妊娠期糖尿病早期预测标记物研究进展

Research Progress in First-trimester Biomarker for Prediction of Gestational Diabetes Mellitus

妊娠期糖尿病（GDM）是妊娠期重要的并发症之一。GDM对孕产妇及围生儿均有较大危害：孕妇易并发妊娠期高血压疾病、胎膜早破、产后出血等,孕妇产后发生2型糖尿病的概率增加,胎儿巨大儿的发生率和畸形率高,新生儿窒息和低血糖发生率高,新生儿成年后罹患代谢性疾病及肥胖的概率增高。目前临床上GDM筛查是在孕24～28周通过糖耐量实验进行的。但对于孕早期患GDM的孕妇目前尚无很好的技术进行检测。随着GDM患者的不断增多,早期筛查越来越引起重视。目前已开展了关于GDM早期预测标记物的研究,这些预测标记物主要包括超敏C反应蛋白、性激素结合球蛋白、可溶性肾素/肾素原受体、糖基化纤连蛋白和甘丙肽等,对这些标记物的基本性质及其在预测GDM时的效果等方面的研究进展进行综述。

Gestational diabetes mellitus（GDM） is one of the most important complications emerging at pregnancy. Women diagnosed with GDM is characterized by increased risk of various fetal and maternal complications which include gestational hypertension disease, premature rupture of membranes, postpartum hemorrhage and developing type Ⅱ diabetes mellitus after childbirth. At the same time, the babies are at higher risk of fetal macrosomia and deformity, neonatal asphyxia and neonatal hypoglycemia, and suffering from metabolic diseases and obesity after reaching adulthood. The routine screening for GDM begins at 24-28 weeks with a glucose challenge test. But a test method for GDM detection at the first-trimester is still lacking. With the increasing of GDM patients, early screening is getting more and more attention. Over the years, several scientists reported their new findings on early predictors of GDM. The new predictors include high-sensitivity C-reactive protein, sex hormone binding globulin, soluble pro-renin receptor, glycosylated fibronectin and galanin. This review is focused on summarizing the recent advances of these five potential predictors.