妊娠期糖尿病早期预测的研究进展

Research Progress in Early Prediction of Gestational Diabetes Mellitus

妊娠期糖尿病（gestational diabetes mellitus,GDM）作为2型糖尿病（T2DM）的前期,其发病中心环节是胰岛素抵抗（insulin resistance,IR）。目前的GDM筛查时机为妊娠24~28周,已至孕中晚期,且试验费时、费力并增加潜在GDM孕妇糖负荷,因此如何寻找GDM孕早期预测指标,提高GDM的筛查效率,预防和降低GDM发生显得尤为重要。目前国内外已开展了早期筛查GDM的相关研究,热点集中在炎症因子、脂肪因子和肝酶代谢等方面。越来越多的研究支持T2DM是慢性炎症反应状态的假说,众多的临床研究显示T2DM常有多种炎症因子浓度的升高。肝脏与脂肪组织作为IR的主要场所之一,参与糖代谢,是体内维持血糖稳态的重要器官。近年有研究显示肝脏代谢水平和脂肪因子与GDM发病间存在相关性。综述近年来对于GDM早期预测的研究进展。

Gestational diabetes mellitus（GDM） as the prophase of type 2 diabetes（T2DM） and the onset of the key points is insulin resistance（IR）. Current of GDM screening time is during 24-28 weeks of pregnancy. However, this time has been the middle and late pregnancy, before delivery to the GDM intervention time is short and the test is time-consuming, laborious and increase the potential of pregnant women with GDM glucose load, therefore, looking for early prediction of GDM factors, not only to improve the efficiency of GDM screening, but also to prevent and reduce the occurrence of GDM play an important role. There have been a large number of early screening GDM related research in the world, which focus on inflammatory factors,adipocytokines, liver enzymes and other aspects of metabolism. More and more research support of T2 DM is in the status of chronic inflammation hypothesis, there is a higher inflammatory factor concentration increased. Liver and adipoes tissue as the main places of IR, involved in carbohydrate metabolism and maintain glucose homeostasis. In recent years, a study shows that there is a correlation between the liver metabolism, adipocytokines and the pathogenesis of GDM. In this paper, the research progress of the early prediction of GDM in recent years is reviewed.