BACKGROUND Food insecurity(FI)during pregnancy negatively impacts maternal health and raises the risk of gestational diabetes mellitus(GDM)and pregnancy-induced hypertension(PIH),resulting in adverse outcomes for both...BACKGROUND Food insecurity(FI)during pregnancy negatively impacts maternal health and raises the risk of gestational diabetes mellitus(GDM)and pregnancy-induced hypertension(PIH),resulting in adverse outcomes for both mother and baby.AIM To investigate the relationships between FI and pregnancy outcomes,particularly GDM and PIH,while also examining the mediating role of the dietary diversity score(DDS).METHODS A cross-sectional study was undertaken to examine this relationship,involving 600 pregnant women.Participants were women aged 18 years or older who provided complete data on FI and pregnancy outcomes.The FI was measured via the Household Food Security Survey Module,with GDM defined as fasting plasma glucose levels of≥5.1 mmol/L or a 2-hour oral glucose tolerance test value of≥8.5 mmol/L.The DDS is determined by evaluating one's food consumption based on nine distinct food groups.A logistic regression model was used to explore the relationship between FI and PIH,and GDM.RESULTS Seventeen percent of participants reported experiencing FI during pregnancy.The study found a significant association between FI and an elevated risk of GDM[odds ratio(OR)=3.32,95%CI:1.2-5.4].Once more,food-insecure pregnant women had higher rates of PIH(OR=0.10,95%CI:0.02-0.45)and they also faced a higher likelihood of neonatal complications,such as neonatal intensive care unit’s admissions and the birth of infants with extremely low birth weight.The FI wasfurther linked to metabolic disruptions,such as elevated fasting blood sugar(FBS),low-density lipoprotein cholesterol,and triglyceride levels.Our results indicate that the DDS acts as a significant mediator in the relationship between FI and the incidence of GDM.In particular,the mediation analysis showed that approximately 65%of the effect was mediated through DDS(P=0.002).CONCLUSION These findings underscore the serious challenges that FI presents during pregnancy and its effects on maternal and infant health.Additionally,the study explored how DDS mediates the relationship between FI and the incidence of GDM.展开更多
BACKGROUND The primary complication associated with gestational diabetes mellitus(GDM)is delivery of an infant that is large for gestational age(LGA).Epidemiological findings have demonstrated that irregular lipid met...BACKGROUND The primary complication associated with gestational diabetes mellitus(GDM)is delivery of an infant that is large for gestational age(LGA).Epidemiological findings have demonstrated that irregular lipid metabolism significantly con-tributes to insulin resistance,a key pathophysiological mechanism in GDM.However,the correlation between various lipid indices and the probability of delivering LGA infants remains inconsistent.AIM To explore the relationships between lipid indices and the possibility of having LGA infants among GDM-affected pregnant females.METHODS Binary logistic regression methods were employed to evaluate the odds ratios and corresponding 95%confidence intervals for LGA according to five lipid indices.Restricted cubic spline models were applied to investigate dose-response relationships.The association between lipid indices and the risk of delivering LGA infants was further investigated among different subgroups.Receiver operating characteristic curves were utilized to assess the diagnostic performance of lipid indices.RESULTS Across crude and adjusted models,females with lipid indices in the upper two tertiles presented a markedly elevated risk of delivering LGA infants compared with the lowest tertile category.Conversely,high-density lipoprotein cholesterol levels demonstrated the contrary trend.Restricted cubic spline analyses revealed linear associations between the five lipid indices,except triglyceride levels,and the prevalence of LGA.The subgroup analysis highlighted that the correlation between lipid indices and the probability of LGA was inconsistent.The five lipid indices presented significant diagnostic efficacy,as indicated by receiver operating characteristic curve areas.CONCLUSION Our research demonstrated that lipid indices were effective predictors of the incidence of LGA infants in GDM-affected pregnancies irrespective of potential confounding factors.展开更多
Gestational diabetes mellitus(GDM)is defined as any degree of hyperglycaemia that is recognized for the first time during pregnancy.This definition includes cases of undiagnosed type 2 diabetes mellitus(T2 DM)identifi...Gestational diabetes mellitus(GDM)is defined as any degree of hyperglycaemia that is recognized for the first time during pregnancy.This definition includes cases of undiagnosed type 2 diabetes mellitus(T2 DM)identified early in pregnancy and true GDM which develops later.GDM constitutes a greater impact on diabetes epidemic as it carries a major risk of developing T2 DM to the mother and foetus later in life.In addition,GDM has also been linked with cardiometabolic risk factors such as lipid abnormalities,hypertensive disorders and hyperinsulinemia.These might result in later development of cardiovascular disease and metabolic syndrome.The understanding of the different risk factors,the pathophysiological mechanisms and the genetic factors of GDM,will help us to identify the women at risk,to develop effective preventive measures and to provide adequate management of the disease.Clinical trials have shown that T2 DM can be prevented in women with prior GDM,by intensive lifestyle modification and by using pioglitazone and metformin.However,a matter of controversy surrounding both screening and management of GDM continues to emerge,despite several recent welldesigned clinical trials tackling these issues.The aim of this manuscript is to critically review GDM in a detailed and comprehensive manner,in order to provide a scientific analysis and updated write-up of different related aspects.展开更多
In this editorial,we comment on an article by Wang et al.Recent literature shows an increase in research on pelvic organ prolapse(POP).Although the true incidence of POP remains uncertain,its impact on quality of life...In this editorial,we comment on an article by Wang et al.Recent literature shows an increase in research on pelvic organ prolapse(POP).Although the true incidence of POP remains uncertain,its impact on quality of life is substantial.Anatomical studies report high incidence rates,surpassing those observed in symptom-based surveys.Weakness of the endopelvic fascia is a primary anatomical risk factor for POP.Additionally,gestational diabetes mellitus(GDM)has emerged as a growing concern,as poor glycemic control increases complications for both mother and fetus.GDM and POP are interconnected,with factors like maternal obesity,macrosomia,and hormonal changes exacerbating pelvic floor dysfunction.Modifiable risk factors,such as obesity and chronic hyperglycemia,along with multiparity,instrumental deliveries,and obstetric trauma,further increase susceptibility.For patients with GDM,gynecological exams,Pelvic Organ Prolapse Quantification staging,and pelvic floor ultrasonography are valuable diagnostics,with proctological exams and magnetic resonance defecography aiding in multi-compartment prolapse diagnoses.Imaging,though uncomfortable during pregnancy,is safe in the early postpartum period.This editorial emphasizes the need for further research on the pathophysiology of GDM-related POP and offers recommendations for improving diagnosis and clinical management of patients with GDM.展开更多
BACKGROUND Gestational diabetes mellitus(GDM)is a growing public health concern,particularly in regions with diverse ethnic populations.Understanding the incidence and risk factors of GDM is crucial for early preventi...BACKGROUND Gestational diabetes mellitus(GDM)is a growing public health concern,particularly in regions with diverse ethnic populations.Understanding the incidence and risk factors of GDM is crucial for early prevention and management,especially in underrepresented areas like Guizhou Province,China,where geographic and ethnic diversity may influence the disease’s prevalence and risk profiles.AIM To investigate the incidence of GDM and identify its associated risk and protective factors among different ethnic groups in Guizhou Province,providing essential data for early prevention strategies.METHODS A multi-center retrospective study was conducted,dividing participants into GDM and non-GDM groups according to standardized diagnostic criteria.Data were collected from 103629 deliveries across 40 hospitals in Guizhou.Various demographic,clinical,and laboratory parameters were analyzed using logistic regression to identify risk and protective factors for GDM.RESULTS Among the 103629 deliveries,18957 cases of GDM were identified,with an incidence of approximately 18.3%.The risk of GDM was higher in the Han ethnic group compared to minority ethnic groups.The Dong ethnic group had the lowest incidence among the minorities.Key risk factors identified included older age(especially>35 years),higher pre-pregnancy body mass index(BMI),light physical activity,gravidity,family history of diabetes,hemoglobin,aspartate aminotransferase,alanine aminotransferase,and direct bilirubin.Protective factors included higher education level,total protein,and albumin.There were also differences based on blood type,with type A associated with higher risk.CONCLUSION The incidence rate in Guizhou is 18.3%.Older age(especially>35 years),Han ethnicity,lower education level,higher pre-pregnancy BMI,light physical activity,and higher gravidity are the main risk factors for GDM.Laboratory findings indicate that higher hemoglobin,higher liver function parameters(alanine aminotransferase,aspartate aminotransferase,and direct bilirubin),and lower total protein and albumin are associated with a higher risk of GDM.Blood type A has a higher risk of GDM compared to blood types AB and O.展开更多
