The role of obesity and adipose tissue dysfunction in gestational diabetes mellitus

Gestational diabetes mellitus is defined as diabetes diagnosed in the second or third trimester of pregnancy in patients with no history of diabetes prior to gestation. It is the most common complication of pregnancy. The underlying pathophysiology shares some common features with type 2 diabetes me...

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Published inJournal of endocrinology Vol. 238; no. 2; pp. R63 - R77
Main Authors Šimják, Patrik, Cinkajzlová, Anna, Anderlová, Kateřina, Pařízek, Antonín, Mráz, Miloš, Kršek, Michal, Haluzík, Martin
Format Journal Article
LanguageEnglish
Published England Bioscientifica Ltd 01.08.2018
Portland Press Ltd The Biochemical Society
Subjects
Adipose tissue
Diabetes
Diabetes mellitus
Diabetes mellitus (non-insulin dependent)
Gestation
Insulin
Insulin resistance
Insulin secretion
Obesity
Patients
Phenotypes
Pregnancy
Review
adipose tissue
adipokines
gestational diabetes mellitus
inflammation
obesity
Online AccessGet full text
ISSN0022-0795
1479-6805
1479-6805
DOI10.1530/JOE-18-0032

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Abstract Gestational diabetes mellitus is defined as diabetes diagnosed in the second or third trimester of pregnancy in patients with no history of diabetes prior to gestation. It is the most common complication of pregnancy. The underlying pathophysiology shares some common features with type 2 diabetes mellitus (T2DM) combining relatively insufficient insulin secretion with increased peripheral insulin resistance. While a certain degree of insulin resistance is the physiological characteristics of the second half of pregnancy, it is significantly more pronounced in patients with gestational diabetes. Adipose tissue dysfunction and subclinical inflammation in obesity are well-described causes of increased insulin resistance in non-pregnant subjects and are often observed in individuals with T2DM. Emerging evidence of altered adipokine expression and local inflammation in adipose tissue in patients with gestational diabetes suggests an important involvement of adipose tissue in its etiopathogenesis. This review aims to summarize current knowledge of adipose tissue dysfunction and its role in the development of gestational diabetes. We specifically focus on the significance of alterations of adipokines and immunocompetent cells number and phenotype in fat. Detailed understanding of the role of adipose tissue in gestational diabetes may provide new insights into its pathophysiology and open new possibilities of its prevention and treatment.
AbstractList Gestational diabetes mellitus is defined as diabetes diagnosed in the second or third trimester of pregnancy in patients with no history of diabetes prior to gestation. It is the most common complication of pregnancy. The underlying pathophysiology shares some common features with type 2 diabetes mellitus (T2DM) combining relatively insufficient insulin secretion with increased peripheral insulin resistance. While a certain degree of insulin resistance is the physiological characteristics of the second half of pregnancy, it is significantly more pronounced in patients with gestational diabetes. Adipose tissue dysfunction and subclinical inflammation in obesity are well-described causes of increased insulin resistance in non-pregnant subjects and are often observed in individuals with T2DM. Emerging evidence of altered adipokine expression and local inflammation in adipose tissue in patients with gestational diabetes suggests an important involvement of adipose tissue in its etiopathogenesis. This review aims to summarize current knowledge of adipose tissue dysfunction and its role in the development of gestational diabetes. We specifically focus on the significance of alterations of adipokines and immunocompetent cells number and phenotype in fat. Detailed understanding of the role of adipose tissue in gestational diabetes may provide new insights into its pathophysiology and open new possibilities of its prevention and treatment.
Gestational diabetes mellitus is defined as diabetes diagnosed in the second or third trimester of pregnancy in patients with no history of diabetes prior to gestation. It is the most common complication of pregnancy. The underlying pathophysiology shares some common features with type 2 diabetes mellitus (T2DM) combining relatively insufficient insulin secretion with increased peripheral insulin resistance. While a certain degree of insulin resistance is the physiological characteristics of the second half of pregnancy, it is significantly more pronounced in patients with gestational diabetes. Adipose tissue dysfunction and subclinical inflammation in obesity are well-described causes of increased insulin resistance in non-pregnant subjects and are often observed in individuals with T2DM. Emerging evidence of altered adipokine expression and local inflammation in adipose tissue in patients with gestational diabetes suggests an important involvement of adipose tissue in its etiopathogenesis. This review aims to summarize current knowledge of adipose tissue dysfunction and its role in the development of gestational