Article

Metabolic changes in pregnancy

Departments of Obstetrics and Gynecology and Internal Medicine, University of Kentucky, Lexington, Kentucky 40536-0293, USA.
Clinical obstetrics and gynecology (Impact Factor: 1.53). 01/2008; 50(4):938-48. DOI: 10.1097/GRF.0b013e31815a5494
Source: PubMed

ABSTRACT Maternal metabolism changes substantially during pregnancy. Early gestation can be viewed as an anabolic state in the mother with an increase in maternal fat stores and small increases in insulin sensitivity. Hence, nutrients are stored in early pregnancy to meet the feto-placental and maternal demands of late gestation and lactation. In contrast, late pregnancy is better characterized as a catabolic state with decreased insulin sensitivity (increased insulin resistance). An increase in insulin resistance results in increases in maternal glucose and free fatty acid concentrations, allowing for greater substrate availability for fetal growth.

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    • "Pregnancy involves physiological changes in the mother, including elevation of cardiac output, increased basal metabolic rate, increased lipid levels, and weight gain (Forsum and Lof, 2007; Granger, 2002; Lain and Catalano, 2007; Tan and Tan, 2013). In pregnancy there are changes in the levels of hormones such as estriol, progesterone, prolactin, early pregnancy factor (EPF), alpha-fetoprotein (Brunton and Russell, 2010) and leptin (Molvarec et al., 2011), and elevated levels of growth factors such as insulin-like growth factor (IGF) (Lauszus et al., 2003). "
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    Frontiers in Neuroendocrinology 04/2014; 35(3). DOI:10.1016/j.yfrne.2014.04.004 · 7.58 Impact Factor
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    • "Pregnancy involves physiological changes in the mother, including elevation of cardiac output, increased basal metabolic rate, increased lipid levels, and weight gain (Forsum and Lof, 2007; Granger, 2002; Lain and Catalano, 2007; Tan and Tan, 2013). In pregnancy there are changes in the levels of hormones such as estriol, progesterone, prolactin, early pregnancy factor (EPF), alpha-fetoprotein (Brunton and Russell, 2010) and leptin (Molvarec et al., 2011), and elevated levels of growth factors such as insulin-like growth factor (IGF) (Lauszus et al., 2003). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Autoimmune diseases are a range of diseases in which the immune response to self-antigens results in damage or dysfunction of tissues. Autoimmune diseases can be systemic or can affect specific organs or body systems. For most autoimmune diseases there is a clear sex difference in prevalence, whereby females are generally more frequently affected than males. In this review, we consider gender differences in systemic and organ-specific autoimmune diseases, and we summarize human data that outlines the prevalence of common autoimmune diseases specific to adult males and females in countries commonly surveyed. We discuss possible mechanisms for sex specific differences including gender differences in immune response and organ vulnerability, reproductive capacity including pregnancy, sex hormones, genetic predisposition, parental inheritance, and epigenetics. Evidence demonstrates that gender has a significant influence on the development of autoimmune disease. Thus, considerations of gender should be at the forefront of all studies that attempt to define mechanisms that underpin autoimmune disease.
    Frontiers in Neuroendocrinology 01/2014; · 7.58 Impact Factor
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    • "In particular, human placental lactogen, human placental growth hormone, progesterone , cortisol, and prolactin are known to counteract the effects of insulin [25]. This is supported by some evidence such as (i) the chronology between raised insulin resistance and the growth of fetoplacental unit which is accompanied by increased production of these hormones, (ii) the similarity of metabolic changes after administration of these hormones to nonpregnant individuals having the metabolic dysregulation of GDM, and (iii) impaired glucose uptake after exposure of insulin-sensitive cells such as adipocytes caused by pregnancy hormones [25]. However, changes in hormone concentrations do not directly correlate with insulin resistance and do not imply a simple cause-andeffect relationship [26]. "
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    ABSTRACT: Gestational diabetes mellitus (GDM) is defined as glucose intolerance first diagnosed during pregnancy. This condition shares same array of underlying abnormalities as occurs in diabetes outside of pregnancy, for example, genetic and environmental causes. However, the role of a sedentary lifestyle and/or excess energy intake is more prominent in GDM. Physically active women are less likely to develop GDM and other pregnancy-related diseases. Weight gain in pregnancy causes increased release of adipokines from adipose tissue; many adipokines increase oxidative stress and insulin resistance. Increased intramyocellular lipids also increase cellular oxidative stress with subsequent generation of reactive oxygen species. A well-planned program of exercise is an important component of a healthy lifestyle and, in spite of old myths, is also recommended during pregnancy. This paper briefly reviews the role of adipokines in gestational diabetes and attempts to shed some light on the mechanisms by which exercise can be beneficial as an adjuvant therapy in GDM. In this regard, we discuss the mechanisms by which exercise increases insulin sensitivity, changes adipokine profile levels, and boosts antioxidant mechanisms.
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