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妊娠对心脏代谢疾病风险的影响:子痫前期和妊娠期糖尿病。

Implications of pregnancy on cardiometabolic disease risk: preeclampsia and gestational diabetes.

机构信息

Department of Physiology, Medical College of Georgia, Augusta University, Augusta, Georgia, United States.

Genetics Unit, Department of Histology and Cell Biology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.

出版信息

Am J Physiol Cell Physiol. 2024 Sep 1;327(3):C646-C660. doi: 10.1152/ajpcell.00293.2024. Epub 2024 Jul 16.

Abstract

Cardiometabolic disorders, such as obesity, insulin resistance, and hypertension, prior to and within pregnancy are increasing in prevalence worldwide. Pregnancy-associated cardiometabolic disease poses a great risk to the short- and long-term well-being of the mother and offspring. Hypertensive pregnancy, notably preeclampsia, as well as gestational diabetes are the major diseases of pregnancy growing in prevalence as a result of growing cardiometabolic disease prevalence. The mechanisms whereby obesity, diabetes, and other comorbidities lead to preeclampsia and gestational diabetes are incompletely understood and continually evolving in the literature. In addition, novel therapeutic avenues are currently being explored in these patients to offset cardiometabolic-induced adverse pregnancy outcomes in preeclamptic and gestational diabetes pregnancies. In this review, we discuss the emerging pathophysiological mechanisms of preeclampsia and gestational diabetes in the context of cardiometabolic risk as well as the most recent preclinical and clinical updates in the pathogenesis and treatment of these conditions.

摘要

在全球范围内,心血管代谢疾病(如肥胖、胰岛素抵抗和高血压)在妊娠前和妊娠期间的患病率不断上升。妊娠相关的心血管代谢疾病对母亲和后代的短期和长期健康构成了巨大风险。高血压妊娠,特别是子痫前期,以及妊娠糖尿病是由于心血管代谢疾病患病率上升而日益流行的主要妊娠疾病。肥胖、糖尿病和其他合并症导致子痫前期和妊娠糖尿病的机制尚不完全清楚,并在文献中不断发展。此外,目前正在这些患者中探索新的治疗途径,以抵消子痫前期和妊娠糖尿病妊娠中由心血管代谢引起的不良妊娠结局。在这篇综述中,我们讨论了心血管代谢风险背景下子痫前期和妊娠糖尿病的新兴病理生理学机制,以及这些疾病发病机制和治疗的最新临床前和临床更新。

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