Du Runyu, Wu Na, Li Ling
Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, People's Republic of China.
Diabetes Metab Syndr Obes. 2021 Aug 21;14:3719-3732. doi: 10.2147/DMSO.S325993. eCollection 2021.
Gestational diabetes mellitus (GDM), one of the most common complications during pregnancy, is associated with a high risk of short- and long-term adverse effects on the mother and offspring. Placenta-derived hormones and cytokines aggravate maternal insulin resistance (IR) during pregnancy, which in turn contribute to GDM. The hyperglycemia and IR in GDM result in aberrant placental structure and function adversely affecting fetal growth and well-being. Therefore, it is reasonable to assume that structural and functional alterations in the placenta contribute to the pathogenesis of GDM and GDM-related complications. Increasing evidence suggests that multiple non-coding RNAs (ncRNAs), including microRNAs, long non-coding RNAs, and circular RNAs, are dysregulated in placentas of patients with GDM and linked to abnormal placental structure, metabolism, and function. Manipulation of ncRNA expression led to some key pathophysiological features of GDM, such as trophoblast dysfunction, changes in intracellular glucose metabolism, and inflammation. Moreover, placenta-specific ncRNAs may be potential diagnostic biomarkers and even therapeutic targets for GDM. This review summarizes data published on the involvement of aberrantly expressed placental ncRNAs in GDM and provides information on their role in the pathogenesis of GDM and GDM-associated complications.
妊娠期糖尿病(GDM)是孕期最常见的并发症之一,与母婴短期和长期不良影响的高风险相关。胎盘衍生的激素和细胞因子在孕期会加重母体胰岛素抵抗(IR),进而导致GDM。GDM中的高血糖和IR会导致胎盘结构和功能异常,对胎儿生长和健康产生不利影响。因此,有理由认为胎盘的结构和功能改变会导致GDM及其相关并发症的发病机制。越来越多的证据表明,包括微小RNA、长链非编码RNA和环状RNA在内的多种非编码RNA(ncRNAs)在GDM患者的胎盘中表达失调,并与胎盘结构、代谢和功能异常有关。操纵ncRNA表达会导致GDM的一些关键病理生理特征,如滋养层细胞功能障碍、细胞内葡萄糖代谢变化和炎症。此外,胎盘特异性ncRNAs可能是GDM的潜在诊断生物标志物,甚至是治疗靶点。本综述总结了关于异常表达的胎盘ncRNAs参与GDM的已发表数据,并提供了它们在GDM及其相关并发症发病机制中的作用信息。