Objective To investigate the association between ABO blood types and gestational diabetes mellitus(GDM)risk.Methods A prospective birth cohort study was conducted.ABO blood types were determined using the slide method...Objective To investigate the association between ABO blood types and gestational diabetes mellitus(GDM)risk.Methods A prospective birth cohort study was conducted.ABO blood types were determined using the slide method.GDM diagnosis was based on a 75-g,2-h oral glucose tolerance test(OGTT)according to the criteria of the International Association of Diabetes and Pregnancy Study Groups.Logistic regression was applied to calculate the odds ratios(ORs)and 95%confidence intervals(CIs)between ABO blood types and GDM risk.Results A total of 30,740 pregnant women with a mean age of 31.81 years were enrolled in this study.The ABO blood types distribution was:type O(30.99%),type A(26.58%),type B(32.20%),and type AB(10.23%).GDM was identified in 14.44%of participants.Using blood type O as a reference,GDM risk was not significantly higher for types A(OR=1.05)or B(OR=1.04).However,women with type AB had a 19%increased risk of GDM(OR=1.19,95%CI=1.05–1.34;P<0.05),even after adjusting for various factors.This increased risk for type AB was consistent across subgroup and sensitivity analyses.Conclusion The ABO blood types may influence GDM risk,with type AB associated with a higher risk.Incorporating it—either as a single risk factor or in combination with other known factors—could help identify individuals at risk for GDM before or during early pregnancy.展开更多
Gestational diabetes mellitus(GDM)refers to varying degrees of abnormal glucose metabolism that occur during pregnancy and excludes patients pre-viously diagnosed with diabetes.GDM is a unique among the four subtypes ...Gestational diabetes mellitus(GDM)refers to varying degrees of abnormal glucose metabolism that occur during pregnancy and excludes patients pre-viously diagnosed with diabetes.GDM is a unique among the four subtypes of diabetes classified by the international World Health Organization standards.Although GDM patients constitute a small proportion of the total number of diabetes cases,the incidence of GDM has risen significantly over the past decade,posing substantial risk to pregnant women and infants.Therefore,it warrants considerable attention.The pathogenesis of GDM is generally considered to resemble that of type II diabetes,though it may have distinct characteristics.Analyzing blood biochemical proteins in the context of GDM can help elucidate its pathogenesis,thereby facilitating more effective prevention and management strategies.This article reviews this critical clinical issue to enhance the medical community's sufficient understanding of GDM.展开更多
The study by Cao et al aimed to identify early second-trimester biomarkers that could predict gestational diabetes mellitus(GDM)development using advanced proteomic techniques,such as Isobaric tags for relative and ab...The study by Cao et al aimed to identify early second-trimester biomarkers that could predict gestational diabetes mellitus(GDM)development using advanced proteomic techniques,such as Isobaric tags for relative and absolute quantitation isobaric tags for relative and absolute quantitation and liquid chromatography-mass spectrometry liquid chromatography-mass spectrometry.Their analysis revealed 47 differentially expressed proteins in the GDM group,with retinol-binding protein 4 and angiopoietin-like 8 showing significantly elevated serum levels compared to controls.Although these findings are promising,the study is limited by its small sample size(n=4 per group)and lacks essential details on the reproducibility and reliability of the protein quantification methods used.Furthermore,the absence of experimental validation weakens the interpretation of the protein-protein interaction network identified through bioinformatics analysis.The study's focus on second-trimester biomarkers raises concerns about whether this is a sufficiently early period to implement preventive interventions for GDM.Predicting GDM risk during the first trimester or pre-conceptional period may offer more clinical relevance.Despite its limitations,the study presents valuable insights into potential GDM biomarkers,but larger,well-validated studies are needed to establish their predictive utility and generalizability.展开更多
Gestational diabetes mellitus(GDM)is a metabolic disorder,recognised during 24-28 weeks of pregnancy.GDM is linked with adverse newborn outcomes such as macrosomia,premature delivery,metabolic disorder,cardiovascular,...Gestational diabetes mellitus(GDM)is a metabolic disorder,recognised during 24-28 weeks of pregnancy.GDM is linked with adverse newborn outcomes such as macrosomia,premature delivery,metabolic disorder,cardiovascular,and neurological disorders.Recent investigations have focused on the correlation of genetic factors such asβ-cell function and insulin secretary genes(transcription factor 7 like 2,potassium voltage-gated channel subfamily q member 1,adipo-nectin etc.)on maternal metabolism during gestation leading to GDM.Epigenetic alterations like DNA methylation,histone modification,and miRNA expression can influence gene expression and play a dominant role in feto-maternal meta-bolic pathways.Interactions between genes and environment,resulting in differ-ential gene expression patterns may lead to GDM.Researchers suggested that GDM women are more susceptible to insulin resistance,which alters intrauterine surroundings,resulting hyperglycemia and hyperinsulinemia.Epigenetic modi-fications in genes affecting neuroendocrine activities,and metabolism,increase the risk of obesity and type 2 diabetes in offspring.There is currently no treatment or effective preventive method for GDM,since the molecular processes of insulin resistance are not well understood.The present review was undertaken to un-derstand the pathophysiology of GDM and its effects on adverse neonatal out-comes.In addition,the study of genetic and epigenetic alterations will provide lead to researchers in the search for predictive molecular biomarkers.展开更多
This study aimed to compare the complications of preterm twins versus singletons and analyze differences across gestational ages.Preterm twins delivered between 2 March 2022 and 6 November 2022 were compared to an age...This study aimed to compare the complications of preterm twins versus singletons and analyze differences across gestational ages.Preterm twins delivered between 2 March 2022 and 6 November 2022 were compared to an age-matched control group of singletons,involving 65 twins and 103 singletons.The most common complication in premature infants was neonatal jaundice(87.72%),followed by patent foramen ovale(79.76%)and neonatal respiratory distress syndrome(NRDS)(57.14%).Twins had significantly higher Apgar scores at 1,5,and 10 minutes compared to singletons.However,twins showed a higher incidence of ventricular septal defect(VSD)(7.69%)than singletons,with a statistically significant difference.In contrast,twins exhibited significantly lower rates of neonatal jaundice(78.46%),electrolyte imbalance(18.4%),and acid-base imbalance(9.23%)compared to singletons.Furthermore,as gestational age increased,the incidence of intrauterine infection,electrolyte and acid-base imbalances,neonatal coagulation disorders,patent ductus arteriosus(PDA),anemia,and NRDS in preterm infants gradually decreased,with all differences reaching statistical significance(P<0.05).These findings highlight the importance of close monitoring and timely management of complications in premature infants to prevent severe outcomes.展开更多
