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Sex Hormone-binding Globulin,Cardiometabolic Biomarkers,and gestational Diabetes:A Longitudinal Study and Meta-analysis

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Maternal-Fetal Medicine 2020年第1期2卷 2-9页

作者： Meng-Ying Li Shristi Rawal Stefanie N.Hinkle Ye-Yi Zhu Fasil Tekola-Ayele Michael Y.Tsai Si-Min Liu Cui-Lin Zhang Epidemiology Branch Division of Intramural Population Health ResearchEunice Kennedy Shriver National Institute of Child Health and Human DevelopmentBethesda MD 20817USA Department of Nutritional Sciences School of Health ProfessionsRutgers UniversityNewark NJ 07107USA Division of Research Kaiser Permanente Northern CaliforniaOakland CA 94612USA Department of Laboratory Medicine and Pathology University of Minnesota Medical SchoolMinneapolis MN 55455USA Department of Epidemiology Brown University School of Public HealthProvidence RI 02912USA Department of Endocrinology Guangdong General Hospital and Guangdong Academy of Medical SciencesGuangdong 510080China

Objective::This study investigated the prospective associations of circulating levels of sex hormone-binding globulin(SHBG)levels with cardiometabolic biomarkers and risk of gestational Diabetes(GDM)during pregnancy.It also examines the longitudinal trajectory of SHBG in women with and without GDM.Methods::We conducted a nested case-control study of 107 incident GDM cases and 214 matched controls within the Eunice Kennedy Shriver National Institute of Child Health and Human Development Fetal Growth Studies-Singleton Cohort.The cohort enrolled non-obese and obese women aged 18-40 years with a singleton pregnancy between 8 and 13 weeks of gestation from 2009 to 2013.GDM was ascertained via medical records review.Blood samples were drawn four times at gestational weeks 10-14,15-26,23-31,and 33-39.The prospective associations between SHBG levels and cardiometabolic biomarkers were examined using the Spearman partial correlation among the controls.The longitudinal trajectories of SHBG levels were examined among the cases and the controls.Meta-analysis of prospective studies were performed to examine the association between SHBG levels and GDM risk.Results::SHBG levels at gestational weeks 10-14 were significantly inversely associated with fasting insulin(r=-0.17,P=0.01)and insulin resistance as measured by HOMA-IR(r=-0.17,P=0.01)at gestational week 15-26.SHBG at gestational weeks 10-14 and 15-26 was lower in cases than controls(mean±standard deviation:(204.0±97.6)vs.(220.9±102.5)nmol/L,P=0.16 and(305.6±124.3)vs.(322.7±105.1)nmol/L,P=0.14,respectively),yet the differences were not significant.In the meta-analysis,SHBG was 41.5 nmol/L(95%confidence interval:23.9,59.1,P<0.01)significantly lower among women with GDM than without,and each 50 nmol/L increase in SHBG was significantly associated with an odds ratio of 0.85(95%confidence interval:0.76-0.95,P=0.01)for GDM.Conclusion::Lower SHBG levels in early pregnancy were prospectively associated with higher high insulin levels and insulin resistance in mid-pregnancy and sub

关键词： Diabetes,gestational Sex binding hormones Cardiometabolic risk markers Cohort analysis Longitudinal measurement Meta-analysis

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The Relationship Between the Expression of Resistin and Apoptosis Factors in Placenta and the Pathogenesis of gestational Diabetes Mellitus

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Maternal-Fetal Medicine 2020年第2期2卷 80-83页

作者： Jun Yu Xiao-Ling Su Jing Jia Yu Zeng Jing-Yi Zhang Shao-Shuai Wang Ling Feng Department of Obstetrics and Gynecology Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430030China

