Hami Javad, Shojae Fatemeh, Vafaee-Nezhad Saeed, Lotfi Nasim, Kheradmand Hamed, Haghir Hossein
Javad Hami, Fatemeh Shojae, Saeed Vafaee-Nezhad, Nasim Lotfi, Department of Anatomy, School of Medicine, Birjand University of Medical Sciences, Birjand 97178, Iran.
World J Diabetes. 2015 Apr 15;6(3):412-22. doi: 10.4239/wjd.v6.i3.412.
Diabetes mellitus during pregnancy is associated with an increased risk of multiple congenital anomalies in progeny. There are sufficient evidence suggesting that the children of diabetic women exhibit intellectual and behavioral abnormalities accompanied by modification of hippocampus structure and function. Although, the exact mechanism by which maternal diabetes affects the developing hippocampus remains to be defined. Multiple biological alterations, including hyperglycemia, hyperinsulinemia, oxidative stress, hypoxia, and iron deficiency occur in pregnancies with diabetes and affect the development of central nervous system (CNS) of the fetus. The conclusion from several studies is that disturbance in glucose and insulin homeostasis in mothers and infants are major teratogenic factor in the development of CNS. Insulin and Insulin-like growth factor-1 (IGF-1) are two key regulators of CNS function and development. Insulin and IGF-1 receptors (IR and IGF1R, respectively) are distributed in a highly specific pattern with the high density in some brain regions such as hippocampus. Recent researches have clearly established that maternal diabetes disrupts the regulation of both IR and IGF1R in the hippocampus of rat newborn. Dissecting out the mechanisms responsible for maternal diabetes-related changes in the development of hippocampus is helping to prevent from impaired cognitive and memory functions in offspring.
孕期糖尿病与子代发生多种先天性畸形的风险增加有关。有充分证据表明,糖尿病女性的子女表现出智力和行为异常,并伴有海马体结构和功能的改变。然而,母体糖尿病影响发育中海马体的确切机制仍有待确定。糖尿病妊娠会出现多种生物学改变,包括高血糖、高胰岛素血症、氧化应激、缺氧和缺铁,这些都会影响胎儿中枢神经系统(CNS)的发育。多项研究得出的结论是,母婴葡萄糖和胰岛素稳态的紊乱是中枢神经系统发育中的主要致畸因素。胰岛素和胰岛素样生长因子-1(IGF-1)是中枢神经系统功能和发育的两个关键调节因子。胰岛素和IGF-1受体(分别为IR和IGF1R)以高度特异性的模式分布,在海马体等一些脑区密度很高。最近的研究明确证实,母体糖尿病会破坏新生大鼠海马体中IR和IGF1R的调节。剖析母体糖尿病相关的海马体发育变化机制,有助于预防子代认知和记忆功能受损。