心脏病的发生:妊娠期糖尿病与后代早发心血管疾病的关联机制

IF 4.6 3区 医学 Q2 MEDICINE, RESEARCH & EXPERIMENTAL WIREs Mechanisms of Disease Pub Date : 2022-03-18 DOI:10.1002/wsbm.1555
Carolina Tocantins, Mariana S. Diniz, L. Grilo, Susana P. Pereira
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引用次数: 11

摘要

心血管疾病(CVD)是全球最大的杀手,是卫生保健系统的主要经济负担。肥胖和糖尿病是呈上升趋势的双重流行病,是诱发心血管疾病的主要危险因素。肥胖和糖尿病相关的发病率在儿童、青少年和年轻人中有所增加。妊娠期糖尿病(GDM)是妊娠期最常见的代谢性疾病,其患病率呈快速上升趋势。在妊娠合并GDM期间,后代暴露于以高血糖期为特征的宫内环境。在胎儿心脏发育的关键时期,不利的子宫条件可以产生发育适应,重塑心血管系统,在某种程度上可能导致成人发病的心脏病,这是由于胎儿生命中的编程。流行病学研究报告了gdm后代心血管并发症的增加,强调了迫切需要调查和了解子宫内gdm暴露后代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。在这篇论文中,我们概述了这一领域之前的研究,并收集了GDM与后代CVD发展相关的证据,为GDM导致后代CVD规划的新机制提供了新的见解,从母胎相互作用的作用到它们对胎儿心血管发育的影响,心脏规划如何在出生后生活中维持,并推进代际影响导致CVD过早起源增加。了解心血管疾病的持续可能是管理和扭转这一发病率和死亡率的主要原因的第一步。本文分类为: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。
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The birth of cardiac disease: Mechanisms linking gestational diabetes mellitus and early onset of cardiovascular disease in offspring.
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.
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来源期刊
WIREs Mechanisms of Disease
WIREs Mechanisms of Disease MEDICINE, RESEARCH & EXPERIMENTAL-
CiteScore
11.40
自引率
0.00%
发文量
45
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