Objective::To detect the expression of caspase-3,baculoviral inhibitor of apoptosis repeat containing 5(BIRC-5),vascular endothelial growth factor(VEGF),hypoxia-inducible factor(HIF),and the concentration of resistin protein in placental of patients with gestational Diabetes mellitus(GDM)and normal pregnant women,and to explore its correlation with the pathogenesis of GDM and its significance.Methods::This study includes 30 pregnant women who chose cesarean section at Tongji Hospital of Tongji Medical College during May 2013 to February 2014:15 GDM patients and 15 normal glucose tolerance patients,26-36 years old.The expression of caspase-3,VEGF,HIF,and BIRC-5 in placenta of 15 patients with GDM(GDM group)and 15 normal late pregnancy(control group)was detected by real-time fluorescence quantitative polymerase chain reaction.The concentration of resistin protein in the placenta was detected by enzyme-linked immunosorbent assay.Results::Compared with the control group,the expression of caspase-3,HIF,VEGF,resistin in placenta of GDM group increased significantly(P<0.05);the expression of BIRC-5 in placenta of GDM group decreased significantly(P<0.05).Conclusion::The expression of caspase-3,BIRC-5,VEGF,HIF,and resistin in placenta of GDM patients and normal pregnant women are significantly different,which may be involved in the pathogenesis of GDM disease.

关键词： Diabetes,gestational Placenta Survivin Apoptosis Resistin

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Genetic Variants of Potassium Voltage-gated Channel Subfamily J Member 11 in gestational Diabetes Mellitus:A Case-control Study

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Maternal-Fetal Medicine 2020年第1期2卷 12-16页

作者： Li-Jie Wei Xuan Zhou Sheng-Lan Zhu Jia-Qi Li Yu Zeng Jun Yu Shao-Shuai Wang Ling Feng Department of Obstetrics and Gynecology Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyHubei 430030China

Objective::To investigate the association of rs5210 in potassium voltage-gated channel subfamily J member 11(KCNJ11)with gestational Diabetes mellitus(GDM).Methods::Six hundred and thirty-two uncorrelated pregnancy females were recruited in Tongji hospital from October 2017 to June 2018,in which 241 pregnant women were identified as GDM,and 391 were non-GDM.All the pregnant women recruited in this study their peripheral venous blood of 5 mL were withdrawn,and DNA in the blood was extracted.rs5210 in KCNJ11 were genotyped using TaqMan Assays and genotype models were analyzed using logistic regression analyses.Results::After adjusting age and body mass index,the variant genotypes of rs5210 in genotype models were as follows:P for dominant model was 0.945,(odd ratio:0.987,95%confidence intervals(CI):0.681-1.430);P for recessive model:0.556,(odd ratio:1.217,95%CI:0.633-2.343)and P for addictive model was 0.098(genotype AA vs.GG),(odds ratio:1.435,95%CI:0.936-2.201).Weight-gain during pregnancy and total cholesterol were significantly different in recessive model(P=0.015,P=0.022,respectively)of all participants.Conclusion::No significant association between gene susceptibility of rs5210 in KCNJ11 and GDM occurrence in Chinese pregnant women.But the variant of rs5210 was associated with weight-gain during pregnancy and total cholesterol blood levels.However,more cases are needed in genetic study to check its susceptibility with GDM occurrence in Chinese women.

关键词： Diabetes,gestational Polymorphism,single nucleotide Potassium channels,voltage-gated

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Maternal Thyroid-Stimulating Hormone Level and Thyroid Peroxidase Antibody Status in the First and Second Trimester of Pregnancy and Their Relationship with the Risk of gestational Diabetes Mellitus

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Maternal-Fetal Medicine 2019年第2期1卷 81-85页

作者： Song-Qing Deng Hai-Tian Chen Dong-Yu Wang Bin Liu Han-Qing Chen Zi-Lian Wang Department of Obstetrics and Gynecology The First Affiliated HospitalSun Yat-senUniversityGuangzhouGuangdong 510080China

