Bogdanet Delia, Reddin Catriona, Murphy Dearbhla, Doheny Helen C, Halperin Jose A, Dunne Fidelma, O'Shea Paula M
College of Medicine Nursing and Health Sciences, National University of Ireland Galway, H91TK33 Galway, Ireland.
Centre for Diabetes Endocrinology and Metabolism, Galway University Hospital, Newcastle Road, H91YR71 Galway, Ireland.
J Clin Med. 2021 Apr 6;10(7):1533. doi: 10.3390/jcm10071533.
Gestational diabetes (GDM), defined as hyperglycemia with onset or initial recognition during pregnancy, has a rising prevalence paralleling the rise in type 2 diabetes (T2DM) and obesity. GDM is associated with short-term and long-term consequences for both mother and child. Therefore, it is crucial we efficiently identify all cases and initiate early treatment, reducing fetal exposure to hyperglycemia and reducing GDM-related adverse pregnancy outcomes. For this reason, GDM screening is recommended as part of routine pregnancy care. The current screening method, the oral glucose tolerance test (OGTT), is a lengthy, cumbersome and inconvenient test with poor reproducibility. Newer biomarkers that do not necessitate a fasting sample are needed for the prompt diagnosis of GDM. The aim of this scoping review is to highlight and describe emerging protein biomarkers that fulfill these requirements for the diagnosis of GDM. This scoping review was conducted according to preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines for scoping reviews using Cochrane Central Register of Controlled Trials (CENTRAL), the Cumulative Index to Nursing & Allied Health Literature (CINAHL), PubMed, Embase and Web of Science with a double screening and extraction process. The search included all articles published in the literature to July 2020. Of the 3519 original database citations identified, 385 were eligible for full-text review. Of these, 332 (86.2%) were included in the scoping review providing a total of 589 biomarkers studied in relation to GDM diagnosis. Given the high number of biomarkers identified, three post hoc criteria were introduced to reduce the items set for discussion: we chose only protein biomarkers with at least five citations in the articles identified by our search and published in the years 2017-2020. When applied, these criteria identified a total of 15 biomarkers, which went forward for review and discussion. This review details protein biomarkers that have been studied to find a suitable test for GDM diagnosis with the potential to replace the OGTT used in current GDM screening protocols. Ongoing research efforts will continue to identify more accurate and practical biomarkers to take GDM screening and diagnosis into the 21st century.
妊娠期糖尿病（GDM）被定义为在孕期出现或首次被识别出的高血糖症，其患病率随着2型糖尿病（T2DM）和肥胖症患病率的上升而上升。GDM对母亲和孩子都有短期和长期影响。因此，有效识别所有病例并尽早开始治疗，减少胎儿暴露于高血糖环境并降低与GDM相关的不良妊娠结局至关重要。出于这个原因，建议将GDM筛查作为常规孕期保健的一部分。目前的筛查方法，即口服葡萄糖耐量试验（OGTT），是一项耗时、繁琐且不便的检查，重复性差。快速诊断GDM需要无需空腹样本的新型生物标志物。本范围综述的目的是突出并描述符合这些GDM诊断要求的新兴蛋白质生物标志物。 本范围综述是根据系统评价和Meta分析的首选报告项目（PRISMA）指南进行的范围综述，使用Cochrane对照试验中心注册库（CENTRAL）、护理及相关健康文献累积索引（CINAHL）、PubMed、Embase和科学网进行双筛选和提取过程。检索包括截至2020年7月发表在文献中的所有文章。 在识别出的3519条原始数据库引用中，385条符合全文审查的条件。其中，332条（86.2%）被纳入范围综述，共研究了589种与GDM诊断相关的生物标志物。鉴于识别出的生物标志物数量众多，引入了三个事后标准以减少讨论项目：我们仅选择在我们检索到的、2017 - 2020年发表的文章中至少被引用五次的蛋白质生物标志物。应用这些标准后，共识别出15种生物标志物，这些生物标志物进入审查和讨论阶段。 本综述详细介绍了为找到适合GDM诊断的检测方法而研究的蛋白质生物标志物，这些生物标志物有可能取代当前GDM筛查方案中使用的OGTT。正在进行的研究工作将继续识别更准确实用的生物标志物，将GDM筛查和诊断带入21世纪。
