Coimbra Institute for Clinical and Biomedical Research (iCBR) and Institute of Physiology, Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal.
CIBB-Centre for Innovative Biomedicine and Biotechnology, University of Coimbra, 3004-504 Coimbra, Portugal.
Biosci Rep. 2024 Aug 28;44(8). doi: 10.1042/BSR20231679.
Obesity during pregnancy has been escalating, becoming a huge problem that poses consequences not only for the health of the offspring but also for the maternal well-being. Women's adipose and hepatic tissue metabolism undergoes significant changes during the gestational period. During pregnancy, obesity is a primary instigator of steatosis, increasing the risk of non-alcholic fatty liver disease (NAFLD), now recognized under the updated nomenclature metabolic dysfunction-associated steatotic liver disease (MASLD). Pregnant women with obesity present higher levels of free fatty acids and glucose, reduction in insulin sensitivity, and adipose tissue endocrine dysregulation. Furthermore, obesity-induced modifications in clock genes and lipid-associated gene expression within adipose tissue disrupt crucial metabolic adaptations, potentially culminating in adipose tissue dysfunction. Thus, the liver experiences increased exposure to free fatty acids through the portal vein. Higher uptake of free fatty acids into the liver disrupts hepatic lipid oxidation while enhances lipogenesis, thereby predisposing to ectopic fat deposition within the liver. This review focuses on the obesity-induced changes during pregnancy in both liver and adipose tissue metabolism, elucidating how the metabolic crosstalk between these two organs can be dysregulated in pregnant women living with obesity.
孕期肥胖问题日益严重，不仅对后代健康构成威胁，也对母体健康产生影响。女性脂肪和肝脏组织代谢在妊娠期会发生显著变化。孕期肥胖是脂肪变性的主要诱因，增加了非酒精性脂肪肝（NAFLD）的风险，根据更新的命名法，现在被认为是代谢功能障碍相关脂肪性肝病（MASLD）。肥胖孕妇体内游离脂肪酸和葡萄糖水平升高，胰岛素敏感性降低，脂肪组织内分泌失调。此外，肥胖引起的脂肪组织时钟基因和脂质相关基因表达改变会破坏关键的代谢适应，可能导致脂肪组织功能障碍。因此，肝脏通过门静脉暴露于更多的游离脂肪酸。更多的游离脂肪酸进入肝脏会破坏肝内脂质氧化，同时促进脂肪生成，从而导致肝脏内异位脂肪沉积。本综述重点关注孕期肥胖对肝脏和脂肪组织代谢的影响，阐明肥胖孕妇体内这两个器官之间的代谢串扰如何失调。
