REVIEW   

Minerva Endocrinologica 2020 September;45(3):228-42

DOI: 10.23736/S0391-1977.20.03192-2

Copyright © 2020 EDIZIONI MINERVA MEDICA

language: English

The possible role of endocrine dysfunction of adipose tissue in gestational diabetes mellitus

Patrik ŠIMJÁK ¹, Kateřina ANDERLOVÁ ^{1, 2}, Anna CINKAJZLOVÁ ³, Antonín PAŘÍZEK ¹, Michal KRŠEK ², Martin HALUZÍK ⁴ ✉

¹ Department of Gynecology and Obstetrics, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic; ² Third Department of Medicine, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic; ³ Center for Experimental Medicine, Institute for Clinical and Experimental Medicine, Prague, Czech Republic; ⁴ Diabetes Center, Institute for Clinical and Experimental Medicine, Prague, Czech Republic

Gestational diabetes mellitus (GDM) is diabetes that is first diagnosed in the second or third trimester of pregnancy in patients who did not have a history of diabetes before pregnancy. Consequences of GDM include increased risk of macrosomia and birth complications in the infant and an increased risk of maternal type 2 diabetes mellitus (T2DM) after pregnancy. There is also a longer-term risk of obesity, T2DM, and cardiovascular diseases in the child. GDM is the result of impaired glucose tolerance due to pancreatic β-cell dysfunction on a background of insulin resistance that physiologically increases during pregnancy. The strongest clinical predictors of GDM are overweight and obesity. The fact that women with GDM are more likely to be overweight or obese suggests that adipose tissue dysfunction may be involved in the pathogenesis of GDM, similarly to T2DM. Adipose tissue is not only involved in energy storage but also functions as an active endocrine organ secreting adipokines (specific hormones and cytokines) with the ability to alter insulin sensitivity. Recent evidence points to a crucial role of numerous adipokines produced by fat in the development of GDM. The following text summarizes the current knowledge about a possible role of selected adipokines in the development of GDM.

KEY WORDS: Adipose tissue; Gestational diabetes; Diabetes mellitus; Endocrine system diseases