妊娠糖尿病(GDM)影响全球约14%的妊娠,并与母亲和孩子的短期和长期并发症有关。此外,GDM与慢性低度炎症有关,最近的研究表明病理生理学中潜在的免疫失调和调节性T细胞的差异。
■本系统综述和荟萃分析旨在确定GDM与外周血Tregs水平之间是否存在关联。
■文献检索在PubMed中进行,Embase,和奥维德在2022年2月7日至14日之间。纳入标准是以英语发表的任何原始研究,测量GDM女性与糖耐量孕妇的分化Tregs。在可比较的Treg标志物之间进行Meta分析。统计检验用于量化异质性:τ2、χ2和I2。使用改良版本的纽卡斯尔-渥太华量表评估研究质量。
■搜索产生了223个结果:8个研究纳入了综述,7个纳入了荟萃分析(GDM=228,对照=286)。对所有三个月的Treg分析显示,GDM女性的Treg数量显着降低(SMD,-0.76;95%CI,-1.37,-0.15;I2=90%)。这反映在特定Treg标志物的分析中(SMD-0.55;95%CI,-1.04,-0.07;I2=83%;妊娠晚期,五项研究)。在亚组内发现无显着差异(通过CD4+FoxP3+,CD4+CD127-,和CD4+CD127-FoxP3)。
■GDM与外周血中Treg数量减少有关。在怀孕早期,临床上有可能使用Treg水平作为GDM后续发展的预测工具.还存在通过增加Treg群体来预防GDM发展的潜在治疗干预。然而,Tregs介导GDM的确切机制尚不清楚.
■https://www.crd.约克。AC.英国/普劳里,标识符CRD42022309796。
Gestational diabetes (GDM) affects approximately 14% of pregnancies globally and is associated with short- and long-term complications for both the mother and child. In addition, GDM has been linked to chronic low-grade inflammation with recent research indicating a potential immune dysregulation in pathophysiology and a disparity in regulatory T cells.
This systematic
review and meta-analysis aimed to determine whether there is an association between GDM and the level of Tregs in the peripheral blood.
Literature searches were conducted in PubMed, Embase, and Ovid between the 7th and 14th of February 2022. The inclusion criteria were any original studies published in the English language, measuring differentiated Tregs in women with GDM compared with glucose-tolerant pregnant women. Meta-analysis was performed between comparable Treg markers. Statistical tests were used to quantify heterogeneity: τ 2, χ 2, and I 2. Study quality was assessed using a modified version of the Newcastle-Ottawa scale.
The search yielded 223 results: eight studies were included in the
review and seven in the meta-analysis (GDM = 228, control = 286). Analysis of Tregs across all trimesters showed significantly lower Treg numbers in women with GDM (SMD, -0.76; 95% CI, -1.37, -0.15; I 2 = 90%). This was reflected in the analysis by specific Treg markers (SMD -0.55; 95% CI, -1.04, -0.07; I 2 = 83%; third trimester, five studies). Non-significant differences were found within subgroups (differentiated by CD4+FoxP3+, CD4+CD127-, and CD4+CD127-FoxP3) of both analyses.
GDM is associated with lower Treg numbers in the peripheral maternal blood. In early pregnancy, there is clinical potential to use Treg levels as a predictive tool for the subsequent development of GDM. There is also a potential therapeutic intervention to prevent the development of GDM by increasing Treg populations. However, the precise mechanism by which Tregs mediate GDM remains unclear.
https://www.crd.york.ac.uk/prospero, identifier CRD42022309796.