The current study aims to identify potential metabolic biomarkers that predict the progression to prediabetes in women with a history of gestational diabetes mellitus(GDM).We constructed a prediabetes group(n=42)and a...The current study aims to identify potential metabolic biomarkers that predict the progression to prediabetes in women with a history of gestational diabetes mellitus(GDM).We constructed a prediabetes group(n=42)and a control group(n=40)based on a 2-h 75 g oral glucose tolerance test for women with a history of GDM from six weeks to six months postpartum,and collected their clinical data and biochemical test results.We performed the plasma metabolomics analysis of the subjects at the fasting and 2-h post-load time points using ultra-high performance liquid chromatography-quadrupole time-of-flight mass spectrometry(UHPLC-Q-TOF-MS/MS).We found that the prediabetes group was older and had higher 2-h post-load glucose levels during pregnancy than the control group.The metabolomic analysis identified 164 differential metabolites between the groups.Compared with the control group,15 metabolites in the prediabetes group exhibited consistent change trends at both time points,including three increased and 12 decreased metabolites.By building a prediction model of the progression from GDM to prediabetes,we found that a combination of three clinical markers yielded an area under the curve(AUC)of 0.71(95%confidence interval[CI],0.60–0.82).We also assessed the discriminative power of the panel of 15 metabolites for distinguishing between postpartum prediabetes and normal glucose tolerance of the subjects at the fasting(AUC,0.98;95%CI,0.94–1.00)and 2-h post-load(AUC,0.99;95%CI,0.97–1.00)time points.The metabolic pathway analysis indicated that energy metabolism and branched-chain amino acids played a role in prediabetes development in women with a history of GDM during the early postpartum period.In conclusion,this study identified potential metabolic biomarkers and pathways associated with the progression from GDM to prediabetes in the early postpartum period.A panel of 15 metabolites showed promising discriminative power for distinguishing between postpartum prediabetes and normal glucose tolerance.These findings provide insights into the underlying pathophysiology of this transition and suggest the feasibility of developing a metabolic profiling test for the early identification of women at high risk of prediabetes following GDM.展开更多
Background: Some studies have indicated a potential link between a history of induced abortion (IA) and the subsequent risk of gestational diabetes mellitus (GDM), but the relationship is not fully understood, and the...Background: Some studies have indicated a potential link between a history of induced abortion (IA) and the subsequent risk of gestational diabetes mellitus (GDM), but the relationship is not fully understood, and the aim of this study was to further elucidate the association. Methods: The case-control study was conducted at 2 hospitals in central China from April 2018 to October 2020. GDM was diagnosed by an oral glucose tolerance test (OGTT). Information on history of IA was obtained through a face-to-face interview. Results: Among 396 GDM cases and 904 controls, the proportion of participants with history of IA in the case group was 30.6%, which was higher than that in the control group (23.1%), and the difference was statistically significant (p = 0.005). After adjusting for potential confounders, women with a history of IA had an increased subsequent risk of GDM compared with women without (OR, 1.24, 95% CI, 1.10 - 1.40, p = 0.002). The subsequent risk of GDM in pregnant women increased as the number of previous IAs increased (p for trend was equal to 0.004). Stratified analysis showed that women with a history of medical abortion (OR, 1.28, 95% CI, 1.01 - 1.62, p = 0.048) or surgical abortion (OR, 1.20, 95% CI, 1.04 - 1.38, p = 0.024) both had an increased subsequent risk of GDM compared with women without. Conclusion: History of IA, either medical or surgical, was related to an increased risk of GDM in subsequent pregnancy. The greater the number of previous IAs, the greater the subsequent risk of GDM.展开更多
Objective:To explore the correlation between fetal foot length measured by ultrasound and gestational age.Methods:This study employed ultrasound to measure the fetal foot length,femoral length,and foot length/femoral ...Objective:To explore the correlation between fetal foot length measured by ultrasound and gestational age.Methods:This study employed ultrasound to measure the fetal foot length,femoral length,and foot length/femoral length ratio in 214 pregnant women from 12 to 40 weeks of gestation,all of whom had no pregnancy complications or obstetric complications,and whose fetuses were normal.Results:A significant positive correlation was found between fetal foot length and gestational age(r=0.967,p<0.001);a similarly significant positive correlation was observed between fetal femoral length and gestational age(r=0.972,p<0.001);and a non-significant positive correlation was noted between the foot length/femoral length ratio and gestational age(r=0.943,p<0.001).Conclusion:Ultrasound can accurately measure fetal foot length and femoral length,both of which exhibit a significant positive correlation with gestational age,making them important reference indicators for assessing fetal growth and development.展开更多
Gestational diabetes mellitus(GDM)is a disease of glucose intolerance that first occurs during pregnancy.Accumulating evidence underlined a link between gut microbiota dysbiosis and GDM,and microbial metabolites repre...Gestational diabetes mellitus(GDM)is a disease of glucose intolerance that first occurs during pregnancy.Accumulating evidence underlined a link between gut microbiota dysbiosis and GDM,and microbial metabolites represent a unique way to explore microbiota-host interactions.However,the associations between changes in the gut microbiota and microbial metabolites and immune homeostasis in the GDM pathogenesis remain largely unclear.In this prospective study,the characteristics of gut microbiota in both first trimester(T1)and second trimester(T2)were investigated in 46 GDM patients and 44 matched controls.We comprehensively profiled the microbial metabolites using non-targeted metabolomics and quantitatively targeted metabolomics,measurements of inflammatory cytokines and biomarkers of intestinal barrier function,and combined with correlation analysis in T2.Gut microbiota dybiosis was observed in GDM patients in both T1 and T2,and was characterised by the enrichment of multiple potentially harmful bacteria,such as UBA1819 and Erysipelatoclostridium.Besides,alterations in the microbiota were accompanied by a disturbance in tryptophan metabolism,mainly manifested as a shift towards the production of more kynurenine and less indole derivatives.Most importantly,correlation network analysis indicated that overgrowth of potential pathogens and tryptophan metabolism disorder were associated with inflammatory imbalance and disrupted epithelial barrier in GDM patients.These findings provide a greater understanding of the pathogenesis and new targets for microecological interventions by mediating tryptophan metabolism in GDM.展开更多
With diabetes currently affecting 537 million people globally,innovative research approaches are urgently required.Zebrafish(Danio rerio)has emerged as a pivotal model organism in diabetes research,particularly valuab...With diabetes currently affecting 537 million people globally,innovative research approaches are urgently required.Zebrafish(Danio rerio)has emerged as a pivotal model organism in diabetes research,particularly valuable for developmental biology studies and preclinical therapeutic validation.Its rapid life cycle,optical transparency,and genetic tractability collectively enable efficient longitudinal observation of pathological progression and pharmacological responses.Utilizing zebrafish models,researchers have elucidated fundamental mechanisms governing islet development,β-cell dysfunction,and metabolic dysregulation.These experimental systems have significantly advanced our understanding of various diabetes subtypes,including type 1,type 2,gestational,and monogenic forms,while also facilitating mechanistic studies of diabetic complications such as retinopathy and nephropathy.Recent model refinements,particularly in simulating monogenic disorders and pregnancy-associated metabolic changes,promise to deepen our comprehension of disease pathophysiology and therapeutic interventions.Nevertheless,a persistent limitation lies in their incomplete recapitulation of human-specific physiological complexity and multi-organ metabolic interactions,factors that may influence translational applicability.Despite these constraints,zebrafish-based research continues to provide an indispensable platform for diabetes investigation,holding significant promise for alleviating the escalating global burden of this metabolic disorder.展开更多
