Neurophysiology Unit, Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand.
Center of Excellence in Cardiac Electrophysiology, Chiang Mai University, Chiang Mai, 50200, Thailand.
Eur J Nutr. 2021 Aug;60(5):2343-2360. doi: 10.1007/s00394-021-02483-6. Epub 2021 Jan 29.
Gestational diabetes mellitus (GDM) is a condition that seriously threatens mother and child health. The incidence of GDM has increased worldwide in the past decades. In addition, the complications of GDM such as type 2 diabetes (T2DM) and neonatal malformations could negatively affect the living quality of mothers and their children.
It has been widely known that the imbalance of gut microbiota or called 'gut dysbiosis' plays a key role in the development of insulin resistance and chronic low-grade inflammation in T2DM patients. However, the impacts of gut microbiota on GDM remain controversial. Here, we aim to comprehensively review the alterations of gut microbiota in GDM mothers and their offspring.
The alterations of Firmicutes/Bacteroidetes (F/B) ratio, short-chain fatty acid (SCFA)-producing bacteria, bacteria with probiotics properties and gram-negative lipopolysaccharide (LPS)-producing bacteria play a vital role in the development of GDM. The beneficial roles of gut microbiota modification (probiotics, synbiotics and lifestyle modification) as a treatment of GDM were found in some, but not all studies.
In the near future, gut microbiota modification may be considered as one of the standard treatments for GDM. Moreover, further studies regarding the specific gut microbiota that are associated with the early development of GDM are required. This may contribute to the novel diagnostic markers for early stages of GDM.
妊娠糖尿病（GDM）是一种严重威胁母婴健康的疾病。在过去几十年中，全球范围内 GDM 的发病率有所增加。此外，GDM 的并发症，如 2 型糖尿病（T2DM）和新生儿畸形，可能会对母亲及其子女的生活质量产生负面影响。
众所周知，肠道微生物群失衡或称为“肠道菌群失调”在 T2DM 患者胰岛素抵抗和慢性低度炎症的发展中起着关键作用。然而，肠道微生物群对 GDM 的影响仍存在争议。在这里，我们旨在全面综述 GDM 母亲及其后代肠道微生物群的变化。
厚壁菌门/拟杆菌门（F/B）比值、短链脂肪酸（SCFA）产生菌、具有益生菌特性的细菌和革兰氏阴性脂多糖（LPS）产生菌的变化在 GDM 的发展中起着重要作用。一些但不是所有研究都发现了肠道微生物群修饰（益生菌、合生菌和生活方式改变）作为 GDM 治疗方法的有益作用。
在不久的将来，肠道微生物群修饰可能被认为是 GDM 的标准治疗方法之一。此外，还需要进一步研究与 GDM 早期发展相关的特定肠道微生物群。这可能有助于为 GDM 的早期阶段提供新的诊断标志物。
