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KMID : 1199120090330020077
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Korean Diabetes Journal
2009 Volume.33 No. 2 p.77 ~ p.82
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Insulin Resistance During Pregnancy
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Ahn Kyu-Jeong
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Abstract
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Pregnancy is a complex metabolic state involving dramatic alterations in the hormonal or cytokine environments (increases in estrogen, progesterone, prolactin, cortisol, human chorionic gonadotropin, placental growth hormone and human placental lactogen, TNF-alpha, resistin, leptin, and a decrease in adiponectin) as well as an increasing burden of fuel utilization by the conceptus. Metabolically, the first trimester is characterized by increased insulin sensitivity and lipogenesis. The second and third trimesters, in contrast, are characterized by insulin resistance and increased lipolysis.
The adipose tissue is considered an active organ, capable of secreting substances such as adipokines, which may play a role in the pathogenesis of insulin resistance. Resistin, leptin, serum and placental levels increase as pregnancy progresses, which is in contrast to levels of adiponectin. These levels correlate with the state of increased insulin resistance that develops in the latter stages of pregnancy.
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KEYWORD
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Cytokines, Insulin resistance, Placental hormones, Pregnancy
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