Placental function in maternal obesity.
Placental function in maternal obesity.
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DOI：
10.1042/cs20190266
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发表时间：
2020-04-30
期刊：
影响因子：
--
通讯作者：
Jansson T
中科院分区：
文献类型：
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作者：
Kelly AC;Powell TL;Jansson T
产妇肥胖与妊娠并发症有关，并增加了婴儿在以后生活中患肥胖症、糖尿病和心血管疾病的风险。然而，将母体肥胖环境与不良短期和长期结果联系起来的机制仍然知之甚少。与BMI正常的孕妇相比，进入妊娠期的肥胖妇女具有更明显的胰岛素抵抗，更高的循环血浆胰岛素、瘦素、IGF-1、脂质和可能的促炎细胞因子以及更低的血浆脂联素。重要的是，母体营养素、生长因子和激素水平在母体肥胖中的变化调节胎盘功能。例如，肥胖孕妇中的高胰岛素、瘦素、IGF-1和低脂联素预期会激活胎盘中的mTOR信号传导，促进蛋白质合成、线粒体功能和营养转运。这些变化被认为增加了胎儿的营养供应，并导致胎儿过度生长和/或后代肥胖，这增加了以后生活中发生疾病的风险。专门针对胎盘功能的干预措施，如激活胎盘脂联素受体，可能会防止肥胖妇女将代谢性疾病从生育大婴儿传播给下一代。大多数肥胖妇女生下正常大小的婴儿，这些妊娠与炎症信号通路的激活、氧化应激、氧化磷酸化减少和胎盘中的脂质积累有关。最近的生物信息学方法将这些改变扩展到包括新的靶点，然而，生育正常大小婴儿的肥胖妇女的胎盘变化如何与不良的短期和长期婴儿结局有关尚不清楚。
Maternal obesity is associated with pregnancy complications and increases the risk for the infant to develop obesity, diabetes and cardiovascular disease later in life. However, the mechanisms linking the maternal obesogenic environment to adverse short- and long term outcomes remain poorly understood. As compared with pregnant women with normal BMI, women entering pregnancy obese have more pronounced insulin resistance, higher circulating plasma insulin, leptin, IGF-1, lipids and possibly proinflammatory cytokines and lower plasma adiponectin. Importantly, the changes in maternal levels of nutrients, growth factors and hormones in maternal obesity modulate placental function. For example, high insulin, leptin, IGF-1 and low adiponectin in obese pregnant women are expected to activate mTOR signalling in the placenta, promoting protein synthesis, mitochondrial function and nutrient transport. These changes are believed to increase fetal nutrient supply and contribute to fetal overgrowth and/or adiposity in offspring, which increases the risk to develop disease later in life. Interventions that specifically target placental function, such as activation of placental adiponectin receptors, may prevent the transmission of metabolic disease from obese women giving birth to large babies to the next generation. The majority of obese women give birth to normal sized infants and these pregnancies are associated with activation of inflammatory signalling pathways, oxidative stress, decreased oxidative phosphorylation and lipid accumulation in the placenta. Recent bioinformatics approaches expand these alterations to include novel targets, however how placental changes in obese women giving birth to normal sized babies are linked to poor short and long-term infant outcomes is unclear.