Feichtinger Michael, Stopp Tina, Hofmann Sandra, Springer Stephanie, Pils Sophie, Kautzky-Willer Alexandra, Kiss Herbert, Eppel Wolfgang, Tura Andrea, Bozkurt Latife, Göbl Christian S
Department of Obstetrics and Gynaecology, Division of Obstetrics and Feto-maternal Medicine, Medical University of Vienna, Waehringer Guertel 18-20, A-1090, Vienna, Austria.
Department of Internal Medicine III, Division of Endocrinology and Metabolism, Medical University of Vienna, Vienna, Austria.
Diabetologia. 2017 Jan;60(1):153-157. doi: 10.1007/s00125-016-4128-8. Epub 2016 Oct 18.
AIMS/HYPOTHESIS: A history of gastric bypass surgery can influence the results of the OGTT recommended during pregnancy. Therefore, we compared OGTT glucose kinetics and pregnancy outcome between pregnant gastric bypass patients and BMI-matched, lean and obese controls.
Medical records were used to collect data on glucose measurements during the 2 h 75 g OGTT as well as on pregnancy and fetal outcome for 304 women (n = 76 per group, matched for age and date of delivery).
Women after bariatric surgery had lower fasting glucose levels compared with lean, obese and BMI-matched controls, and showed altered postprandial glucose kinetics, including a rise at 60 min followed by hypoglycaemia with serum glucose of <3.34 mmol/l (which occurred in 54.8%). Moreover, their risk of pre-eclampsia or gestational hypertension was reduced, with an increased risk of delivering small for gestational age infants.
CONCLUSIONS/INTERPRETATION: Alternative strategies to accurately define impaired glucose metabolism in pregnancies after bariatric surgery should be explored.
目的/假设：胃旁路手术史会影响孕期推荐的口服葡萄糖耐量试验（OGTT）结果。因此，我们比较了接受胃旁路手术的孕妇与体重指数（BMI）匹配的瘦型和肥胖型对照者的OGTT葡萄糖动力学及妊娠结局。
利用医疗记录收集304名女性（每组76人，年龄和分娩日期匹配）在75克OGTT 2小时期间的葡萄糖测量数据以及妊娠和胎儿结局数据。
与瘦型、肥胖型及BMI匹配的对照者相比，接受减肥手术的女性空腹血糖水平较低，餐后葡萄糖动力学改变，包括60分钟时血糖升高，随后出现低血糖，血糖<3.34 mmol/L（发生率为54.8%）。此外，她们发生先兆子痫或妊娠期高血压的风险降低，但分娩小于胎龄儿的风险增加。
结论/解读：应探索准确界定减肥手术后妊娠期间葡萄糖代谢受损的替代策略。
