Reiher H, Fuhrmann K, Noack S, Woltanski K P, Jutzi E, Hahn von Dorsche H, Hahn H J
Central Institute for Diabetes, Gerhardt Katsch, Karlsburg, German Democratic Republic.
Diabetes Care. 1983 Sep-Oct;6(5):446-51. doi: 10.2337/diacare.6.5.446.
Fetal hyperinsulinemia is assumed to play a key role in the pathogenesis of diabetic fetopathy. To investigate the role of enhanced fetal B-cell mass as one cause of fetal hyperinsulinemia during diabetic pregnancy, we studied human fetal pancreatic slices from diabetic women (FDW) with poor metabolic control and nondiabetic women (FNDW) between 11 and 26 wk of pregnancy, morphometrically and by in vitro incubation experiments. Abortions had been performed due to different medical indications. We found a good correlation between the calculated B-cell mass and the gestational age in both FDW and FNDW, but the increase in FDW was much more pronounced. Such a correlation was also found in vitro regarding the insulin response to glucose and IBMX. The FDW had significantly higher values than FNDW of the same age range. In contrast to this, we found in two diabetic patients with tight metabolic control during the whole pregnancy results similar to those in FNDW. Therefore, we assume that it could be possible to prevent fetal hyperinsulinemia and perhaps even diabetic fetopathy in diabetic women by tight metabolic control during the whole pregnancy, but further investigations are necessary.
胎儿高胰岛素血症被认为在糖尿病胎儿病的发病机制中起关键作用。为了研究胎儿B细胞量增加作为糖尿病妊娠期间胎儿高胰岛素血症的一个原因所起的作用，我们对妊娠11至26周的代谢控制不良的糖尿病女性（FDW）和非糖尿病女性（FNDW）的人胎儿胰腺切片进行了形态学研究和体外培养实验。流产是由于不同的医学指征而进行的。我们发现FDW和FNDW中计算出的B细胞量与胎龄之间都有良好的相关性，但FDW中的增加更为明显。在体外，关于胰岛素对葡萄糖和异丁基甲基黄嘌呤（IBMX）的反应也发现了这种相关性。在相同年龄范围内，FDW的值显著高于FNDW。与此相反，我们发现两名在整个妊娠期间代谢控制良好的糖尿病患者的结果与FNDW相似。因此，我们认为通过在整个妊娠期间严格的代谢控制，有可能预防糖尿病女性的胎儿高胰岛素血症，甚至可能预防糖尿病胎儿病，但还需要进一步的研究。
