Jovanovic-Peterson L, Peterson C M
Sansum Medical Research Foundation, Santa Barbara, California 93105, USA.
J Am Coll Nutr. 1996 Feb;15(1):14-20. doi: 10.1080/07315724.1996.10718560.
There is an increased requirement for nutrients in normal pregnancy, not only due to increased demand, but also increased loss. There is also an increased insulin-resistant state during pregnancy mediated by the placental anti-insulin hormones estrogen, progesterone, human somatomammotropin; the pituitary hormone prolactin; and the adrenal hormone, cortisol. If the maternal pancreas cannot increase production of insulin of sustain normoglycemia despite these anti-insulin hormones, gestational diabetes occurs. Gestational diabetes is associated with excessive nutrient losses due to glycosuria. Specific nutrient deficiencies of chromium, magnesium, potassium and pyridoxine may potentiate the tendency towards hyperglycemia in gestational diabetic women because each of these four deficiencies causes impairment of pancreatic insulin production. This review describes the pathophysiology of the hyperglycemia and the nutrient loss in gestational diabetes and further postulates the mechanism whereby vitamin/mineral supplementation may be useful to prevent or ameliorate pregnancy-related glucose intolerance.
正常孕期对营养素的需求增加，这不仅是由于需求增加，还因为流失增加。孕期还会出现胰岛素抵抗状态增强，这是由胎盘抗胰岛素激素雌激素、孕激素、人胎盘生乳素；垂体激素催乳素；以及肾上腺激素皮质醇介导的。如果尽管存在这些抗胰岛素激素，母体胰腺仍无法增加胰岛素分泌以维持正常血糖水平，就会发生妊娠期糖尿病。妊娠期糖尿病与因糖尿导致的营养素过度流失有关。铬、镁、钾和维生素B6的特定营养素缺乏可能会增强妊娠期糖尿病女性的高血糖倾向，因为这四种缺乏症中的每一种都会导致胰腺胰岛素分泌受损。本综述描述了妊娠期糖尿病中高血糖和营养素流失的病理生理学，并进一步推测了维生素/矿物质补充剂可能有助于预防或改善妊娠相关糖耐量异常的机制。
