Clinical and pathological characteristics of gestational diabetes mellitus with different insulin resistance

IF 2.9 3区医学 Q3 ENDOCRINOLOGY & METABOLISM Journal of diabetes and its complications Pub Date : 2024-06-17 DOI:10.1016/j.jdiacomp.2024.108796

Yidan Luo , Yuqin Qin , Lin Kong , Junqing Long , Veronika Lukacs-Kornek , Jian Li , Hongwei Wei , Jie Qin

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Abstract

Aims

To elucidate the clinical and pathological characteristics of gestational diabetes mellitus (GDM) with high and low insulin resistance.

Methods

In total, 1393 GDM and 1001 non-GDM singleton deliveries were included in this study. Insulin resistance subtypes were classified according to the HOMA2-IR value. Clinical data were analyzed using SPSS 26.0. Placenta samples were collected for pathological analysis.

Results

Maternal age and fasting glucose were identified as independent risk factors for GDM with high insulin resistance (p < 0.01), while fasting glucose was the sole risk factor for GDM with low insulin resistance (p < 0.001). Fetal distress was associated with both of GDM subtypes (both p < 0.01), while anemia, fetal growth restriction, large for gestational age and intrahepatic cholestasis in pregnancy were related to specific GDM insulin resistance subtype. In addition, GDM with high insulin resistance showed an increase of syncytial knots with down-regulation of PI3K/AKT signaling, while GDM with low insulin resistance showed normal syncytial knot counts and up-regulation of PI3K/AKT signaling.

Conclusions

Our findings provide novel perspectives to the clinical and pathological comprehensions of GDM with high and low insulin resistance, which might facilitate the mechanism study of GDM and its precision pregnancy management.

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具有不同胰岛素抵抗的妊娠糖尿病的临床和病理特征。

目的：阐明胰岛素抵抗高和胰岛素抵抗低的妊娠糖尿病（GDM）的临床和病理特征：方法：本研究共纳入 1393 例 GDM 和 1001 例非 GDM 单胎产妇。根据 HOMA2-IR 值对胰岛素抵抗亚型进行分类。临床数据使用 SPSS 26.0 进行分析。收集胎盘样本进行病理分析：结果：孕产妇年龄和空腹血糖被确定为高胰岛素抵抗型 GDM 的独立风险因素（p 结论：我们的研究结果为胰岛素抵抗型 GDM 的临床治疗提供了新的视角：我们的研究结果为GDM伴高胰岛素抵抗和伴低胰岛素抵抗的临床和病理理解提供了新的视角，这可能有助于GDM的机制研究及其孕期精准管理。

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来源期刊

Journal of diabetes and its complications 医学-内分泌学与代谢

CiteScore

5.90

自引率

3.30%

发文量

153

审稿时长

16 days

期刊介绍： Journal of Diabetes and Its Complications (JDC) is a journal for health care practitioners and researchers, that publishes original research about the pathogenesis, diagnosis and management of diabetes mellitus and its complications. JDC also publishes articles on physiological and molecular aspects of glucose homeostasis. The primary purpose of JDC is to act as a source of information usable by diabetes practitioners and researchers to increase their knowledge about mechanisms of diabetes and complications development, and promote better management of people with diabetes who are at risk for those complications. Manuscripts submitted to JDC can report any aspect of basic, translational or clinical research as well as epidemiology. Topics can range broadly from early prediabetes to late-stage complicated diabetes. Topics relevant to basic/translational reports include pancreatic islet dysfunction and insulin resistance, altered adipose tissue function in diabetes, altered neuronal control of glucose homeostasis and mechanisms of drug action. Topics relevant to diabetic complications include diabetic retinopathy, neuropathy and nephropathy; peripheral vascular disease and coronary heart disease; gastrointestinal disorders, renal failure and impotence; and hypertension and hyperlipidemia.