Wung Shu-Fen, Lin Pei-Chao
College of Nursing, The University of Arizona, Tucson, USA.
Annu Rev Nurs Res. 2011;29:227-60. doi: 10.1891/0739-6686.29.227.
Gestational diabetes mellitus (GDM) is one of the most common complications of pregnancy and the prevalence of GDM is increasing worldwide. Short- and long-term complications of GDM on mothers and fetuses are well-recognized. These include more than seven-fold higher risk for type 2 diabetes mellitus (T2DM) later in life in women with GDM than those without. Evidence supports that GDM shares several risk factors with T2DM, including genetic risks. This chapter reviewed studies on candidate genes shared by T2DM and GDM published from 1990 to 2011. At least 20 susceptible genes of T2DM have been studied in women with GDM in various races. Results from current association studies on T2DM susceptible genes in GDM have shown significant heterogeneity There may be primary evidence that polymorphisms of susceptible genes of T2DM such as transcription factor 7-like 2 (TCF7L2) gene, potassium channel voltage-gate KQT-like subfamily member 1 (KCNQ1) gene, and cyclin-dependent kinase 5 regulatory subunit-associated protein 1-like 1 (CDKAL1) gene, may increase risk of GDM. Associations between GDM and many genetic variants have led to different findings across populations. Many genetic polymorphisms related to GDM were investigated in a single study or a single population. Replication studies to verify contributions of both common and rare genetic variants for GDM and T2DM in specific racial/ethnic groups are needed.
妊娠期糖尿病(GDM)是妊娠最常见的并发症之一,且其在全球范围内的患病率正在上升。GDM对母亲和胎儿的短期及长期并发症已广为人知。这些并发症包括,患有GDM的女性在日后患2型糖尿病(T2DM)的风险比未患GDM的女性高出七倍多。有证据表明,GDM与T2DM有若干共同的风险因素,包括遗传风险。本章回顾了1990年至2011年发表的关于T2DM和GDM共同候选基因的研究。至少对20个T2DM易感基因在不同种族的GDM女性中进行了研究。目前关于GDM中T2DM易感基因的关联研究结果显示出显著的异质性。可能有初步证据表明,T2DM易感基因的多态性,如转录因子7样2(TCF7L2)基因、钾通道电压门控KQT样亚家族成员1(KCNQ1)基因和细胞周期蛋白依赖性激酶5调节亚基相关蛋白1样1(CDKAL1)基因,可能会增加GDM的风险。GDM与许多基因变异之间的关联在不同人群中导致了不同的结果。许多与GDM相关的基因多态性仅在一项研究或单一人群中进行了调查。需要进行复制研究,以验证常见和罕见基因变异对特定种族/族裔群体中GDM和T2DM的影响。