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急性葡萄糖负荷、炎症、氧化应激、非酶糖基化和妊娠期糖尿病筛查。

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

机构信息

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

High Risk Pregnancy Center, 2011 Pinto Lane, #200, Las Vegas, NV, 89106, USA.

出版信息

Reprod Sci. 2020 Aug;27(8):1587-1594. doi: 10.1007/s43032-020-00188-5.

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 capacityperoxyl 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(如潮红、出汗)、血液非酶性晚期糖基化终产物(AGE)、急性期反应性炎症标志物和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 名非禁食、妊娠中期连续的孕妇被分配到 50g OGTT 或水组。还招募了 5 名进行 3 小时禁食 100g OGTT 的女性。免疫测定母体血清葡萄糖、AGE、可溶性 AGE 受体(sRAGE)、白细胞介素(IL)-6 和 C 反应蛋白(CRP)。用抗氧化能力过氧自由基测定法估计总自由基捕获抗氧化参数(TRAP)。数据根据胎龄和母体体重指数进行校正。

结果

在 50g OGTT 期间,收缩压下降,但没有出现不良临床症状。喝水后 1 小时血清葡萄糖水平下降(P =.019),但葡萄糖摄入后没有下降。血清 CRP(P =.001)而不是 IL-6 增加。AGE、sRAGE 和 TRAP 水平保持不变。在 100g OGTT 期间也出现了类似的结果,除了 1 小时后血清葡萄糖明显升高。

结论

结果表明,妊娠期糖尿病的筛查工具在怀孕期间是安全的,且临床耐受性良好。

临床试验注册

ClinicalTrials.gov NCT03029546。

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