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SHR Neuro Cancer Cardio Lipid Metab Microb

Desoye, G; van Poppel, M.
The feto-placental dialogue and diabesity.
Best Pract Res Clin Obstet Gynaecol. 2015; 29(1):15-23 Doi: 10.1016/j.bpobgyn.2014.05.012
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Desoye Gernot
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Abstract:
Recent studies have established that the neonate born to a pregnancy with maternal diabetes or obesity ('diabesity') is characterized by increased fat accumulation. The neonatal fat is the result of triglyceride synthesis and deposition stimulated by elevated fetal insulin levels combined with insulin's mitogenic activity directly stimulating the growth of the white adipocytes. Fetal insulin levels are determined by fetal glucose and some amino acids such as arginine. Although the placenta plays a key role in providing maternally derived nutrients to the growing fetus, there is currently no evidence that it actively contributes to an excessive maternal-to-fetal glucose flux at the end of gestation. Early in gestation, the maternal environment in diabesity, and in particular the glucose-insulin axis, can modify placental growth and development, which may contribute to an enhanced glucose flux to the fetus already early in pregnancy. This may have long-lasting effects on the fetal pancreas and accelerate beta-cell maturation. The association of fetal and neonatal insulin levels and the proportion of body fat with obesity later in the offspring's life calls for interventions during pregnancy to prevent or reduce fetal hyperinsulinaemia. Dietary and/or physical activity interventions initiated before or in early pregnancy would likely be most effective. Results from the very few studies with fetal insulin as the outcome are inconsistent. However, there is a major lack of randomized intervention trials on this topic. Copyright © 2014 Elsevier Ltd. All rights reserved.
Find related publications in this database (using NLM MeSH Indexing)
Biomarkers - metabolism
Female -
Fetal Development - physiology
Glucose - metabolism
Humans -
Infant, Newborn -
Insulin - metabolism
Maternal-Fetal Exchange - physiology
Obesity - etiology
Obesity - metabolism
Phenotype -
Placenta - metabolism
Pregnancy -
Pregnancy in Diabetics - metabolism
Prenatal Exposure Delayed Effects - etiology
Prenatal Exposure Delayed Effects - metabolism

Find related publications in this database (Keywords)
glucose
insulin
hypothalamus
fetal/neonatal fat
first trimester of pregnancy
lifestyle interventions
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