{"title":"妊娠期糖尿病患者血清晚期糖基化终产物及其受体介导的氧化应激与围产儿结局的相关性","authors":"Ying Zhang, Teng Li, Zhi-Heng Wang, Yun Liu","doi":"10.4239/wjd.v16.i6.104177","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Gestational diabetes mellitus (GDM) is one of the most prevalent metabolic disorders of pregnancy. Advanced glycation end-products (AGEs) are a complex and highly heterogeneous group of compounds formed from amino acids and reducing sugars. High-AGE diet exposure during pregnancy may cause adverse effects.</p><p><strong>Aim: </strong>To investigate the expression levels of AGE and AGE receptor (RAGE) in the serum and placenta of pregnant women with GDM and to assess the association of their mediated oxidative stress response with perinatal outcomes.</p><p><strong>Methods: </strong>This study retrospectively analyzed the clinical data of 126 pregnant women with GDM who gave birth in the Obstetrics Department of Obstetrics and Gynecology Hospital of Fudan University from January 2023 to January 2024. A total of 85 pregnant women of similar age without GDM during the same period were selected as the control group. Fasting blood glucose, glycated hemoglobin, AGEs, soluble RAGE (sRAGE), and oxidative stress were compared in both groups. Postpartum placental tissue was collected to identify RAGE protein expression. Participants with GDM were categorized based on perinatal outcomes into normal (<i>n</i> = 89) and adverse perinatal outcome groups (<i>n</i> = 37), and differences in serum AGE-RAGE levels and oxidative stress were analyzed. The influencing factors of adverse perinatal outcomes were analyzed using logistic regression.</p><p><strong>Results: </strong>The GDM group demonstrated notably higher serum AGE (<i>t</i> = 8.955) and malondialdehyde (MDA) levels (<i>t</i> = 14.14) and lower sRAGE (<i>t</i> = 16.37) and superoxide dismutase (SOD) levels (<i>t</i> = 18.50) than the control group at 24-28 weeks of gestation and before delivery (<i>P</i> < 0.0001). Serum AGE levels were positively correlated with MDA and negatively related to SOD at 24-28 weeks of pregnancy (SOD: <i>r</i> = 0.393, MDA: <i>r</i> = 0.424, <i>P</i> < 0.0001) and before delivery (SOD: <i>r</i> = 0.443, MDA: <i>r</i> = 0.492, <i>P</i> < 0.0001), whereas AGE was inversely associated with sRAGE in the GDM group (<i>r</i> = -0.495, <i>P</i> < 0.0001). Serum AGE levels were significantly higher (<i>t</i> = 9.225, <i>P</i> < 0.0001) and the sRAGE level (<i>r</i> = 3.563, <i>P</i> < 0.0001) was significantly lower in participants with adverse perinatal outcomes than those with normal perinatal outcomes in the GDM group. Logistic regression analysis revealed AGE level as a risk factor (OR = 1.056, P < 0.0001) and sRAGE level (OR = 0.949, <i>P</i> < 0.0001) as a protective factor for adverse perinatal outcomes in GDM.</p><p><strong>Conclusion: </strong>High serum AGE level is a risk factor for adverse perinatal outcomes in GDM, whereas high sRAGE levels are protective. AGEs and RAGE may be associated with oxidative stress in pregnant women with GDM.</p>","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":"16 6","pages":"104177"},"PeriodicalIF":4.2000,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12179900/pdf/","citationCount":"0","resultStr":"{\"title\":\"Correlation between serum advanced glycation end-products and their receptor-mediated oxidative stress and perinatal outcomes in gestational diabetes mellitus.\",\"authors\":\"Ying Zhang, Teng Li, Zhi-Heng Wang, Yun Liu\",\"doi\":\"10.4239/wjd.v16.i6.104177\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Gestational diabetes mellitus (GDM) is one of the most prevalent metabolic disorders of pregnancy. Advanced glycation end-products (AGEs) are a complex and highly heterogeneous group of compounds formed from amino acids and reducing sugars. High-AGE diet exposure during pregnancy may cause adverse effects.