Burlina S, Dalfrà M G, Lapolla A
a Department of Medicine , University of Padua , Padua , Italy.
J Matern Fetal Neonatal Med. 2019 Feb;32(4):687-694. doi: 10.1080/14767058.2017.1387893. Epub 2017 Oct 16.
The prevalence of gestational diabetes mellitus is increasing, as is the worldwide prevalence of type 2 diabetes and obesity, even in children and adolescents. Exposure in utero to maternal diabetes carries several short-term consequences due mainly to maternal hyperglycemia, and consequent fetal hyperinsulinemia. Current evidence also supports the hypothesis that adult health and disease have developmental origins, and that disorders in early-life environments prompt metabolic imprinting that results in a greater risk of negative metabolic outcomes later in life. In particular, exposure in utero to maternal diabetes seems to influence long-term metabolic outcomes, carrying a higher risk of obesity and type 2 diabetes, and thus creating a vicious cycle for future generations. In this paper, the short- and long-term consequences of exposure in utero to hyperglycemia are reviewed, focusing particularly on the long-term metabolic consequences, and investigating the possible pathogenic mechanisms involved.
妊娠糖尿病的患病率正在上升，2型糖尿病和肥胖症在全球的患病率也在上升，甚至在儿童和青少年中也是如此。子宫内暴露于母体糖尿病会带来一些短期后果，主要是由于母体高血糖以及随之而来的胎儿高胰岛素血症。目前的证据也支持这样一种假说，即成人的健康和疾病有其发育起源，早期生活环境中的紊乱会促使代谢印记的形成，从而导致日后出现负面代谢结果的风险增加。特别是，子宫内暴露于母体糖尿病似乎会影响长期代谢结果，增加肥胖和2型糖尿病的风险，从而为后代创造一个恶性循环。本文综述了子宫内暴露于高血糖的短期和长期后果，特别关注长期代谢后果，并研究其中可能涉及的致病机制。
