Department of Obstetrics and Gynecology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea.
Department of Obstetrics and Gynecology, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Sci Rep. 2021 Sep 21;11(1):18695. doi: 10.1038/s41598-021-98180-9.
Multiple pregnancies are prone to gestational diabetes mellitus (GDM). This study investigated the association between pregravid liver enzyme levels and the development of GDM in a twin pregnancy. Women who had the National Health Screening Examination and delivered their twin babies within one year were enrolled. Pregravid liver enzyme levels were divided into high and low level. Risks for developing GDM by high levels of liver enzymes were analyzed, in subgroups by pregravid obesity or metabolic syndrome. Among the 4348 twin pregnancies, 369 women (8.5%) developed GDM not requiring insulin treatment (GDM - IT), and 119 women (2.7%) developed GDM requiring insulin treatment(GDM + IT). High levels of pregravid GGT and ALT were related to risks of GDM + IT not only in women with obesity or metabolic syndrome (odds ratio[OR] 6.348, 95% confidence interval [CI] 2.579-15.624 and OR 6.879, 95% CI 2.232-21.204, respectively), but also in women without obesity (OR 3.05, 95% CI 1.565-5.946) or without metabolic syndrome (OR 3.338, 95% CI 1.86-5.992), compared to in women with low levels of those. However, there were no significant associations in the pregravid ALT and GGT levels and risks for development of GDM - IT, unrelated to pregravid obesity or metabolic syndrome. Therefore, this study suggests that women with high levels of pregravid GGT and ALT need to recognize their increased risk of GDM + IT, regardless of pregravid obesity or MetS, when they get pregnant twin.
多胎妊娠易患妊娠期糖尿病（GDM）。本研究旨在探讨双胎妊娠孕妇孕前肝酶水平与 GDM 发病的关系。纳入在一年内接受国家健康检查并分娩双胞胎的孕妇。将孕前肝酶水平分为高水平和低水平。分析高水平肝酶与妊娠前肥胖或代谢综合征亚组 GDM 发病风险的关系。在 4348 例双胎妊娠中，369 例（8.5%）孕妇发生无需胰岛素治疗的 GDM（GDM-IT），119 例（2.7%）孕妇发生需要胰岛素治疗的 GDM（GDM+IT）。孕前高水平 GGT 和 ALT 与肥胖或代谢综合征（OR 6.348，95%CI 2.579-15.624 和 OR 6.879，95%CI 2.232-21.204）或无肥胖（OR 3.05，95%CI 1.565-5.946）或无代谢综合征（OR 3.338，95%CI 1.86-5.992）的 GDM+IT 发病风险相关，但与孕前低水平的 GGT 和 ALT 与 GDM-IT 发病风险无关。因此，本研究提示孕前 GGT 和 ALT 水平升高的孕妇无论孕前是否肥胖或患有代谢综合征，在双胎妊娠时均应认识到发生 GDM+IT 的风险增加。
