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2型糖尿病和妊娠期糖尿病孕妇脐带血中的抗苗勒管激素、性类固醇与代谢谱。

Anti-Müllerian hormone, sex steroids, and metabolic profile in cord blood of pregnancies with type 2 diabetes and gestational diabetes.

作者信息

Villarroel Claudio, López Patricia, Henriquez Soledad, Kohen Paulina, Codner Ethel

机构信息

Institute for Maternal and Child Research (IDIMI), School of Medicine, University of Chile, Santiago, Chile.

Hospital Clínico San Borja Arriarán, Servicio de Salud Centro, Ministerio de Salud, Santiago, Chile.

出版信息

Front Endocrinol (Lausanne). 2025 Jul 28;16:1589541. doi: 10.3389/fendo.2025.1589541. eCollection 2025.

Abstract

CONTEXT

The prevalence of type 2 diabetes (T2D) and gestational diabetes (GD)among women of reproductive age has increased in recent decades, making it the most common pregnancy complication. Many studies have examined pregnancy complications in women with diabetes; however, the impact of diabetes on the intrauterine environment, specifically ovarian markers and metabolic profiles in very preterm infants at birth, has not been studied. This study aimed to investigate AMH, sex steroid levels, and the metabolic profile in venous cord blood (VCB) in gestations affected by type 2 diabetes (T2D) and gestational diabetes (GD).

MATERIAL AND METHODS

Hormonal profile was evaluated in VCB of pregnancies with T2D (n=24), GD (n=26), and pregnancies without diabetes (C, n=25). Only pregnancies carrying a female offspring were included. AMH, sex steroids, and metabolic function biomarkers, including glucose, insulin, IGF-1, and adiponectin (APN) were measured. Clinical and anthropometric data were assessed in the mothers and offspring.

RESULTS

AMH VCB levels were significantly higher in T2D than in GD and C pregnancies (P<0.01 and P<0.005, respectively). Dehydroepiandrosterone sulfate (DHEAS) and sex hormone-binding globulin (SHBG) VCB levels were lower in T2D pregnancies than in GD and C (P < 0.01, P < 0.0001, respectively). APN levels were lower in T2D pregnancies than in C (P < 0.05). Additionally, higher insulin and IGF-1 VCB levels and HOMA-IR index were observed in T2D than in C and GD (P < 0.001, P<0.05, and P<0.05, respectively). No significant correlations were observed between maternal and AMH, insulin, IGF-1, and androgen VCB levels.

DISCUSSION

T2D disrupts the intrauterine environment, leading to increased insulin, IGF-1, HOMA-IR, and AMH concentrations and decreased adiponectin levels in VCB. These findings describe the impact that maternal T2D may have on the health and development of their offspring.

摘要

背景

近几十年来,育龄女性中2型糖尿病(T2D)和妊娠期糖尿病(GD)的患病率有所上升,使其成为最常见的妊娠并发症。许多研究已经调查了糖尿病女性的妊娠并发症;然而,糖尿病对子宫内环境的影响,特别是对极早产儿出生时卵巢标志物和代谢谱的影响,尚未得到研究。本研究旨在调查2型糖尿病(T2D)和妊娠期糖尿病(GD)影响的妊娠中静脉脐血(VCB)中的抗苗勒管激素(AMH)、性激素水平和代谢谱。

材料与方法

对患有T2D(n = 24)、GD(n = 26)和无糖尿病妊娠(C组,n = 25)的VCB中的激素谱进行评估。仅纳入怀有女性后代的妊娠。测量了AMH、性激素和代谢功能生物标志物,包括葡萄糖、胰岛素、胰岛素样生长因子-1(IGF-1)和脂联素(APN)。对母亲和后代的临床和人体测量数据进行了评估。

结果

T2D妊娠的VCB中AMH水平显著高于GD和C组妊娠(分别为P < 0.01和P < 0.005)。T2D妊娠的硫酸脱氢表雄酮(DHEAS)和性激素结合球蛋白(SHBG)的VCB水平低于GD和C组(分别为P < 0.01,P < 0.0001)。T2D妊娠的APN水平低于C组(P < 0.05)。此外,T2D妊娠的胰岛素和IGF-1的VCB水平以及胰岛素抵抗指数(HOMA-IR)高于C组和GD组(分别为P < 0.001,P < 0.05和P < 0.05)。母亲与AMH、胰岛素、IGF-1和雄激素的VCB水平之间未观察到显著相关性。

讨论

T2D会破坏子宫内环境,导致VCB中胰岛素、IGF-1、HOMA-IR和AMH浓度升高,脂联素水平降低。这些发现描述了母亲T2D可能对其后代健康和发育产生的影响。

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