diabetes. We specifically focus on the significance of alterations of adipokines and immunocompetent cells number and phenotype in fat. Detailed understanding of the role of adipose tissue in gestational diabetes may provide new insights into its pathophysiology and open new possibilities of its prevention and treatment.Gestational diabetes mellitus is defined as diabetes diagnosed in the second or third trimester of pregnancy in patients with no history of diabetes prior to gestation. It is the most common complication of pregnancy. The underlying pathophysiology shares some common features with type 2 diabetes mellitus (T2DM) combining relatively insufficient insulin secretion with increased peripheral insulin resistance. While a certain degree of insulin resistance is the physiological characteristics of the second half of pregnancy, it is significantly more pronounced in patients with gestational diabetes. Adipose tissue dysfunction and subclinical inflammation in obesity are well-described causes of increased insulin resistance in non-pregnant subjects and are often observed in individuals with T2DM. Emerging evidence of altered adipokine expression and local inflammation in adipose tissue in patients with gestational diabetes suggests an important involvement of adipose tissue in its etiopathogenesis. This review aims to summarize current knowledge of adipose tissue dysfunction and its role in the development of gestational diabetes. We specifically focus on the significance of alterations of adipokines and immunocompetent cells number and phenotype in fat. Detailed understanding of the role of adipose tissue in gestational diabetes may provide new insights into its pathophysiology and open new possibilities of its prevention and treatment.
Author Pařízek, Antonín
Kršek, Michal
Anderlová, Kateřina
Cinkajzlová, Anna
Haluzík, Martin
Šimják, Patrik
Mráz, Miloš
AuthorAffiliation Diabetes Centre, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
3rd Department of Medicine, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
Department of Gynaecology and Obstetrics, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
Institute of Medical Biochemistry and Laboratory Diagnostics, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
2nd Internal Department, 3rd Faculty of Medicine, Charles University and University Hospital Královské Vinohrady, Prague, Czech Republic
Centre for Experimental Medicine, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
AuthorAffiliation_xml – name: Institute of Medical Biochemistry and Laboratory Diagnostics, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
– name: Diabetes Centre, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
– name: Centre for Experimental Medicine, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
– name: Department of Gynaecology and Obstetrics, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
– name: 3rd Department of Medicine, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
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Author_xml – sequence: 1
  givenname: Patrik
  surname: Šimják
  fullname: Šimják, Patrik
  organization: Department of Gynaecology and Obstetrics, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
– sequence: 2
  givenname: Anna
  surname: Cinkajzlová
  fullname: Cinkajzlová, Anna
  organization: Centre for Experimental Medicine, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
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  givenname: Antonín
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  fullname: Pařízek, Antonín
  organization: Department of Gynaecology and Obstetrics, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
– sequence: 5
  givenname: Miloš
  surname: Mráz
  fullname: Mráz, Miloš
  organization: Diabetes Centre, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
– sequence: 6
  givenname: Michal
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  fullname: Kršek, Michal
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– sequence: 7
  givenname: Martin
  surname: Haluzík
  fullname: Haluzík, Martin
  email: halm@ikem.cz
  organization: Diabetes Centre, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
BackLink https://www.ncbi.nlm.nih.gov/pubmed/29743342$$D View this record in MEDLINE/PubMed
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Keywords adipose tissue
adipokines
gestational diabetes mellitus
inflammation
obesity
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Snippet Gestational diabetes mellitus is defined as diabetes diagnosed in the second or third trimester of pregnancy in patients with no history of diabetes prior to...
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SubjectTerms Adipose tissue
Diabetes
Diabetes mellitus
Diabetes mellitus (non-insulin dependent)
Gestation
Insulin
Insulin resistance
Insulin secretion
Obesity
Patients
Phenotypes
Pregnancy
Review
Title The role of obesity and adipose tissue dysfunction in gestational diabetes mellitus
URI http://dx.doi.org/10.1530/JOE-18-0032
https://www.ncbi.nlm.nih.gov/pubmed/29743342
https://www.proquest.com/docview/2069236317
https://www.proquest.com/docview/2037056932
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