Role of adipokines in embryo implantation

Jafari-Gharabaghlou, Davoud; Vaghari‐Tabari, Mostafa; Oghbaei, Hajar; Lotz, Laura; Zarezadeh, Reza; Rezaei, Yeganeh Rastgar; Ranjkesh, Mohammad Reza; Nouri, Mohammad; Fattahi, Amir; Nikanfar, Saba; Dittrich, Ralf

doi:10.1530/ec-21-0288

Cited by 6 publications

(6 citation statements)

References 119 publications

(163 reference statements)

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“…Excess free fatty acids may also have a toxic effect in reproductive tissues, leading to cellular damage and chronic low-grade inflammation ( Broughton and Moley, 2017 ). Adipose tissue also acts as an endocrine tissue, releasing adipokines that interact with multiple molecular pathways of insulin resistance and inflammation, leading to hypertension, increased coagulability and cardiovascular risk ( Silvestris et al , 2018 ; Jafari-Gharabaghlou et al , 2021 ). Altered levels of adipokines, such as increased leptin, may affect the endometrium, leading to impaired stromal decidualization and placental abnormalities that may then result in miscarriage, stillbirth or preeclampsia ( Jafari-Gharabaghlou et al , 2021 ).…”

Section: Discussionmentioning

confidence: 99%

Association between body mass index, weight loss and the chance of pregnancy in women with polycystic ovary syndrome and overweight or obesity: a retrospective cohort study in the UK

et al. 2023

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STUDY QUESTION What are the associations between baseline BMI (Study 1) and change in body weight (Study 2) with the likelihood of pregnancy in women with polycystic ovary syndrome (PCOS). SUMMARY ANSWER In women with PCOS, higher baseline BMI was associated with a lower chance of pregnancy; however, weight loss was associated with an increased chance of pregnancy versus maintaining a stable weight or gaining weight. WHAT IS KNOWN ALREADY Two studies in large cohorts of Danish women with the intention to become pregnant showed a decline in fecundability ratios with higher BMI. Furthermore, a meta-analysis found that overweight/obesity significantly worsened metabolic and reproductive outcomes in women with PCOS. STUDY DESIGN, SIZE, DURATION Data were extracted from the UK Clinical Practice Research Datalink GOLD database. Patients included women aged 18–45 years with BMI ≥18.5 (Study 1) or ≥25 kg/m2 (Study 2) at time of PCOS diagnosis (index date). The primary outcome was the time to first pregnancy recorded during 36-months’ follow-up, analysed with Cox proportional hazard models and presented as hazard ratios (HRs). PARTICIPANTS/MATERIALS, SETTING, METHODS Study 1 included 9955 women with PCOS. Study 2 included 7593 women with PCOS and median BMI of 34.0 kg/m2. MAIN RESULTS AND THE ROLE OF CHANCE Higher BMI was associated with a lower chance of pregnancy in the 3 years following diagnosis. It was estimated that 41% of women with normal weight (18.5–24.9 kg/m2) would become pregnant compared to 17% of women with obesity class III (BMI ≥40.0 kg/m2) during follow-up. Furthermore, the chance of pregnancy for women with obesity class III was estimated to be 63% lower than for women with normal weight, with the same age and glycaemic status (HR 0.37, 95% CI 0.31–0.44; P < 0.0001). A significant inverse association was found between BMI change and chance of pregnancy: 10% weight loss was estimated to increase the chance of pregnancy by 68% for women with baseline BMI of 40 kg/m2 (HR 1.68, 95% CI 1.49–1.90). LIMITATIONS, REASONS FOR CAUTION Multiple factors influence the chance of pregnancy (the ability and willingness to become pregnant), which was addressed by exclusion criteria employed. The real-world nature of the study means that use of non-prescription contraceptives was not available. Bias may have been introduced by the fact that only around 40% of women with PCOS in the CPRD GOLD database had their BMI recorded during the year prior to PCOS diagnosis. BMI categories used in the analyses may not be applicable to women of all ethnicities. The study population was only representative of women in the UK and results may not be generalizable to other regions. PCOS diagnoses were based on codes entered into the system by primary care providers, and no information was available regarding the criteria used for diagnosis, although symptoms used to diagnose PCOS have not changed over time. WIDER IMPLICATIONS OF THE FINDINGS Our observations provide further evidence of the benefits of weight loss in women with overweight/obesity and PCOS who are seeking to become pregnant. STUDY FUNDING/COMPETING INTEREST(S) Novo Nordisk A/S. A.H.B. declares fees for consultancy from Novo Nordisk. P.N.L. and C.L.H. are employees of Novo Nordisk. V.S. and A.V. are employees of, and hold shares in, Novo Nordisk. TRIAL REGISTRATION NUMBER N/A.

