vestommВестник охраны материнства и младенчестваBulletin of maternal and child care3034-395XФГБУ «НИИ ОММ» Минздрава России10.69964/BMCC-2024-1-3-42-52vestomm-50Research ArticleОБЗОРЫREVIEWSИзменения микробиома у женщин с гестационным сахарным диабетом (обзор литературы)Microbiome alterations in women with gestational diabetes mellitus (literature review)https://orcid.org/0009-0009-7193-2968ГайфуллинаО. В.GaifullinaOlga V.

Гайфуллина Ольга Васыловна — ординатор

ул. Репина, д. 1, г. Екатеринбург, 620028

Olga V. Gaifullina — resident

st. Repina, 1, Ekaterinburg, 620028

gaifullinaolga.vasilovna@gmail.comhttps://orcid.org/0000-0001-8955-5085ДерябинаЕ. Г.DeryabinaElena G.

Дерябина Елена Геннадьевна — доктор медицинских наук, ведущий научный сотрудник отделения антенатальной охраны плода, врач-эндокринолог

ул. Репина, д. 1, г. Екатеринбург, 620028

ResearcherID: A-4758-2017

Scopus Author ID: 57191620146

Elena G. Deryabina — MD, PhD, Leading researcher of the Department of Antenatal Fetal Protection

st. Repina, 1, Ekaterinburg, 620028

ResearcherID: A-4758-2017

Scopus Author ID: 57191620146

helen_mic@mail.ruhttps://orcid.org/0000-0002-4090-0578МелкозероваО. А.MelkozerovaOksana A.

Мелкозерова Оксана Александровна — доктор медицинских наук, доцент, заместитель директора института по науке

ул. Репина, д. 1, г. Екатеринбург, 620028

Телефон: +7 (343) 371 87 68

Oksana A. Melkozerova — МD, docent, Deputy of Director for Science

st. Repina, 1, Ekaterinburg, 620028

Phone: +7 (343) 371 87 68

abolmed1@mail.ruФедеральное государственное бюджетное учреждение «Уральский научно-исследовательский институт охраны материнства и младенчества» Министерства здравоохранения Российской ФедерацииРоссияFederal State Budgetary Institution “Ural Research Institute of Maternity and Child Care” of the Ministry of Health of the Russian FederationRussian Federation202414012025134252Copyright © Гайфуллина О.В., Дерябина Е.Г., Мелкозерова О.А., 20252025Гайфуллина О.В., Дерябина Е.Г., Мелкозерова О.А.Gaifullina O.V., Deryabina E.G., Melkozerova O.A.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.vestnikomm.ru/jour/article/view/50Введение

Введение. Гестационный сахарный диабет (ГСД)  — это распространенное заболевание, которое в последнее время привлекает особое внимание из-за нежелательных последствий для здоровья как женщин, так и их детей. Применяются новые подходы для разработки стратегий, которые предотвращают ГСД и его последствия. Один из таких подходов заключается в оценке изменений микробиома.

Цель

Цель. Обобщение современных научных представлений о связи состава микробиоты матери с ГСД и обсуждение возможности управления ГСД с использованием микробиома.

Материалы и методы

Материалы и методы. Был проведён обширный обзор литературы с использованием базы данных MEDLINE (PubMed) по состоянию на декабрь 2024 года с использованием ключевых слов и фильтра: рандомизированное контролируемое исследование, метаанализ, систематический обзор.

Результаты

Результаты. В этом обзоре суммированы основные данные о влиянии состава и разнообразия микробиоты на возникновение и развитие ГСД. Хотя были некоторые несоответствия среди результатов, была замечена картина значительных изменений в кишечном, оральном, вагинальном микробиоме женщин с ГСД. В частности, обилие определенных кишечных бактерий связано с повышенным риском развития ГСД, в то время как другие изменения в микробиоме могут быть связаны с улучшением чувствительности к инсулину. Кроме того, изменения в микробиоте кишечника могут влиять на контроль уровня глюкозы в крови с помощью различных механизмов, включая выработку короткоцепочечных жирных кислот, активацию воспалительных путей и метаболизм витаминов группы В.

Заключение

Заключение. Существует четкая корреляция между ГСД и микробными сообществами, где определенные закономерности изменений микробиома наблюдались в желудочно-кишечном и репродуктивном трактах беременных женщин. Эти результаты, хотя и имеют некоторые ограничения, являются многообещающими и обнадеживающими для разработки стратегий, нацеленных на модулцию микробиома человека, с целью разработки новых терапевтических планов для лечения или профилактики ГСД с использованием пробиотиков и парабиотиков следующего поколения. Будущие исследования должны оценить результаты и эффективность таких терапевтических методов.

Background

Background. Gestational Diabetes Mellitus (GDM) is a common disorder that is getting a special attention recently due to the unwanted outcomes that it leaves on the health of both the women and their offspring. New approaches are being applied in order to develop strategies that prevent GDM and its consequences on the metabolic and physiological state. One of the factors that have been thought to be involved in the pathology behind this disorder is the microbiome.

Objective

Objective: to determine the current evidence regarding the association of the maternal microbiota composition with gestational diabetes mellitus and to discuss the possibility of the management of GDM using the microbiome.

Material and methods

Material and methods. An extensive literature review was conducted using the MEDLINE database (PubMed) using keywords and filter: randomized controlled trial, meta-analysis, systematic review.

Research results

Research results. This review summarizes the main data on the influence of microbiota composition and diversity on the occurrence and development of GDM. Although there were some inconsistencies among the results, a pattern of significant changes in the gut, oral, and vaginal microbiome of women with GDM was observed. It was found that the composition and diversity of gut microbiota were significantly associated with the occurrence and development of GDM. Specifically, the abundance of certain gut bacteria is associated with anincreased risk of GDM, while other changes in the microbiome may beassociated with improved insulin sensitivity. In addition, alterations in the gutmicrobiota may affect blood glucose control through a variety of mechanisms, including the production of short-chain fatty acids, activation of inflammatory pathways, and metabolism of the B vitamin group.

Conclusion

Conclusion. We concluded a clear existing correlation between GDM and the microbial communities, where specific patterns of alterations in the microbiome was observed in the gut, oral and vaginal tracts of the pregnant women. These findings, although having some limitations, are promising and encouraging to develop strategies that target the human microbiome in order to develop novel therapeutic plans to treat or prevent GDM using next generation probiotics and parabiotics. Future studies should assess the outcomes and the efficacy of such therapeutic methods.

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The authors declare that there are no conflicts of interest present.