BACKGROUND Gestational diabetes mellitus(GDM)has emerged as a global public health cha-llenge,fueled by increasing maternal age,rising obesity rates,and lifestyle shifts.It is linked to substantial short-and long-term...BACKGROUND Gestational diabetes mellitus(GDM)has emerged as a global public health cha-llenge,fueled by increasing maternal age,rising obesity rates,and lifestyle shifts.It is linked to substantial short-and long-term health risks for both mothers and their offspring,offering a critical opportunity for intergenerational prevention of metabolic disorders.AIM To synthesize current evidence on the pathophysiology,diagnosis,management,complications,and individualized treatment strategies of GDM.METHODS We conducted a narrative review in accordance with PRISMA guidelines.Pub-Med,Scopus,Web of Science,and EMBASE were searched for English-language articles(2017-2025)using terms such as“GDM”,“pregnancy”,“insulin resis-tance”,and“maternal outcomes”.After removing duplicates,512 records were screened;102 full texts were assessed for eligibility,and 55 studies were included based on methodological quality,clinical relevance,and alignment with the review objectives.RESULTS GDM results from a complex interplay among progressive insulin resistance,β-cell dysfunction,immune dysregulation,and placental inflammation.Emerging evidence indicates that hyperglycemia before formal diagnosis can impair fetal programming via epigenetic mechanisms.GDM increases a mother’s risk of developing type 2 diabetes mellitus seven-to tenfold and raises the incidence of cardiovascular disease,preeclampsia,and cesarean delivery.Offspring are at higher risk of macrosomia,neonatal hypoglycemia,and future metabolic and cardiovascular disorders.Lifestyle modification remains the cornerstone of therapy and,when necessary,can be supplemented with pharmacologic agents such as metformin or insulin.Postpartum follow-up,breastfeeding support,and preconception counseling are vital to long-term metabolic health.CONCLUSION GDM requires precision-based,life-course care.Future priorities include early risk detection,biomarker validation,unified diagnosis,and culturally sensitive interventions to improve maternal-child outcomes.展开更多
BACKGROUND There are conflicting results on the potential correlation between folic acid and gestational diabetes mellitus(GDM),and the correlation between genetic factors related to folic acid metabolism pathways and...BACKGROUND There are conflicting results on the potential correlation between folic acid and gestational diabetes mellitus(GDM),and the correlation between genetic factors related to folic acid metabolism pathways and GDM remains to be revealed.AIM To examine the association between single-nucleotide polymorphisms(SNPs)of enzyme genes in the folate metabolite pathway as well as that between GDM-related genes and risk for GDM.METHODS A nested case-control study was conducted with GDM cases(n=412)and healthy controls(n=412).DNA was extracted blood samples and SNPs were genotyped using Agena Bioscience’s MassARRAY gene mass spectrometry system.The associations between different SNPs of genes and the risk for GDM were estimated using logistic regression models.The generalized multi-factor dimensionality reduction(GMDR)method was used to analyze gene-gene and gene-environment interactions using the GMDR 0.9 software.RESULTS The variation allele frequency of melatonin receptor 1B(MTNR1B)rs10830963 was higher in the GDM group than in controls(P<0.05).MTNR1B rs10830963 mutant G was associated with risk for GDM[adjusted odds ratio(aOR):1.43;95%confidence interval(95%CI):1.13-1.80]in the additive model.MTNR1B rs10830963 GG+GC was significantly associated with the risk for GDM(aOR:1.65;95%CI:1.23-2.22)in the dominant model.The two-locus model of MTNR1B rs10830963 and CHEMERIN rs4721 was the best model(P<0.05)for gene-gene interactions in the GMDR results.The high-risk rs10830963×rs4721 type of interaction was a risk factor for GDM(aOR:2.09;95%CI:1.49-2.93).CONCLUSION This study does not find an association between SNPs of folate metabolic enzymes and risk for GDM.The G mutant allele of MTNR1B rs10830963 is identified as a risk factor for GDM in the additive model,and there may be gene-gene interactions between MTNR1B rs10830963 and CHEMERIN rs4721.It is conducive to studying the causes of GDM and provides a new perspective for the precise prevention of this disease.展开更多
Nonalcoholic fatty liver disease(NAFLD)has emerged as the prevailing chronic liver disease in the pediatric population due to the global obesity pandemic.Evidence shows that prenatal and postnatal exposure to maternal...Nonalcoholic fatty liver disease(NAFLD)has emerged as the prevailing chronic liver disease in the pediatric population due to the global obesity pandemic.Evidence shows that prenatal and postnatal exposure to maternal abnormalities leads to a higher risk of pediatric NAFLD through persistent alterations in developmental programming.Gestational diabetes mellitus(GDM)is a hyperglycemic syndrome which has become the most prevalent complication in pregnant women.An increasing number of both epidemiologic investigations and animal model studies have validated adverse and long-term outcomes in offspring following GDM exposure in utero.Similarly,GDM is considered a crucial risk factor for pediatric NAFLD.This review aimed to summarize currently published studies concerning the inductive roles of GDM in offspring NAFLD de velopment during childhood and adolescence.Dysregulations in hepatic lipid metabolism and gut microbiota in offspring,as well as dysfunctions in the placenta are potential factors in the pathogenesis of GDM-associated pediatric NAFLD.In addition,potentially effective interventions for GDM-associated offspring NAFLD are also discussed in this review.However,most of these therapeutic approaches still require further clinical research for validation.展开更多
Gestational diabetes mellitus(GDM)is a metabolic condition caused by chronic insulin resistance during pregnancy,affecting millions of women globally and causing significant health concerns.Its consequences are far-re...Gestational diabetes mellitus(GDM)is a metabolic condition caused by chronic insulin resistance during pregnancy,affecting millions of women globally and causing significant health concerns.Its consequences are far-reaching,associated with poor feto-maternal outcomes.GDM has serious implications on metabolic health in both mother and child.Early diagnosis and management of GDM are crucial to prevent related consequences.Traditional diagnostic and predictive biomarkers for GDM,including oral glucose tolerance test,adiponectin,resistin,etc.,have limitations.Recent advances in research have identified novel biomarkers for GDM,offering promising alternatives for early diagnosis and prediction to prevent the associated adverse pediatric outcomes.Emerging biomarkers include microRNAs,cell-free DNA,exosomes,glycolytic intermediates,inflammatory biomarkers(C-reactive protein and interleukin-6),metabolic biomarkers(Betatrophin,fetuin-A,etc.),etc.Emerging bidirectional communication pathway(gut microbiota gut-brain-axis)plays a crucial role in GDM pathophysiology,and could be a promising biomarker.Emerging technologies such as next-generation seque-ncing,metabolomics,and proteomics have enabled the discovery of novel bio-markers for GDM and related pediatric outcomes.This review aims to summarize the current state of knowledge on emerging biomarkers for GDM,including their diagnostic accuracy,predictive value,and potential clinical applications to improve feto-maternal outcomes by personalized medicine approaches.展开更多
BACKGROUND Gestational diabetes mellitus(GDM)has recently been associated with abnormal profiles of inflammatory cells and cytokines,though the findings remain incon-sistent and unclear.AIM To elucidate the peripheral...BACKGROUND Gestational diabetes mellitus(GDM)has recently been associated with abnormal profiles of inflammatory cells and cytokines,though the findings remain incon-sistent and unclear.AIM To elucidate the peripheral immune status in GDM.METHODS We systematically screened databases including Web of Science,PubMed,and EMBASE for eligible studies.Original articles reporting different immune cell levels in GDM compared to normal glucose-tolerance pregnant women were included to extract usable data.The pooled mean difference(MD)with 95%confidence interval(CI)was analyzed as the outcome measure.The Newcastle-Ottawa scale was employed to assess study quality.RESULTS A total of 19 studies involving various immune cell subgroups were included in our analysis.Specifically,total CD4+T cells(WMD=3.08;95%CI:0.81-5.35)were significantly increased in GDM groups.In contrast,total lymphocytes(SMD=0.05;95%CI:-0.16 to 0.26),CD3+T cells(SMD=-0.34;95%CI:-1.01 to 0.32),CD8+T cells(SMD=0.21;95%CI:-0.31 to 0.73),and natural killer T(NKT)Cells(SMD=0.83;95%CI:-1.10 to 2.75)showed no significant changes in GDM.Activation markers(HLA-DR+or CD69+)on CD4+T cells(WMD=0.20;95%CI:0.06-0.34)were increased in GDM patients.Treg cells,a classical subgroup of CD4+T cells,showed a decreasing trend in GDM compared to controls(SMD=-0.83;95%CI:-1.31 to-0.34).These results indicate an abnormal immune status in the peripheral profiles of GDM.CONCLUSION GDM may not only be a dysglycemia-related condition but also an immune disorder characterized by abnormal peripheral immune profiles,including higher levels of CD4+T cells and a reduced population of Treg cells.Tr-eating immune dysregulation could be a new direction for GDM management,although further research is needed to understand the precise mechanisms of immune overactivation in GDM.展开更多
基金The research received approval from Children’s Hospital of Shanxi Committee (Approval Number:KLT6230511).
