Mức glycodeoxycholic acid giảm liên quan đến các kết quả lâm sàng tiêu cực của tiểu đường thai kỳ

Journal of Zhejiang University-SCIENCE B - 2021
Bo Zhu1,2, Zhixin Ma1,2, Yuning Zhu1,2, Lei Fang1,2, Hong Zhang2,1, Hongwei Kong3,4, Dajing Xia5,6
1Department of Laboratorial Medicine, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, China
2Clinical Prenatal Diagnosis Center, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, China
3Key Laboratory of Separation Science for Analytical Chemistry, Dalian Institute of Chemical Physics, Chinese Academy of Sciences, Dalian, China
4Hangzhou HealthBank Medical Laboratory, Hangzhou, China
5Department of Toxicology, School of Public Health, Zhejiang University, Hangzhou, China
6Department of Gynecologic Oncology; Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, China

Tóm tắt

Tiểu đường thai kỳ (GDM) được đặc trưng bởi rối loạn glycemia và insulin. Axit mật (BAs) đã nổi lên như là những phân tử tín hiệu quan trọng trong việc điều chỉnh chuyển hóa glucose. Sự thay đổi của BAs trong GDM vẫn chưa được rõ ràng, điều này có ý nghĩa rất lớn để minh họa sự thay đổi của BAs trong GDM. Những bệnh nhân GDM và phụ nữ mang thai bình thường đã được tuyển chọn trong thời gian sàng lọc thử nghiệm dung nạp glucose qua đường miệng (OGTT). Máu đói đã được lấy mẫu để đo BAs. Hồ sơ chuyển hóa BAs đã được phân tích ở cả phụ nữ mang thai bị GDM và những người có dung nạp glucose bình thường (NGT). Các đặc điểm sinh nở, tuổi thai khi sinh và trọng lượng sơ sinh của trẻ được trích xuất từ hồ sơ y tế. Các bệnh nhân GDM thể hiện các đặc điểm nổi bật so với bệnh nhân NGT, bao gồm chỉ số khối cơ thể (BMI) cao hơn, nồng độ glucose huyết thanh tăng, insulin tăng (cả trong trạng thái đói và OGTT), và mức độ hemoglobin A1c (HbA1c) cao hơn. Mô hình đánh giá tính kháng insulin (HOMA-IR) tăng cao và sự bù trừ của tế bào β (tức là chỉ số phân bố miệng (DIo)) giảm cũng phổ biến trong nhóm này. Tổng lượng BAs (TBAs) vẫn ổn định, nhưng nồng độ axit glycodeoxycholic (GDCA) và axit taurodeoxycholic (TDCA) giảm đáng kể ở GDM. GDCA có tương quan nghịch với HOMA-IR và tương quan thuận với DIo. Không có sự khác biệt rõ ràng về kết quả lâm sàng giữa các nhóm GDM và NGT được quan sát. Tuy nhiên, bệnh nhân GDM với HOMA-IR cao và DIo thấp có xu hướng có tỷ lệ sinh mổ cao hơn và tuổi thai khi sinh trẻ hơn. Tóm lại, GDCA cung cấp một chỉ thị sinh học giá trị để đánh giá HOMA-IR và DIo, và mức GDCA giảm cho thấy kết quả lâm sàng kém hơn cho GDM.

Từ khóa

#tiểu đường thai kỳ #axit mật #glycodeoxycholic acid #HOMA-IR #chỉ số phân bố miệng

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