Pregnancy-induced diabetes

  • 文章类型: Journal Article
    妊娠期糖尿病(GDM)的遗传方面受多种因果遗传变异的影响,每个都有不同的效果大小。由于其在调节葡萄糖诱导的胰岛素分泌中的作用,KCNJ11基因作为GDM风险的潜在贡献者尤其值得注意。为了评估KCNJ11多态性与GDM之间的关联,我们进行了全面的荟萃分析,以回顾现有文献并定量评估相关性.
    在PubMed上进行了彻底的搜索,EMBASE,Scopus,和CNKI数据库,直到2023年12月25日,使用与妊娠糖尿病相关的精确术语和关键词,KCNJ11基因,和多态性。使用赔率比和95%置信区间来评估这些关系。采用综合Meta分析软件进行统计分析。并使用Cochrane偏倚风险评估工具确定偏倚存在。
    荟萃分析包括9项研究,其中3108例GDM病例和5374例对照rs5219多态性,3项研究涉及1209例GDM病例和1438例rs5210多态性对照。汇总的数据表明rs5219多态性与全球和各个种族之间的GDM之间存在值得注意的联系,特别是在高加索和亚洲人群中。然而,rs5210多态性与GDM之间未观察到实质性关联.
    汇总数据显示KCNJ11rs5219多态性与GDM易感性之间存在相关性,但rs5210多态性没有发现关联。未来的研究需要更大的样本量和更多样化的群体,以提高结果的普遍性。
    在线版本包含补充材料,可在10.1007/s40200-024-01428-0获得。
    UNASSIGNED: The genetic aspect of gestational diabetes mellitus (GDM) is influenced by multiple causal genetic variants, each with different effect sizes. The KCNJ11 gene is particularly noteworthy as a potential contributor to the risk of GDM due to its role in regulating glucose-induced insulin secretion. To evaluate the association between KCNJ11 polymorphisms and GDM, a comprehensive meta-analysis was conducted to review the existing literature and quantitatively assess the correlation.
    UNASSIGNED: A thorough search was performed on the PubMed, EMBASE, Scopus, and CNKI databases until December 25, 2023, using precise terms and keywords related to Gestational Diabetes, KCNJ11 gene, and polymorphism. Odds ratios and 95% confidence intervals were used to evaluate the relationships. The statistical analysis was conducted using Comprehensive Meta-Analysis software, and the Cochrane risk of bias assessment tool was used to determine bias presence.
    UNASSIGNED: The meta-analysis comprised 9 studies with 3108 GDM cases and 5374 controls for the rs5219 polymorphism, and 3 studies with 1209 GDM cases and 1438 controls for the rs5210 polymorphism. The pooled data indicated a noteworthy link between the rs5219 polymorphism and GDM globally and among various ethnic groups, notably in Caucasian and Asian populations. However, no substantial association was observed between the rs5210 polymorphism and GDM.
    UNASSIGNED: Pooled data showed a correlation between the KCNJ11 rs5219 polymorphism and GDM susceptibility, but no association was found for the rs5210 polymorphism. Future research with larger sample sizes and more diverse populations is needed to improve result generalizability.
    UNASSIGNED: The online version contains supplementary material available at 10.1007/s40200-024-01428-0.
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  • 文章类型: Journal Article
    肥胖和糖代谢失调是胎儿过度生长的危险因素,但是它们的综合作用并不经常在一项研究中进行检查。
    使用来自疾病控制和预防中心的妊娠风险评估监测系统7期(2012-2015年)的数据。使用Logistic回归分析孕妇孕前BMI与已存在的糖尿病/妊娠期糖尿病在分娩大胎龄婴儿或巨大儿婴儿的几率之间的关系。
    使用了128,199例单胎分娩的完整数据。随着肥胖程度的增加,胎龄较大的婴儿和巨大儿的比例增加(p<0.001),并且患有糖尿病的女性高于没有糖尿病的女性(p<0.001)。与正常体重女性的AOR相比,在病态肥胖妇女(BMI≥40)中分娩胎龄较大的婴儿和巨大儿的AOR分别为2.82(p<0.001)和2.67(p<0.001),分别。与非糖尿病女性的AOR相比,在既往有糖尿病的患者中,分娩大于胎龄婴儿的AOR为1.88(p<0.001),在妊娠糖尿病患者中为1.49(p<0.001).除了体重不足组,既往有糖尿病的女性分娩大胎龄婴儿的可能性几乎是BMI相似但没有糖尿病的女性的两倍.患有病态肥胖和妊娠期糖尿病的妇女的胎龄大婴儿和巨大儿婴儿的可能性是BMI正常的非糖尿病妇女的两倍。
    我们已经表明,当产妇肥胖和糖尿病时,特别是先前存在的糖尿病,一起发生,分娩大于胎龄和巨大儿的风险显著增加.我们的研究结果呼吁公共卫生关注,以解决产妇肥胖和糖尿病,以最大程度地减少胎儿生长不良。
    UNASSIGNED: Obesity and dysregulation in glucose metabolism are risk factors for excessive fetal growth, but their combined effects are not often examined in a single study.
