Ozler Sibel, Oztas Efser, Caglar Ali Turhan, Uygur Dilek, Ergin Merve, Erel Ozcan, Danisman Nuri
a Department of Perinatology , Zekai Tahir Burak Women's Health Training and Research Hospital , Ankara , Turkey and.
b Department of Clinical Biochemistry , Faculty of Medicine, Yildirim Beyazit University , Ankara , Turkey.
J Matern Fetal Neonatal Med. 2016 Nov;29(22):3699-704. doi: 10.3109/14767058.2016.1141885. Epub 2016 Feb 24.
The main aim of this study was to investigate thiol/disulfide homeostasis at 24-28 weeks of pregnancy and to evaluate whether it is predictive for adverse perinatal outcomes or not in gestational diabetes mellitus (GDM).
A total of 110 pregnant women at 24-28 weeks of pregnancy (74 GDM patients and 36 age- and BMI-matched healthy pregnant women) were enrolled in this prospective case-control study. Thiol/disulfide homeostasis was evaluated with a novel spectrophotometric method to determine if there is an association with adverse perinatal outcomes in GDM, by using logistic regression analysis.
GDM patients, with decreased native thiol levels at 24-28 weeks (OR: 4.890, 95% CI: 1.355-5.764, p = 0.015) and with higher pre-pregnancy BMI (OR: 1.280, 95% CI: 1.072-1.528, p = 0.006), were found to be at increased risk of adverse perinatal outcomes in GDM. There were no statistically significant differences in thiol/disulfide homeostasis between diet- and insulin-treated GDM subgroups. Additionally, 1-h and 2-h glucose levels on 100 g OGTT were found to be predictive for the insulin need in achieving good glycemic control in GDM (OR: 1.022, 95% CI: 1.005-1.038, p = 0.010 and OR: 1.019, 95% CI: 1.004-1.035, p = 0.015).
GDM patients, with decreased native thiol levels at 24-28 weeks of pregnancy and with higher pre-pregnancy BMI, have an increased risk of possible adverse perinatal outcomes. Also, increased 1-h and 2-h glucose levels on 100 g OGTT can predict the need for insulin treatment for GDM.
本研究的主要目的是调查妊娠24 - 28周时的硫醇/二硫键稳态，并评估其是否可预测妊娠期糖尿病（GDM）的不良围产期结局。
本前瞻性病例对照研究共纳入110例妊娠24 - 28周的孕妇（74例GDM患者和36例年龄及BMI匹配的健康孕妇）。采用一种新型分光光度法评估硫醇/二硫键稳态，通过逻辑回归分析确定其与GDM不良围产期结局是否存在关联。
发现GDM患者在妊娠24 - 28周时天然硫醇水平降低（比值比：4.890，95%置信区间：1.355 - 5.764，p = 0.015）且孕前BMI较高（比值比：1.280，95%置信区间：1.072 - 1.528，p = 0.006），其发生GDM不良围产期结局的风险增加。饮食治疗和胰岛素治疗的GDM亚组之间硫醇/二硫键稳态无统计学显著差异。此外，发现100g口服葡萄糖耐量试验（OGTT）的1小时和2小时血糖水平可预测GDM患者实现良好血糖控制所需的胰岛素剂量（比值比：1.022，95%置信区间：1.005 - 1.038，p = 0.010；比值比：1.019，95%置信区间：1.004 - 1.035，p = 0.015）。
妊娠24 - 28周时天然硫醇水平降低且孕前BMI较高的GDM患者，发生不良围产期结局的风险增加。此外，100g OGTT中1小时和2小时血糖水平升高可预测GDM患者的胰岛素治疗需求。
