Abnormal peripheral cellular immune profiles in gestational diabetes mellitus: A meta-analysis.

IF 4.2 3区 医学 Q1 ENDOCRINOLOGY & METABOLISM
Yan Yang, Quan-Zhou Xiao, Jian Zhou, Ya-Qi Wang
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引用次数: 0

Abstract

Background: Gestational diabetes mellitus (GDM) has recently been associated with abnormal profiles of inflammatory cells and cytokines, though the findings remain inconsistent 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. Treating 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.

妊娠期糖尿病外周细胞免疫异常:一项荟萃分析。
背景:妊娠期糖尿病(GDM)最近被认为与炎症细胞和细胞因子的异常有关,尽管研究结果仍然不一致和不清楚。目的:探讨GDM患者的外周免疫状态。方法:我们系统地筛选了Web of Science、PubMed和EMBASE等数据库,寻找符合条件的研究。纳入了报道GDM与正常葡萄糖耐量孕妇免疫细胞水平不同的原始文章,以提取可用数据。以95%可信区间(CI)的合并平均差(MD)作为结果测量。采用纽卡斯尔-渥太华量表评估研究质量。结果:我们的分析共纳入了19项涉及不同免疫细胞亚群的研究。其中,总CD4+ T细胞(WMD = 3.08;95%CI: 0.81-5.35)在GDM组显著升高。总淋巴细胞(SMD = 0.05;95%CI: -0.16 ~ 0.26), CD3+ T细胞(SMD = -0.34;95%CI: -1.01 ~ 0.32), CD8+ T细胞(SMD = 0.21;95%CI: -0.31 ~ 0.73)和自然杀伤T (NKT)细胞(SMD = 0.83;95%CI: -1.10 ~ 2.75)显示GDM无显著变化。CD4+ T细胞上的激活标记(HLA-DR+或CD69+) (WMD = 0.20;95%CI: 0.06-0.34)在GDM患者中升高。Treg细胞是CD4+ T细胞的一个经典亚群,在GDM中与对照组相比呈下降趋势(SMD = -0.83;95%CI: -1.31 ~ -0.34)。这些结果表明GDM的外周免疫状态异常。结论:GDM可能不仅是一种与血糖异常相关的疾病,也是一种以外周免疫异常为特征的免疫疾病,包括CD4+ T细胞水平升高和Treg细胞数量减少。治疗免疫失调可能是GDM治疗的新方向,尽管还需要进一步的研究来了解GDM中免疫过度激活的确切机制。
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来源期刊
World Journal of Diabetes
World Journal of Diabetes ENDOCRINOLOGY & METABOLISM-
自引率
2.40%
发文量
909
期刊介绍: The WJD is a high-quality, peer reviewed, open-access journal. The primary task of WJD is to rapidly publish high-quality original articles, reviews, editorials, and case reports in the field of diabetes. In order to promote productive academic communication, the peer review process for the WJD is transparent; to this end, all published manuscripts are accompanied by the anonymized reviewers’ comments as well as the authors’ responses. The primary aims of the WJD are to improve diagnostic, therapeutic and preventive modalities and the skills of clinicians and to guide clinical practice in diabetes. Scope: Diabetes Complications, Experimental Diabetes Mellitus, Type 1 Diabetes Mellitus, Type 2 Diabetes Mellitus, Diabetes, Gestational, Diabetic Angiopathies, Diabetic Cardiomyopathies, Diabetic Coma, Diabetic Ketoacidosis, Diabetic Nephropathies, Diabetic Neuropathies, Donohue Syndrome, Fetal Macrosomia, and Prediabetic State.
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