患有妊娠糖尿病并经血糖水平控制的女性表现出母体和胎儿血脂异常，这可能需要治疗。

Women with gestational diabetes mellitus, controlled for plasma glucose level, exhibit maternal and fetal dyslipidaemia that may warrant treatment.

机构信息

School of Medical, Indigenous and Health Science, University of Wollongong, Northfields Ave, Illawarra Health and Medical Research Institute, Molecular Horizons, Wollongong, NSW 2522, Australia.

Graduate School of Medicine, University of Wollongong, Northfields Ave, Illawarra Health and Medical Research Institute, Wollongong, NSW 2522, Australia.

出版信息

Diabetes Res Clin Pract. 2023 Oct;204:110929. doi: 10.1016/j.diabres.2023.110929. Epub 2023 Sep 30.

DOI:10.1016/j.diabres.2023.110929

PMID:37783345

Abstract

AIMS

To compare maternal and fetal cord plasma and lipoprotein triglyceride (TG) concentrations in women with Gestational Diabetes Mellitus (GDM), with hyperglycaemia and hypertriglyceridaemia, and healthy women.

METHODS

Fasted maternal blood at 28.6 ± 3.4 (T1) and 36.2 ± 1.0 (T2) [mean ± S.D] weeks of gestation, and cord blood were collected. Plasma lipoprotein fractions underwent compositional analysis.

RESULTS

Plasma glucose did not differ between GDM and healthy women. T1 maternal plasma TG (2.60 ± 0.89 mmol/l versus 1.71 ± 0.69 mmol/l) and plasma apolipoprotein B (1.30 ± 0.48 g/l versus 0.75 ± 0.40 g/l) were higher in GDM compared to healthy. Maternal plasma TG increased over gestation in both groups. T1 plasma VLDL total protein (38 ± 15 mg/dl versus 25 ± 11 mg/dl), total cholesterol (TC) (30 ± 14 mg/dl versus 16 ± 13 mg/dl) and phospholipid (PL) (43 ± 17 mg/dl versus 26 ± 16 mg/dl) were higher in GDM than healthy, and similarly for IDL, suggesting increased lipoprotein particle number. T1 VLDL-TG enrichment was higher in healthy and increased over gestation in GDM women but decreased in healthy. IDL-TG enrichment (TG/TC) increased over gestation in women with GDM and decreased in healthy. Cord blood VLDL, IDL and LDL from GDM had a two-fold higher TG enrichment than healthy pregnancy.

CONCLUSION

Increased maternal lipoprotein number, but not TG enrichment, in GDM mothers may explain TG enrichment of cord lipoproteins.

摘要

目的

比较患有妊娠期糖尿病（GDM）伴高血糖和高甘油三酯血症的孕妇与健康孕妇的母血和脐血血浆及脂蛋白甘油三酯（TG）浓度。

方法

在妊娠 28.6±3.4（T1）和 36.2±1.0（T2）周时采集空腹母血和脐血。对血浆脂蛋白进行组份分析。

结果

GDM 孕妇与健康孕妇的血糖水平无差异。与健康孕妇相比，T1 时 GDM 孕妇的母血甘油三酯（2.60±0.89mmol/l 比 1.71±0.69mmol/l）和载脂蛋白 B（1.30±0.48g/l 比 0.75±0.40g/l）更高。两组孕妇的母血 TG 均随妊娠进展而升高。T1 时 GDM 孕妇的 VLDL 总蛋白（38±15mg/dl 比 25±11mg/dl）、总胆固醇（TC）（30±14mg/dl 比 16±13mg/dl）和磷脂（PL）（43±17mg/dl 比 26±16mg/dl）水平均高于健康孕妇，IDL 也如此，提示脂蛋白颗粒数增加。T1 时 VLDL-TG 丰度在健康孕妇中较高，并随 GDM 孕妇的妊娠进展而增加，但在健康孕妇中则下降。GDM 孕妇的 IDL-TG 丰度（TG/TC）随妊娠进展而增加，而健康孕妇则下降。GDM 孕妇的脐血 VLDL、IDL 和 LDL 的 TG 丰度比健康妊娠时高两倍。