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1.
Gestational diabetes mellitus(GDM) is characterized by glycemia and insulin disorders.Bile acids(BAs) have emerged as vital signaling molecules in glucose metabolic regulation.BA change in GDM is still unclear,which exerts great significance to illustrate the change of BAs in GDM.GDM patients and normal pregnant women were enrolled during the oral glucose tolerance test(OGTT) screening period.Fasting serums were sampled for the measurement of BAs.BA metabolism profiles were analyzed in both pregnant women with GDM and those with normal glucose tolerance(NGT).Delivery characteristics,delivery gestational age,and infant birthweight were extracted from medical records.GDM patients presented distinctive features compared with NGT patients,including higher body mass index(BMI),elevated serum glucose concentration,raised insulin(both fasting and OGTT),and increased hemoglobin A1 c(HbA1c) levels.Higher homeostasis model assessment of insulin resistance(HOMA-IR) and decreased β-cell compensation(i.e.,oral disposition index(DIo)) were also prevalent in this group.Total BAs(TBAs) remained stable,but glycodeoxycholic acid(GDCA) and taurodeoxycholic acid(TDCA) levels declined significantly in GDM.GDCA was inversely correlated with HOMA-IR and positively correlated with DIo.No obvious differences in clinical outcome between the GDM and NGT groups were observed.However,GDM patients with high HOMA-IR and low DIo tended to have a higher cesarean delivery rate and younger delivery gestational age.In conclusion,GDCA provides a valuable biomarker to evaluate HOMA-IR and DIo, and decreased GDCA levels predict poorer clinical outcomes for GDM.  相似文献   

2.
目的：观察个体化饮食干预疗法对妊娠期糖尿病（GDM）的治疗作用;方法：将确诊为GDM的50例孕妇随机分为观察组及对照组,观察两组治疗前后的血糖水平及胰岛素用量等的变化;结果：出院时观察组空腹血糖（FPG）、餐后2小时血糖（p2hBG）、血糖迭标时每日胰岛素总量及住院期阍出现低血糖次数较对照组均有明显下降（P〈0．05）;结论：个体化饮食干预治疗对GDM患者血糖有较好的控制效果。  相似文献   

3.
目前妊娠期糖尿病的发病机制尚不完全清楚,随着研究的进展,免疫炎症假说日益受到学者的重视.妊娠期糖尿病的发病与病人体内的促炎/抗炎细胞因子平衡失常有关,该平衡倾向于促炎细胞因子的分泌,而抗炎细胞因子在疾病的发生、发展中可能发挥保护作用,文章综述了促炎细胞因子(TNF-6、IL-6、IFN-γ、IL-2、IL-17、IL-1β)和抗炎细胞因子(IL-10、IL-37、IL-4)在妊娠期糖尿病发生、发展中的作用,以及它们在临床筛查和诊断中的应用,以期为妊娠期糖尿病的预测和防治提供参考.  相似文献   

4.
This study examined the association of gestational diabetes mellitus (GDM), prenatal, and postnatal maternal depressive symptoms with externalizing, internalizing, and autism spectrum problems on the Preschool Child Behavior Checklist in 2379 children aged 4.12 ± 0.60 (48% female; 47% White, 32% Black, 15% Mixed Race, 4% Asian, <2% American Indian/Alaskan Native, <2% Native Hawaiian; 23% Hispanic). Data were collected from the NIH Environmental influences on Child Health Outcomes (ECHO) Program from 2009-2021. GDM, prenatal, and postnatal maternal depressive symptoms were each associated with increased child externalizing and internalizing problems. GDM was associated with increased autism behaviors only among children exposed to perinatal maternal depressive symptoms above the median level. Stratified analyses revealed a relation between GDM and child outcomes in males only.  相似文献   

5.
A revised Prechtl Neurological Examination was administered to 510 singleton infants at term conceptional age to assess the influence of gestational age, race, and sex on neurobehavioral responses in a "typical" newborn population. The infants were born at 1 of 5 centers and were subjects of the NIH Collaborative Study on Antenatal Steroid Therapy. Of these babies, 392 were born at less than 37 weeks gestational age, whereas 118 infants were born at greater than or equal to 37 weeks. Of a total of 50 items of interest, 12 differed significantly based on race, 14 items differed in terms of gestational age at birth, and 5 items were influenced by the sex of the baby. These data suggest that singleton preterm infants born at differing gestational ages should not be considered to comprise a homogeneous sample. Further, caution should be exercised when considering babies of heterogeneous race groupings, and the babies' sex has minimal impact on neurobehavioral responses at term conceptional age.  相似文献   

