Frontiers in Clinical Diabetes and Healthcare, Journal Year: 2024, Volume and Issue: 5
Published: Nov. 22, 2024
Gestational diabetes mellitus (GDM) is a complex and increasingly prevalent condition that poses significant challenges to maternal fetal health, as well public healthcare costs. In this special issue, we present collection of studies highlighting innovative approaches GDM management. These include the use technology, such integrated bioinformatics analysis data-driven clusters, insights into pathophysiology risk factors.GDM defined glucose intolerance develops during pregnancy, typically diagnosed second or third trimester. The current prevalence in Europe estimated be around 10.9% based on recent meta-analysis (1). Rates are rising globally, partly explained by increasing obesity age. International association pregnancy study groups recommendations diagnosis classification hyperglycemia (IADPSG) suggest diagnostic criteria: fasting plasma (FPG) ≥5.1 mmol/L (92 mg/dL); 1-hour ≥10.0 (180 mg/dL) and/or 2-hour ≥8.5 (153 75 g oral tolerance test (2). Known factors for development obesity, advanced age, family history type 2 (T2DM), polycystic ovary syndrome, with other under (3). Interestingly, published issue Hui Liu colleagues, highest quartile liver function index (LFI) was linked heightened GDM, odds ratios (OR) ranging from 1.29 3.15. Additionally, noteworthy interaction between AST/ALT levels triglycerides (TG) identified regarding (P = 0.026). TG have also been associated vascular dysfunction, being possible common pathophysiologic mechanism hypertensive disorders (4). As Authors reported, found heterogenous results different markers, associations GGT but not AST ALT. To overcome reverse causation, performed Mendelian randomization analysis, showing causal relationship ALT an OR 1.28 (95% CI: 1.05-1.54). metabolic dysfunction leading crucial only developing new scores better understanding GDM.The etiopathogenesis unclear, immune chronic inflammation key contributors (5,6). Elevated cytotoxic NK cells dysregulated Tregs Th17 cells, alongside cytokines like IL-6, IL-1β, TNF-α, exacerbate insulin resistance, contributing (5)(6)(7)(8). Inflammation plays role endothelial (9)(10)(11)(12) angiogenic imbalance occurrence cardiovascular diseases patients (13)(14)(15). However, microenvironment remains limited (7). Jie-ling Chen colleagues Special Issue comprehensive bioinformatic gene expression profiles two databases Human Umbilical Vein Endothelial Cells (HUVEC) RNA-seq data controls. Furthermore, evaluated six hub Differentially expressed genes (DEG) high value cells. biomarkers value, PLAUR SLIT2, had strong correlation B naïve T follicular helper, respectively. authors emphasize need animal validate their findings. context, another article within same examined cell functionality models Yujing Xiong colleagues. Decidual differ phenotype circulating (16,17). They interact fetus engaging human leukocyte antigen (HLA) ligands extravillous trophoblasts, promoting mother fetus. streptozotocin-induced model disrupted homeostasis, affecting both proportions functions analyzed women vs. controls there no differences percentage total amount single phenotypes. summary, abovementioned submitted contribute growing body literature mechanisms at basis pathophysiology, providing valuable types molecular involved.Women face increased risks complications, including preeclampsia, cesarean delivery, likelihood T2D later life. Indeed, preeclampsia share several pathophysiological pathways (3,18). can adversely affect development, higher rates macrosomia, neonatal hypoglycemia, longterm issues child (19,20). Approximately one-third using pre-IADPSG criteria will exhibit indicative prediabetes postpartum assessments 3 months delivery. Anna Lesniara-Stachon highlighted point distinction induced reduced caused peripheral resistance. This differentiation underlying guiding its management therapeutic strategies. predictors 1-year were among For belonging resistant cluster, HOMA-IR best predictor (OR 1.9). On hand, 8.7) FBG (7.8) cluster. A precision medicine approach considers subtypes could enhance diagnosis, assessment, treatment strategies.Personalized medicine, allowing recognition specific phenotypes consequent tailored treatment, long term follow-up strategies reduce diseases, translational research clarify inflammatory pathogenetic main areas addressed future GDM. Addressing these would improve prevention, condition.
Language: Английский
