Steroids and insulin resistance in pregnancy

Vejražková, Daniela; Včelák, Josef; Vaňková, Markéta; Lukasova, Petra; Bradnova, Olga; Halkova, Tereza; Kancheva, Radmila; Bendlová, Běla

doi:10.1016/j.jsbmb.2012.11.007

Cited by 80 publications

(59 citation statements)

References 103 publications

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“…In particular, a linkage analysis study revealed that the exon-1 of AR of the offspring who was born preterm had more repetitions of a sequence encoding for a site in the domain involved in ligand activation (Karjalainen et al , 2012). Abnormal increase in androgens during pregnancy has been additionally correlated with the development of gestational diabetes, which is further associated with PTB (Espinos et al , 1992; Abbott et al , 2010; Vejrazkova et al , 2014; Ackerman et al , 2013; Morisset et al , 2013). This is probably due to the role of androgens in modulation of insulin secretion from the pancreas and inhibition of glucose uptake in fat and muscle cells (Corbould, 2008; Rao et al , 2013).…”

Section: Resultsmentioning

confidence: 99%

Androgens in pregnancy: roles in parturition

Makieva

Saunders

Norman

2014

Human Reproduction Update

179

143

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BACKGROUNDUnderstanding the physiology of pregnancy enables effective management of pregnancy complications that could otherwise be life threatening for both mother and fetus. A functional uterus (i) retains the fetus in utero during pregnancy without initiating stretch-induced contractions and (ii) is able to dilate the cervix and contract the myometrium at term to deliver the fetus. The onset of labour is associated with successful cervical remodelling and contraction of myometrium, arising from concomitant activation of uterine immune and endocrine systems. A large body of evidence suggests that actions of local steroid hormones may drive changes occurring in the uterine microenvironment at term. Although there have been a number of studies considering the potential role(s) played by progesterone and estrogen at the time of parturition, the bio-availability and effects of androgens during pregnancy have received less scrutiny. The aim of this review is to highlight potential roles of androgens in the biology of pregnancy and parturition.METHODSA review of published literature was performed to address (i) androgen concentrations, including biosynthesis and clearance, in maternal and fetal compartments throughout gestation, (ii) associations of androgen concentrations with adverse pregnancy outcomes, (iii) the role of androgens in the physiology of cervical remodelling and finally (iv) the role of androgens in the physiology of myometrial function including any impact on contractility.RESULTSSome, but not all, androgens increase throughout gestation in maternal circulation. The effects of this increase are not fully understood; however, evidence suggests that increased androgens might regulate key processes during pregnancy and parturition. For example, androgens are believed to be critical for cervical remodelling at term, in particular cervical ripening, via regulation of cervical collagen fibril organization. Additionally, a number of studies highlight potential roles for androgens in myometrial relaxation via non-genomic, AR-independent pathways critical for the pregnancy reaching term. Understanding of the molecular events leading to myometrial relaxation is an important step towards development of novel targeted tocolytic drugs.CONCLUSIONSThe increase in androgen levels throughout gestation is likely to be important for establishment and maintenance of pregnancy and initiation of parturition. Further investigation of the underlying mechanisms of androgen action on cervical remodelling and myometrial contractility is needed. The insights gained may facilitate the development of new therapeutic approaches to manage pregnancy complications such as preterm birth.

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Section: Resultsmentioning

confidence: 99%

Androgens in pregnancy: roles in parturition

Makieva

Saunders

Norman

2014

Human Reproduction Update

179

143

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“…Lower sex hormone-binding globulin, which may be associated with higher androgens and lower estrogens, has been implicated as a risk factor for GDM, but it may also indicate greater insulin resistance. 196,197 To summarize, although PCOS and GDM are associated with cardiovascular risk factors and a higher risk for DM, the evidence for cardiovascular events and mortality is less established, in part as a result of limitations in prospectively collected data. Well-characterized longitudinal cohorts are needed to better determine cardiovascular risk and predictors for cardiovascular risk.…”

