Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy.
Department of Medicine and Aging, School of Medicine and Health Sciences, 'G. d'Annunzio' University of Chieti-Pescara, Chieti, Italy.
Front Endocrinol (Lausanne). 2021 May 24;12:612829. doi: 10.3389/fendo.2021.612829. eCollection 2021.
Gestational diabetes mellitus (GDM) is associated with a high risk of developing type 2 diabetes (T2DM) and cardiovascular disease (CVD). Identifying among GDM women those who are at high risk may help prevent T2DM and, possibly CVD. Several studies have shown that in women with GDM, hyperglycemia at 1 h during an oral glucose tolerance test (OGTT) (1-h PG) is not only associated with an increase in adverse maternal and perinatal outcomes but is also an independent predictor of T2DM. Interestingly, also in pregnant women who did not meet the criteria for a GDM diagnosis, 1-h PG was an independent predictor of postpartum impaired insulin sensitivity and beta-cell dysfunction. Moreover, maternal 1- and 2-h PG levels have been found to be independently associated with insulin resistance and impaired insulin secretion also during childhood. There is evidence that hyperglycemia at 1h PG during pregnancy may identify women at high risk of future CVD, due to its association with an unfavorable CV risk profile, inflammation, arterial stiffness and endothelial dysfunction. Overall, hyperglycemia at 1h during an OGTT in pregnancy may be a valuable prediction tool for identifying women at a high risk of future T2DM, who may then benefit from therapeutic strategies aimed at preventing cardiovascular outcomes.
妊娠期糖尿病（GDM）与发生 2 型糖尿病（T2DM）和心血管疾病（CVD）的风险增加有关。在 GDM 女性中识别出那些处于高风险的人群可能有助于预防 T2DM ，甚至可能预防 CVD 。多项研究表明，在患有 GDM 的女性中，口服葡萄糖耐量试验（OGTT）期间 1 小时的高血糖（1hPG）不仅与不良的母婴和围产期结局增加有关，而且是 T2DM 的独立预测因素。有趣的是，即使在不符合 GDM 诊断标准的孕妇中，1hPG 也是产后胰岛素敏感性受损和β细胞功能障碍的独立预测因素。此外，还发现母亲的 1 小时和 2 小时 PG 水平与胰岛素抵抗和胰岛素分泌受损也有关，即使在儿童时期也是如此。有证据表明，怀孕期间 1hPG 的高血糖可能会识别出未来 CVD 风险较高的女性，因为它与不良的心血管风险特征、炎症、动脉僵硬和内皮功能障碍有关。总的来说，怀孕期间 OGTT 中的 1hPG 升高可能是识别未来发生 T2DM 风险较高的女性的一个有价值的预测工具，这些女性可能会受益于旨在预防心血管结局的治疗策略。
