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妊娠期糖尿病与子代糖耐量异常及超重的长期风险:一项叙述性综述

Gestational Diabetes Mellitus and the Long-Term Risk for Glucose Intolerance and Overweight in the Offspring: A Narrative Review.

作者信息

Nijs Hannah, Benhalima Katrien

机构信息

Medical school, University Hospital Gasthuisberg, KU Leuven, Herestraat 49, 3000 Leuven, Belgium.

Department of Endocrinology, University Hospital Gasthuisberg, KU Leuven, Herestraat 49, 3000 Leuven, Belgium.

出版信息

J Clin Med. 2020 Feb 22;9(2):599. doi: 10.3390/jcm9020599.

Abstract

Gestational diabetes mellitus (GDM) is a common condition with increasing prevalence worldwide. GDM is associated with an increased risk for maternal and neonatal complications. In this review we provide an overview of the most recent evidence on the long-term metabolic risk associated with GDM in the offspring. We conducted an extensive literature search on PubMed and Embase between February 2019 and December 2019. We performed a narrative review including 20 cohort studies, one cross-sectional study, and two randomized controlled trials. Our review shows that the prevalence of overweight/obesity and glucose intolerance is higher in children exposed to GDM compared to unexposed children. Maternal overweight is an important confounding factor, but recent studies show that in general the association remains significant after correction for maternal overweight. There is limited evidence suggesting that the association between GDM and adverse metabolic profile in the offspring becomes more significant with increasing offspring age and is also more pronounced in female offspring than in male offspring. More research is needed to evaluate whether treatment of GDM can prevent the long-term metabolic complications in the offspring.

摘要

妊娠期糖尿病(GDM)是一种常见病症,在全球范围内的患病率呈上升趋势。GDM与孕产妇和新生儿并发症风险增加相关。在本综述中,我们概述了有关后代中与GDM相关的长期代谢风险的最新证据。我们于2019年2月至2019年12月期间在PubMed和Embase上进行了广泛的文献检索。我们进行了一项叙述性综述,纳入了20项队列研究、1项横断面研究和2项随机对照试验。我们的综述表明,与未暴露于GDM的儿童相比,暴露于GDM的儿童超重/肥胖和葡萄糖不耐受的患病率更高。孕产妇超重是一个重要的混杂因素,但最近的研究表明,一般而言,在校正孕产妇超重后,这种关联仍然显著。有有限的证据表明,GDM与后代不良代谢状况之间的关联随着后代年龄的增加而变得更加显著,并且在雌性后代中比在雄性后代中更明显。需要更多的研究来评估GDM的治疗是否可以预防后代的长期代谢并发症。

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