6.
OBJECTIVE: The purpose of this study was to investigate retrospectively neonatal health and maternal background among a sample of children taken into custody and placed in foster care and to investigate the relation between medical and social risk in the neonatal period. METHOD: The data-linkage study combined two registries: the Finnish Medical Birth Registry (MBR), from January 1, 1987 to December 31, 1989, and the Finnish Child Welfare Registry (CWR) from January 1, 1987 to December 31, 1997 using personal identification numbers (n=1,668). As controls all Finnish children born in 1987 were chosen (n=59,727). Infant neonatal health was estimated using the following indicators: birth-weight and birth-length, birth-weight by gestational age, 1-minute Apgar scores, and discharge age from the nursery. Maternal background characteristics included maternal age, parity, marital status, number of antenatal visits at maternity clinics and smoking during pregnancy. RESULTS: We found that the 1,668 children in the study had a lower birth-weight and birth-length, shorter gestational age, lower 1-minute Apgar scores and later discharge from the nursery than the population-based controls. The proportion of teen-age mothers was about four times higher and the proportion of unmarried women was twice as high. A majority of the women (56%) reported smoking during pregnancy, compared with only 15% of the population-based comparisons. Children subsequently taken into custody had poorer health at the time of birth than other children and these differences could only partly be explained by the differences in smoking habits during pregnancy. The women in the study made use of the free health controls at maternity clinics as much as the population-based comparisons. CONCLUSIONS: Our findings indicate that social and medical risks are related in the neonatal period. Since almost all mothers visit maternity clinics, there are possibilities for early intervention.  相似文献   

7.
PTP-1B是1988年被分离的一种蛋白质酪氨酸磷酸酶,它通过对胰岛素受体激酶活化部位(IRK)酪氨酸残基(pTyr)的去磷酸化来介导胰岛素信号.蛋白质酪氨酸磷酸化在信号转导的过程中起着关键作用,它通过在信号传导中的负调节功能导致个体胰岛素抵抗,从而发生糖脂代谢紊乱,进一步形成2型糖尿病.我国现有糖尿病患者约4000万,其中90%以上为2型糖尿病.21世纪2型糖尿病将成为中国、印度等亚太人口大国的流行病.随着对PTP-1B作用机理认识的逐渐深入,研究者发现它是2型糖尿病治疗的一个理想靶位点,为2型糖尿病发病机理和预防治疗研究提供了一条新的线索.该文综述了PTP-1B在基因结构、基因产物和生物学功能等方面的最新研究进展.  相似文献   

8.
目的 分析门诊输液病人发生低血糖反应的原因,寻求预防方法.方法 对襄阳职业技术学院附属医院2012年1至12月门诊输液出现低血糖反应的病人进行原因分析.结果 出现低血糖反应者多为幼儿、老年人和老年糖尿病人,输液溶媒为盐水.结论 门诊输液病人出现低血糖的原因多样,尤以幼儿、老年及老年糖尿病人多见,早预防可防止其发生.  相似文献   

9.
目的 :观察中药方剂 (自拟降糖汤 )对控制糖尿病病情的治疗效果 .方法 :6 3例糖尿病患者分成A、B两组 .A组在常规治疗基础上加用降糖汤 ,B组予以常规治疗 ,不加降糖汤 .结果 :A组治疗后空腹及餐后 2小时血糖均明显下降 ,差异具有显著性 (P <0 0 5 ) .B组治疗前后空腹及餐后 2小时血糖无明显变化 ,差异无显著性 (P >0 0 5 ) .结论 :降糖汤对控制糖尿病患者血糖确有一定疗效  相似文献   

10.
To gain better understanding of telomerase’s possible role in the carcinogenesis of gestational trophoblastic tumors, the authors conducted RT-PCR amplification-based analysis and carried out telomeric repeat amplification to determine the levels of the human telomerase RNA (hTR) and that of telomerase enzymatic activity itself in 43 normal human placental tissues, 35 gestational trophoblastic tumor tissues and three choriocarcinoma cell lines. hTR was expressed in malignant gestational trophoblastic tumor tissues as well as choriocarcinoma cell lines. The results showed that hTR of early placenta villi and a part of hydatidiform mole were positive. But relatively low levels of the hTR could be found in placental tissues. Telomerase enzymatic activity was strongly positive in 32 of the 35 (91.4%) gestational trophoblastic tumor tissues and all the three choriocarcinoma cell lines. The enzymatic activity of telomerase itself was detectable at relatively low lelves in 14 of the 21 (66.7%) early placental villi, only three of the 22 (13.6%) term placenta were weakly positive. These results suggest that telomerase activity may be correlated with the development of trophoblastic tumors, and so, may be a useful diagnostic marker for detecting the existence of malignant trophoblastic cells. Project (39670753) supported by NSFC  相似文献   

