Dell'Edera Domenico, Sarlo Francesca, Allegretti Arianna, Simone Francesca, Lupo Maria Giovanna, Epifania Annunziata Anna
Unit of Cytogenetic and Molecular Genetics, 'Madonna delle Grazie' Hospital, 75100 Matera, Italy.
Biomed Rep. 2017 Aug;7(2):169-172. doi: 10.3892/br.2017.939. Epub 2017 Jul 4.
The aim of the present study was to demonstrate that the use of inositol and folic acid from the first trimester of pregnancy, counteracts the onset of gestational diabetes mellitus (GDM) in women at risk, preserving the infants from macrosomia, hypoglycemia and preterm delivery. The authors collected data from the pregnant women at the laboratory (Unit of Cytogenic and Molecular Genetics), from January 2014 to April 2016, all with first trimester fasting plasma glucose (FPG) >92 mg/dl. A total of 40 women were treated with 250 mg/day D--inositol, 1.75 g/day D--inositol, 12.5 mg/day zinc, 10 mg/day methylsulfonylmethane, 400 µg/day 5-methyltetrahydrofolic acid. The other 43 women (control group) were treated with only 400 µg/day folic acid. The primary outcome measure was the incidence of maternal GDM. The secondary outcome measures were the incidence of fetal macrosomia, preterm delivery and neonatal hypoglycemia. At the 24th week of pregnancy, the incidence of maternal GDM was recorded in 18 women in the control group and in 5 women in the treated group [relative risk (RR)=3.35; 95% confidence interval (CI)=1.37-8.17; P=0.0028). A significant difference was observed between treated and control groups in terms of risk of macrosomia. A total of seven infants in the control group, and two in the treated group, weighed >4,000 g (RR=5,12; 95% CI=1.21-21.68; P=0.0099). No significant difference was identified between two groups, regarding the other two secondary outcomes, neonatal hypoglycemia (RR=4.650; 95% CI=0.57-38.11; P=0.1086) and preterm delivery (RR=1.74; 95% CI=0.83-3.66; P=0.1301). The current study demonstrated the potential benefit of supplementation with the association of D--inositol and D--inositol in pregnant 'at risk' women, with first trimester FPG >92 mg/dl, in preventing the onset of maternal GDM and macrosomia in newborns.
本研究的目的是证明,从妊娠早期开始使用肌醇和叶酸,可抵消高危女性妊娠糖尿病(GDM)的发病,使婴儿免受巨大儿、低血糖和早产的影响。作者于2014年1月至2016年4月在实验室(细胞遗传学和分子遗传学科室)收集了孕妇的数据,所有孕妇的孕早期空腹血糖(FPG)>92mg/dl。共有40名女性接受了如下治疗:每天250mg D-肌醇、1.75g D-肌醇、12.5mg锌、10mg甲基磺酰甲烷、400μg 5-甲基四氢叶酸。另外43名女性(对照组)仅接受每天400μg叶酸的治疗。主要结局指标是孕妇GDM的发病率。次要结局指标是胎儿巨大儿、早产和新生儿低血糖的发病率。在妊娠第24周时,记录到对照组有18名女性发生孕妇GDM,治疗组有5名女性发生(相对危险度(RR)=3.35;95%置信区间(CI)=1.37-8.17;P=0.0028)。在巨大儿风险方面,治疗组和对照组之间观察到显著差异。对照组共有7名婴儿,治疗组有2名婴儿体重>4000g(RR=5.12;95%CI=1.21-21.68;P=0.0099)。在另外两个次要结局,即新生儿低血糖(RR=4.650;95%CI=0.57-38.11;P=0.1086)和早产(RR=1.74;95%CI=0.83-3.66;P=0.1301)方面,两组之间未发现显著差异。本研究证明,对于孕早期FPG>92mg/dl的“高危”孕妇,补充D-肌醇和D-肌醇组合具有预防孕妇GDM和新生儿巨大儿发病的潜在益处。