Zheng Yang, Deng Hai-Yan, Qiao Zeng-Yong, Gong Fang-Xiao
Department of Critical Care Medicine, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, China.
Department of Cardiovascular Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital South Campus, Shanghai, China.
Gynecol Endocrinol. 2021 Nov;37(11):987-994. doi: 10.1080/09513590.2021.1967314. Epub 2021 Aug 19.
It is reported that elevated homocysteine (Hcy) level represents an independent risk factor for gestational diabetes mellitus (GDM). However, the relationship between Hcy level and GDM remains controversial. Our study aimed to systematically review available literature linking Hcy to GDM for a comprehensive understanding of the relationship between circulating Hcy level and GDM in humans.
PubMed, The Cochrane Library, and Web of Science were searched for studies published up to January 2021. Manual searches of references of the relevant studies were also conducted. Standard mean difference (SMD) with 95% confidence interval (95%CI) were calculated to evaluate the relationship between Hcy level and GDM using the Review Manager 5.3 and Stata 12.0.
Of 106 references reviewed, 12 studies with a total of 712 GDM patients contributed to the present meta-analysis. Hcy level was significantly elevated in women with GDM compared with those without GDM (SMD = 0.55; 95% CI: 0.25-0.85, = .0003). In the subgroup meta-analyses, this evidence was more consistent among women with Hcy sampling during the second trimester (SMD = 0.76, 95% CI: 0.34-1.18, = .0004) and with average age ≥30 years (SMD = 0.69, 95% CI: 0.25-1.12, = .002).
The evidence indicated that the level of circulating Hcy was significantly elevated among women with GDM compared with those with normal glucose tolerance, especially with mean age ≥30 years and in the second trimester.
据报道，同型半胱氨酸（Hcy）水平升高是妊娠期糖尿病（GDM）的一个独立危险因素。然而，Hcy水平与GDM之间的关系仍存在争议。我们的研究旨在系统回顾将Hcy与GDM联系起来的现有文献，以全面了解人体循环Hcy水平与GDM之间的关系。
检索了截至2021年1月发表在PubMed、Cochrane图书馆和科学网的研究。还对手动检索了相关研究的参考文献。使用Review Manager 5.3和Stata 12.0计算了95%置信区间（95%CI）的标准平均差（SMD），以评估Hcy水平与GDM之间的关系。
在审查的106篇参考文献中，有12项研究共712例GDM患者纳入了本荟萃分析。与无GDM的女性相比，GDM女性的Hcy水平显著升高（SMD = 0.55；95% CI：0.25 - 0.85，P = 0.0003）。在亚组荟萃分析中，这一证据在孕中期进行Hcy采样的女性（SMD = 0.76，95% CI：0.34 - 1.18，P = 0.0004）和平均年龄≥30岁的女性（SMD = 0.69，95% CI：0.25 - 1.12，P = 0.002）中更为一致。
证据表明，与糖耐量正常的女性相比，GDM女性的循环Hcy水平显著升高，尤其是平均年龄≥30岁且处于孕中期的女性。
