Morita Ai, Ishigaki Yasushi
Nihon Rinsho. 2015 Apr;73(4):606-10.
Gender-difference is thought to be an important factor in the pathogenesis of glucose metabolism. Imbalances in sex hormones, such as increasing levels of progesterone or testosterone, are associated with systemic insulin resistance. After menopause, women are at an increased risk to develop visceral obesity due to the loss of endogenous ovarian hormone production. On the other hand, insulin resistance caused excess secretion of androgen, leading to menstrual disorder in obese young female. For the better management of glucose intolerance in pregnancy, the diagnostic criteria for gestational diabetes was revised in Japan. Although glucose intolerance in pregnancy is usually recovered after delivery, the subjects who diagnosed gestational diabetes need to be followed for an early detection of type 2 diabetes development. In addition, gender-differences in living practice and attitude are related to their lifestyle, including diet and exercise, therefore, gender-specific medicine increasingly plays key roles in the treatment of diabetes.
性别差异被认为是葡萄糖代谢发病机制中的一个重要因素。性激素失衡，如孕酮或睾酮水平升高，与全身胰岛素抵抗有关。绝经后，由于内源性卵巢激素分泌减少，女性患内脏肥胖的风险增加。另一方面，胰岛素抵抗导致雄激素分泌过多，进而导致肥胖年轻女性月经紊乱。为了更好地管理妊娠期糖耐量异常，日本修订了妊娠期糖尿病的诊断标准。尽管妊娠期糖耐量异常通常在产后恢复，但被诊断为妊娠期糖尿病的患者需要接受随访，以便早期发现2型糖尿病的发生。此外，生活习惯和态度上的性别差异与包括饮食和运动在内的生活方式有关，因此，性别特异性医学在糖尿病治疗中越来越发挥关键作用。
