Gerede Angeliki, Oikonomou Efthymios, Potiris Anastasios, Chatzakis Christos, Drakakis Peter, Domali Ekaterini, Nikolettos Nikolaos, Stavros Sofoklis
Unit of Maternal-Fetal-Medicine, Department of Obstetrics and Gynecology, Medical School, Democritus University of Thrake, GR-68100 Alexandroupolis, Greece.
Third Department of Obstetrics and Gynecology, Medical School, National and Kapodistrian University of Athens, GR-11527 Athens, Greece.
Int J Mol Sci. 2025 Aug 25;26(17):8234. doi: 10.3390/ijms26178234.
Gestational diabetes mellitus (GDM) is a frequently encountered medical complication during pregnancy that is increasing at a rapid pace globally, posing significant public health concerns. Similarly, there is a rising trend in the number of women who have utilized assisted reproductive technology (ART). Numerous studies have been carried out to investigate the relationship between GDM and ART. This comprehensive systematic review seeks to identify potential biomarkers for the early diagnosis of GDM in pregnancies conceived through ART. We conducted a PubMed search covering the past five years to identify studies that explore biomarkers associated with the development of GDM in pregnancies conceived through ART. The outcome measures included human chorionic gonadotropin (HCG), the body mass index (BMI), the Follicle Stimulating Hormone to Luteinizing Hormone (FSH/LH) ratio, increased hemoglobin A1c levels, fasting insulin concentrations, homeostatic model assessment of insulin resistance (HOMA-IR), triglyceride levels, total cholesterol levels, low-density lipoprotein cholesterol concentrations, low-density lipoprotein/high-density lipoprotein (LDL/HDL), total cholesterol to high-density lipoprotein (TC/HDL), the estradiol/follicle ratio, soluble fms-like tyrosine kinase-1 (sFlt-1), Placental Growth Factor (PLGF), endometrial thickness, and psychological stress. Seventeen studies were included. The identification and development of serum or ultrasound biomarkers for the early detection of GDM in pregnancies conceived through ART pose considerable challenges. These challenges arise from the multifactorial nature of GDM, the methodological variations in ART, and the limited availability of relevant studies. The most promising biomarker identified was the estradiol/follicle ratio. Women with a higher estradiol/follicle ratio exhibited significantly lower rates of GDM. There is a pressing necessity for biomarkers to enable the early detection of GDM in pregnancies conceived through ART. E2 levels, β-hCG, and the E2/F ratio, along with the TC/HDL and LDL/HDL ratios, show potential as reliable biomarkers for identifying GDM.
妊娠期糖尿病（GDM）是孕期常见的医学并发症，在全球范围内正迅速增加，引发了重大的公共卫生问题。同样，使用辅助生殖技术（ART）的女性数量也呈上升趋势。已经开展了大量研究来调查GDM与ART之间的关系。这项全面的系统综述旨在确定通过ART受孕的妊娠中GDM早期诊断的潜在生物标志物。我们在PubMed上进行了一项涵盖过去五年的搜索，以识别探索与通过ART受孕的妊娠中GDM发生相关生物标志物的研究。结局指标包括人绒毛膜促性腺激素（HCG）、体重指数（BMI）、促卵泡生成素与促黄体生成素（FSH/LH）比值、糖化血红蛋白A1c水平升高、空腹胰岛素浓度、胰岛素抵抗稳态模型评估（HOMA-IR）、甘油三酯水平、总胆固醇水平、低密度脂蛋白胆固醇浓度、低密度脂蛋白/高密度脂蛋白（LDL/HDL）、总胆固醇与高密度脂蛋白（TC/HDL）、雌二醇/卵泡比值、可溶性fms样酪氨酸激酶-1（sFlt-1）、胎盘生长因子（PLGF）、子宫内膜厚度和心理压力。纳入了17项研究。识别和开发用于早期检测通过ART受孕的妊娠中GDM的血清或超声生物标志物面临相当大的挑战。这些挑战源于GDM的多因素性质、ART的方法学差异以及相关研究的有限可用性。确定的最有前景的生物标志物是雌二醇/卵泡比值。雌二醇/卵泡比值较高的女性患GDM的比率显著较低。迫切需要能够在通过ART受孕的妊娠中早期检测GDM的生物标志物。E2水平、β-HCG以及E2/F比值，连同TC/HDL和LDL/HDL比值，显示出作为识别GDM的可靠生物标志物的潜力。
