CNC-Center for Neuroscience and Cell Biology, CIBB-Centre for Innovative Biomedicine and Biotechnology, University of Coimbra, Coimbra, Portugal.
PhD Programme in Experimental Biology and Biomedicine (PDBEB), Institute for Interdisciplinary Research (IIIUC), University of Coimbra, Coimbra, Portugal.
WIREs Mech Dis. 2022 Jul;14(4):e1555. doi: 10.1002/wsbm.1555. Epub 2022 Mar 18.
Cardiovascular disease (CVD) is the biggest killer worldwide, composing a major economic burden for health care systems. Obesity and diabetes are dual epidemics on the rise and major risk factors predisposing for CVD. Increased obesity- and diabetes-related incidence is now observed among children, adolescents, and young adults. Gestational diabetes mellitus (GDM) is the most common metabolic pregnancy disorder, and its prevalence is rapidly increasing. During pregnancies complicated by GDM, the offspring are exposed to a compromised intrauterine environment characterized by hyperglycemic periods. Unfavorable in utero conditions at critical periods of fetal cardiac development can produce developmental adaptations that remodel the cardiovascular system in a way that can contribute to adult-onset of heart disease due to the programming during fetal life. Epidemiological studies have reported increased cardiovascular complications among GDM-descendants, highlighting the urgent need to investigate and understand the mechanisms modulated during fetal development of in utero GDM-exposed offspring that predispose an individual to increased CVD during life. In this manuscript, we overview previous studies in this area and gather evidence linking GDM and CVD development in the offspring, providing new insights on novel mechanisms contributing to offspring CVD programming by GDM, from the role of maternal-fetal interactions to their impact on fetal cardiovascular development, how the perpetuation of cardiac programming is maintained in postnatal life, and advance the intergenerational implications contributing to increased CVD premature origin. Understanding the perpetuation of CVD can be the first step to manage and reverse this leading cause of morbidity and mortality. This article is categorized under: Reproductive System Diseases > Molecular and Cellular Physiology Cardiovascular Diseases > Molecular and Cellular Physiology Metabolic Diseases > Genetics/Genomics/Epigenetics.
心血管疾病（CVD）是全球范围内最大的杀手，给医疗系统带来了巨大的经济负担。肥胖症和糖尿病呈双重流行趋势，是导致 CVD 的主要危险因素。肥胖症和糖尿病相关的发病率现在在儿童、青少年和年轻人中也在增加。妊娠期糖尿病（GDM）是最常见的代谢性妊娠疾病，其患病率正在迅速上升。在 GDM 合并妊娠中，后代暴露于高血糖期的受损宫内环境中。在胎儿心脏发育的关键时期，宫内条件不佳会导致发育适应，重塑心血管系统，从而导致成年后心脏病的发生，这是胎儿期编程的结果。流行病学研究报告称，GDM 后代的心血管并发症增加，这突出表明迫切需要研究和了解在宫内 GDM 暴露后代的胎儿发育过程中调节的机制，这些机制使个体在一生中易患 CVD。在本文中，我们综述了该领域的先前研究，并收集了将 GDM 与后代 CVD 发展联系起来的证据，提供了关于 GDM 导致后代 CVD 编程的新机制的新见解，从母婴相互作用的作用到它们对胎儿心血管发育的影响，以及心脏编程的延续如何在产后生活中维持，以及对增加 CVD 早发的代际影响。了解 CVD 的延续性可能是管理和逆转这种主要发病率和死亡率原因的第一步。本文属于以下分类：生殖系统疾病 > 分子和细胞生理学心血管疾病 > 分子和细胞生理学代谢疾病 > 遗传学/基因组学/表观遗传学。
