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Diabet Care:肝脏特殊酶类水平升高或与高风险的妊娠糖尿病直接相关

  1. 妊娠糖尿病
  2. 水平
  3. 肝脏
  4. 酶类
  5. 风险

来源:生物谷 2014-05-07 10:20

近日,来自凯萨医疗机构的研究人员通过研究表示,怀孕前女性机体中常见的肝脏酶类水平如果较高的话,其患妊娠糖尿病的可能性是较低水平肝脏酶类女性的2倍,相关研究成果刊登于国际杂志Diabetes Care上。

2014年5月6日 讯 /生物谷BIOON/ --近日,来自凯萨医疗机构的研究人员通过研究表示,怀孕前女性机体中常见的肝脏酶类水平如果较高的话,其患妊娠糖尿病的可能性是较低水平肝脏酶类女性的2倍,相关研究成果刊登于国际杂志Diabetes Care上。

肝脏在调节机体葡萄糖水平上扮演了重要角色,名为γ-谷氨酰转肽酶(GGT)的肝脏酶类是肝功能常见的一种标记物,其和胰岛素耐受性直接相关,也是妊娠糖尿病和2型糖尿病的一个前体物质。研究者Monique M. Hedderson教授说道,许多生物标记物都和妊娠糖尿病风险直接相关,这项研究为揭示患妊娠糖尿病的女性一般都会存在机体代谢异常提供了一定的研究证据,未来研究者就可以在女性怀孕之前对其进行干预来抑制女性妊娠糖尿病的发生。

近些年来,妊娠糖尿病发病率日益升高,其往往会导致患者生出比正常婴儿尺寸大的婴儿,并且会使患者出现分娩并发症。有研究发现,患妊娠糖尿病的女性在日后的生活中发生2型糖尿病的风险是正常女性的7倍,而且患者所生小孩患肥胖和糖尿病的风险也较高。

文章中研究者对256名怀孕期间患妊娠糖尿病的女性的医疗记录进行了分析,同时对比了497名正常怀孕女性的医疗记录,在考虑众多的混杂因素,比如BMI及酒精使用等因素后,研究者发现,较高水平GGT的女性患妊娠糖尿病的风险是较低水平GGT女性的2倍;研究者Sneha Sridhar博士表示,目前已经有一些研究来揭示怀孕期间肝脏酶类水平和患妊娠糖尿病风险之间的关系,但是本文研究是首次揭示女性怀孕前机体的肝脏酶类水平同怀孕期间患糖尿病风险的一项研究。

最后研究者表示,我们希望开发出一种新型的风险模型来帮助鉴别出因提前干预而获益的女性,当然本文研究对于开发合适的疗法治疗女性的妊娠期糖尿病或者预防措施也提供了一定的研究依据。(生物谷Bioon.com)

Pregravid Liver Enzyme Levels and Risk of Gestational Diabetes During a Subsequent Pregnancy.

Sridhar SB1, Xu F, Darbinian J, Quesenberry CP, Ferrara A, Hedderson MM.

OBJECTIVELiver enzymes are independent predictors of type 2 diabetes. Although liver fat content correlates with features of insulin resistance, a risk factor for developing gestational diabetes mellitus (GDM), the relationship between liver enzymes and GDM is unclear. The objective of this study was to assess whether pregravid liver enzyme levels are associated with subsequent risk of GDM.RESEARCH DESIGN AND METHODSA nested case-control study was conducted among women who participated in the Kaiser Permanente Northern California multiphasic health checkup (1984-1996) and had a subsequent pregnancy (1984-2009). Case patients were 256 women who developed GDM. Two control subjects were selected for each case patient and matched for year of blood draw, age at examination, age at pregnancy, and number of intervening pregnancies.RESULTSBeing in the highest quartile versus the lowest quartile of γ-glutamyl transferase (GGT) levels was associated with a twofold increased risk of subsequent GDM (odds ratio 1.97 [95% CI 1.14-3.42]), after adjusting for race/ethnicity, prepregnancy BMI, family history of diabetes, and alcohol use. This result was attenuated after adjusting for homeostasis model assessment of insulin resistance (HOMA-IR), fasting status, and rate of gestational weight gain. There was significant interaction between GGT and HOMA-IR; the association with GGT was found among women in the highest tertile of HOMA-IR. Aspartate aminotransferase and alanine aminotransferase were not associated with increased GDM risk.CONCLUSIONSPregravid GGT level, but not alanine aminotransferase or aspartate aminotransferase level, predicted the subsequent risk of GDM. Markers of liver fat accumulation, such as GGT level, are present years before pregnancy and may help to identify women at increased risk for subsequent GDM.

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