Higa Romina, Leonardi María Laura, Jawerbaum Alicia
Facultad de Medicina, Universidad de Buenos Aires, Buenos Aires, Argentina.
Laboratory of Reproduction and Metabolism, CONICET-Universidad de Buenos Aires, CEFYBO, Buenos Aires, Argentina.
Front Physiol. 2021 Nov 3;12:760251. doi: 10.3389/fphys.2021.760251. eCollection 2021.
Maternal diabetes is a prevalent pathology that increases the risk of cardiovascular diseases in the offspring, the heart being one of the main target organs affected from the fetal stage until the adult life. Metabolic, pro-oxidant, and proinflammatory alterations in the fetal heart constitute the first steps in the adverse fetal programming of cardiovascular disease in the context of maternal diabetes. This review discusses both human and experimental studies addressing putative mechanisms involved in this fetal programming of heart damage in maternal diabetes. These include cardiac epigenetic changes, alterations in cardiac carbohydrate and lipid metabolism, damaging effects caused by a pro-oxidant and proinflammatory environment, alterations in the cardiac extracellular matrix remodeling, and specific signaling pathways. Putative actions to prevent cardiovascular impairments in the offspring of mothers with diabetes are also discussed.
母体糖尿病是一种常见的病理状况，会增加后代患心血管疾病的风险，心脏是从胎儿期到成年期受影响的主要靶器官之一。胎儿心脏中的代谢、促氧化和促炎改变是母体糖尿病背景下心血管疾病不良胎儿编程的第一步。本综述讨论了针对母体糖尿病中这种心脏损伤胎儿编程所涉及的假定机制的人体和实验研究。这些机制包括心脏表观遗传变化、心脏碳水化合物和脂质代谢改变、促氧化和促炎环境引起的损伤作用、心脏细胞外基质重塑改变以及特定信号通路。还讨论了预防糖尿病母亲后代心血管损伤的假定措施。
