亚洲印度人的妊娠期糖尿病:病理生理和机制

IF 1.8 4区 综合性期刊 Q2 MULTIDISCIPLINARY SCIENCES Journal of the Indian Institute of Science Pub Date : 2023-04-08 DOI:10.1007/s41745-023-00367-8
Deepa Mohan, Suchitra Chandrasekaran
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引用次数: 1

摘要

妊娠期糖尿病(GDM)的定义是在妊娠超过20周期间首次发现的葡萄糖耐受不良,在全球范围内呈上升趋势。不同人群的患病率差异很大(1-25%),取决于所研究的人群。妊娠期葡萄糖稳态异常,GDM与母亲和后代的短期和长期代谢风险相关。一般认为,妊娠期糖尿病的病理生理基础是由于妊娠期胰岛素抵抗增加导致胰岛素分泌异常上调。葡萄糖调节是一个复杂的过程,涉及多种内分泌和神经生物学途径的相互作用。对未怀孕人类的研究表明,中基底下丘脑(MBH)的神经胶质瘤(一种细胞炎症反应)与胰岛素抵抗有关,与肥胖水平无关。最近的数据还表明,MBH胶质瘤的基线存在先于1年后葡萄糖失调的发作,这表明除了胰腺外,大脑的变化可能是葡萄糖代谢的关键驱动因素。这些数据为可能增加导致GDM的代谢功能障碍风险的脑通路提供了机制见解。
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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.

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来源期刊
Journal of the Indian Institute of Science
Journal of the Indian Institute of Science MULTIDISCIPLINARY SCIENCES-
CiteScore
4.30
自引率
0.00%
发文量
75
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.
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