Moyce Gruber Brittany L, Dolinsky Vernon W
Diabetes Research Envisioned and Accomplished in Manitoba (DREAM), Research Theme of the Children's Hospital Research Institute of Manitoba, Winnipeg, MB R3E 3P4, Canada.
Department of Pharmacology and Therapeutics, University of Manitoba, Winnipeg, MB R3E 0T6, Canada.
Life (Basel). 2023 Jan 21;13(2):301. doi: 10.3390/life13020301.
Pregnancy involves a range of metabolic adaptations to supply adequate energy for fetal growth and development. Gestational diabetes (GDM) is defined as hyperglycemia with first onset during pregnancy. GDM is a recognized risk factor for both pregnancy complications and long-term maternal and offspring risk of cardiometabolic disease development. While pregnancy changes maternal metabolism, GDM can be viewed as a maladaptation by maternal systems to pregnancy, which may include mechanisms such as insufficient insulin secretion, dysregulated hepatic glucose output, mitochondrial dysfunction and lipotoxicity. Adiponectin is an adipose-tissue-derived adipokine that circulates in the body and regulates a diverse range of physiologic mechanisms including energy metabolism and insulin sensitivity. In pregnant women, circulating adiponectin levels decrease correspondingly with insulin sensitivity, and adiponectin levels are low in GDM. In this review, we summarize the current state of knowledge about metabolic adaptations to pregnancy and the role of adiponectin in these processes, with a focus on GDM. Recent studies from rodent model systems have clarified that adiponectin deficiency during pregnancy contributes to GDM development. The upregulation of adiponectin alleviates hyperglycemia in pregnant mice, although much remains to be understood for adiponectin to be utilized clinically for GDM.
怀孕涉及一系列代谢适应过程，以为胎儿生长发育提供充足能量。妊娠期糖尿病（GDM）被定义为妊娠期间首次出现的高血糖症。GDM是公认的妊娠并发症以及母亲和后代发生心脏代谢疾病长期风险的危险因素。虽然怀孕会改变母体代谢，但GDM可被视为母体系统对怀孕的一种适应不良，这可能包括胰岛素分泌不足、肝脏葡萄糖输出失调、线粒体功能障碍和脂毒性等机制。脂联素是一种源自脂肪组织的脂肪因子，在体内循环并调节包括能量代谢和胰岛素敏感性在内的多种生理机制。在孕妇中，循环脂联素水平随胰岛素敏感性相应降低，且GDM患者的脂联素水平较低。在本综述中，我们总结了关于妊娠代谢适应以及脂联素在这些过程中的作用的当前知识状态，重点关注GDM。来自啮齿动物模型系统的近期研究表明，孕期脂联素缺乏会导致GDM的发生。脂联素上调可减轻孕鼠的高血糖症，尽管脂联素在临床上用于治疗GDM仍有许多有待了解之处。
