Адаптация сердечно-сосудистой системы младенцев, рожденных матерями с сахарным диабетом
По данным статистики, сахарный диабет (СД) осложняет от 2 до 3 % всех беременностей. Несмотря на относительно небольшой процент распространенности в общей популяции, СД в период беременности оказывает существенное влияние на рост и развитие плода и ассоциирован с повышенным риском врожденных пороков развития, увеличением частоты перинатальной заболеваемости и смертности. Наибольшее влияние гипергликемия в период беременности оказывает на сердечно-сосудистую систему плода, вызывая увеличение частоты врожденных пороков сердца на ранних этапах эмбрионального развития и различного рода структурные и функциональные изменения в растущем сердце во втором и третьем триместрах беременности.В данном обзоре систематизированы данные научной литературы о патогенетических аспектах и молекулярных механизмах влияния гипергликемии на развитие сердца плода с целью оценить клинические, эхокардиографические и некоторые лабораторные изменения функционирования сердечно-сосудистой системы у детей, рожденных матеря- ми с СД, а также проследить имеющиеся в литературе данные о связи между диабетом матери, диагностированным до или во время беременности, и отдаленными рисками возникновения сердечно-сосудистых заболеваний у их детей.
1. American Diabetes Association, Diagnosis and classification of diabetes mellitus // Diabetes Care. – 2014. – Vol. 37, suppl. 1. – P. 81–90. https://doi.org/10.2337/dc14-S081
2. Jones, L. V. Techniques of monitoring blood glucose during pregnancy for women with pre-existing diabetes [Electronic resource] // Cochrane Database of Systematic Reviews 2019. – Mode of access: https://doi.org/10.1002/14651858.CD009613.pub4/. – Date of access: 18.10.2020.
3. Macintosh, М. Perinatal mortality and congenital anomalies in babies of women with type 1 or type 2 diabetes in England, Wales, and Northern Ireland: population based study / М. C. M. Macintosh [et al.] // BMJ. – 2006. – Vol. 333, N 7560. – Art. 177. https://doi.org/10.1136/bmj.38856.692986.AE
4. Roglic, G. WHO Global report on diabetes: а summary [Electronic resource] // World Health Organization. – Mode of access: https://www.ijncd.org/text.asp?2016/1/1/3/184853/. – Date of access: 18.10.2020.
5. Trends in incidence of diabetes in pregnancy and serious perinatal outcomes: a large, population-based study in Ontario, Canada, 1996–2010 / D. S. Feig [et al.] // Diabetes Care. – 2014. – Vol. 37, N 6. – P. 1590–1596. https://doi.org/10.2337/dc13-2717
6. Ferrara, A. Increasing prevalence of gestational diabetes mellitus: a public health perspective / A. Ferrara // Diabetes Care. – 2007. – Vol. 30, suppl. 2. – P. S141–S146. https://doi.org/10.2337/dc07-s206
7. Diabetes trends among delivery hospitalizations in the U. S., 1994–2004 / S. S. Albrecht [et al.] // Diabetes Care. – 2010. – Vol. 33, N 4. – P. 768–773. https://doi.org/10.2337/dc09-1801
8. Global estimates of the prevalence of hyperglycaemia in pregnancy / L. Guariguata [et al.] // Diabetes Res. Clin. Practice. – 2014. – Vol. 103, N 2. – P. 176–185. https://doi.org/10.1016/j.diabres.2013.11.003
9. Improvement in pregnancy-related outcomes in the offspring of diabetic mothers in Bavaria, Germany, during 1987–2007 / А. Beyerlein [et al.] // Diabet Med. – 2010. – Vol. 27, N 12. – P. 1379–1384. https://doi.org/10.1111/j.1464-5491.2010.03109.x
10. Lipscombe, L. L. Trends in diabetes prevalence, incidence, and mortality in Ontario, Canada 1995–2005: a population-based study / L. L. Lipscombe, J. E. Hux // Lancet. – 2007. – Vol. 369, N 9563. – P. 750–756. https://doi.org/10.1016/S0140-6736(07)60361-4
11. Maternal and fetal outcome in women with type 2 versus type 1 diabetes mellitus: a systematic review and metaanalysis / M. Balsells [et al.] // J. Clin. Endocrinol. Metab. – 2009. – Vol. 94, N 11. – P. 4284–4291. https://doi.org/10.1210/jc.2009-1231
12. Outcomes of pregnancies in women with pre-gestational diabetes mellitus and gestational diabetes mellitus; a populationbased study in New South Wales, Australia, 1998–2002 / A. W. Shand [et al.] // Diabet Med. – 2008. – Vol. 25, N 6. – P. 708–715. https://doi.org/10.1111/j.1464-5491.2008.02431.x
13. Wren, C. Cardiovascular malformations in infants of diabetic mothers / С. Wren // Heart. – 2003. – Vol. 89, N 10. – P. 1217–1220. https://doi.org/10.1136/heart.89.10.1217
14. Ray, J. G. Preconception care and the risk of congenital anomalies in the offspring of women with diabetes mellitus: a meta-analysis / J. G. Ray, T. E. O’Brien, W. S. Chan // QJM. – 2001. – Vol. 94, N 8. – P. 435–444. https://doi.org/10.1093/qjmed/94.8.435
15. Socioeconomic correlation of the increasing trend in prevalence of gestational diabetes in large population of women between 1995–2005 / А. Vibeke [et al.] // Diabetes Care. – 2008. – Vol. 31, N 12. – P. 2288–2293. https://doi.org/10.2337/dc08-1038
