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妊娠期糖尿病（GDM）中 1 型糖尿病自身抗体的检测：是否具有临床意义？

Testing for type 1 diabetes autoantibodies in gestational diabetes mellitus (GDM): is it clinically useful?

机构信息

Endocrinology and Diabetes, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.

Endocrinology, Department of Experimental Medicine, Sapienza University of Rome, Policlinico Umberto I, 00161, Rome, Italy.

出版信息

BMC Endocr Disord. 2019 May 3;19(1):44. doi: 10.1186/s12902-019-0373-4.

DOI:10.1186/s12902-019-0373-4
PMID:31053128
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6500053/
Abstract

Gestational Diabetes Mellitus (GDM) is the most common metabolic disorder in pregnancy, and it is associated with increased risk of morbidity in maternal-fetal outcomes. GDM is also associated with a higher risk to develop diabetes in the future. Diabetes-related autoantibodies (AABs) have been detected in a small percentage (usually less than 10%) of women with gestational diabetes. The prevalence in gestational diabetes of these autoimmune markers of type 1 diabetes (T1D) has been assessed in many studies, together with the risk of progression of AABs-positive GDM towards impaired glucose regulation (IFG or IGT) and overt diabetes after pregancy. The question whether it is necessary to test for T1D autoantibodies in all pregnancies with GDM is still debated. Here we examine the epidemiology of T1D autoantibodies in GDM, their clinical relevance in term of future risk of diabetes or impaired glucose regulation and in term of maternal-fetal outcomes, and discuss when it may be the most appropriate time to search for T1D autoantibodies in women with gestational diabetes.

摘要

妊娠期糖尿病（GDM）是妊娠期间最常见的代谢紊乱疾病，与母婴结局的发病率增加有关。GDM 也与未来发生糖尿病的风险增加有关。在一小部分（通常小于 10%）患有妊娠糖尿病的女性中已经检测到与糖尿病相关的自身抗体（AAB）。许多研究评估了这些 1 型糖尿病（T1D）的自身免疫标志物在妊娠糖尿病中的患病率，以及 AAB 阳性 GDM 向葡萄糖调节受损（IFG 或 IGT）和产后显性糖尿病进展的风险。是否有必要在所有患有 GDM 的妊娠中检测 T1D 自身抗体的问题仍存在争议。在这里，我们检查了 GDM 中 T1D 自身抗体的流行病学，以及它们在未来发生糖尿病或葡萄糖调节受损的风险以及母婴结局方面的临床意义，并讨论了在什么时候最适合在患有妊娠糖尿病的女性中寻找 T1D 自身抗体。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/acb5/6500053/82f7daa39e1b/12902_2019_373_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/acb5/6500053/82f7daa39e1b/12902_2019_373_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/acb5/6500053/82f7daa39e1b/12902_2019_373_Fig1_HTML.jpg

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