</p><p><strong>Aim: </strong>To investigate the expression levels of AGE and AGE receptor (RAGE) in the serum and placenta of pregnant women with GDM and to assess the association of their mediated oxidative stress response with perinatal outcomes.</p><p><strong>Methods: </strong>This study retrospectively analyzed the clinical data of 126 pregnant women with GDM who gave birth in the Obstetrics Department of Obstetrics and Gynecology Hospital of Fudan University from January 2023 to January 2024. A total of 85 pregnant women of similar age without GDM during the same period were selected as the control group. Fasting blood glucose, glycated hemoglobin, AGEs, soluble RAGE (sRAGE), and oxidative stress were compared in both groups. Postpartum placental tissue was collected to identify RAGE protein expression. Participants with GDM were categorized based on perinatal outcomes into normal (<i>n</i> = 89) and adverse perinatal outcome groups (<i>n</i> = 37), and differences in serum AGE-RAGE levels and oxidative stress were analyzed. The influencing factors of adverse perinatal outcomes were analyzed using logistic regression.</p><p><strong>Results: </strong>The GDM group demonstrated notably higher serum AGE (<i>t</i> = 8.955) and malondialdehyde (MDA) levels (<i>t</i> = 14.14) and lower sRAGE (<i>t</i> = 16.37) and superoxide dismutase (SOD) levels (<i>t</i> = 18.50) than the control group at 24-28 weeks of gestation and before delivery (<i>P</i> < 0.0001). Serum AGE levels were positively correlated with MDA and negatively related to SOD at 24-28 weeks of pregnancy (SOD: <i>r</i> = 0.393, MDA: <i>r</i> = 0.424, <i>P</i> < 0.0001) and before delivery (SOD: <i>r</i> = 0.443, MDA: <i>r</i> = 0.492, <i>P</i> < 0.0001), whereas AGE was inversely associated with sRAGE in the GDM group (<i>r</i> = -0.495, <i>P</i> < 0.0001). Serum AGE levels were significantly higher (<i>t</i> = 9.225, <i>P</i> < 0.0001) and the sRAGE level (<i>r</i> = 3.563, <i>P</i> < 0.0001) was significantly lower in participants with adverse perinatal outcomes than those with normal perinatal outcomes in the GDM group. Logistic regression analysis revealed AGE level as a risk factor (OR = 1.056, P < 0.0001) and sRAGE level (OR = 0.949, <i>P</i> < 0.0001) as a protective factor for adverse perinatal outcomes in GDM.</p><p><strong>Conclusion: </strong>High serum AGE level is a risk factor for adverse perinatal outcomes in GDM, whereas high sRAGE levels are protective. AGEs and RAGE may be associated with oxidative stress in pregnant women with GDM.</p>\",\"PeriodicalId\":48607,\"journal\":{\"name\":\"World Journal of Diabetes\",\"volume\":\"16 6\",\"pages\":\"104177\"},\"PeriodicalIF\":4.2000,\"publicationDate\":\"2025-06-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12179900/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"World Journal of Diabetes\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.4239/wjd.v16.i6.104177\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ENDOCRINOLOGY & METABOLISM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"World Journal of Diabetes","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.4239/wjd.v16.i6.104177","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}
引用次数: 0
摘要