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Section: Discussionmentioning

confidence: 99%

Association between body mass index, weight loss and the chance of pregnancy in women with polycystic ovary syndrome and overweight or obesity: a retrospective cohort study in the UK

et al. 2023

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“…Было высказано предположение, что интенсивный рост плода у матерей с ожирением может быть связан с низкими концентрациями адипонектина у матери [6, 34,35,38].…”

Section: адипонектин и его связь с ростом плодаunclassified

“…Aye и соавт. подтвердили, что увеличение концентрации адипонектина у матери предотвращает избыточный рост плода путем ингибирования плацентарного инсулина, что приводит к нормализации переноса питательных плацентарных веществ [35]. Также в проведенных исследованиях у беременных крыс адипонектин снижал экспрессию транспортера глюкозы GLUT3, липопротеинлипазы и транспортных жирных кислот в плаценте [36,47].…”

Section: адипонектин и его связь с ростом плодаunclassified

“…Положительная корреляция уровня адипонектина с чувствительностью к инсулину подтверждена во многих исследованиях как на животных моделях, так и на людях. Таким образом, при снижении уровня адипонектина в крови матери повышается трансплацентарная проницаемость для питательных веществ к плоду через плаценту [34,35,37,39,40]. Снижение уровня адипонектина способствует снижению чувствительности к инсулину и распределению питательных веществ от материнского к плодовому кровообращению, что приводит к значительному увеличению массы плода и рождению детей, больших для гестационного возраста [40,41].…”

Section: адипонектин и его связь с ростом плодаunclassified

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Features of Adiponectin at the Mother–placenta–fetus System

Петренко,

Прокопьева,

Ковалева

et al. 2023

University Therapeutic Journal

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Ожирение является серьезной медико-социальной проблемой современной медицины и достигает в мире масштабов эпидемии. Наряду с высокими темпами роста ожирения среди взрослых, неуклонно растет распространенность ожирения и среди женщин детородного возраста. Особое беспокойство вызывает материнское ожирение, так как оно может приводить к нарушению формирования и развития будущего ребенка. Влияние ожирения на течение беременности изучается уже не первое десятилетие, результаты многих исследований показывают роль материнского ожирения в формировании различных осложнений беременности и родов. Механизмы, лежащие в основе влияния материнского ожирения и осложнений беременности, могут включать инсулинорезистентность, эндотелиальную дисфункцию, липотоксичность и метафламмацию. Материнское ожирение также связано с характерными изменениями высвобождения адипокинов, которые оказывают системное влияние на метаболизм и энергетический гомеостаз. У женщин с ожирением уровень адипонектина в плазме ниже, чем у женщин с нормальным индексом массы тела, на протяжении всей беременности, а материнский адипонектин обратно коррелирует с массой материнского жира, резистентностью к инсулину и выработкой глюкозы, а также с ростом плода, что указывает на роль адипонектина в регуляции материнского метаболизма, плацентарной функции и развития плода. Изменения уровня адипокина также были обнаружены в пуповинной крови, что указывает на его активную роль в синтезе у плода. Эти наблюдения убедительно свидетельствуют о том, что адипонектины играют одну из ключевых ролей в метаболизме плода и матери, оказываясь на границе между матерью, плацентой и плодом. Obesity is a serious medical and social problem of modern medicine and reaches epidemic proportions in the world. Given the high rate of increase in obesity among adults, the prevalence of obesity among women of childbearing age is also steadily increasing. Of particular concern is maternal obesity, as it can lead to disruption of the formation and development of the unborn child. The impact of obesity on pregnancy has been studied for decades, and many studies show the role of maternal obesity in the formation of various complications of pregnancy and childbirth. The mechanisms underlying the influence of maternal obesity and pregnancy complications may include insulin resistance, endothelial dysfunction, lipotoxicity, and metaflammation. Maternal obesity is also associated with characteristic changes in the release of adipokines, which have a systemic effect on metabolism and energy homeostasis. In obese women, plasma levels of adiponectin are lower than in women with a normal body mass index throughout pregnancy, and maternal adiponectin is inversely correlated with maternal fat mass, insulin resistance and glucose production, and fetal growth, suggesting a role adiponectin in the regulation of maternal metabolism, placental function and fetal development. Also, changes in the level of adipokines were found in umbilical cord blood, which indicates its active role in the synthesis in the fetus. These observations strongly suggest that adiponectins play one of the key roles in fetal and maternal metabolism, being at the interface between the mother, placenta and fetus

