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韩国妊娠期糖尿病女性中GAD抗体的患病率及其孕期和产后的临床特征。

The prevalence of GAD antibodies in Korean women with gestational diabetes mellitus and their clinical characteristics during and after pregnancy.

作者信息

Yu Sung Hoon, Park Sunmin, Kim Hun-Sung, Park So-Young, Yim Chang Hoon, Han Ki Ok, Yoon Hyun Koo, Jang Hak Chul, Chung Ho Yeon, Kim Sung-Hoon

机构信息

Division of Endocrinology & Metabolism, Department of Medicine, Cheil General Hospital & Women's Healthcare Center, Kwandong University, College of Medicine, Seoul, Korea.

出版信息

Diabetes Metab Res Rev. 2009 May;25(4):329-34. doi: 10.1002/dmrr.963.

Abstract

BACKGROUND

We conducted this research in order to evaluate the prevalence of glutamic acid decarboxylase antibodies (GADA) in Korean women with gestational diabetes mellitus (GDM), to identify the clinical characteristics of these women, and to gauge the prevalence of diabetes among them after childbirth.

METHODS

We studied 887 Korean women with GDM who were screened for GADA, and assessed their antepartum clinical characteristics and the outcomes of their pregnancies. At 6 weeks' postpartum, 75 g oral glucose tolerance tests were performed to determine the diabetic status of GDM women with GADA.

RESULTS

The prevalence of GADA in Korean women with GDM was 1.7%. Plasma glucose levels at 0- and 3-h during oral glucose tolerance tests were significantly different between GADA-positive and GADA-negative women with GDM. There were no significant differences between them in terms of age, body mass index, family history of diabetes, fasting insulin, and lipid profiles. However, GADA-positive women with GDM required insulin treatment during pregnancy more frequently than GADA-negative patients. The development of diabetes at early postpartum was significantly higher in GADA-positive women with GDM than those who were GADA negative.

CONCLUSIONS

The prevalence of GADA in Korean women with GDM was low. However, GADA-positive women with GDM are more susceptible to subsequently developing type 1 diabetes, even in the early postpartum period. Long-term follow up studies and intervention to prevent type 1 diabetes among GADA-positive GDM women are needed.

摘要

背景

我们开展这项研究是为了评估韩国妊娠期糖尿病(GDM)女性中谷氨酸脱羧酶抗体(GADA)的患病率,确定这些女性的临床特征,并衡量她们产后患糖尿病的患病率。

方法

我们研究了887名接受GADA筛查的韩国GDM女性,评估她们的产前临床特征和妊娠结局。产后6周,对GADA阳性的GDM女性进行75克口服葡萄糖耐量试验以确定糖尿病状态。

结果

韩国GDM女性中GADA的患病率为1.7%。GADA阳性和阴性的GDM女性在口服葡萄糖耐量试验中0小时和3小时的血糖水平有显著差异。在年龄、体重指数、糖尿病家族史、空腹胰岛素和血脂谱方面,她们之间没有显著差异。然而,GADA阳性的GDM女性在孕期比GADA阴性患者更频繁地需要胰岛素治疗。GADA阳性的GDM女性产后早期患糖尿病的发生率明显高于GADA阴性者。

结论

韩国GDM女性中GADA的患病率较低。然而,GADA阳性的GDM女性即使在产后早期也更容易随后发展为1型糖尿病。需要对GADA阳性的GDM女性进行长期随访研究和干预以预防1型糖尿病。

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