Krystynik Ondrej, Karasek David, Kahle Michal, Kubickova Veronika, Macakova Dominika, Cibickova Lubica, Mraz Milos, Haluzik Martin
Third Department of Internal Medicine - Nephrology, Rheumatology and Endocrinology, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University, I. P. Pavlova 6, 77900, Olomouc, Czech Republic.
Department of Data Science, Institute for Clinical and Experimental Medicine, Vídeňská 1958,140 21, Prague, Czech Republic.
Diabetol Metab Syndr. 2023 Jan 30;15(1):12. doi: 10.1186/s13098-023-00981-7.
Glucagon-like peptide 1 (GLP-1) and glucose-dependent insulinotropic peptide (GIP) may be involved in pathogenesis of gestational diabetes mellitus (GDM). The aim was to compare GLP-1 and GIP production in fasting state and during 3 h mixed meal tolerance test (MMTT) measured by mean area under the curve (AUC) between pregnant women with normal and impaired fasting glucose in an early phase of pregnancy, and healthy non-pregnant controls.
This study was undertaken as a case-control study. Repeated measurement of fasting plasma glucose ≥ 5.1 mmol/L and < 7.0 mmol/L during the first trimester of pregnancy and exclusion of overt diabetes according to IADSPG criteria was used to find women with impaired fasting glucose (n = 22). Age-matched controls consisted of healthy pregnant (n = 25) and non-pregnant (n = 24) women. In addition to incretins, anthropometric parameters and markers of insulin resistance and beta-cell function were assessed. Variables were summarized as median (interquartile range).
Fasting GLP-1 and GIP concentration or their AUC during MMTT did not significantly differ between pregnant women with impaired fasting plasma glucose [GLP-1 19.0 (53.1) and GIP 302 (100) pg/mL/min] and healthy pregnant women [GLP-1 16.7 (22.3) and GIP 297 (142) pg/mL/min] or non-pregnant controls [GLP-1 16.8 (9.8) and for GIP 313 (98) pg/mL/min]. Although women with impaired fasting glucose were more obese and showed decreased beta-cell function, there were not significant correlations between incretin production and parameters of insulin secretion, insulin resistance, or obesity.
Women with impaired fasting plasma glucose did not show altered incretin production in the first trimester of pregnancy. In contrast to type 2 diabetes, impaired incretin secretion does not seem to play a major role in the early development of GDM.
胰高血糖素样肽1（GLP-1）和葡萄糖依赖性促胰岛素多肽（GIP）可能参与妊娠期糖尿病（GDM）的发病机制。目的是比较妊娠早期空腹血糖正常和空腹血糖受损的孕妇与健康非妊娠对照组在空腹状态和3小时混合餐耐量试验（MMTT）期间通过曲线下平均面积（AUC）测量的GLP-1和GIP的分泌情况。
本研究为病例对照研究。在妊娠早期重复测量空腹血糖≥5.1 mmol/L且<7.0 mmol/L，并根据国际糖尿病与妊娠研究组（IADSPG）标准排除显性糖尿病，以找出空腹血糖受损的女性（n = 22）。年龄匹配的对照组包括健康孕妇（n = 25）和非孕妇（n = 24）。除了肠促胰岛素外，还评估了人体测量参数以及胰岛素抵抗和β细胞功能的标志物。变量总结为中位数（四分位间距）。
空腹血糖受损的孕妇[GLP-1 19.0（53.1）和GIP 302（100）pg/mL/min]与健康孕妇[GLP-1 16.7（22.3）和GIP 297（142）pg/mL/min]或非妊娠对照组[GLP-1 16.8（9.8）和GIP 313（98）pg/mL/min]之间，空腹GLP-1和GIP浓度或其在MMTT期间的AUC无显著差异。尽管空腹血糖受损的女性更肥胖且β细胞功能降低，但肠促胰岛素分泌与胰岛素分泌、胰岛素抵抗或肥胖参数之间无显著相关性。
空腹血糖受损的女性在妊娠早期并未表现出肠促胰岛素分泌改变。与2型糖尿病不同，肠促胰岛素分泌受损似乎在GDM的早期发展中不起主要作用。