    UNASSIGNED: Data from the Centers for Disease Control and Prevention\'s Pregnancy Risk Assessment Monitoring System Phase 7 (2012-2015) were used. Logistic regression was used to investigate the association between maternal prepregnancy BMI and pre-existing diabetes/gestational diabetes on the odds of delivering a large-for-gestational-age infant or an infant with macrosomia.
    UNASSIGNED: Complete data for 128,199 singleton births were used. The proportions of large-for-gestational-age infants and infants with macrosomia increased with the degree of obesity (p<0.001) and were higher in women with diabetes than in those without (p<0.001). Compared with the AOR among normal-weight women, the AOR of delivering large-for-gestational-age infants and infants with macrosomia among women with morbid obesity (BMI≥40) were 2.82 (p<0.001) and 2.67 (p<0.001), respectively. Compared with the AOR among nondiabetic women, the AOR of delivering a large-for-gestational-age infant was 1.88 (p<0.001) among those with pre-existing diabetes and 1.49 (p<0.001) among those with gestational diabetes. Except for the underweight group, women with pre-existing diabetes were nearly twice as likely to deliver a large-for-gestational-age infant as those with similar BMI without diabetes. Women with morbid obesity and gestational diabetes were twice as likely to have a large-for-gestational-age infant and an infant with macrosomia as nondiabetic women with normal BMI.
    UNASSIGNED: We have shown that when maternal obesity and diabetes, particularly pre-existing diabetes, occur together, the risk of delivering large-for-gestational-age and macrosomia increases significantly. Our findings call for public health attention to address maternal obesity and diabetes to minimize suboptimal fetal growth.
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  • 文章类型: Systematic Review
    未经证实:妊娠期糖尿病(GDM)是一种代谢紊乱,可能使孕妇易患2型糖尿病或导致后代严重不良结局。被认为与这种疾病背后的病理学有关的因素之一是微生物组。在这次系统审查中,我们全面回顾了有关GDM孕妇及其后代不同部位微生物群变化的文献.
    UNASSIGNED:在包括MEDLINE(PubMed)在内的主要数据库中进行了全面搜索,Scopus,和WebofSciences截至2021年8月。人口统计数据,方法论,根据GDM孕妇及其后代的微生物组类型,提取并分类微生物组改变。使用纽卡斯尔-渥太华量表(NOS)评估研究质量。
    未经评估:在检索到的49篇文章中,这些发现在α和β多样性的变化水平上是可变的,门的富集或耗尽,属,物种和OTU,在每个微生物组类型中。尽管结果之间存在一些不一致之处,在肠道中看到了明显的变化模式,口服,GDM和肠道女性的阴道微生物组,口服,和他们后代的胎盘微生物组。
    未经证实:尽管在GDM病例中观察到不同区域微生物组的改变,研究之间的不一致使我们无法识别独特的模式。然而,结果似乎很有希望,需要进一步的研究来克服与人口统计学和方法论相关的混杂因素。
    Gestational diabetes mellitus (GDM) is a metabolic disorder that might predispose pregnant women to develop type 2 Diabetes Mellitus or lead to severe adverse outcomes in their offspring. One of the factors that have been thought to be involved in the pathology behind this disorder is the microbiome. In this systematic review, we comprehensively review the documents regarding the microbiota alterations in different tracts of pregnant women with GDM and their offspring.
    A comprehensive search was conducted in major databases including MEDLINE (PubMed), Scopus, and Web of sciences up to August 2021. Data on the demographics, methodology, and microbiome alterations were extracted and classified according to the type of microbiome in pregnant women with GDM and their offspring. The quality of studies was assessed using the Newcastle-Ottawa Scale (NOS).
    In 49 articles which were retrieved, the findings were variable on the level of changes in alpha and beta diversity, enrichment or depletion in phyla, genera, species and OTUs, in each microbiome type. Although there were some inconsistencies among the results, a pattern of significant alterations was seen in the gut, oral, vaginal microbiome of women with GDM and gut, oral, and placental microbiome of their offspring.
