妊娠期糖尿病患者的胎盘血管内皮细胞代谢紊乱与胰岛素信号通路的相关性研究进展

Metabolic disorder of placental vascular endothelial cells and insulin signaling pathway in patients with gestational diabetes mellitus

妊娠期糖尿病(GDM)是孕期常见的合并症。GDM患者胎盘的结构及功能均有异于正常孕妇,胎盘代谢的紊乱是引起GDM不良妊娠结局的重要原因之一。在妊娠末期,胎盘血管内皮细胞对胎盘功能的调节占有重要的地位。GDM患者的胎盘内皮细胞功能受损,但具体机制尚不清楚。目前一些研究结果初步表明,胰岛素可能是调节胎盘内皮细胞代谢的一个关键因子。胎盘内皮细胞上胰岛素信号通路的异常与内皮细胞的内质网应激反应、血管生成异常以及脂代谢异常均有关。因此,研究GDM患者胎盘内皮细胞上胰岛素信号通路的改变,可能对阐明GDM患者胎盘代谢的紊乱有着重要的意义。

Gestational diabetes mellitus(GDM)is a common complication during pregnancy.The structure and function of the placenta in patients with GDM are different from that of normal pregnant women,and disorder of placenta metabolism may cause adverse pregnancy outcome in patients with GDM.Placental endothelium plays an important role in the regulation of placental function in the third trimester of pregnancy.The mechanism of placental endothelial dysfunction in GDM patients remains unclear.Some studies have suggested that insulin may be a key modulator of placental endothelium function.Disturbance of insulin signaling pathway is associated with endoplasmic reticulum stress response,abnormal angiogenesis and lipid metabolism disorders in placental endothelial cells.Therefore,study on insulin signaling alteration in the placental endothelium,may be crucial in the better understanding of placenta dysfunction in GDM,and preventing adverse outcome.