Title:Increased Fetal Cardiovascular Disease Risk: Potential Synergy Between Gestational Diabetes Mellitus and Maternal Hypercholesterolemia
Volume: 19
Issue: 6
Author(s): Cristian Espinoza, Barbara Fuenzalida and Andrea Leiva*
Affiliation:
- School of Medical Technology, Health Sciences Faculty, Universidad San Sebastian, Providencia 7510157,Chile
Keywords:
Dyslipidemia, gestational diabetes, endothelium, pregnancy, cardiovascular disease, diabetes mellitus.
Abstract: Cardiovascular diseases (CVD) remain a major cause of death worldwide. Evidence
suggests that the risk for CVD can increase at the fetal stages due to maternal metabolic diseases,
such as gestational diabetes mellitus (GDM) and maternal supraphysiological hypercholesterolemia
(MSPH). GDM is a hyperglycemic, inflammatory, and insulin-resistant state that increases
plasma levels of free fatty acids and triglycerides, impairs endothelial vascular tone regulation,
and due to the increased nutrient transport, exposes the fetus to the altered metabolic conditions of
the mother. MSPH involves increased levels of cholesterol (mainly as low-density lipoprotein
cholesterol) which also causes endothelial dysfunction and alters nutrient transport to the fetus. Despite
that an association has already been established between MSPH and increased CVD risk, however,
little is known about the cellular processes underlying this relationship. Our knowledge is further
obscured when the simultaneous presentation of MSPH and GDM takes place. In this context,
GDM and MSPH may substantially increase fetal CVD risk due to synergistic impairment of placental
nutrient transport and endothelial dysfunction. More studies on the separate and/or cumulative
role of both processes are warranted to suggest specific treatment options.