文摘BACKGROUND Food insecurity(FI)during pregnancy negatively impacts maternal health and raises the risk of gestational diabetes mellitus(GDM)and pregnancy-induced hypertension(PIH),resulting in adverse outcomes for both mother and baby.AIM To investigate the relationships between FI and pregnancy outcomes,particularly GDM and PIH,while also examining the mediating role of the dietary diversity score(DDS).METHODS A cross-sectional study was undertaken to examine this relationship,involving 600 pregnant women.Participants were women aged 18 years or older who provided complete data on FI and pregnancy outcomes.The FI was measured via the Household Food Security Survey Module,with GDM defined as fasting plasma glucose levels of≥5.1 mmol/L or a 2-hour oral glucose tolerance test value of≥8.5 mmol/L.The DDS is determined by evaluating one's food consumption based on nine distinct food groups.A logistic regression model was used to explore the relationship between FI and PIH,and GDM.RESULTS Seventeen percent of participants reported experiencing FI during pregnancy.The study found a significant association between FI and an elevated risk of GDM[odds ratio(OR)=3.32,95%CI:1.2-5.4].Once more,food-insecure pregnant women had higher rates of PIH(OR=0.10,95%CI:0.02-0.45)and they also faced a higher likelihood of neonatal complications,such as neonatal intensive care unit’s admissions and the birth of infants with extremely low birth weight.The FI wasfurther linked to metabolic disruptions,such as elevated fasting blood sugar(FBS),low-density lipoprotein cholesterol,and triglyceride levels.Our results indicate that the DDS acts as a significant mediator in the relationship between FI and the incidence of GDM.In particular,the mediation analysis showed that approximately 65%of the effect was mediated through DDS(P=0.002).CONCLUSION These findings underscore the serious challenges that FI presents during pregnancy and its effects on maternal and infant health.Additionally,the study explored how DDS mediates the relationship between FI and the incidence of GDM.
基金Supported by Nanjing Medical Science and Technique Development Foundation,No.YKK23151the Opening Foundation of Key Laboratory,No.JSHD202313+3 种基金Yingke Xinchuang Research Foundation of Jiangsu Blood Transfusion Association,No.JSYK2024006the Jiangsu Province Capability Improvement Project through Science,Technology and Education,No.ZDXYS202210Open Project of the State Key Laboratory of Reproductive Medicine of Nanjing Medical University,No.SKLRM-K202107the Jiangsu Provincial Maternal and Child Health Research Program,No.F202040.
文摘BACKGROUND The primary complication associated with gestational diabetes mellitus(GDM)is delivery of an infant that is large for gestational age(LGA).Epidemiological findings have demonstrated that irregular lipid metabolism significantly con-tributes to insulin resistance,a key pathophysiological mechanism in GDM.However,the correlation between various lipid indices and the probability of delivering LGA infants remains inconsistent.AIM To explore the relationships between lipid indices and the possibility of having LGA infants among GDM-affected pregnant females.METHODS Binary logistic regression methods were employed to evaluate the odds ratios and corresponding 95%confidence intervals for LGA according to five lipid indices.Restricted cubic spline models were applied to investigate dose-response relationships.The association between lipid indices and the risk of delivering LGA infants was further investigated among different subgroups.Receiver operating characteristic curves were utilized to assess the diagnostic performance of lipid indices.RESULTS Across crude and adjusted models,females with lipid indices in the upper two tertiles presented a markedly elevated risk of delivering LGA infants compared with the lowest tertile category.Conversely,high-density lipoprotein cholesterol levels demonstrated the contrary trend.Restricted cubic spline analyses revealed linear associations between the five lipid indices,except triglyceride levels,and the prevalence of LGA.The subgroup analysis highlighted that the correlation between lipid indices and the probability of LGA was inconsistent.The five lipid indices presented significant diagnostic efficacy,as indicated by receiver operating characteristic curve areas.CONCLUSION Our research demonstrated that lipid indices were effective predictors of the incidence of LGA infants in GDM-affected pregnancies irrespective of potential confounding factors.
文摘Gestational diabetes mellitus(GDM)is defined as any degree of hyperglycaemia that is recognized for the first time during pregnancy.This definition includes cases of undiagnosed type 2 diabetes mellitus(T2 DM)identified early in pregnancy and true GDM which develops later.GDM constitutes a greater impact on diabetes epidemic as it carries a major risk of developing T2 DM to the mother and foetus later in life.In addition,GDM has also been linked with cardiometabolic risk factors such as lipid abnormalities,hypertensive disorders and hyperinsulinemia.These might result in later development of cardiovascular disease and metabolic syndrome.The understanding of the different risk factors,the pathophysiological mechanisms and the genetic factors of GDM,will help us to identify the women at risk,to develop effective preventive measures and to provide adequate management of the disease.Clinical trials have shown that T2 DM can be prevented in women with prior GDM,by intensive lifestyle modification and by using pioglitazone and metformin.However,a matter of controversy surrounding both screening and management of GDM continues to emerge,despite several recent welldesigned clinical trials tackling these issues.The aim of this manuscript is to critically review GDM in a detailed and comprehensive manner,in order to provide a scientific analysis and updated write-up of different related aspects.
文摘In this editorial,we comment on an article by Wang et al.Recent literature shows an increase in research on pelvic organ prolapse(POP).Although the true incidence of POP remains uncertain,its impact on quality of life is substantial.Anatomical studies report high incidence rates,surpassing those observed in symptom-based surveys.Weakness of the endopelvic fascia is a primary anatomical risk factor for POP.Additionally,gestational diabetes mellitus(GDM)has emerged as a growing concern,as poor glycemic control increases complications for both mother and fetus.GDM and POP are interconnected,with factors like maternal obesity,macrosomia,and hormonal changes exacerbating pelvic floor dysfunction.Modifiable risk factors,such as obesity and chronic hyperglycemia,along with multiparity,instrumental deliveries,and obstetric trauma,further increase susceptibility.For patients with GDM,gynecological exams,Pelvic Organ Prolapse Quantification staging,and pelvic floor ultrasonography are valuable diagnostics,with proctological exams and magnetic resonance defecography aiding in multi-compartment prolapse diagnoses.Imaging,though uncomfortable during pregnancy,is safe in the early postpartum period.This editorial emphasizes the need for further research on the pathophysiology of GDM-related POP and offers recommendations for improving diagnosis and clinical management of patients with GDM.
基金National Natural Science Foundation of China,No.81960284Science and Technology Support Program of Science and Technology Department of Guizhou Province,No.Qian Ke He Zhi Cheng[2022]Yi Ban 183.
文摘BACKGROUND Gestational diabetes mellitus(GDM)is a growing public health concern,particularly in regions with diverse ethnic populations.Understanding the incidence and risk factors of GDM is crucial for early prevention and management,especially in underrepresented areas like Guizhou Province,China,where geographic and ethnic diversity may influence the disease’s prevalence and risk profiles.AIM To investigate the incidence of GDM and identify its associated risk and protective factors among different ethnic groups in Guizhou Province,providing essential data for early prevention strategies.METHODS A multi-center retrospective study was conducted,dividing participants into GDM and non-GDM groups according to standardized diagnostic criteria.Data were collected from 103629 deliveries across 40 hospitals in Guizhou.Various demographic,clinical,and laboratory parameters were analyzed using logistic regression to identify risk and protective factors for GDM.RESULTS Among the 103629 deliveries,18957 cases of GDM were identified,with an incidence of approximately 18.3%.The risk of GDM was higher in the Han ethnic group compared to minority ethnic groups.The Dong ethnic group had the lowest incidence among the minorities.Key risk factors identified included older age(especially>35 years),higher pre-pregnancy body mass index(BMI),light physical activity,gravidity,family history of diabetes,hemoglobin,aspartate aminotransferase,alanine aminotransferase,and direct bilirubin.Protective factors included higher education level,total protein,and albumin.There were also differences based on blood type,with type A associated with higher risk.CONCLUSION The incidence rate in Guizhou is 18.3%.Older age(especially>35 years),Han ethnicity,lower education level,higher pre-pregnancy BMI,light physical activity,and higher gravidity are the main risk factors for GDM.Laboratory findings indicate that higher hemoglobin,higher liver function parameters(alanine aminotransferase,aspartate aminotransferase,and direct bilirubin),and lower total protein and albumin are associated with a higher risk of GDM.Blood type A has a higher risk of GDM compared to blood types AB and O.
