妊娠期生理性胰岛素抵抗(IR)是维持胎儿营养供给的重要适应性改变,然而病理性IR已成为影响母婴健康的关键病理基础。近年研究表明,IR不仅与复发性流产、妊娠期糖尿病(GDM)、妊娠期高血压疾病(HDP)等常见产科并发症密切相关,更会通过表观遗传机制对子代远期代谢功能产生跨代影响。本文系统阐述IR导致妊娠并发症的分子机制,重点解析IR通过影响卵母细胞质量、子宫内膜容受性、血管内皮功能等途径引发不良妊娠结局的作用通路,并对当前干预策略的临床证据进行循证评价。Physiological Insulin Resistance (IR) during pregnancy is an important adaptive change to maintain fetal nutrition supply. However, pathological IR has become a key pathological basis affecting the health of both the mother and the fetus. Recent studies have shown that IR is not only closely related to common obstetric complications such as recurrent miscarriage, Gestational Diabetes Mellitus (GDM), and Hypertensive Disorders of Pregnancy (HDP), but also has a trans-generational impact on the long-term metabolic function of offspring through epigenetic mechanisms. This article systematically expounds on the molecular mechanisms by which IR leads to pregnancy complications, focuses on analyzing the pathways through which IR causes adverse pregnancy outcomes by affecting oocyte quality, endometrial receptivity, vascular endothelial function, etc., and conducts an evidence-based evaluation of the clinical evidence of current intervention strategies.
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