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妊娠酮血症与胎儿中枢神经系统发育

Pregnancy Ketonemia and Development of the Fetal Central Nervous System.

作者信息

Bronisz Agata, Ozorowski Mateusz, Hagner-Derengowska Magdalena

机构信息

Endocrinology and Diabetology, Faculty of Medicine, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 9 Skłodowskiej-Curie Street, 85-094 Bydgoszcz, Poland.

Clinical Neuropsychology, Faculty of Health Sciences, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 9 Skłodowskiej-Curie Street, 85-094 Bydgoszcz, Poland.

出版信息

Int J Endocrinol. 2018 Jun 4;2018:1242901. doi: 10.1155/2018/1242901. eCollection 2018.

Abstract

Glucose is the major source of energy for the human brain which in turn uses ketone bodies as a supplement for energy deficit in glucose cell deficiency conditions. Pregnancy complicated by gestational diabetes is a condition associated with significantly increased risk of ketonemia development. The data available proves a changing influence of ketones on the central nervous system during fetal life and in adults as well. Ketone bodies freely pass through the placenta. They can affect fetal growth and organ damage development, especially the central nervous system. As agreed in the current recommendation of the diabetes associations, it is not obligatory for the attending doctor to conduct a routine inspection of ketone bodies during diabetes treatment in pregnancy. This article is a literature review of ketones' effect on the central nervous system and an attempt to initiate discussion whether we should consider including ketonemia assessment into the standard care package for pregnant women with diabetes and begin some research on the explanation of its influence on fetal development.

摘要

葡萄糖是人类大脑的主要能量来源,而在葡萄糖细胞缺乏的情况下,大脑会转而利用酮体作为能量不足的补充。妊娠期糖尿病合并妊娠是一种与酮血症发生风险显著增加相关的疾病。现有数据证明,酮体在胎儿期和成人期对中枢神经系统的影响也在不断变化。酮体可自由通过胎盘。它们会影响胎儿生长和器官损伤的发展,尤其是中枢神经系统。正如糖尿病协会目前的建议所认同的那样,在妊娠糖尿病治疗期间,主治医生没有义务对酮体进行常规检查。本文是对酮体对中枢神经系统影响的文献综述,并试图引发讨论:我们是否应该考虑将酮血症评估纳入糖尿病孕妇的标准护理方案,并开展一些关于其对胎儿发育影响的解释的研究。

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