基金supported by the Capital’s Funds for Health Improvement and Research(No.2024-2G-2118)the National Key Research and Development Program of China(2016YFC1000101)+2 种基金the Leading Talents in the Construction Project of High-Level Public Health Technical Talents in Beijing(2022-1-003)the“Green Seedling”Youth Program by the Beijing Hospitals Authority(QML20231402)the Young Elite Scientist Sponsorship Program by the Beijing Association for Science and Technology(BYESS2022200)。
文摘Objective To investigate the association between ABO blood types and gestational diabetes mellitus(GDM)risk.Methods A prospective birth cohort study was conducted.ABO blood types were determined using the slide method.GDM diagnosis was based on a 75-g,2-h oral glucose tolerance test(OGTT)according to the criteria of the International Association of Diabetes and Pregnancy Study Groups.Logistic regression was applied to calculate the odds ratios(ORs)and 95%confidence intervals(CIs)between ABO blood types and GDM risk.Results A total of 30,740 pregnant women with a mean age of 31.81 years were enrolled in this study.The ABO blood types distribution was:type O(30.99%),type A(26.58%),type B(32.20%),and type AB(10.23%).GDM was identified in 14.44%of participants.Using blood type O as a reference,GDM risk was not significantly higher for types A(OR=1.05)or B(OR=1.04).However,women with type AB had a 19%increased risk of GDM(OR=1.19,95%CI=1.05–1.34;P<0.05),even after adjusting for various factors.This increased risk for type AB was consistent across subgroup and sensitivity analyses.Conclusion The ABO blood types may influence GDM risk,with type AB associated with a higher risk.Incorporating it—either as a single risk factor or in combination with other known factors—could help identify individuals at risk for GDM before or during early pregnancy.
基金Supported by National Natural Science Foundation of China,No.32060182Qiannan Prefecture Science and Technology Plan Project in China:Qiannan Kehe She Zi[2022]No.1.
文摘Gestational diabetes mellitus(GDM)refers to varying degrees of abnormal glucose metabolism that occur during pregnancy and excludes patients pre-viously diagnosed with diabetes.GDM is a unique among the four subtypes of diabetes classified by the international World Health Organization standards.Although GDM patients constitute a small proportion of the total number of diabetes cases,the incidence of GDM has risen significantly over the past decade,posing substantial risk to pregnant women and infants.Therefore,it warrants considerable attention.The pathogenesis of GDM is generally considered to resemble that of type II diabetes,though it may have distinct characteristics.Analyzing blood biochemical proteins in the context of GDM can help elucidate its pathogenesis,thereby facilitating more effective prevention and management strategies.This article reviews this critical clinical issue to enhance the medical community's sufficient understanding of GDM.
文摘The study by Cao et al aimed to identify early second-trimester biomarkers that could predict gestational diabetes mellitus(GDM)development using advanced proteomic techniques,such as Isobaric tags for relative and absolute quantitation isobaric tags for relative and absolute quantitation and liquid chromatography-mass spectrometry liquid chromatography-mass spectrometry.Their analysis revealed 47 differentially expressed proteins in the GDM group,with retinol-binding protein 4 and angiopoietin-like 8 showing significantly elevated serum levels compared to controls.Although these findings are promising,the study is limited by its small sample size(n=4 per group)and lacks essential details on the reproducibility and reliability of the protein quantification methods used.Furthermore,the absence of experimental validation weakens the interpretation of the protein-protein interaction network identified through bioinformatics analysis.The study's focus on second-trimester biomarkers raises concerns about whether this is a sufficiently early period to implement preventive interventions for GDM.Predicting GDM risk during the first trimester or pre-conceptional period may offer more clinical relevance.Despite its limitations,the study presents valuable insights into potential GDM biomarkers,but larger,well-validated studies are needed to establish their predictive utility and generalizability.
基金Supported by Maulana Azad National Fellowship,University Grants Commission,New Delhi,and Department of Biotechnology,New Delhi,No.AS[82-27/2019(SA III)]DBT-BUILDER-University of Lucknow Interdisciplinary Life Science Programme for Advance Research and Education(Level II),No.TG(BT/INF/22/SP47623/2022).
文摘Gestational diabetes mellitus(GDM)is a metabolic disorder,recognised during 24-28 weeks of pregnancy.GDM is linked with adverse newborn outcomes such as macrosomia,premature delivery,metabolic disorder,cardiovascular,and neurological disorders.Recent investigations have focused on the correlation of genetic factors such asβ-cell function and insulin secretary genes(transcription factor 7 like 2,potassium voltage-gated channel subfamily q member 1,adipo-nectin etc.)on maternal metabolism during gestation leading to GDM.Epigenetic alterations like DNA methylation,histone modification,and miRNA expression can influence gene expression and play a dominant role in feto-maternal meta-bolic pathways.Interactions between genes and environment,resulting in differ-ential gene expression patterns may lead to GDM.Researchers suggested that GDM women are more susceptible to insulin resistance,which alters intrauterine surroundings,resulting hyperglycemia and hyperinsulinemia.Epigenetic modi-fications in genes affecting neuroendocrine activities,and metabolism,increase the risk of obesity and type 2 diabetes in offspring.There is currently no treatment or effective preventive method for GDM,since the molecular processes of insulin resistance are not well understood.The present review was undertaken to un-derstand the pathophysiology of GDM and its effects on adverse neonatal out-comes.In addition,the study of genetic and epigenetic alterations will provide lead to researchers in the search for predictive molecular biomarkers.
文摘This study aimed to compare the complications of preterm twins versus singletons and analyze differences across gestational ages.Preterm twins delivered between 2 March 2022 and 6 November 2022 were compared to an age-matched control group of singletons,involving 65 twins and 103 singletons.The most common complication in premature infants was neonatal jaundice(87.72%),followed by patent foramen ovale(79.76%)and neonatal respiratory distress syndrome(NRDS)(57.14%).Twins had significantly higher Apgar scores at 1,5,and 10 minutes compared to singletons.However,twins showed a higher incidence of ventricular septal defect(VSD)(7.69%)than singletons,with a statistically significant difference.In contrast,twins exhibited significantly lower rates of neonatal jaundice(78.46%),electrolyte imbalance(18.4%),and acid-base imbalance(9.23%)compared to singletons.Furthermore,as gestational age increased,the incidence of intrauterine infection,electrolyte and acid-base imbalances,neonatal coagulation disorders,patent ductus arteriosus(PDA),anemia,and NRDS in preterm infants gradually decreased,with all differences reaching statistical significance(P<0.05).These findings highlight the importance of close monitoring and timely management of complications in premature infants to prevent severe outcomes.
基金supported by Key Medical Research Projects of Jiangsu Commission of Health(Grant No.ZD2022023).
