脂肪因子与妊娠期糖尿病及糖脂代谢

Adipokines and Gestational Diabetes Mellitus and Glucose Lipid Metabolism

妊娠期糖尿病(gestational diabetes mellitus,GDM)是妊娠期的主要并发症之一,随着我国二孩政策的实施、生活水平的提高、婚姻观念的转变,在肥胖、高龄和遗传易感性等高危因素的影响下,GDM的发病率呈逐年上升趋势。目前GDM的具体发病机制尚不明确,可能与胰岛素抵抗及胰岛β细胞功能缺陷有关。GDM孕妇体内糖代谢的紊乱会进一步导致脂质代谢的异常,从而引发不良妊娠结局。其中脂肪因子,如促代谢因子(betatrophin)、趋化素(chemerin)、C1q/肿瘤坏死因子相关蛋白(CTRP9)和瘦素(leptin)等在GDM的相关发病机制中可能起到一定作用。综述脂肪因子在调节糖脂代谢中的作用,及其在GDM病理发生中的作用。

Gestational diabetes mellitus(GDM)is one of the major complications during pregnancy.With the implementation of the two-child policy,the improvement of living standard and the change of marriage concept,the incidence of GDM has been increasing year by year under the influence of high risk factors such as obesity,age and genetic susceptibility.At present,the specific pathogenesis of GDM is not clear,which may be related to insulin resistance and dysfunction of insulinβcell.The disorder of glucose metabolism in pregnant women with GDM will further lead to the disorder of lipid metabolism,leading to adverse pregnant outcomes.Adipokines,such as betatrophin,chemerin,C1q/tumor necrosis factor related protein(CTRP9)and leptin,may play a role in the pathogenesis of GDM.This article reviews the roles of adipokines in the regulation of glucose and lipid metabolism,and the pathogenesis of GDM.