McCabe Carolyn F, Perng Wei
Department of Nutritional Sciences, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI, USA.
Department of Epidemiology, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI, USA.
Curr Diab Rep. 2017 Aug;17(8):57. doi: 10.1007/s11892-017-0890-3.
The purpose of this review is to describe ways in which metabolomics may enhance understanding of gestational diabetes mellitus (GDM) etiology and refine current diagnostic criteria.
Current clinical recommendations suggest screening for GDM between 24 and 28 of gestational weeks using an oral glucose tolerance test. Despite this consensus, there are discrepancies regarding the exact criteria for GDM diagnosis. Further, emerging evidence has unveiled heterogeneous physiological pathways underlying GDM-specifically, GDM with defective insulin secretion vs. sensitivity-that have important implications for disease diagnosis and management. The objectives of this review are threefold. First, we seek to provide a brief summary of current knowledge regarding GDM pathophysiology. Next, we describe the potential role of metabolomics to refine and improve the prediction, screening, and diagnosis of GDM. Finally, we propose ways in which metabolomics may eventually impact clinical care and risk assessment for GDM and its comorbidities.
本综述旨在描述代谢组学可增进对妊娠期糖尿病(GDM)病因的理解并完善当前诊断标准的方式。
当前临床建议提出在妊娠24至28周期间使用口服葡萄糖耐量试验筛查GDM。尽管有这一共识,但关于GDM诊断的确切标准仍存在差异。此外,新出现的证据揭示了GDM背后的异质性生理途径——特别是胰岛素分泌缺陷型与胰岛素敏感性缺陷型GDM——这对疾病的诊断和管理具有重要意义。本综述有三个目标。首先,我们试图简要总结关于GDM病理生理学的当前知识。其次,我们描述代谢组学在完善和改进GDM的预测、筛查及诊断方面的潜在作用。最后,我们提出代谢组学最终可能影响GDM及其合并症的临床护理和风险评估的方式。