    Even though the alteration of the microbiome of the different tracts was seen in the cases of GDM, the inconsistency among the studies prevents us from identifying unique pattern. However, the results seem promising and further studies that overcome the confounding factors related to the demographics and methodology are needed.
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  • 文章类型: Journal Article
    妊娠期糖尿病(GDM)通过饮食建议进行管理,但是关于依从性对健康的影响的证据有限。我们评估了GDM女性是否遵守新西兰卫生部的饮食建议与母婴健康有关。使用了313名GDM女性的数据。对食品相关建议的依从性从0分(不遵守)到10分(遵守所有建议),并在三元组中进行分析(高,中度,低依从性)。坚持拜访营养师和适当的体重增加被评估为是或否。卡方,方差分析,和比值比用于比较组。与低依从性相比,高饮食依从性与口服低血糖和胰岛素使用减少有关(OR=0.55,CI=0.30-1.00)。与未拜访营养师相比,拜访营养师与口服低血糖和胰岛素使用增加有关(OR=2.96,CI=1.12-7.80),胎龄较大的婴儿(OR=0.32,CI=0.14-0.73)和新生儿高胆红素血症(OR=0.27,CI=0.08-0.95)的几率降低.与推荐的体重增加相比,高于推荐的体重增加与口服低血糖和胰岛素使用增加相关(OR=2.51,CI=1.26-5.01),而低于推荐的体重增加与产后出血减少(OR=0.45,CI=0.23-0.91)和母乳喂养增加(OR=1.96,CI=1.04-3.70)相关.坚持GDM女性的饮食建议可能会改善健康结果。
    Gestational diabetes mellitus (GDM) is managed by dietary advice, but limited evidence exists about the impact of adherence on health. We assessed whether adherence to the New Zealand Ministry of Health dietary recommendations is associated with maternal and infant health in women with GDM. Data from 313 women with GDM were used. Adherence to food-related recommendations was scored from 0 (no adherence) to 10 (adhered to all recommendations) and analysed in tertile groups (high, moderate, low adherence). Adherence to visiting a dietitian and appropriate weight gain were assessed as yes or no. Chi-square, ANOVA, and odds ratios were used to compare groups. High dietary adherence compared to low adherence was associated with reduced oral hypoglycaemic and insulin use (OR = 0.55, CI = 0.30-1.00). Visiting a dietitian compared to not was associated with increased oral hypoglycaemic and insulin use (OR = 2.96, CI = 1.12-7.80), decreased odds of a large-for-gestational-age infant (OR = 0.32, CI = 0.14-0.73) and neonatal hyperbilirubinaemia (OR = 0.27, CI = 0.08-0.95). Greater than recommended compared with recommended weight gain was associated with increased oral hypoglycaemic and insulin use (OR = 2.51, CI = 1.26-5.01), while lower than recommended weight gain was associated with decreased postpartum haemorrhage (OR = 0.45, CI = 0.23-0.91) and increased breastfeeding (OR = 1.96, CI = 1.04-3.70). Adherence to dietary recommendations for women with GDM likely improves health outcomes.
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  • 文章类型: Journal Article
    BACKGROUND: Gestational diabetes mellitus (GDM) is associated with both maternal and offspring adverse effects. The World Health Organization (WHO) has recently adopted novel GDM criteria. The aim of this study was to evaluate the former WHO and a simplified version of the new International Association for Diabetes in Pregnancy Study Group (IADPSG) criteria as to prevalence of and risk factors for GDM in a Nordic Caucasian population.
    METHODS: A 75 g oral glucose tolerance test was performed in 687 women at 18-22 and 32-36 pregnancy weeks. GDM was defined according to the WHO criteria as fasting plasma glucose ≥ 7.0 mmol/L and/or 2-hour plasma glucose ≥ 7.8 mmol/L and by a simplified version of the IADPSG criteria as either fasting glucose ≥ 5.1 mmol/L and/or 2-h plasma glucose ≥ 8.5 mmol/L. One-hour glucose values were not available and were thus not included in the diagnosis of GDM by IADPSG. Prevalence of GDM during pregnancy and risk factors for GDM at 18-22 weeks were studied in retrospect according to each of the two criteria.
    RESULTS: The total prevalence of GDM during pregnancy was 6.1% (42/687) for the WHO criteria and 7.4% (51/687) for the simplified IADPSG criteria. High maternal age and short stature were independently associated with WHO GDM. Maternal age, fasting insulin and no regular exercise at 18-22 pregnancy weeks associated with simplified IADPSG GDM.
    CONCLUSIONS: Simplified IADPSG criteria moderately increase GDM prevalence compared with the WHO criteria. Risk factors for GDM differ with the diagnostic criteria used.
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