Abstract
Gestational diabetes mellitus (GDM) is a syndrome compromising the health of the mother and the fetus. Endothelial damage and reduced metabolism of the vasodilator adenosine occur and fetal hyperinsulinemia associated with deficient insulin response and a metabolic rather than mitogenic phenotype is characteristic of this pathology. These phenomena lead to endothelial dysfunction of the fetoplacental unit. Major databases were searched for the relevant literature in the field. Special attention was placed on publications related with diabetes and hormone/metabolic disorders. We aimed to summarize the information regarding insulin sensitivity changes in GDM and the role of adenosine in this phenomenon. Evidence supporting the possibility that fetal endothelial dysfunction involves a functional link between adenosine and insulin signaling in the fetal endothelium from GDM pregnancies is summarized. Since insulin acts via membrane receptors type A (preferentially associated with mitogenic responses) or type B (preferentially associated with metabolic responses), a differential activation of these receptors in this syndrome is proposed.
Keywords: Adenosine, endothelium, fetus, gestational diabetes, insulin receptor, placenta, hyperinsulinemia, endothelial dysfunction, oral glucose tolerance test, macrosomia
Current Vascular Pharmacology
Title: Functional Link Between Adenosine and Insulin: A Hypothesis for Fetoplacental Vascular Endothelial Dysfunction in Gestational Diabetes
Volume: 9 Issue: 6
Author(s): Enrique Guzman-Gutierrez, Fernando Abarzua, Cristian Belmar, Jyh K. Nien, Marco A. Ramirez, Pablo Arroyo, Carlos Salomon, Francisco Westermeier, Carlos Puebla, Andrea Leiva, Paola Casanello and Luis Sobrevia
Affiliation:
Keywords: Adenosine, endothelium, fetus, gestational diabetes, insulin receptor, placenta, hyperinsulinemia, endothelial dysfunction, oral glucose tolerance test, macrosomia
Abstract: Gestational diabetes mellitus (GDM) is a syndrome compromising the health of the mother and the fetus. Endothelial damage and reduced metabolism of the vasodilator adenosine occur and fetal hyperinsulinemia associated with deficient insulin response and a metabolic rather than mitogenic phenotype is characteristic of this pathology. These phenomena lead to endothelial dysfunction of the fetoplacental unit. Major databases were searched for the relevant literature in the field. Special attention was placed on publications related with diabetes and hormone/metabolic disorders. We aimed to summarize the information regarding insulin sensitivity changes in GDM and the role of adenosine in this phenomenon. Evidence supporting the possibility that fetal endothelial dysfunction involves a functional link between adenosine and insulin signaling in the fetal endothelium from GDM pregnancies is summarized. Since insulin acts via membrane receptors type A (preferentially associated with mitogenic responses) or type B (preferentially associated with metabolic responses), a differential activation of these receptors in this syndrome is proposed.
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Guzman-Gutierrez Enrique, Abarzua Fernando, Belmar Cristian, K. Nien Jyh, A. Ramirez Marco, Arroyo Pablo, Salomon Carlos, Westermeier Francisco, Puebla Carlos, Leiva Andrea, Casanello Paola and Sobrevia Luis, Functional Link Between Adenosine and Insulin: A Hypothesis for Fetoplacental Vascular Endothelial Dysfunction in Gestational Diabetes, Current Vascular Pharmacology 2011; 9 (6) . https://dx.doi.org/10.2174/157016111797484062
DOI https://dx.doi.org/10.2174/157016111797484062 |
Print ISSN 1570-1611 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-6212 |
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