{"title":"亚洲印度人的妊娠期糖尿病:病理生理和机制","authors":"Deepa Mohan, Suchitra Chandrasekaran","doi":"10.1007/s41745-023-00367-8","DOIUrl":null,"url":null,"abstract":"<div><p>Gestational diabetes mellitus (GDM), defined as glucose intolerance that is first recognized during pregnancy beyond 20 weeks of gestation, is rising globally. The prevalence varies widely across populations (1–25%), depending on the population studied. The abnormal glucose homeostasis during pregnancy, GDM is associated with short and long-term metabolic risks, both for the mother and the offspring. The pathophysiological basis of GDM is classically thought to stem from abnormal up-regulation of insulin production relative to the degree of increased insulin resistance intrinsic to pregnancy. Glucose regulation is a complex process involving interactions among multiple endocrine and neurobiological pathways. Studies in non-pregnant humans demonstrate that gliosis (a cellular inflammatory response) in the mediobasal hypothalamus (MBH) is associated with insulin resistance, independent of the level of adiposity. Recent data also suggests that baseline existence of MBH gliosis precedes the onset of glucose dysregulation 1 year later, suggesting that the in addition to the pancreas, brain changes may be a key driver in glucose metabolism. These data provide mechanistic insights into brain pathways which may increase risk for metabolic dysfunction leading to GDM.\n</p></div>","PeriodicalId":675,"journal":{"name":"Journal of the Indian Institute of Science","volume":null,"pages":null},"PeriodicalIF":1.8000,"publicationDate":"2023-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s41745-023-00367-8.pdf","citationCount":"1","resultStr":"{\"title\":\"Gestational Diabetes Mellitus in Asian Indian Population: Pathophysiology and Mechanism\",\"authors\":\"Deepa Mohan, Suchitra Chandrasekaran\",\"doi\":\"10.1007/s41745-023-00367-8\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><p>Gestational diabetes mellitus (GDM), defined as glucose intolerance that is first recognized during pregnancy beyond 20 weeks of gestation, is rising globally. The prevalence varies widely across populations (1–25%), depending on the population studied. The abnormal glucose homeostasis during pregnancy, GDM is associated with short and long-term metabolic risks, both for the mother and the offspring. The pathophysiological basis of GDM is classically thought to stem from abnormal up-regulation of insulin production relative to the degree of increased insulin resistance intrinsic to pregnancy. Glucose regulation is a complex process involving interactions among multiple endocrine and neurobiological pathways. Studies in non-pregnant humans demonstrate that gliosis (a cellular inflammatory response) in the mediobasal hypothalamus (MBH) is associated with insulin resistance, independent of the level of adiposity. Recent data also suggests that baseline existence of MBH gliosis precedes the onset of glucose dysregulation 1 year later, suggesting that the in addition to the pancreas, brain changes may be a key driver in glucose metabolism. These data provide mechanistic insights into brain pathways which may increase risk for metabolic dysfunction leading to GDM.\\n</p></div>\",\"PeriodicalId\":675,\"journal\":{\"name\":\"Journal of the Indian Institute of Science\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.8000,\"publicationDate\":\"2023-04-08\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://link.springer.com/content/pdf/10.1007/s41745-023-00367-8.pdf\",\"citationCount\":\"1\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of the Indian Institute of Science\",\"FirstCategoryId\":\"103\",\"ListUrlMain\":\"https://link.springer.com/article/10.1007/s41745-023-00367-8\",\"RegionNum\":4,\"RegionCategory\":\"综合性期刊\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"MULTIDISCIPLINARY SCIENCES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of the Indian Institute of Science","FirstCategoryId":"103","ListUrlMain":"https://link.springer.com/article/10.1007/s41745-023-00367-8","RegionNum":4,"RegionCategory":"综合性期刊","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"MULTIDISCIPLINARY SCIENCES","Score":null,"Total":0}
Gestational Diabetes Mellitus in Asian Indian Population: Pathophysiology and Mechanism
Gestational diabetes mellitus (GDM), defined as glucose intolerance that is first recognized during pregnancy beyond 20 weeks of gestation, is rising globally. The prevalence varies widely across populations (1–25%), depending on the population studied. The abnormal glucose homeostasis during pregnancy, GDM is associated with short and long-term metabolic risks, both for the mother and the offspring. The pathophysiological basis of GDM is classically thought to stem from abnormal up-regulation of insulin production relative to the degree of increased insulin resistance intrinsic to pregnancy. Glucose regulation is a complex process involving interactions among multiple endocrine and neurobiological pathways. Studies in non-pregnant humans demonstrate that gliosis (a cellular inflammatory response) in the mediobasal hypothalamus (MBH) is associated with insulin resistance, independent of the level of adiposity. Recent data also suggests that baseline existence of MBH gliosis precedes the onset of glucose dysregulation 1 year later, suggesting that the in addition to the pancreas, brain changes may be a key driver in glucose metabolism. These data provide mechanistic insights into brain pathways which may increase risk for metabolic dysfunction leading to GDM.
期刊介绍:
Started in 1914 as the second scientific journal to be published from India, the Journal of the Indian Institute of Science became a multidisciplinary reviews journal covering all disciplines of science, engineering and technology in 2007. Since then each issue is devoted to a specific topic of contemporary research interest and guest-edited by eminent researchers. Authors selected by the Guest Editor(s) and/or the Editorial Board are invited to submit their review articles; each issue is expected to serve as a state-of-the-art review of a topic from multiple viewpoints.