Al-Ofi Ebtisam Aziz
Department of Physiology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
SAGE Open Med Case Rep. 2019 Apr 22;7:2050313X19843737. doi: 10.1177/2050313X19843737. eCollection 2019.
Obesity is one of the leading pregnancy risks for both the mother and the neonate. The prevalence of gestational diabetes mellitus has been increasing, especially with the increase in obesity in reproductive-aged women. A high body mass index, a sedentary lifestyle, a previous macrosomic infant, polycystic ovary syndrome and hypothyroidism are the main risk factors for gestational diabetes mellitus. Early gestational diabetes mellitus detection in high-risk individuals is a useful method for preventing further complications and/or preventing this disease by improving the patient's lifestyle.
A morbidly obese woman with a high body mass index (>36) at 24 weeks gestational age presented with several gestational diabetes mellitus risk factors. Her glucose tolerance test verified gestational diabetes mellitus, and, incidentally, her C-reactive protein level was elevated without obvious reason. Her plasma levels of inflammatory cytokines had also been assessed and were exaggerated. After lifestyle intervention, including weight management, the patient's inflammatory mediators, including her C-reactive protein level, dropped. Therefore, this study aimed to identify the relationship between the patient's inflammation and obesity.
Antenatal C-reactive protein screening could be used throughout pregnancy to predict inflammation from high-risk pregnant women. This case scenario describes the interrelationships between inflammation, insulin resistance and adipokines, as well as the contributions of hypothyroidism and polycystic ovary syndrome. Further research should emphasise the relationships between inflammation and obesity in pregnancy.
肥胖是母亲和新生儿面临的主要妊娠风险之一。妊娠期糖尿病的患病率一直在上升,尤其是随着育龄妇女肥胖率的增加。高体重指数、久坐不动的生活方式、既往有巨大儿、多囊卵巢综合征和甲状腺功能减退是妊娠期糖尿病的主要危险因素。对高危个体进行早期妊娠期糖尿病检测是预防进一步并发症和/或通过改善患者生活方式预防该疾病的有效方法。
一名孕24周时体重指数极高(>36)的病态肥胖女性,存在多种妊娠期糖尿病危险因素。她的葡萄糖耐量试验证实患有妊娠期糖尿病,偶然发现她的C反应蛋白水平无故升高。还评估了她的血浆炎症细胞因子水平,结果显示升高。经过包括体重管理在内的生活方式干预后,患者的炎症介质,包括C反应蛋白水平下降。因此,本研究旨在确定患者炎症与肥胖之间的关系。
产前C反应蛋白筛查可在整个孕期用于预测高危孕妇的炎症情况。本病例描述了炎症、胰岛素抵抗和脂肪因子之间的相互关系,以及甲状腺功能减退和多囊卵巢综合征的影响。进一步的研究应着重于妊娠期炎症与肥胖之间的关系。