成纤维细胞生长因子21与妊娠期代谢性疾病的研究进展

Research Progress of Fibroblast Growth Factor 21 and Gestational Metabolic Diseases

妊娠期代谢性疾病(gestational metabolic diseases,GMD)是影响孕产妇及新生儿结局最主要的原因,目前其作用机制仍不清楚。成纤维细胞生长因子21(fibroblast growth factor 21,FGF21)是由多种器官合成的多肽激素,其作用机制复杂,在体外和体内调节一系列代谢过程,主要以内分泌方式参与葡萄糖、脂质、能量调节及胆汁酸的肝肠循环等代谢活动,还在细胞增殖与分化、神经元发育、血管生成及伤口愈合过程中发挥关键作用。因此,FGF21的释放障碍、信号失调和功能异常与GMD如妊娠期糖尿病、妊娠期高血压疾病和妊娠期肝内胆汁淤积症等密切相关。综述FGF21在GMD中作用机制的最新研究进展,以期及早、精确地发现GMD及其隐匿病情,达到早诊断、早干预的目的,最终改善母儿预后。

Gestational metabolic diseases(GMD)are the most common cause of maternal and neonatal outcomes,but the mechanism remains unclear.Fibroblast growth factor 21(FGF21)is a polypeptide hormone synthesized by a variety of organs.Its mechanism of action is complex.It regulates a series of metabolic processes in vitro and in vivo,and mainly participates in metabolic activities such as glucose,lipid,energy regulation and hepato-intestinal circulation of bile acid by means of endocrine.It also plays a key role in cell proliferation and differentiation,neuronal development,angiogenesis and wound healing.Therefore,FGF21 release disorders,signal dysregulation,and abnormal function are closely associated with GMD such as gestational diabetes mellitus,gestational hypertension disease,and intrahepatic cholestasis of pregnancy.This article reviews the latest research progress on the mechanism of FGF21 in GMD,so as to identify GMD and its hidden disease as early and accurate as possible,achieve the purpose of early diagnosis and intervention,and ultimately improve the prognosis of mothers and infants.