和脂联素浓度的显著差异。二元逻辑回归分析表明，胰岛素和脂联素均与随后发生的妊娠期糖尿病有关。在11周时测量的血浆胰岛素和脂联素浓度可能预测即将发生的妊娠期糖尿病。有必要进行进一步研究以确定这些生物标志物的可靠性。