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“…Также не стоит забывать, что жировая ткань, помимо прочего, является эндокринным органом, и гормоны, которые она продуцирует, могут оказывать значительное влияние на функцию матки и эндометрия. Есть убедительные данные о том, что лептин участвует в ремоделировании эпителия эндометрия путем стимулирования пролиферации и усиления апоптоза, вызванного Fasлигандом [77]. У женщин с ожирением отмечается рези-стентность рецепторов к лептину, что может приводить к снижению пролиферации эндометрия и замедлению восстановления эндометрия во время менструации [18].…”

Section: Reproductive Health and Artunclassified

Obesity in women: current aspects of reproductive health disorders

et al. 2022

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Obesity and overweight tend to increase in prevalence in the whole world. Obese people have a higher incidence of cardiovascular diseases, stroke, osteoarthritis, diabetes mellitus and reproductive system diseases. This is especially evident in women. Hormonal imbalances is developed among obese women in the hypothalamic-pituitary-ovarian axis, typically there are menstruation disorders, anovulation and female infertility. Adipose tissue is an endocrine organ, with an intricate role in bioactive molecules secrete, in particularly adipokines, which interact differently with a variety of molecular pathways, contribute to the development of insulin resistance, inflammation, hypertension, increased risk of cardiovascular events, disorders of blood clotting, differentiation and maturation of oocytes. In addition, women with obesity and metabolic syndrome have problems with conception at the endometrial level often, a significantly higher risk of having a miscarriage, and worse assisted reproductive technology outcomes. Obesity has negative effects on the endometrium in non-pregnant women, it is increasing the risk of abnormal uterine bleeding. Hormones derived from adipose tissue could be affected on the function of the uterus/endometrium and, consequently, affect the amount of menstrual blood loss. Contradictory results are observed in patients with endometriosis. The correlation of body mass index to the risk of endometriosis has not been proven in clinical studies, but there was a direct relationship between the severity of endometriosis and a high body mass index. The review presents possible relationships of diseases of the reproductive system with obesity and overweight, determining their development and pathogenesis of disorders of the formation of the functions of reproductive organs.

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Role of adipokines in embryo implantation

Cited by 6 publications

References 119 publications

Association between body mass index, weight loss and the chance of pregnancy in women with polycystic ovary syndrome and overweight or obesity: a retrospective cohort study in the UK

Association between body mass index, weight loss and the chance of pregnancy in women with polycystic ovary syndrome and overweight or obesity: a retrospective cohort study in the UK

Features of Adiponectin at the Mother–placenta–fetus System

Obesity in women: current aspects of reproductive health disorders

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