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[妊娠期肝内胆汁淤积症与妊娠期糖尿病之间的关联]

[Association between intrahepatic cholestasis of pregnancy and gestational diabetes mellitus].

作者信息

Ozsvári-Vidákovich Magdolna, Somogyi Anikó, Rosta Klára

机构信息

1 Dél-budai Centrumkórház - Szent Imre Egyetemi Oktatókórház, Szülészeti és Nőgyógyászati Osztály Budapest Magyarország.

2 Semmelweis Egyetem, Általános Orvostudományi Kar, Belgyógyászati és Hematológiai Klinika Budapest Magyarország.

出版信息

Orv Hetil. 2023 May 28;164(21):831-835. doi: 10.1556/650.2023.32778.

Abstract

Gestational diabetes mellitus is one of the most prevalent prenatal illnesses (ranging from 5% to 18%), while intrahepatic cholestasis of pregnancy takes the first place among liver diseases during pregnancy (ranging from 0.2% to 27%). In our summary, we examined the relationship between the two gestation-related medical conditions and their combined presence affects on the outcome of pregnancy. Based on research available, it can be stated that intrahepatic cholestasis of pregnancy may be a predisposing factor to late-onset gestational diabetes mellitus. This connection stems from the modulating role of serum bile acids, as due to the regulation of farnesoid X receptor and Takeda G protein-coupled receptor 5 the bile acids affect glucose and lipid homeostasis. Common fetal complications of gestational diabetes and intrahepatic cholestasis of pregnancy are stillbirth, acute respiratory distress syndrome and preterm delivery. Gestational diabetes mellitus may be more common in patients with intrahepatic cholestasis of pregnancy, and the co-occurrence of the two diseases can increase the risk of fetal and maternal complications, therefore special attention must be paid to the prevention and treatment of these by the prenatal caregiver. Orv Hetil. 2023; 164(21): 831-835.

摘要

妊娠期糖尿病是最常见的产前疾病之一(发病率在5%至18%之间),而妊娠肝内胆汁淤积症在孕期肝脏疾病中位居首位(发病率在0.2%至27%之间)。在我们的综述中,我们研究了这两种与妊娠相关的疾病之间的关系以及它们共同存在对妊娠结局的影响。根据现有研究,可以说妊娠肝内胆汁淤积症可能是晚发型妊娠期糖尿病的一个诱发因素。这种联系源于血清胆汁酸的调节作用,因为通过法尼醇X受体和武田G蛋白偶联受体5的调节,胆汁酸会影响葡萄糖和脂质稳态。妊娠期糖尿病和妊娠肝内胆汁淤积症常见的胎儿并发症有死产、急性呼吸窘迫综合征和早产。妊娠期糖尿病在妊娠肝内胆汁淤积症患者中可能更常见,两种疾病同时发生会增加胎儿和母亲并发症的风险,因此产前护理人员必须特别关注对这些疾病的预防和治疗。《匈牙利医学周报》。2023年;164(21): 831 - 835。

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