Objective:To investigate thyroid-stimulating hormone(TSH)levels and thyroid peroxidase antibody(TPOAb)in early pregnancy and to estimate the risk of development of gestational Diabetes mellitus(GDM).Methods:The levels of TSH,free thyroxine,free triiodothyronine,and TPOAb were retrospectively evaluated in 2333 pregnant women.All women recruited were divided into groups of TSH high(H),TSH low(L),TSH(H)TPOAb positive(+),TSH(H)TPOAb negative(-),TSH normal(N)TPOAb(+),TSH(L)TPOAb(+),TSH(L)TPOAb(-),and estimated the risk of GDM.Results:TSH level(X^(2)=13.0024,P=0.0015)and TSH combined TPOAb(X^(2)=20.0038,P=0.0012)were correlated to development of GDM.The level of TSH in 95 women was increased,and in 216 women were decreased.Of the 2333 pregnant women,546 patients were diagnosed with GDM,with a prevalence of 23.40%.The prevalence of GDM was 35.78%and 28.70%for the TSH high(H)and TSH low(L)pregnant women,respectively.The increased TSH(P=0.0013,odds ratio:2.09,confidence interval:1.34-3.28)was correlated to increase GDM incidence.TSH(H)TPOAb(+)(n=29),TSH(H)TPOAb(-)(n=58),TSH normal(N)TPOAb(+)(n=265),TSH(L)TPOAb(+)(n=30),TSH(L)TPOAb(-)(n=154)were in this study.The prevalence of GDM was 51.72%,29.31%,23.02%,26.67%,and 29.87%for the TSH(H)TPOAb(+),TSH(H)TPOAb(-),TSH(N)TPOAb(+),TSH(L)TPOAb(+),and TSH(L)TPOAb(-)pregnant women,respectively.Only the TSH(H)TPOAb(+)pregnant women had a significant higher incidence of GDM(P=0.0018,odds ratio:3.63,confidence interval:1.62-8.16).Trimester specific results showed that only second trimester had higher GDM risk either analyze TSH or the combination of TSH and TPOAb.Conclusion:Elevated TSH level and TPOAb positive in the second trimester of pregnancy were correlated to an increased risk of GDM.

关键词： Diabetes,gestational Thyrotropin Pregnancy trimester,first Pregnancy trimester,second

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Role of Ultrasonography in Pregnancies Complicated by gestational Diabetes: A Review

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Maternal-Fetal Medicine 2019年第2期1卷 86-90页

作者： Sara S.Hamze Sinno Anwar H.Nassar Department of Obstetrics and Gynecology American University of Beirut Medical CenterBeirut 11072020Lebanon

This review is to better clarify the role of ultrasonography during pregnancies complicated with gestational Diabetes mellitus(GDM).It will focus on the effect of GDM on pregnancy,and the use of ultrasound modality to estimate fetal size and accordingly the mode of delivery.It will also shed light on how this technology can be used to improve our understanding of the pathophysiology of this diagnosis and hopefully improve the maternal-fetal outcome.

关键词： Ultrasonography Diabetes,gestational Fetal weight

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Metformin in Pregnancy with Diabetes—Opinions from Several Latest Guidelines

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Maternal-Fetal Medicine 2020年第1期2卷 10-11页

作者： Ye Feng Hui-Xia Yang Department of Obstetrics and Gynecology Peking University First HospitalBeijing 100034China Beijing Key Laboratory of Maternal Fetal Medicine of gestational Diabetes Mellitus Beijing 100034China

Pregnancy complicated with Diabetes is associated with adverse maternal and fetal outcomes.Good control of glucose level during pregnancy contributes to improve maternal and fetal outcomes and break the vicious cycle of"Diabetes begetting Diabetes".The first line antidiabetic drug in pregnancy is insulin,which is expensive and inconvenient to use.Lots of clinical trials and meta-analyses have constantly confirmed the safety and efficacy of metformin in pregnancy.Several guidelines across the world have been discussing metformin as an alternative to insulin in pregnancy.This article summarizes the opinions about metformin from several latest guidelines.

关键词： Diabetes,gestational Type 2 Diabetes mellitus Pregnancy Metformin Guidelines

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