Department of Basic Medical Science, College of Applied Medical Science, King Khalid University, Abha, Saudi Arabia.
Department of Infection Prevention and Control, The Specialist Hospital, Abha, Saudi Arabia.
Sci Rep. 2024 Mar 14;14(1):6182. doi: 10.1038/s41598-024-56790-z.
Gestational diabetes mellitus (GDM) is a known risk factor for gestational hypertension which further progress toward conditions like proteinuria, dyslipidemia, thrombocytopenia, pulmonary edema leading to Preeclampsia (PE). Pregnancy can be a challenging time for many women, especially those diagnosed with GDM and PE. Thus, the current prospective study investigates the association of OGTT glucose levels with systolic and diastolic blood pressure and lipid profile parameters in pregnant women diagnosed with GDM and PE. A total of 140 pregnant women were stratified into GDM (n = 50), PE (n = 40) and controls (n = 50). Two hour 75 g oral glucose tolerance test (OGTT) was performed for screening GDM. Biochemical parameters analysis of OGTT, total cholesterol (TC), triglyceride (Tg), high density lipoprotein-cholesterol (HDL-C), low density lipoprotein-cholesterol (LDL-C), urinary albumin and creatinine were tested to find urinary albumin creatinine ratio (uACR). Statistical analysis was performed using ANOVA followed by post hoc test and regression analysis. Among the studied groups, GDM and PE groups showed no significant difference in age and increased BMI. Increased 2 h OGTT & TC in GDM group; elevated uACR, systolic/diastolic blood pressure, Tg, HDL-C, LDL-C in PE group was observed and differ significantly (p < 0.0001) with other groups. A significant positive effect of 2 h OGTT was observed on blood pressure (R: GDM = 0.85, PE = 0.71) and lipid profile determinants (R: GDM = 0.85, PE = 0.33) at p < 0.0001. The current study concludes that glucose intolerance during the later weeks of pregnancy is associated with gestational hypertension and hyperlipidemia as a risk factor for PE. Further research is needed for a detailed assessment of maternal glucose metabolism at various pregnancy stages, including the use of more sensitive markers such as C-peptide and their relation to pregnancy-related hypertensive disorders.
妊娠期糖尿病（GDM）是妊娠期高血压的已知危险因素，进一步发展可导致蛋白尿、血脂异常、血小板减少症、肺水肿，从而导致子痫前期（PE）。对于许多女性来说，怀孕可能是一个具有挑战性的时期，尤其是那些被诊断患有 GDM 和 PE 的女性。因此，目前的前瞻性研究调查了在患有 GDM 和 PE 的孕妇中，口服葡萄糖耐量试验（OGTT）血糖水平与收缩压和舒张压以及血脂谱参数之间的关联。总共将 140 名孕妇分为 GDM（n=50）、PE（n=40）和对照组（n=50）。对所有孕妇进行 2 小时 75g 口服葡萄糖耐量试验（OGTT）筛查 GDM。检测 OGTT 的生化参数分析、总胆固醇（TC）、甘油三酯（Tg）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、尿白蛋白和肌酐以找到尿白蛋白肌酐比（uACR）。采用方差分析（ANOVA），然后进行事后检验和回归分析进行统计分析。在所研究的组中，GDM 和 PE 组在年龄和 BMI 增加方面没有显著差异。GDM 组 2 小时 OGTT 和 TC 增加；PE 组的 uACR、收缩压/舒张压、Tg、HDL-C、LDL-C 升高，且与其他组有显著差异（p<0.0001）。2 小时 OGTT 对血压（R：GDM=0.85，PE=0.71）和血脂谱决定因素（R：GDM=0.85，PE=0.33）有显著的正影响，p<0.0001。本研究得出结论，妊娠晚期的葡萄糖不耐受与妊娠期高血压和高脂血症有关，是 PE 的危险因素。需要进一步研究，以详细评估孕妇在不同妊娠阶段的葡萄糖代谢，包括使用更敏感的标志物，如 C 肽，及其与妊娠相关的高血压疾病的关系。
