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Pathophysiology of Diabetes01:20

Pathophysiology of Diabetes

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Diabetes mellitus is a chronic metabolic disorder characterized by hyperglycemia. The four categories of diabetes are type 1 diabetes, type 2 diabetes, other specific types of diabetes, and gestational diabetes.
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Type 2 diabetes, characterized by insulin resistance, arises when the insulin receptors on cells lose responsiveness to insulin, diminishing the cell's capacity to take up glucose, resulting in elevated blood glucose levels. To receive a diagnosis of Type 2 diabetes, a series of blood glucose tests are necessary to assess whether the blood glucose falls within normal parameters. If the result is out of the normal range, a patient may be diagnosed as prediabetic or diabetic, depending on the...
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Incretins include glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP), which stimulate insulin secretion post-meals. In type 2 diabetes, GIP's efficacy is reduced, making GLP-1 a viable drug target. GIP originates from preproGIP.
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The ability of a drug to produce structural deformations and functional abnormalities in the developing embryo or the fetus is called teratogenicity, and the drug producing this effect is known as a teratogen. Teratogenic effects include stillbirth, miscarriage, intrauterine growth restriction, and neurocognitive delay. A teratogen may affect the embryo at different stages of development, which is important in determining the type and extent of the damage. During blastocyst formation, the early...
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Adrenal hormones play a pivotal role in maintaining the body's electrolyte balance and orchestrating responses to stress, showcasing the intricate functions of the adrenal cortex and medulla.
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Adiponectin and Glucocorticoids Modulate Risk for Preterm Birth: The Healthy Start Study.

Gabriella Mayne1, Peter E DeWitt2, Jennifer Wen3

  • 1Department of Health & Behavioral Sciences, University of Colorado, Denver, CO 80204, USA.

The Journal of Clinical Endocrinology and Metabolism
|July 9, 2024
PubMed
Summary

Maternal adiponectin and cortisol levels are linked to preterm birth risk. Lower adiponectin and higher cortisone levels were observed in preterm births, suggesting a connection between maternal stress and metabolism in pregnancy.

Keywords:
Cohen's Perceived Stress ScaleEdinburgh Perinatal/Postnatal Depression Scaleadipokineneuroactive steroid measurementneuroendocrinesteroid hormone measurement

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Area of Science:

  • Reproductive biology
  • Endocrinology
  • Metabolic health

Background:

  • Adiponectin, a uterine tocolytic, decreases with gestational age, potentially indicating maternal metabolic quiescence.
  • Maternal stress is a risk factor for preterm birth, and adiponectin levels may respond to stress.

Purpose of the Study:

  • To investigate the association between adiponectin and glucocorticoids in preterm birth.
  • To model the predictive value of these biomarkers for preterm birth.
  • To test the hypothesis that maternal adiponectin and cortisol are inversely related and associated with preterm birth.

Main Methods:

  • A nested case-control study using biobanked maternal plasma from low-risk singleton pregnancies.
  • Quantification of high molecular weight (HMW), low molecular weight (LMW), and total adiponectin.
  • Measurement of cortisol, cortisone, and related steroid hormones using validated LC-MS/MS assay.
  • Application of regression and machine learning for predictive modeling.

Main Results:

  • Preterm births were associated with lower mean LMW adiponectin and higher mean cortisone levels at 15 weeks gestation.
  • Lower cortisol/cortisone ratios and LMW adiponectin/cortisol ratios were observed in the preterm group.
  • HMW adiponectin, cortisol/cortisone ratio, cortisone, maternal height, age, and BMI were strong predictors of preterm birth (AUC=0.8167).

Conclusions:

  • Metabolic and stress biomarkers are associated with preterm birth in healthy pregnancies.
  • A potential mechanistic link between maternal stress, metabolism, and pregnancy maintenance is identified.