Hantrakun Panisa, Sekararithi Rattanaporn, Jaiwongkam Thidarat, Kumfu Sirinart, Chai-Adisaksopha Chatree, Chattipakorn Nipon, Tongsong Theera, Jatavan Phudit
Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Cardiac Electrophysiology Research and Training Center (CERT), Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Endocr Connect. 2022 Apr 29;11(4):e220110. doi: 10.1530/EC-22-0110.
To evaluate the effect of metformin in improving platelet dysfunction in women with gestational diabetes mellitus (GDM).
A randomized controlled trial was conducted on pregnant women diagnosed with GDM. Singleton low-risk pregnancies meeting the inclusion criteria were randomly allocated at 27-31 weeks to receive metformin and placebo through the rest of pregnancy. Thirty-seven and 39 cases were recruited into the metformin group and the placebo group, respectively. MPVs, P-selectin, and 8-isoprostane levels were determined at the time of allocation and 6 weeks after treatment. Obstetric and neonatal outcomes were also assessed.
Most baseline characteristics of the two groups were comparable. The levels of P-selectin after 6 weeks of treatment were significantly higher in the metformin group (68.9 ± 14.4 vs 60.6 ± 11.3; P-value = 0.006), indicating more platelet activation. All of the obstetric and neonatal outcomes were comparable except that birth weight was significantly lower in the metformin group (3018 ± 364 g vs 3204 ± 393 g; P-value = 0.037).
Metformin, in addition to diet and lifestyle modifications, does not improve or worsen oxidative stress and platelet dysfunction in women with GDM. Nevertheless, metformin significantly reduces fetal weight in women with GDM, theoretically preventing macrosomia.
评估二甲双胍对改善妊娠期糖尿病（GDM）女性血小板功能障碍的作用。
对诊断为GDM的孕妇进行了一项随机对照试验。符合纳入标准的单胎低风险妊娠孕妇在孕27 - 31周时被随机分配，在孕期剩余时间接受二甲双胍和安慰剂治疗。二甲双胍组和安慰剂组分别招募了37例和39例患者。在分配时和治疗6周后测定MPV、P-选择素和8-异前列腺素水平。还评估了产科和新生儿结局。
两组的大多数基线特征具有可比性。二甲双胍组治疗6周后的P-选择素水平显著更高（68.9±14.4对60.6±11.3；P值=0.006），表明血小板活化程度更高。除二甲双胍组出生体重显著更低外（3018±364克对3204±393克；P值=0.037），所有产科和新生儿结局均具有可比性。
除饮食和生活方式改变外，二甲双胍对改善或加重GDM女性的氧化应激和血小板功能障碍无作用。然而，二甲双胍可显著降低GDM女性的胎儿体重，理论上可预防巨大儿。