11.
This study describes the development of emotional and behavioral regulation in a regional cohort of children born extremely preterm (<28 weeks gestational age, n = 39), very preterm (<34 weeks gestational age, n = 56), and full term (n = 103). At 2 and 4 years, children born at younger gestational ages demonstrated poorer self-regulation across multiple contexts spanning observed interactions, formal cognitive testing, and parental report of child behavior at home. Among children born preterm, the 2 strongest predictors of impairments in self-regulation were the presence of moderate-to-severe cerebral white matter abnormalities on neonatal magnetic resonance and a less sensitive parenting style when children were aged 2 years. Findings support the importance of early neurological development and parenting for developing regulation in children born very preterm.  相似文献   

12.
Previous studies have found that stressful events during pregnancy can influence the developing fetus, resulting in attentional and neuromotor problems. This prospective study examined whether periods of vulnerability exist for neurobehavioral impairments associated with prenatal stress, using a nonhuman primate model. Twenty-eight rhesus monkey infants were born to mothers in 3 groups: (1) early gestation stress involving mild psychological stress from gestational days 45-90, (2) mid-late gestation stress from days 90-145, and (3) undisturbed controls. Infants were separated from their mothers on days 4, 9, 15, and 22 (+/- 1) postpartum for growth and neurobehavioral assessments. Results indicated that infants from the early gestation stress condition weighed less than infants from mothers stressed during mid-late gestation. Moreover, whereas both groups scored lower than controls on measures of attention and neuromotor maturity, early gestation stress was associated with more pronounced and more pervasive motor impairments than mid-late gestation stress. These results suggest sensitivity to prenatal stress effects peaks during early gestation, tapering off during mid-late gestation. Clarifying the period of greatest vulnerability to prenatal stress moves toward elucidating the underlying mechanism for prenatal stress effects and may lead to more successful intervention and/or prevention.  相似文献   

13.
This essay explores how rhetorics of diabetes management informed Sonia Sotomayor’s judicial persona during her ascent to the Supreme Court. Sotomayor’s confirmation hearings were clouded famously by institutional racism and sexism. She was accused repeatedly by congressional Republicans of being intemperate, emotional, and illogical in a judicial sphere that prizes circumspection, deliberateness, and collegiality. As part of a larger strategy to counter such claims, the Obama administration forwarded her lifetime of managing type-one diabetes as proof of personal control, and by extension judicial prudence. This strategic invocation of intersectionality, using a disability to rhetorically “contain” race and gender, helped to successfully resituate universal notions of wisdom and secure Sotomayor a seat on the nation’s highest court.  相似文献   

14.
Estimation of Gestational Age: Implications for Developmental Research   总被引：1，自引：0，他引：1  
Recent research in neonatology and obstetrics has challenged the validity of standard gestational age assessment methods. Length of gestation is a central component of research on the development of at-risk infants, yet issues concerning accuracy of this information are rarely addressed by developmental researchers. This article reviews prenatal and postnatal methods of gestational age estimation and evaluates implementation of this information in research. Recommendations concerning the assignment of gestational age in the perinatal period and the use of age correction for preterm infants are offered.  相似文献   

15.
We investigated the effects of gestational age at birth on behavioral and electrophysiological measures of 135 medically healthy infants, studied at 42 weeks postconception, and stratified into 3 groups--early-born preterms, 26-32 weeks (n = 55); middle-group preterms, 33-37 weeks (n = 43); and fullterms, 38-41 weeks (n = 37). Subjects were studied behaviorally with the Assessment of Preterm Infants' Behavior (APIB) and electrophysiologically with brain electrical activity mapping (BEAM). Fullterms showed significantly better behavioral function than both preterm groups. Less difference was found between the preterm groups. EEG spectral and photic evoked response were of significantly less amplitude for the preterms than the fullterms. Path analysis showed gestational age effects on behavioral (3 of 6) and electrophysiological (13 of 17) variables due to postnatal complications. We conclude that some differences attributable to gestational age at birth are explained by the cumulative effect of minor but unavoidable complications associated with premature birth. We speculate that remaining effects may result from developmentally inappropriate sensorimotor stimulation consequent to the premature experience of an extrauterine environment.  相似文献   

16.
This research was conducted in a public general hospital in Mexico City, Mexico. The objective was to evaluate efficacy of the support given by a doula during labor to reduce cesarean rate. From March 1997 to February 1998, a group of 100 pregnant women were studied. These women were at term, engaged in an active phase of labor, exhibited 3 cm. or more cervical dilatation, were nuliparous, had no previous uterine incision, and possessed adequate pelvises. The group was randomly divided into two subgroups comprising 50 women, each: The first subgroup had the support of a childbirth educator trained as a doula, while the second subgroup did not have doula support. Measurements were recorded on the duration of labor, the use of pitocin, and whether or not the birth was a vaginal birth or cesarean section. Characteristics and gestational age were similar in both groups. Results confirmed that support by doulas during labor was associated with a significant reduction in cesarean birth and pitocin administration. There was a trend toward shorter labors and less use of epidurals. The results of this study showed, as in other trials measuring the impact of a doula's presence during labor and birth, that doula support during labor is associated with positive outcomes that have physical, emotional, and economic implications.  相似文献   

