Abstract
Gestational diabetes mellitus (GDM) is a common pregnancy complication which is normally diagnosed in the second trimester of gestation. With an increasing incidence, GDM poses a significant threat to maternal and offspring health. Therefore, we need a deeper understanding of GDM pathophysiology and novel investigation on the diagnosis and treatment for GDM. MicroRNAs (miRNAs), a class of endogenic small noncoding RNAs with a length of approximately 19-24 nucleotides, have been reported to exert their function in gene expression by binding to proteins or being enclosed in membranous vesicles, such as exosomes. Studies have investigated the roles of miRNAs in the pathophysiological mechanism of GDM and their potential as noninvasive biological candidates for the management of GDM, including diagnosis and treatment. This review is aimed at summarizing the pathophysiological significance of miRNAs in GDM development and their potential function in GDM clinical diagnosis and therapeutic approach. In this review, we summarized an integrated expressional profile and the pathophysiological significance of placental exosomes and associated miRNAs, as well as other plasma miRNAs such as exo-AT. Furthermore, we also discussed the practical application of exosomes in GDM postpartum outcomes and the potential function of several miRNAs as therapeutic target in the GDM pathological pathway, thus providing a novel clinical insight of these biological signatures into GDM therapeutic approach.
Highlights
Zhao-Nan Liu,1 Ying Jiang,2 Xuan-Qi Liu,1 Meng-Meng Yang,2 Cheng Chen,2 Bai-Hui Zhao,2 He-Feng Huang,1 and Qiong Luo 2
The results revealed that a high D-glucose level promotes exosomes released from trophoblast cells during the firsttrimester pregnancy, suggesting a correlation between high glucose and exosomal bioactivity, which is of clinical relevance in Gestational diabetes mellitus (GDM) pathophysiology [115]
GDM is well known as a common pregnancy complication, it could not be diagnosed until the late second trimester [6]
Summary
Zhao-Nan Liu ,1 Ying Jiang ,2 Xuan-Qi Liu ,1 Meng-Meng Yang ,2 Cheng Chen ,2 Bai-Hui Zhao ,2 He-Feng Huang ,1 and Qiong Luo 2. This review is aimed at summarizing the pathophysiological significance of miRNAs in GDM development and their potential function in GDM clinical diagnosis and therapeutic approach. Mothers complicated by GDM have higher rates of preeclampsia and adverse pregnancy outcomes, such as cesarean deliveries and shoulder dystocia [2]. They are more susceptible to developing postpartum type 2 diabetes mellitus (T2DM) compared with normal women [3]. A retrospective study conducted in France reported a lower postprandial glycemic control and a higher use of insulin therapy during quarantine (18 March–7 May 2020) These observations were explained by anxiety, reduced physical activity, and changes in diet [10]. A higher rate of GDM was observed in pregnant women during March– April 2020 compared with the same period in 2019 [12]
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