文摘The current study aims to identify potential metabolic biomarkers that predict the progression to prediabetes in women with a history of gestational diabetes mellitus(GDM).We constructed a prediabetes group(n=42)and a control group(n=40)based on a 2-h 75 g oral glucose tolerance test for women with a history of GDM from six weeks to six months postpartum,and collected their clinical data and biochemical test results.We performed the plasma metabolomics analysis of the subjects at the fasting and 2-h post-load time points using ultra-high performance liquid chromatography-quadrupole time-of-flight mass spectrometry(UHPLC-Q-TOF-MS/MS).We found that the prediabetes group was older and had higher 2-h post-load glucose levels during pregnancy than the control group.The metabolomic analysis identified 164 differential metabolites between the groups.Compared with the control group,15 metabolites in the prediabetes group exhibited consistent change trends at both time points,including three increased and 12 decreased metabolites.By building a prediction model of the progression from GDM to prediabetes,we found that a combination of three clinical markers yielded an area under the curve(AUC)of 0.71(95%confidence interval[CI],0.60–0.82).We also assessed the discriminative power of the panel of 15 metabolites for distinguishing between postpartum prediabetes and normal glucose tolerance of the subjects at the fasting(AUC,0.98;95%CI,0.94–1.00)and 2-h post-load(AUC,0.99;95%CI,0.97–1.00)time points.The metabolic pathway analysis indicated that energy metabolism and branched-chain amino acids played a role in prediabetes development in women with a history of GDM during the early postpartum period.In conclusion,this study identified potential metabolic biomarkers and pathways associated with the progression from GDM to prediabetes in the early postpartum period.A panel of 15 metabolites showed promising discriminative power for distinguishing between postpartum prediabetes and normal glucose tolerance.These findings provide insights into the underlying pathophysiology of this transition and suggest the feasibility of developing a metabolic profiling test for the early identification of women at high risk of prediabetes following GDM.
文摘Background: Some studies have indicated a potential link between a history of induced abortion (IA) and the subsequent risk of gestational diabetes mellitus (GDM), but the relationship is not fully understood, and the aim of this study was to further elucidate the association. Methods: The case-control study was conducted at 2 hospitals in central China from April 2018 to October 2020. GDM was diagnosed by an oral glucose tolerance test (OGTT). Information on history of IA was obtained through a face-to-face interview. Results: Among 396 GDM cases and 904 controls, the proportion of participants with history of IA in the case group was 30.6%, which was higher than that in the control group (23.1%), and the difference was statistically significant (p = 0.005). After adjusting for potential confounders, women with a history of IA had an increased subsequent risk of GDM compared with women without (OR, 1.24, 95% CI, 1.10 - 1.40, p = 0.002). The subsequent risk of GDM in pregnant women increased as the number of previous IAs increased (p for trend was equal to 0.004). Stratified analysis showed that women with a history of medical abortion (OR, 1.28, 95% CI, 1.01 - 1.62, p = 0.048) or surgical abortion (OR, 1.20, 95% CI, 1.04 - 1.38, p = 0.024) both had an increased subsequent risk of GDM compared with women without. Conclusion: History of IA, either medical or surgical, was related to an increased risk of GDM in subsequent pregnancy. The greater the number of previous IAs, the greater the subsequent risk of GDM.
文摘Objective:To explore the correlation between fetal foot length measured by ultrasound and gestational age.Methods:This study employed ultrasound to measure the fetal foot length,femoral length,and foot length/femoral length ratio in 214 pregnant women from 12 to 40 weeks of gestation,all of whom had no pregnancy complications or obstetric complications,and whose fetuses were normal.Results:A significant positive correlation was found between fetal foot length and gestational age(r=0.967,p<0.001);a similarly significant positive correlation was observed between fetal femoral length and gestational age(r=0.972,p<0.001);and a non-significant positive correlation was noted between the foot length/femoral length ratio and gestational age(r=0.943,p<0.001).Conclusion:Ultrasound can accurately measure fetal foot length and femoral length,both of which exhibit a significant positive correlation with gestational age,making them important reference indicators for assessing fetal growth and development.
基金supported by the National Natural Science Foundation of China(32272332,32021005)the Fundamental Research Funds for the Central Universities(JUSRP622020,JUSRP22006,and JUSRP51501)+2 种基金the Program of Collaborative Innovation Centre of Food Safety and Quality Control in Jiangsu ProvinceTop Talent Support Program for Young and Middle-aged People of Wuxi Health Committee(bj2020111)Appropriate Technology Promotion Project of Wuxi Municipal Health Commission(FYTG202006)。
文摘Gestational diabetes mellitus(GDM)is a disease of glucose intolerance that first occurs during pregnancy.Accumulating evidence underlined a link between gut microbiota dysbiosis and GDM,and microbial metabolites represent a unique way to explore microbiota-host interactions.However,the associations between changes in the gut microbiota and microbial metabolites and immune homeostasis in the GDM pathogenesis remain largely unclear.In this prospective study,the characteristics of gut microbiota in both first trimester(T1)and second trimester(T2)were investigated in 46 GDM patients and 44 matched controls.We comprehensively profiled the microbial metabolites using non-targeted metabolomics and quantitatively targeted metabolomics,measurements of inflammatory cytokines and biomarkers of intestinal barrier function,and combined with correlation analysis in T2.Gut microbiota dybiosis was observed in GDM patients in both T1 and T2,and was characterised by the enrichment of multiple potentially harmful bacteria,such as UBA1819 and Erysipelatoclostridium.Besides,alterations in the microbiota were accompanied by a disturbance in tryptophan metabolism,mainly manifested as a shift towards the production of more kynurenine and less indole derivatives.Most importantly,correlation network analysis indicated that overgrowth of potential pathogens and tryptophan metabolism disorder were associated with inflammatory imbalance and disrupted epithelial barrier in GDM patients.These findings provide a greater understanding of the pathogenesis and new targets for microecological interventions by mediating tryptophan metabolism in GDM.
基金Supported by Natural Science Foundation of Zhejiang Province,China,No.LQ24H070007。
文摘With diabetes currently affecting 537 million people globally,innovative research approaches are urgently required.Zebrafish(Danio rerio)has emerged as a pivotal model organism in diabetes research,particularly valuable for developmental biology studies and preclinical therapeutic validation.Its rapid life cycle,optical transparency,and genetic tractability collectively enable efficient longitudinal observation of pathological progression and pharmacological responses.Utilizing zebrafish models,researchers have elucidated fundamental mechanisms governing islet development,β-cell dysfunction,and metabolic dysregulation.These experimental systems have significantly advanced our understanding of various diabetes subtypes,including type 1,type 2,gestational,and monogenic forms,while also facilitating mechanistic studies of diabetic complications such as retinopathy and nephropathy.Recent model refinements,particularly in simulating monogenic disorders and pregnancy-associated metabolic changes,promise to deepen our comprehension of disease pathophysiology and therapeutic interventions.Nevertheless,a persistent limitation lies in their incomplete recapitulation of human-specific physiological complexity and multi-organ metabolic interactions,factors that may influence translational applicability.Despite these constraints,zebrafish-based research continues to provide an indispensable platform for diabetes investigation,holding significant promise for alleviating the escalating global burden of this metabolic disorder.
文摘BACKGROUND Gestational diabetes mellitus(GDM)has emerged as a global public health cha-llenge,fueled by increasing maternal age,rising obesity rates,and lifestyle shifts.It is linked to substantial short-and long-term health risks for both mothers and their offspring,offering a critical opportunity for intergenerational prevention of metabolic disorders.AIM To synthesize current evidence on the pathophysiology,diagnosis,management,complications,and individualized treatment strategies of GDM.METHODS We conducted a narrative review in accordance with PRISMA guidelines.Pub-Med,Scopus,Web of Science,and EMBASE were searched for English-language articles(2017-2025)using terms such as“GDM”,“pregnancy”,“insulin resis-tance”,and“maternal outcomes”.After removing duplicates,512 records were screened;102 full texts were assessed for eligibility,and 55 studies were included based on methodological quality,clinical relevance,and alignment with the review objectives.RESULTS GDM results from a complex interplay among progressive insulin resistance,β-cell dysfunction,immune dysregulation,and placental inflammation.Emerging evidence indicates that hyperglycemia before formal diagnosis can impair fetal programming via epigenetic mechanisms.GDM increases a mother’s risk of developing type 2 diabetes mellitus seven-to tenfold and raises the incidence of cardiovascular disease,preeclampsia,and cesarean delivery.Offspring are at higher risk of macrosomia,neonatal hypoglycemia,and future metabolic and cardiovascular disorders.Lifestyle modification remains the cornerstone of therapy and,when necessary,can be supplemented with pharmacologic agents such as metformin or insulin.Postpartum follow-up,breastfeeding support,and preconception counseling are vital to long-term metabolic health.CONCLUSION GDM requires precision-based,life-course care.Future priorities include early risk detection,biomarker validation,unified diagnosis,and culturally sensitive interventions to improve maternal-child outcomes.
