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急性葡萄糖负荷、炎症、氧化应激、非酶糖基化与妊娠期糖尿病筛查

Acute Glucose Load, Inflammation, Oxidative Stress, Nonenzymatic Glycation, and Screening for Gestational Diabetes.

作者信息

Jones Megan L, Buhimschi Irina A, Zhao Guomao, Bartholomew Anna, Smith-Timms Jordan, Rood Kara M, Buhimschi Catalin S

机构信息

1 Department of Obstetrics & Gynecology, The Ohio State University College of Medicine, Columbus, OH, USA.

2 Center for Perinatal Research, The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA.

出版信息

Reprod Sci. 2019 Feb 27:1933719119831772. doi: 10.1177/1933719119831772.

Abstract

AIMS

: To investigate if oral glucose tolerance test (OGTT) associates with changes in maternal symptoms (ie, flushing, sweating), blood nonenzymatic advanced glycation end products (AGE), acute-phase reactive inflammatory markers, and oxidative stress.

METHODS

: Prospective case-control study of patients screened for gestational diabetes mellitus (GDM). One hundred nonfasting, second-trimester consecutive pregnant women allocated to either 50 g OGTT or water. Five women who had a 3-hour fasting 100 g OGTT also enrolled. Maternal serum glucose, AGE, soluble receptor for AGE (sRAGE), interleukin (IL)-6, and C-reactive protein (CRP) were immunoassayed. Total radical-trapping antioxidant parameter (TRAP) estimated with antioxidant capacity-peroxyl assay. Data corrected for gestational age and maternal body mass index.

RESULTS

: During 50 g OGTT there was a decrease in systolic blood pressure not accompanied by the onset of adverse clinical symptoms. There was a decrease in serum glucose levels 1 hour after water ( P = .019) but not glucose ingestion. Serum CRP ( P = .001) but not IL-6 was increased. The AGE, sRAGE, and TRAP levels remained unchanged. Similar results were seen during 100 g OGTT, except serum glucose was significantly elevated after 1 hour.

CONCLUSION

: Results suggest screening tools for gestational diabetes are safe and clinically well tolerated during pregnancy. Clinical Trial Registration: ClinicalTrials.gov NCT03029546.

摘要

目的

研究口服葡萄糖耐量试验(OGTT)是否与母体症状(如脸红、出汗)、血液非酶促晚期糖基化终末产物(AGE)、急性期反应性炎症标志物及氧化应激的变化相关。

方法

对妊娠期糖尿病(GDM)筛查患者进行前瞻性病例对照研究。100名非空腹的孕中期连续孕妇被分配接受50g OGTT或饮水。5名进行3小时空腹100g OGTT的孕妇也被纳入。对母体血清葡萄糖、AGE、AGE可溶性受体(sRAGE)、白细胞介素(IL)-6和C反应蛋白(CRP)进行免疫测定。用抗氧化能力-过氧自由基测定法估算总自由基捕获抗氧化参数(TRAP)。数据根据孕周和母体体重指数进行校正。

结果

在50g OGTT期间,收缩压下降,且未伴随不良临床症状的出现。饮水后1小时血清葡萄糖水平下降(P = 0.019),但摄入葡萄糖后未下降。血清CRP升高(P = 0.001),但IL-6未升高。AGE、sRAGE和TRAP水平保持不变。在100g OGTT期间观察到类似结果,只是1小时后血清葡萄糖显著升高。

结论

结果表明,妊娠期糖尿病的筛查工具在孕期是安全的,且临床耐受性良好。临床试验注册:ClinicalTrials.gov NCT03029546。

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