Anwaier Apizi, Li Jian, Liu Wei, Dong Liangjie, Ding Yunfei, Yu Zhaoxia
Department of Critical Care Medicine, The First affiliated Hospital of Xinjiang Medical University, Urumqi, China.
Biomol Biomed. 2025 Apr 26;25(6):1245-1258. doi: 10.17305/bb.2025.11909.
Maternal diabetes during pregnancy, including gestational diabetes mellitus (GDM) and pregestational diabetes mellitus (PDM), has been linked to alterations in fetal development. This meta-analysis aimed to investigate the impact of maternal diabetes on fetal epicardial fat thickness (fEFT), measured via ultrasound-a potential marker of cardiometabolic risk. A systematic search of PubMed, Embase, and Web of Science was conducted to identify observational studies assessing fEFT in pregnant women with and without diabetes. A random-effects model was used to calculate the mean difference (MD) in fEFT between groups. Heterogeneity was evaluated using the I² statistic, and sensitivity, subgroup, and meta-regression analyses were performed to explore sources of variability. Data from 10 studies, comprising 12 datasets and 1303 participants, were pooled. Women with diabetes during pregnancy had significantly higher fEFT compared to those without diabetes (MD: 0.37 mm, 95% confidence interval [CI]: 0.26 to 0.49, P < 0.001), with moderate heterogeneity (I² = 69%). Sensitivity analyses, conducted by excluding one dataset at a time, confirmed the robustness of the findings (all P values < 0.05). Meta-regression revealed a positive correlation between gestational age (GA) at fEFT measurement and fEFT differences (coefficient = 0.040, P = 0.005), accounting for 83.2% of the heterogeneity. Subgroup analyses demonstrated consistent results across study designs, maternal diabetes types, and demographic factors but highlighted greater fEFT differences in studies where GA at fEFT measurement was >26 weeks. In conclusion, maternal diabetes during pregnancy is associated with increased fEFT, particularly in later gestation.
孕期母体糖尿病，包括妊娠期糖尿病（GDM）和孕前糖尿病（PDM），与胎儿发育改变有关。本荟萃分析旨在研究母体糖尿病对通过超声测量的胎儿心包脂肪厚度（fEFT）的影响，fEFT是心血管代谢风险的一个潜在标志物。我们对PubMed、Embase和Web of Science进行了系统检索，以识别评估有糖尿病和无糖尿病孕妇fEFT的观察性研究。采用随机效应模型计算两组之间fEFT的平均差异（MD）。使用I²统计量评估异质性，并进行敏感性、亚组和Meta回归分析以探索变异来源。汇总了来自10项研究的数据，包括12个数据集和1303名参与者。孕期患有糖尿病的女性与未患糖尿病的女性相比，fEFT显著更高（MD：0.37mm，95%置信区间[CI]：0.26至0.49，P<0.001），异质性为中度（I²=69%）。通过一次排除一个数据集进行的敏感性分析证实了研究结果的稳健性（所有P值<0.05）。Meta回归显示，测量fEFT时的孕周（GA）与fEFT差异之间呈正相关（系数=0.040，P=0.005），占异质性的83.2%。亚组分析表明，在不同研究设计、母体糖尿病类型和人口统计学因素中结果一致，但突出显示在测量fEFT时GA>26周的研究中fEFT差异更大。总之，孕期母体糖尿病与fEFT增加有关，尤其是在妊娠后期。
