Platelets and endothelial dysfunction in gestational diabetes mellitus

Abstract

The prevalence of gestational diabetes mellitus (GDM) has increased in recent years, along with the higher prevalence of obesity in women of reproductive age.GDM is a pathology associated with vascular dysfunction in the fetoplacental unit. GDM-associated endothelial dysfunction alters the transfer of nutrients to the foetus affecting newborns and pregnant women. Various mechanisms for this vascular dysfunction have been proposed, of which the most studied are metabolic alterations of the vascular endothelium. However, different cell types are involved in GDM-associated endothelial dysfunction, including platelets. Platelets are small, enucleated cell fragments that actively take part in blood haemostasis and thrombus formation. Thus, they play crucial roles in pathologies coursing with endothelial dysfunction, such as atherosclerosis, cardiovascular diseases, and diabetes mellitus. Nevertheless, platelet function in GDM is understudied.Several reports show a potential relationship between platelet volume and mass with GDM; however, platelet roles and signaling mechanisms in GDM-associated endothelial dysfunction are unclear. This review summarizes the reported findings and proposes a link among altered amount, volume, mass, reactivity, and

The extent of postpartum cardiac reverse remodeling is reflected in urine proteome

“…According to STRING’s functional analysis, some proteins associated with postpartum LVM, namely FN1, TF, ITIH4, and CDC42, are involved in platelet activation, signaling and aggregation . Platelets are actively involved in regulating vascular tone and inflammation and participate in the immune system, showing an important role in hemostasis, thrombosis and the pathophysiology of uteroplacental diseases 28 , 29 . Increased platelet aggregation accompanied by a reduction of circulating platelets has been reported throughout pregnancy 29 – 31 .…”

Role of increased plasminogen activator inhibitor-1 and vitronectin in gestational diabetes mellitus

“…Gestational diabetes is a metabolic disorder that increases women's risk and likelihood of developing type 2 diabetes and cardiovascular disease following life. Inflammatory and metabolic changes that occur in normal pregnancy altered and exaggerated secondary to the excessive systemic inflammatory process in GDM initiated by diffuse endothelial dysfunction 19 . There are several factors regulating PAI-1 expression in GDM, such as hyperglycemia, hyperinsulinemia, proinflammatory cytokines, and elevated angiotensin II 19 .…”

“…Inflammatory and metabolic changes that occur in normal pregnancy altered and exaggerated secondary to the excessive systemic inflammatory process in GDM initiated by diffuse endothelial dysfunction 19 . There are several factors regulating PAI-1 expression in GDM, such as hyperglycemia, hyperinsulinemia, proinflammatory cytokines, and elevated angiotensin II 19 . Vn is an adhesive extracellular glycoprotein with binding sites or PAI-1, the urokinase-type plasminogen activator receptor, and various integrins and is circulated as a high-molecular-weight complex 20 .…”

Genetics and epigenetics of gestational diabetes mellitus

“…Как показал целый ряд недавних исследований, к ним следует отнести и такой важный фактор, как пространственная организация ядра [45,46]. Согласно различным исследованиям, диабет матери вызывает стойкие изменения функции эндотелия плода [47]. Гипергликемия может изменить функцию эндотелия, экспрессию генов и белков через окислительный стресс и воспаление.…”