基金Supported by the National Key Research and Development Program of China,No.2021YFC2700700 and No.2021YFC2700704Capital’s Funds for Health Improvement and Research(CFH)in People’s Republic of China,No.2020-1-5112.
文摘BACKGROUND There are conflicting results on the potential correlation between folic acid and gestational diabetes mellitus(GDM),and the correlation between genetic factors related to folic acid metabolism pathways and GDM remains to be revealed.AIM To examine the association between single-nucleotide polymorphisms(SNPs)of enzyme genes in the folate metabolite pathway as well as that between GDM-related genes and risk for GDM.METHODS A nested case-control study was conducted with GDM cases(n=412)and healthy controls(n=412).DNA was extracted blood samples and SNPs were genotyped using Agena Bioscience’s MassARRAY gene mass spectrometry system.The associations between different SNPs of genes and the risk for GDM were estimated using logistic regression models.The generalized multi-factor dimensionality reduction(GMDR)method was used to analyze gene-gene and gene-environment interactions using the GMDR 0.9 software.RESULTS The variation allele frequency of melatonin receptor 1B(MTNR1B)rs10830963 was higher in the GDM group than in controls(P<0.05).MTNR1B rs10830963 mutant G was associated with risk for GDM[adjusted odds ratio(aOR):1.43;95%confidence interval(95%CI):1.13-1.80]in the additive model.MTNR1B rs10830963 GG+GC was significantly associated with the risk for GDM(aOR:1.65;95%CI:1.23-2.22)in the dominant model.The two-locus model of MTNR1B rs10830963 and CHEMERIN rs4721 was the best model(P<0.05)for gene-gene interactions in the GMDR results.The high-risk rs10830963×rs4721 type of interaction was a risk factor for GDM(aOR:2.09;95%CI:1.49-2.93).CONCLUSION This study does not find an association between SNPs of folate metabolic enzymes and risk for GDM.The G mutant allele of MTNR1B rs10830963 is identified as a risk factor for GDM in the additive model,and there may be gene-gene interactions between MTNR1B rs10830963 and CHEMERIN rs4721.It is conducive to studying the causes of GDM and provides a new perspective for the precise prevention of this disease.
基金supported by grants from the National Nat-ural Science Foundation of China(82170593)National Key R&D Program of China(2021YFC2700802)Collaborative Innovation Program of Shanghai Municipal Health Commission(2020CXJQ01)。
文摘Nonalcoholic fatty liver disease(NAFLD)has emerged as the prevailing chronic liver disease in the pediatric population due to the global obesity pandemic.Evidence shows that prenatal and postnatal exposure to maternal abnormalities leads to a higher risk of pediatric NAFLD through persistent alterations in developmental programming.Gestational diabetes mellitus(GDM)is a hyperglycemic syndrome which has become the most prevalent complication in pregnant women.An increasing number of both epidemiologic investigations and animal model studies have validated adverse and long-term outcomes in offspring following GDM exposure in utero.Similarly,GDM is considered a crucial risk factor for pediatric NAFLD.This review aimed to summarize currently published studies concerning the inductive roles of GDM in offspring NAFLD de velopment during childhood and adolescence.Dysregulations in hepatic lipid metabolism and gut microbiota in offspring,as well as dysfunctions in the placenta are potential factors in the pathogenesis of GDM-associated pediatric NAFLD.In addition,potentially effective interventions for GDM-associated offspring NAFLD are also discussed in this review.However,most of these therapeutic approaches still require further clinical research for validation.
基金Supported by DBT-BUILDER-University of Lucknow Interdisciplinary Life Science Programme for Advance Research and Education(Level Ⅱ),No.TG BT/INF/22/SP47623/2022Maulana Azad National Fellowship,University Grants Commission,New Delhi,Department of Biotechnology,New Delhi,No.F.82-27/2019(SA Ⅲ).
文摘Gestational diabetes mellitus(GDM)is a metabolic condition caused by chronic insulin resistance during pregnancy,affecting millions of women globally and causing significant health concerns.Its consequences are far-reaching,associated with poor feto-maternal outcomes.GDM has serious implications on metabolic health in both mother and child.Early diagnosis and management of GDM are crucial to prevent related consequences.Traditional diagnostic and predictive biomarkers for GDM,including oral glucose tolerance test,adiponectin,resistin,etc.,have limitations.Recent advances in research have identified novel biomarkers for GDM,offering promising alternatives for early diagnosis and prediction to prevent the associated adverse pediatric outcomes.Emerging biomarkers include microRNAs,cell-free DNA,exosomes,glycolytic intermediates,inflammatory biomarkers(C-reactive protein and interleukin-6),metabolic biomarkers(Betatrophin,fetuin-A,etc.),etc.Emerging bidirectional communication pathway(gut microbiota gut-brain-axis)plays a crucial role in GDM pathophysiology,and could be a promising biomarker.Emerging technologies such as next-generation seque-ncing,metabolomics,and proteomics have enabled the discovery of novel bio-markers for GDM and related pediatric outcomes.This review aims to summarize the current state of knowledge on emerging biomarkers for GDM,including their diagnostic accuracy,predictive value,and potential clinical applications to improve feto-maternal outcomes by personalized medicine approaches.
文摘BACKGROUND Gestational diabetes mellitus(GDM)has recently been associated with abnormal profiles of inflammatory cells and cytokines,though the findings remain incon-sistent and unclear.AIM To elucidate the peripheral immune status in GDM.METHODS We systematically screened databases including Web of Science,PubMed,and EMBASE for eligible studies.Original articles reporting different immune cell levels in GDM compared to normal glucose-tolerance pregnant women were included to extract usable data.The pooled mean difference(MD)with 95%confidence interval(CI)was analyzed as the outcome measure.The Newcastle-Ottawa scale was employed to assess study quality.RESULTS A total of 19 studies involving various immune cell subgroups were included in our analysis.Specifically,total CD4+T cells(WMD=3.08;95%CI:0.81-5.35)were significantly increased in GDM groups.In contrast,total lymphocytes(SMD=0.05;95%CI:-0.16 to 0.26),CD3+T cells(SMD=-0.34;95%CI:-1.01 to 0.32),CD8+T cells(SMD=0.21;95%CI:-0.31 to 0.73),and natural killer T(NKT)Cells(SMD=0.83;95%CI:-1.10 to 2.75)showed no significant changes in GDM.Activation markers(HLA-DR+or CD69+)on CD4+T cells(WMD=0.20;95%CI:0.06-0.34)were increased in GDM patients.Treg cells,a classical subgroup of CD4+T cells,showed a decreasing trend in GDM compared to controls(SMD=-0.83;95%CI:-1.31 to-0.34).These results indicate an abnormal immune status in the peripheral profiles of GDM.CONCLUSION GDM may not only be a dysglycemia-related condition but also an immune disorder characterized by abnormal peripheral immune profiles,including higher levels of CD4+T cells and a reduced population of Treg cells.Tr-eating immune dysregulation could be a new direction for GDM management,although further research is needed to understand the precise mechanisms of immune overactivation in GDM.
