Department of Gynecology and Obstetrics, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic.
Third Department of Medicine, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic.
Minerva Endocrinol. 2020 Sep;45(3):228-242. doi: 10.23736/S0391-1977.20.03192-2.
Gestational diabetes mellitus (GDM) is diabetes that is first diagnosed in the second or third trimester of pregnancy in patients who did not have a history of diabetes before pregnancy. Consequences of GDM include increased risk of macrosomia and birth complications in the infant and an increased risk of maternal type 2 diabetes mellitus (T2DM) after pregnancy. There is also a longer-term risk of obesity, T2DM, and cardiovascular diseases in the child. GDM is the result of impaired glucose tolerance due to pancreatic β-cell dysfunction on a background of insulin resistance that physiologically increases during pregnancy. The strongest clinical predictors of GDM are overweight and obesity. The fact that women with GDM are more likely to be overweight or obese suggests that adipose tissue dysfunction may be involved in the pathogenesis of GDM, similarly to T2DM. Adipose tissue is not only involved in energy storage but also functions as an active endocrine organ secreting adipokines (specific hormones and cytokines) with the ability to alter insulin sensitivity. Recent evidence points to a crucial role of numerous adipokines produced by fat in the development of GDM. The following text summarizes the current knowledge about a possible role of selected adipokines in the development of GDM.
妊娠期糖尿病（GDM）是指在妊娠前无糖尿病史的患者在妊娠第二或第三个三个月被诊断为糖尿病。GDM 的后果包括胎儿巨大儿和出生并发症的风险增加，以及妊娠后母亲 2 型糖尿病（T2DM）的风险增加。儿童期还存在肥胖、T2DM 和心血管疾病的长期风险。GDM 是由于在妊娠期间胰岛素抵抗生理性增加的背景下，胰腺β细胞功能障碍导致的葡萄糖耐量受损引起的。GDM 的最强临床预测因子是超重和肥胖。GDM 患者更容易超重或肥胖的事实表明，脂肪组织功能障碍可能与 T2DM 一样参与 GDM 的发病机制。脂肪组织不仅参与能量储存，还作为一个活跃的内分泌器官分泌具有改变胰岛素敏感性能力的脂肪因子（特定的激素和细胞因子）。最近的证据表明，许多由脂肪产生的脂肪因子在 GDM 的发展中起着关键作用。以下文本总结了关于选定脂肪因子在 GDM 发展中可能作用的现有知识。
