Metabolic factors and perinatal outcomes among pregnant individuals with mild glucose intolerance

IF 6.1 3区 医学 Q1 ENDOCRINOLOGY & METABOLISM
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引用次数: 0

Abstract

Aims

Metabolic characteristics and outcomes were compared among pregnant individuals with varying levels of glucose intolerance.

Methods

827 participants from a randomized clinical trial comparing the IADPSG and Carpenter Coustan Criteria were grouped as follows: normal glucose tolerance, mild glucose intolerance (100 g OGTT with one abnormal value) and treated GDM (diagnosed by Carpenter Coustan or IADPSG criteria). Differences in metabolic characteristics and perinatal outcomes were assessed using inverse probability of treatment weighting.

Results

Mild glucose intolerance had lower insulin sensitivity and beta cell response than normal glucose tolerance, and similar findings to treated GDM. Small for gestational age (SGA) (OR 0.13, 95% CI 0.08–0.24) and neonatal composite morbidity were lower (OR 0.53, 95% CI 0.38–0.74), and maternal composite morbidity higher (OR 2.03, 95% CI 1.57–2.62) when comparing mild intolerance to normal glucose tolerance. Large for gestational age (OR 3.42 95% CI 1.39–8.41) was higher while SGA (OR 0.21, 95% CI 0.05–0.81) and neonatal composite morbidity (OR 0.31, 95% CI 0.17–0.57) were lower with mild glucose intolerance compared to treated GDM.

Conclusions

Mild glucose intolerance has a similar metabolic profile to treated GDM, and outcome differences are likely related to knowledge of diagnosis and treatment.

Clinical trials registry: NCT02309138.

轻度葡萄糖不耐受孕妇的代谢因素和围产期结果。
目的:比较不同程度葡萄糖不耐受孕妇的代谢特征和预后。方法:将一项比较 IADPSG 标准和 Carpenter Coustan 标准的随机临床试验中的 827 名参与者分组如下:正常葡萄糖耐受、轻度葡萄糖不耐受(100 克 OGTT 有一个异常值)和经治疗的 GDM(根据 Carpenter Coustan 或 IADPSG 标准诊断)。采用治疗的反概率加权法评估了代谢特征和围产期结果的差异:结果:与正常糖耐量相比,轻度糖耐量患者的胰岛素敏感性和β细胞反应较低,其结果与经治疗的GDM相似。与正常糖耐量相比,轻度葡萄糖不耐受导致的胎龄小(SGA)(OR 0.13,95% CI 0.08-0.24)和新生儿综合发病率较低(OR 0.53,95% CI 0.38-0.74),而孕产妇综合发病率较高(OR 2.03,95% CI 1.57-2.62)。与经过治疗的 GDM 相比,轻度葡萄糖不耐受导致的胎龄大(OR 3.42 95% CI 1.39-8.41)更高,而 SGA(OR 0.21,95% CI 0.05-0.81)和新生儿综合发病率(OR 0.31,95% CI 0.17-0.57)更低:结论:轻度葡萄糖不耐受与经治疗的GDM具有相似的代谢特征,结果差异可能与诊断和治疗知识有关:临床试验登记:NCT02309138。
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来源期刊
Diabetes research and clinical practice
Diabetes research and clinical practice 医学-内分泌学与代谢
CiteScore
10.30
自引率
3.90%
发文量
862
审稿时长
32 days
期刊介绍: Diabetes Research and Clinical Practice is an international journal for health-care providers and clinically oriented researchers that publishes high-quality original research articles and expert reviews in diabetes and related areas. The role of the journal is to provide a venue for dissemination of knowledge and discussion of topics related to diabetes clinical research and patient care. Topics of focus include translational science, genetics, immunology, nutrition, psychosocial research, epidemiology, prevention, socio-economic research, complications, new treatments, technologies and therapy.
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