Yavuz A, Akkurt M O, Yalcin S, Karakoc G, Varol E, Sezik M
Division of Perinatology, Department of Obstetrics and Gynecology, Suleyman Demirel University, Faculty of Medicine Isparta, Turkey.
Division of Perinatology, Department of Obstetrics and Gynecology, Sifa University School of Medicine, Izmir, Turkey.
Horm Metab Res. 2016 Sep;48(9):595-600. doi: 10.1055/s-0042-111435. Epub 2016 Jul 29.
Our aim was to evaluate the association between gestational diabetes mellitus and sonographically measured fetal epicardial fat thickness between 24-28 weeks' gestation. This was a cross-sectional study that included 40 pregnancies with gestational diabetes mellitus, matched with 40 normal pregnancies with similar maternal age, body-mass index, gestational age, fetal gender, and fetal abdominal circumference on ultrasound. Fetal epicardial fat thickness was measured and recorded during ultrasonography at 24-28 weeks of gestation. Maternal evaluation included measurement of maternal epicardial fat thickness, using echocardiography. Fetal and maternal epicardial fat thickness values were compared across the groups. Ultrasound views of fetal epicardial fat thickness were evaluated independently by 3 perinatology fellows to determine inter- and intra-observer variability. Partial and intraclass correlation analyses were used. Fetal and maternal epicardial fat thickness measurements were moderately correlated (r=0.63). Mean fetal and maternal epicardial fat thickness values were higher in gestational diabetes mellitus pregnancies (p=0.004 and p<0.0001, respectively) compared to controls. Fetal epicardial fat thickness was positively correlated (r=0.43) with postchallenge 2-h glucose values. Inter- and intra-observer agreement was high, demonstrated by strong correlations (r=0.99 and r=0.99, respectively) across fetal epicardial fat thickness measurements of the examiners. Fetuses from gestational diabetes mellitus pregnancies have significantly higher fetal and maternal epicardial fat thickness values compared to nongestational diabetes mellitus pregnancies. Fetal epicardial fat thickness obtained during second trimester fetal anatomy ultrasound may potentially be a reliable indicator for gestational diabetes mellitus. However, clinical validation studies are needed.
我们的目的是评估妊娠糖尿病与妊娠24 - 28周时超声测量的胎儿心外膜脂肪厚度之间的关联。这是一项横断面研究，纳入了40例妊娠糖尿病孕妇，并与40例年龄、体重指数、孕周、胎儿性别及超声测量的胎儿腹围相似的正常孕妇进行匹配。在妊娠24 - 28周超声检查时测量并记录胎儿心外膜脂肪厚度。对孕妇的评估包括使用超声心动图测量孕妇的心外膜脂肪厚度。比较两组胎儿和孕妇的心外膜脂肪厚度值。由3名围产医学研究员独立评估胎儿心外膜脂肪厚度的超声图像，以确定观察者间和观察者内的变异性。采用偏相关分析和组内相关分析。胎儿和孕妇的心外膜脂肪厚度测量值呈中度相关（r = 0.63）。与对照组相比，妊娠糖尿病孕妇的胎儿和孕妇心外膜脂肪厚度平均值更高（分别为p = 0.004和p < 0.0001）。胎儿心外膜脂肪厚度与口服葡萄糖耐量试验后2小时血糖值呈正相关（r = 0.43）。观察者间和观察者内的一致性较高，通过检查者对胎儿心外膜脂肪厚度测量值的强相关性（分别为r = 0.99和r = 0.99）得以证明。与非妊娠糖尿病孕妇相比，妊娠糖尿病孕妇的胎儿和孕妇心外膜脂肪厚度值显著更高。孕中期胎儿解剖超声检查时获得的胎儿心外膜脂肪厚度可能是妊娠糖尿病的一个可靠指标。然而，仍需要进行临床验证研究。
