Early Identification of the Maternal, Placental and Fetal Dialog in Gestational Diabetes and Its Prevention
Abstract
:1. Introduction
2. Pathophysiology of GDM
3. Importance of GDM Prediction
4. Predicting GDM by Maternal Risk Factors
5. Predicting GDM Using Individual Biomarkers
6. Predicting GDM by Early Glycemic Markers
6.1. Fasting Glucose
6.2. HbA1c
7. Predicting GDM by Adipokines
7.1. Adiponectin
7.2. Leptin
8. Predicting GDM by Pregnancy-Related Proteins
8.1. Pregnancy-Associated Plasma Protein A (PAPP-A)
8.2. Placental Growth Factor (PLGF)
8.3. First-Trimester Combined Test (FTCT)
9. Predicting GDM by Inflammatory Markers
9.1. Tumor Necrosis Factor-α (TNF-α)
9.2. C-Reactive Protein (CRP)
9.3. Interleukin 6 (IL-6)
10. Predicting GDM by Insulin Resistance Markers
SHBG
11. Early Prediction to Improve Maternal, Placental and Fetal Dialog
12. Future Directions
13. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Risk Factor | Odds Ratio |
---|---|
1. Ethnicity: Asian, Middle Eastern, Hispanic, Latino, African American, and Indigenous | 2.32 [26] |
2. Maternal age ≥35 years | 3.54 [27] |
3. Pre-pregnancy BMI >25 kg/m2 | 2.14 [28] |
4. Polycystic ovary syndrome | 2.32 [29] |
5. GDM in a previous pregnancy | 5.9 [26] |
6. Previous delivery of macrocosmic baby (birth weight >4000 gr or >90th centile) | 1.54 [26] |
7. Family history of diabetes (1st degree relative) | 1.36 [26] |
8. Multiple pregnancy | 1.13 [30] |
9. Assisted reproductive technology | 1.26 [31] |
Biomarker | Function | Suggested Involvement in GDM Pathophysiology |
---|---|---|
Adiponectin | Modulation of glucose and fatty acid metabolism. Involvement in inflammation, apoptosis, and angiogenesis. | Low levels associated with decreased insulin sensitivity and GDM |
Leptin | Regulation of energy balance and expenditure. Role in hormone regulation and immunity. | High leptin levels cause hyperinsulinemia and increase insulin resistance |
PAPP-A | Increase bioavailability of IGF-1 and promotes somatic growth. Involvement in wound healing and bone remodeling. | Decreased levels contribute to an increase in insulin resistance |
PLGF | Vascular endothelial growth factor-like protein. Role in angiogenesis and placentation. | High PLGF levels promote the abnormal vascular network in placentas of GDM pregnancies |
TNF-α | Inflammatory cytokine involved in the regulation of immune cells, inflammation, and autoimmune diseases. | Increased levels impair insulin signaling and beta-cell function, leading to insulin resistance and GDM |
CRP | Acute-phase reactant. Role in tissue injury, inflammation, and infection. | High levels associated with insulin resistance and systemic inflammation |
IL-6 | Circulating inflammatory cytokine. Role in immune response regulation, inflammation, and hematopoiesis. | Increased secretion by adipocytes and placental cells, leading to a chronic inflammatory process and insulin resistance |
SHBG | Glycoprotein that binds androgen and estrogen. | Decrease SHBG levels associated with hyperinsulinemia and GDM |
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Naeh, A.; Maor-Sagie, E.; Hallak, M.; Gabbay-Benziv, R. Early Identification of the Maternal, Placental and Fetal Dialog in Gestational Diabetes and Its Prevention. Reprod. Med. 2022, 3, 1-14. https://doi.org/10.3390/reprodmed3010001
Naeh A, Maor-Sagie E, Hallak M, Gabbay-Benziv R. Early Identification of the Maternal, Placental and Fetal Dialog in Gestational Diabetes and Its Prevention. Reproductive Medicine. 2022; 3(1):1-14. https://doi.org/10.3390/reprodmed3010001
Chicago/Turabian StyleNaeh, Amir, Esther Maor-Sagie, Mordechai Hallak, and Rinat Gabbay-Benziv. 2022. "Early Identification of the Maternal, Placental and Fetal Dialog in Gestational Diabetes and Its Prevention" Reproductive Medicine 3, no. 1: 1-14. https://doi.org/10.3390/reprodmed3010001