Obstetrics and Gynecology Service, Virgen Macarena University Hospital, School of Medicine, University of Seville, Seville, Spain.
Clinical Biochemistry Service, Virgen del Rocio University Hospital, School of Medicine, University of Seville, Seville, Spain.
Front Endocrinol (Lausanne). 2023 Jul 11;14:1172831. doi: 10.3389/fendo.2023.1172831. eCollection 2023.
Gestational diabetes mellitus (GDM) is the most frequent pathophysiological state of pregnancy, which in many cases produces fetuses with macrosomia, requiring increased nutrient transport in the placenta. Recent studies by our group have demonstrated that leptin is a key hormone in placental physiology, and its expression is increased in placentas affected by GDM. However, the effect of leptin on placental nutrient transport, such as transport of glucose, amino acids, and lipids, is not fully understood. Thus, we aimed to review literature on the leptin effect involved in placental nutrient transport as well as activated leptin signaling pathways involved in the expression of placental transporters, which may contribute to an increase in placental nutrient transport in human pregnancies complicated by GDM. Leptin appears to be a relevant key hormone that regulates placental transport, and this regulation is altered in pathophysiological conditions such as gestational diabetes. Adaptations in the placental capacity to transport glucose, amino acids, and lipids may underlie both under- or overgrowth of the fetus when maternal nutrient and hormone levels are altered due to changes in maternal nutrition or metabolic disease. Implementing new strategies to modulate placental transport may improve maternal health and prove effective in normalizing fetal growth in cases of intrauterine growth restriction and fetal overgrowth. However, further studies are needed to confirm this hypothesis.
妊娠期糖尿病（GDM）是最常见的妊娠病理生理状态，它会导致许多胎儿出现巨大儿，从而需要胎盘增加营养物质的转运。我们小组的最近研究表明，瘦素是胎盘生理学中的关键激素，其在受 GDM 影响的胎盘中表达增加。然而，瘦素对胎盘营养物质转运（如葡萄糖、氨基酸和脂质的转运）的影响尚不完全清楚。因此，我们旨在综述与胎盘营养物质转运相关的瘦素作用以及激活的瘦素信号通路在胎盘转运体表达中的作用的文献，这可能有助于增加 GDM 孕妇的胎盘营养物质转运。瘦素似乎是一种调节胎盘转运的相关关键激素，这种调节在病理生理条件下（如妊娠期糖尿病）会发生改变。当由于母体营养或代谢疾病引起母体营养和激素水平改变时，胎盘对葡萄糖、氨基酸和脂质的转运能力的适应性改变可能是胎儿生长受限和胎儿过度生长的基础。实施新的策略来调节胎盘转运可能会改善母体健康，并在宫内生长受限和胎儿过度生长的情况下有效使胎儿生长正常化。然而，还需要进一步的研究来证实这一假设。
