Increased glucose and placental GLUT-1 in large infants of obese nondiabetic mothers
Increased glucose and placental GLUT-1 in large infants of obese nondiabetic mothers
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DOI：
10.1016/j.ajog.2014.08.009
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发表时间：
2015-02-01
影响因子：
9.8
通讯作者：
Jansson, Thomas
中科院分区：
文献类型：
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作者：
Acosta, Ometeotl;Ramirez, Vanessa I.;Jansson, Thomas
目的：肥胖妇女分娩大婴儿的风险增加，然而，其潜在机制尚不清楚。胎儿葡萄糖利用率严重依赖于胎盘转移，并通过调节胎儿生长激素（如胰岛素）的释放与胎儿生长有关。我们假设，（1）脐静脉葡萄糖和胰岛素水平和（2）胎盘葡萄糖转运蛋白（GLUT）的表达和活性呈正相关，早孕母亲的体重指数和婴儿birthweight.Study Design：在这个前瞻性观察队列研究的主题是非糖尿病主要是西班牙裔妇女在任期内交付。在29名不同早孕体重指数（范围18.0-54.3）的妇女中测定了空腹母体和脐静脉葡萄糖和胰岛素浓度，这些妇女分娩的婴儿出生体重范围为2800-4402 g。我们分离了33例胎盘合体滋养细胞微绒毛和基底质膜，并测定了GLUT-1和-9（Western blot）的表达和葡萄糖摄取（放射性标记葡萄糖）。脐静脉血糖水平与胎盘重量和母体体重指数呈正相关，但与母体空腹血糖无相关性。基底细胞膜GLUT-1表达与出生体重正相关。相比之下，合体滋养层微绒毛GLUT-1和-9，基底质膜GLUT-9的表达和合体滋养层微绒毛和基底质膜葡萄糖转运活性与birthweight.CONCLUSION：由于产妇空腹血糖水平和胎盘葡萄糖转运能力没有增加肥胖妇女提供较大的婴儿，我们推测，增加胎盘大小促进葡萄糖输送到这些胎儿。
OBJECTIVE: Obese women are at increased risk to deliver a large infant, however, the underlying mechanisms are poorly understood. Fetal glucose availability is critically dependent on placental transfer and is linked to fetal growth by regulating the release of fetal growth hormones such as insulin. We hypothesized that (1) umbilical vein glucose and insulin levels and (2) placental glucose transporter (GLUT) expression and activity are positively correlated with early pregnancy maternal body mass index and infant birthweight.STUDY DESIGN: Subjects in this prospective observational cohort study were nondiabetic predominantly Hispanic women delivered at term. Fasting maternal and umbilical vein glucose and insulin concentrations were determined in 29 women with varying early pregnancy body mass index (range, 18.0-54.3) who delivered infants with birthweights ranging from 2800-4402 g. We isolated syncytiotrophoblast microvillous and basal plasma membranes from 33 placentas and determined the expression of GLUT-1 and -9 (Western blot) and glucose uptake (radiolabeled glucose).RESULTS: Birthweight was positively correlated with umbilical vein glucose and insulin and maternal body mass index. Umbilical vein glucose levels were positively correlated with placental weight and maternal body mass index, but not with maternal fasting glucose. Basal plasma membranes GLUT-1 expression was positively correlated with birthweight. In contrast, syncytiotrophoblast microvillous GLUT-1 and -9, basal plasma membranes GLUT-9 expression and syncytiotrophoblast microvillous and basal plasma membranes glucose transport activity were not correlated with birthweight.CONCLUSION: Because maternal fasting glucose levels and placental glucose transport capacity were not increased in obese women delivering larger infants, we speculate that increased placental size promotes glucose delivery to these fetuses.