Section: The Influence Of Sex Hormones On Cardiovascular Risk In Pcosmentioning

confidence: 99%

Sex Differences in the Cardiovascular Consequences of Diabetes Mellitus

et al. 2015

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Currently, ≈1 in 13 people living in the United States has DM, and 90% to 95% of these individuals have type 2 DM (T2DM).2 Overall, the prevalence of T2DM is similar in women and men. In the United States, ≈12.6 million women (10.8%) and 13 million men (11.8%) ≥20 years of age are currently estimated to have T2DM. 2 Among individuals with T2DM, cardiovascular disease (CVD) is the leading cause of morbidity and mortality and accounts for >75% of hospitalizations and >50% of all deaths.3 Although nondiabetic women have fewer cardiovascular events than nondiabetic men of the same age, this advantage appears to be lost in the context of T2DM. 4,5 The reasons for this advantage are not entirely clear but are likely multifactorial with contributions from inherent physiological differences, including the impact of the sex hormones, differences in cardiovascular risk factors, and differences between the sexes in the diagnosis and treatment of DM and CVD. 6 In addition, there are racial and ethnic factors to consider because women of ethnic minority backgrounds have a higher prevalence of DM than non-Hispanic white (NHW) women.This scientific statement was designed to provide the current state of knowledge about sex differences in the cardiovascular consequences of DM, and it will identify areas that would benefit from further research because much is still unknown about sex differences in DM and CVD. Areas that are discussed include hormonal differences between the sexes and their possible effects on the interaction between DM and CVD, sex differences in epidemiology, ethnic and racial differences and risk factors for CVD in DM across the life span, sex differences in various types of CVD and heart failure, and sex differences in the effects of treatments for DM, including both medications and lifestyle. In addition, there is discussion about risk factors that are specific to women, including gestational diabetes mellitus (GDM) and polycystic ovarian syndrome (PCOS), which affect CVD risk. Table 1 focuses on sex differences in CVD risk factors and outcomes in DM, and Table 2 provides information about sex differences in CVD treatments and interventions in DM. Table 3 contains some of the important ideas for research in sex differences in the cardiovascular consequences of DM. The American Heart Association makes every effort to avoid any actual or potential conflicts of interest that may arise as a result of an outside relationship or a personal, professional, or business interest of a member of the writing panel. Specifically, all members of the writing group are required to complete and submit a Disclosure Questionnaire showing all such relationships that might be perceived as real or potential conflicts of interest.This statement was approved by the American Heart Association Science Advisory and Coordinating Committee on July 31, 2015, and the American Heart Association Executive Committee on September 5, 2015. A copy of the document is available at http://my.americanheart.org/statements by selecting either the "By...

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“…During pregnancy glucose metabolism is governed by equilibrium between lactogenic hormones stimulating insulin production and counter-regulatory hormones inducing insulin resistance (IR) (1) . Multiple peptides play a major role in pathogenesis of metabolic disorders and carbohydrate metabolism (2) and substances of hormonal character secreted by adipose tissue (Adipokines) are of great importance (3) .…”

Section: …………………………………………………………………………………………………… Introduction:-mentioning

confidence: 99%

Serum Adropin and Adipose Fatty-Acid Binding Protein at 6th Week of Pregnancy Are Significant Predictors for Development of Insulin Resistance at the 24th Week.

Sharafeldeen¹

2018

IJAR

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Steroids and insulin resistance in pregnancy

Cited by 80 publications

References 103 publications

Androgens in pregnancy: roles in parturition

Androgens in pregnancy: roles in parturition

Sex Differences in the Cardiovascular Consequences of Diabetes Mellitus

Serum Adropin and Adipose Fatty-Acid Binding Protein at 6th Week of Pregnancy Are Significant Predictors for Development of Insulin Resistance at the 24th Week.

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