Genetic and epigenetic alterations associated with gestational diabetes mellitus and adverse neonatal outcomes.

Amreen Shamsad, Tanu Gautam, Renu Singh, Monisha Banerjee
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Abstract

Gestational diabetes mellitus (GDM) is a metabolic disorder, recognised during 24-28 weeks of pregnancy. GDM is linked with adverse newborn outcomes such as macrosomia, premature delivery, metabolic disorder, cardiovascular, and neurological disorders. Recent investigations have focused on the correlation of genetic factors such as β-cell function and insulin secretary genes (transcription factor 7 like 2, potassium voltage-gated channel subfamily q member 1, adiponectin etc.) on maternal metabolism during gestation leading to GDM. Epigenetic alterations like DNA methylation, histone modification, and miRNA expression can influence gene expression and play a dominant role in feto-maternal metabolic pathways. Interactions between genes and environment, resulting in differential gene expression patterns may lead to GDM. Researchers suggested that GDM women are more susceptible to insulin resistance, which alters intrauterine surroundings, resulting hyperglycemia and hyperinsulinemia. Epigenetic modifications in genes affecting neuroendocrine activities, and metabolism, increase the risk of obesity and type 2 diabetes in offspring. There is currently no treatment or effective preventive method for GDM, since the molecular processes of insulin resistance are not well understood. The present review was undertaken to understand the pathophysiology of GDM and its effects on adverse neonatal outcomes. In addition, the study of genetic and epigenetic alterations will provide lead to researchers in the search for predictive molecular biomarkers.

与妊娠期糖尿病和不良新生儿结局相关的遗传和表观遗传改变。
妊娠期糖尿病(GDM)是一种代谢性疾病,在妊娠24-28周被发现。GDM与新生儿不良结局有关,如巨大儿、早产、代谢紊乱、心血管和神经紊乱。最近的研究主要集中在β细胞功能和胰岛素分泌基因(转录因子7 like 2、钾电压门控通道亚家族q成员1、脂联素等)等遗传因素与妊娠期母体代谢导致GDM的相关性。表观遗传改变,如DNA甲基化、组蛋白修饰和miRNA表达可以影响基因表达,并在胎母代谢途径中发挥主导作用。基因与环境的相互作用,导致基因表达模式的差异,可能导致GDM。研究人员认为,GDM女性更容易产生胰岛素抵抗,这会改变宫内环境,导致高血糖和高胰岛素血症。影响神经内分泌活动和代谢的基因的表观遗传修饰会增加后代肥胖和2型糖尿病的风险。由于胰岛素抵抗的分子过程尚不清楚,目前尚无治疗或有效预防GDM的方法。本综述旨在了解GDM的病理生理学及其对新生儿不良结局的影响。此外,对遗传和表观遗传改变的研究将为研究人员寻找预测性分子生物标志物提供线索。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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CiteScore
3.20
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