背景：妊娠期糖尿病（GDM）是妊娠期最常见的代谢疾病之一。晚期糖基化终产物（AGEs）是由氨基酸和还原糖形成的一组复杂且高度异构的化合物。孕期接触高ages饮食可能会造成不良影响。目的：探讨GDM孕妇血清和胎盘中AGE及AGE受体（RAGE）的表达水平，并探讨其介导的氧化应激反应与围产期结局的关系。方法：回顾性分析2023年1月至2024年1月在复旦大学妇产医院产科分娩的126例GDM孕妇的临床资料。选取同期年龄相近、未发生GDM的孕妇85例作为对照组。比较两组空腹血糖、糖化血红蛋白、AGEs、可溶性RAGE （sRAGE）和氧化应激。采集产后胎盘组织，检测RAGE蛋白表达。根据围产期结局将GDM患者分为正常（n = 89）和不良围产期结局组（n = 37），并分析血清AGE-RAGE水平和氧化应激的差异。采用logistic回归分析围产儿不良结局的影响因素。结果：GDM组妊娠24 ~ 28周及分娩前血清AGE （t = 8.955）、丙二醛（MDA）水平（t = 14.14）显著高于对照组，sRAGE （t = 16.37）、超氧化物歧化酶（SOD）水平（t = 18.50）显著低于对照组（P < 0.0001）。妊娠24-28周和分娩前血清AGE水平与MDA呈正相关（SOD: r = 0.393, MDA: r = 0.424, P < 0.0001），与SOD呈负相关（SOD: r = 0.443, MDA: r = 0.492, P < 0.0001），而GDM组AGE与sRAGE呈负相关（r = -0.495, P < 0.0001）。GDM组围产儿不良结局组血清AGE水平显著高于正常结局组（t = 9.225, P < 0.0001）， sRAGE水平显著低于正常结局组（r = 3.563, P < 0.0001）。Logistic回归分析显示，年龄水平是GDM围产儿不良结局的危险因素（OR = 1.056, P < 0.0001）， sRAGE水平是GDM围产儿不良结局的保护因素（OR = 0.949, P < 0.0001）。结论：高血清AGE水平是GDM围产儿不良结局的危险因素，而高血清AGE水平具有保护作用。妊娠期糖尿病孕妇的AGEs和RAGE可能与氧化应激有关。
Correlation between serum advanced glycation end-products and their receptor-mediated oxidative stress and perinatal outcomes in gestational diabetes mellitus.
Background: Gestational diabetes mellitus (GDM) is one of the most prevalent metabolic disorders of pregnancy. Advanced glycation end-products (AGEs) are a complex and highly heterogeneous group of compounds formed from amino acids and reducing sugars. High-AGE diet exposure during pregnancy may cause adverse effects.
Aim: To investigate the expression levels of AGE and AGE receptor (RAGE) in the serum and placenta of pregnant women with GDM and to assess the association of their mediated oxidative stress response with perinatal outcomes.
Methods: This study retrospectively analyzed the clinical data of 126 pregnant women with GDM who gave birth in the Obstetrics Department of Obstetrics and Gynecology Hospital of Fudan University from January 2023 to January 2024. A total of 85 pregnant women of similar age without GDM during the same period were selected as the control group. Fasting blood glucose, glycated hemoglobin, AGEs, soluble RAGE (sRAGE), and oxidative stress were compared in both groups. Postpartum placental tissue was collected to identify RAGE protein expression. Participants with GDM were categorized based on perinatal outcomes into normal (n = 89) and adverse perinatal outcome groups (n = 37), and differences in serum AGE-RAGE levels and oxidative stress were analyzed. The influencing factors of adverse perinatal outcomes were analyzed using logistic regression.
Results: The GDM group demonstrated notably higher serum AGE (t = 8.955) and malondialdehyde (MDA) levels (t = 14.14) and lower sRAGE (t = 16.37) and superoxide dismutase (SOD) levels (t = 18.50) than the control group at 24-28 weeks of gestation and before delivery (P < 0.0001). Serum AGE levels were positively correlated with MDA and negatively related to SOD at 24-28 weeks of pregnancy (SOD: r = 0.393, MDA: r = 0.424, P < 0.0001) and before delivery (SOD: r = 0.443, MDA: r = 0.492, P < 0.0001), whereas AGE was inversely associated with sRAGE in the GDM group (r = -0.495, P < 0.0001). Serum AGE levels were significantly higher (t = 9.225, P < 0.0001) and the sRAGE level (r = 3.563, P < 0.0001) was significantly lower in participants with adverse perinatal outcomes than those with normal perinatal outcomes in the GDM group. Logistic regression analysis revealed AGE level as a risk factor (OR = 1.056, P < 0.0001) and sRAGE level (OR = 0.949, P < 0.0001) as a protective factor for adverse perinatal outcomes in GDM.
Conclusion: High serum AGE level is a risk factor for adverse perinatal outcomes in GDM, whereas high sRAGE levels are protective. AGEs and RAGE may be associated with oxidative stress in pregnant women with GDM.
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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