子痫前期合并妊娠期糖尿病妇女的代谢特征

A. S. Anikeev, N. M. Startseva, V.M. Grabovsky, I. M. Ordiyants, L. Gazaryan, A. Savicheva
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摘要

目的:总结妊娠期糖尿病(GDM)合并先兆子痫(PE)所致妊娠并发症的预后和诊断标准。要点。有GDM和PE的现代范式,他们的并发症,以及围产期和母亲和孩子的长期结果的分析审查。对GDM中PE的临床、记忆和实验室危险因素进行了系统整理。PE和GDM发生机制之间的密切关系——胎盘血管生成失衡和代谢紊乱。结论。GDM被认为是PE发生的独立危险因素,GDM得到的补偿越少,这种风险越大。多囊卵巢综合征和体重指数的增加作为代谢紊乱的伴随因素也增加了PE的发生风险。假定GDM和PE的致病共性是存在氧化应激和元炎症,它们会增加胰岛素抵抗并引起内皮功能障碍。关键词:子痫前期,妊娠期糖尿病,代谢,危险因素,发病共性。
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Features of Metabolism in Women with Preeclampsia Combined with Gestational Diabetes Mellitus
Objective of the Review: To summarize the proven prognostic and diagnostic criteria for gestational complications caused by a combination of gestational diabetes mellitus (GDM) and preeclampsia (PE). Key points. There is an analytical review of the modern paradigm of GDM and PE, their complications, as well as perinatal and long-term outcomes for mother and child. The data on clinical, anamnestic and laboratory risk factors of PE in GDM are systematized. A close relationship between the mechanisms of PE and GDM development — angiogenic imbalance and metabolic disorders in the placenta is described. Conclusion. GDM is recognized as an independent risk factor for the development of PE, and this risk is the greater the less GDM is compensated. Polycystic ovary syndrome and an increased body mass index as concomitant factors of metabolic disorders also increase the risk of developing PE. The supposed pathogenetic commonality of GDM and PE is the presence of oxidative stress and metaflammation, which increase insulin resistance and cause endothelial dysfunction. Keywords: preeclampsia, gestational diabetes mellitus, metabolism, risk factors, pathogenetic commonality.
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