17.
Disulfide-bond A oxidoreductase-like protein (DsbA-L) is a molecular chaperone involved in the multimerization of adiponectin. Recent studies have found that DsbA-L is related to metabolic diseases including gestational diabetes mellitus (GDM), and can be regulated by peroxisome proliferator-activated receptor γ (PPARγ) agonists; the specific mechanism, however, is uncertain. Furthermore, the relationship between DsbA-L and the novel adipokine chemerin is also unclear. This article aims to investigate the role of DsbA-L in the improvement of insulin resistance by PPARγ agonists in trophoblast cells cultured by the high-glucose simulation of GDM placenta. Immunohistochemistry and western blot were used to detect differences between GDM patients and normal pregnant women in DsbA-L expression in the adipose tissue. The western blot technique was performed to verify the relationship between PPARγ agonists and DsbA-L, and to explore changes in key molecules of the insulin signaling pathway, as well as the effect of chemerin on DsbA-L. Results showed that DsbA-L was significantly downregulated in the adipose tissue of GDM patients. Both PPARγ agonists and chemerin could upregulate the level of DsbA-L. Silencing DsbA-L affected the function of rosiglitazone to promote the phosphatidylinositol 3-kinase (PI3K)-protein kinase B (PKB)/AKT pathway. Therefore, it is plausible to speculate that DsbA-L is essential in the environment of PPARγ agonists for raising insulin sensitivity. Overall, we further clarified the mechanism by which PPARγ agonists improve insulin resistance.  相似文献   

18.
目的评估个性化护理对糖尿病患者血糖控制的干预作用,探索控制血糖的有效措施。方法回顾性分析2000-2010年糖尿病患者100例,其中2000-2005年50例为对照组,2006-2010年50例为实验组。对照组给予常规护理,实验组系对糖尿病患者在常规护理的基础上再给予针对性的个性化护理。两组均随访3个月,收集检查数据,并进行血糖控制情况的评价。结果对照组与实验组血糖水平比较差异有统计学意义（P〈0.05）,提示实验组血糖控制优于对照组。结论个性化护理干预更有助于糖尿病患者的血糖控制。  相似文献   

19.
This study examined the effect of moderate alcohol and/or psychological stress during prenancy on off-spring growth and behavior in 33 rhesus monkey infants ( Macaca mulatta ). Infants were derived from 1 of 3 groups of female: (1) alcohol-consuming,0.6g/Kg, Daily throughou gestation (equivalet, to 1-2 drinks), beginning 5 day prior to breeding;(2) alcohol-consuming (as above) and exposed to mild psychological stress(removal from home cage and exposed to 3 random noise bursts); (3) sucrose-consuming, equivolemic, and equicaloric to the alcohol solution.Beginning on day 4 postpartum, intantrs underwent brief weekly separations from their mother for assessment of growth, behavior, and facial dimensions. Results indicated that moderate alcohol consumption throughout pregnancy was sufficient to affect attention and neuromotor functioning, even though the infants were normol in birthweight, gestational length, and facial dimensions, Moreover, alcohol-induced neuromotor impairments were exacerbated by maternal exposure to psychological stress, and males from the alcohol/stress condition had reduced birthweights. Finally, although all females consuming alcohol produced viable offspring, alcohol accompanie by stress during gestation resulted in 23% fetal losses (abortion and stillbirths).  相似文献   

20.
Fetal Neurobehavioral Development   总被引：3，自引：0，他引：3  
The ontogeny of fetal autonomic, motoric, state, and interactive functioning was investigated longitudinally in a sample of 31 healthy fetuses from 20 weeks through term. Fetal heart rate and movement data were collected during 50 min of Doppler-based fetal monitoring at 6 gestational ages. Measures of fetal heart rate and variability, activity level and vigor, behavioral state, and reactivity were derived from these digitized data. Weighted least squares analyses were conducted to model the developmental patterns and to examine the role of maternal and fetal covariates. With advancing gestation, fetuses displayed slower heart rate, increased heart rate variability, reduced but more vigorous motor behavior, coalescence of heart rate and movement patterns into distinct behavioral states, and increasing cardiac responsivity to stimulation. Male fetuses were more active than female fetuses, and greater maternal stress appraisal was associated with reduced fetal heart rate variability. An apparent period of neurobehavioral transition exists between 28 and 32 weeks. Fetal research methods are evaluated.  相似文献   

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