Tennessee Valley Healthcare System, Department of Veteran Affairs, Nashville, Tennessee;
Am J Physiol Endocrinol Metab. 2013 Dec 1;305(11):E1327-38. doi: 10.1152/ajpendo.00425.2013. Epub 2013 Oct 1.
The maintenance of glucose homeostasis during pregnancy is critical to the health and well-being of both the mother and the developing fetus. Strikingly, approximately 7% of human pregnancies are characterized by insufficient insulin production or signaling, resulting in gestational diabetes mellitus (GDM). In addition to the acute health concerns of hyperglycemia, women diagnosed with GDM during pregnancy have an increased incidence of complications during pregnancy as well as an increased risk of developing type 2 diabetes (T2D) later in life. Furthermore, children born to mothers diagnosed with GDM have increased incidence of perinatal complications, including hypoglycemia, respiratory distress syndrome, and macrosomia, as well as an increased risk of being obese or developing T2D as adults. No single environmental or genetic factor is solely responsible for the disease; instead, a variety of risk factors, including weight, ethnicity, genetics, and family history, contribute to the likelihood of developing GDM, making the generation of animal models that fully recapitulate the disease difficult. Here, we discuss and critique the various animal models that have been generated to better understand the etiology of diabetes during pregnancy and its physiological impacts on both the mother and the fetus. Strategies utilized are diverse in nature and include the use of surgical manipulation, pharmacological treatment, nutritional manipulation, and genetic approaches in a variety of animal models. Continued development of animal models of GDM is essential for understanding the consequences of this disease as well as providing insights into potential treatments and preventative measures.
妊娠期间葡萄糖内稳态的维持对母亲和胎儿的健康和福祉至关重要。引人注目的是,大约 7%的妊娠存在胰岛素产生或信号不足的情况,导致妊娠期糖尿病(GDM)。除了高血糖带来的急性健康问题外,在妊娠期间被诊断为 GDM 的女性在妊娠期间发生并发症的发生率增加,并且在以后的生活中患 2 型糖尿病(T2D)的风险增加。此外,母亲患有 GDM 的婴儿发生围产期并发症的发生率增加,包括低血糖、呼吸窘迫综合征和巨大儿,并且肥胖或成年后患 T2D 的风险增加。没有单一的环境或遗传因素是导致这种疾病的唯一原因;相反,多种风险因素,包括体重、种族、遗传和家族史,都增加了患 GDM 的可能性,这使得生成完全重现该疾病的动物模型变得困难。在这里,我们讨论并批评了已经生成的各种动物模型,以更好地理解妊娠期间糖尿病的病因及其对母亲和胎儿的生理影响。所采用的策略性质多样,包括在各种动物模型中使用手术操作、药物治疗、营养操作和遗传方法。继续开发 GDM 的动物模型对于了解这种疾病的后果以及为潜在的治疗和预防措施提供见解至关重要。