Gestational diabetes mellitus (GDM) is defined as the presence of high blood glucose levels with the onset, or detected for the first time during pregnancy, as a result of increased insulin resistance. GDM may be induced by dysregulation of pancreatic β-cell function and/or by alteration of secreted gestational hormones and peptides related with glucose homeostasis. It may affect one out of five pregnancies, leading to perinatal morbidity and adverse neonatal outcomes, and high risk of chronic metabolic and cardiovascular injuries in both mother and offspring. Currently, GDM diagnosis is based on evaluation of glucose homeostasis at late stages of pregnancy, but increased age and body-weight, and familiar or previous occurrence of GDM, may conditionate this criteria. In addition, an earlier and more specific detection of GDM with associated metabolic and cardiovascular risk could improve GDM development and outcomes. In this sense, 1st-2nd trimester-released biomarkers found in maternal plasma including adipose tissue-derived factors such as adiponectin, visfatin, omentin-1, fatty acid-binding protein-4 and retinol binding-protein-4 have shown correlations with GDM development. Moreover, placenta-related factors such as sex hormone-binding globulin, afamin, fetuin-A, fibroblast growth factors-21/23, ficolin-3 and follistatin, or specific micro-RNAs may participate in GDM progression and be useful for its recognition. Finally, urine-excreted metabolites such as those related with serotonin system, non-polar amino-acids and ketone bodies, may complete a predictive or early-diagnostic panel of biomarkers for GDM.

中文翻译：

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妊娠糖尿病及其相关代谢和心血管疾病的预测和诊断生物标志物。


妊娠糖尿病（GDM）被定义为由于胰岛素抵抗增加而在怀孕期间出现或首次检测到的高血糖水平。 GDM 可能是由胰腺 β 细胞功能失调和/或分泌的妊娠激素和与葡萄糖稳态相关的肽的改变引起的。它可能会影响五分之一的妊娠，导致围产期发病和新生儿不良结局，以及母亲和后代慢性代谢和心血管损伤的高风险。目前，GDM 的诊断基于妊娠晚期葡萄糖稳态的评估，但年龄和体重的增加以及熟悉或既往发生过 GDM 可能会影响这一标准。此外，更早、更具体地检测 GDM 及其相关代谢和心血管风险可以改善 GDM 的发展和结果。从这个意义上说，在母体血浆中发现的妊娠第一至第二个月释放的生物标志物，包括脂肪组织衍生因子，如脂联素、内脂素、网膜蛋白-1、脂肪酸结合蛋白-4和视黄醇结合蛋白-4，已显示出与 GDM 的相关性发展。此外，胎盘相关因子，如性激素结合球蛋白、afamin、胎球蛋白-A、成纤维细胞生长因子-21/23、ficolin-3 和卵泡抑素或特定的 micro-RNA 可能参与 GDM 进展并有助于其识别。最后，尿液排出的代谢物，例如与血清素系统、非极性氨基酸和酮体相关的代谢物，可以完成 GDM 的预测或早期诊断生物标志物组。