16. Speckle tracking and myocardial tissue imaging in infant of diabetic mother with gestational and pregestational diabetes / M. Al-Biltagi [et al.] // Pediatr. Cardiol. – 2015. – Vol. 36, N 2. – P. 445–453. https://doi.org/10.1007/s00246-014-1033-0
17. Pauliks, L. B. The effect of pregestational diabetes on fetal heart function / L. B. Pauliks // Diabetes Care. – 2015. – Vol. 13, N 1. – P. 67–74. https://doi.org/10.1586/14779072.2015.988141
18. Gibb, А. А. Metabolic coordination of physiological and pathological cardiac remodeling / A. A. Gibb, B. G. Hill // Circ. Res. – 2018. – Vol. 123, N 1. – P. 107–128. https://doi.org/10.1161/CIRCRESAHA.118.312017
19. Maillet, M. Molecular basis of physiological heart growth: fundamental concepts and new players / M. Maillet, J. H. van Berlo, J. D. Molkentin // Nat. Rev. Mol. Cell Biol. – 2013. – Vol. 14, N 1. – P. 38–48. https://doi.org/10.1038/nrm3495
20. Young, M. E. Adaptation and maladaptation of the heart in diabetes: part II: potential mechanisms / M. E. Young, P. McNulty, H. Taegtmeyer // Circulation. – 2002. – Vol. 105, N 15. – P. 1861–1870. https://doi.org/10.1161/01.cir.0000012467.61045.87
21. Eriksson, U. J. Diabetes and embryonic malformations. Role of substrate-induced free-oxygen radical production for dysmorphogenesis in cultured rat embryos / U. J. Eriksson, L. A. H. Borg // Diabetes. – 1993. – Vol. 42, N 3. – P. 411–419. https://doi.org/10.2337/diab.42.3.411
22. Kumar, S. D. Maternal diabetes induces congenital heart defects in mice by altering the expression of genes involved in cardiovascular development / S. D. Kumar, S. T. Dheen, S. S. Tay // Cardiovasc. Diabetol. – 2007. – Vol. 6. – Art. 34. https:// doi.org/10.1186/1475-2840-6-34
23. Corrigan, N. Fetal Cardiac Effects of Maternal Hyperglycemia During Pregnancy / N. Corrigan, D. P. Brazil, F. McAuliffe // Birth Defects Res. Pt. A: Clin. Mol. Terat. – 2009. – Vol. 85, N 6. – P. 523–530. https://doi.org/10.1002/bdra.20567
24. Farrar, D. Hyperglycemia in pregnancy: prevalence, impact, and management challenges / D. Farrar // Int. J. Women’s Health. – 2016. – Vol. 8. – P. 519–527. https://doi.org/10.2147/IJWH.S102117
25. Fetal myocardial deformation in maternal diabetes mellitus and obesity / A. Kulkarni [et al.] // Ultrasound Obstet. Gynecol. – 2017. – Vol. 49, N 5. – P. 630–636. https://doi.org/10.1002/uog.15971
26. Schulze, C. Lipid use and misuse by the heart / С. Schulze, K. Drosatos, I. J. Goldberg // Circ. Res. – 2016. – Vol. 118, N 11. – P. 1736–1751. https://doi.org/10.1161/circresaha.116.306842
27. Markers of maternal and infant metabolism are associated with ventricular dysfunction in infants of obese women with type 2 diabetes / W. T. Cade [et al.] // Pediatr. Res. – 2017. – Vol. 82, N 5. – P. 768–775. https://doi.org/10.1038/pr.2017.140
28. Jensen, M. D. Insulin dose response analysis of free fatty acid kinetics / M. D. Jensen, S. Nielsen // Metabolism. – 2007. – Vol. 56, N 1. – P. 68–76. https://doi.org/10.1016/j.metabol.2006.08.022
29. Higgins, M. A Review of maternal and fetal growth factors in diabetic pregnancy / M. Higgins, F. Mc. Auliffe // Curr. Diab. Rev. – 2010. – Vol. 6, N 2. – P. 116–125. https://doi.org/10.2174/157339910790909431
30. Neonatal cardiac hypertrophy: the role of hyperinsulinism – a review of literature / N. D. Paauw [et al.] // Eur. J. Pediatr. – 2020. – Vol. 179, N 1. – P. 39–50. https://doi.org/10.1007/s00431-019-03521-6
31. Pathologic ventricular hypertrophy in the offspring of diabetic mothers: a retrospective study / S. Ullmo [et al.] // Eur. Heart J. – 2007. – Vol. 28, N 11. – P. 1319–1325. https://doi.org/10.1093/ eurheartj/ehl416
32. Cardiac and extracardiac complications in infants of diabetic mothers and their relation to parameters of carbohydrate metabolism / R. Oberhoffer [et al.] // Eur. J. Pediatr. – 1997. – Vol. 156, N 4. – P. 262–265. https://doi.org/10.1007/s004310050596
33. Cardiomyopathy and cardiomegaly in stillborn infants of diabetic mothers / N. E. Russell [et al.] // Pediatr. Development. Pathol. – 2008. – Vol. 11, N 1. – P. 10–14. https://doi.org/10.2350/07-05-0277.1
34. Ивашкевич, А. Б. Характеристика состояния сердечно-сосудистой системы у новорожденных от матерей с сахарным диабетом : автореф. дис. ... канд. мед. наук : 14.01.08 / А. Б. Ивашкевич ; Респ. науч.-практ. центр «Мать и дитя». – Минск, 2012. – 20 с.
35. Лысенко, С. Н. Особенности формирования диабетической фетопатии: диагностика и оптимизация акушерской тактики : автореф. дис. … д-ра мед. наук : 14.01.01 / С. Н. Лысенко ; Моск. обл. науч.-исслед. ин-т акушерства и гинекологии. – М., 2019. – 48 с.
36. Sobeih, A. A. Assessment of cardiac diastolic function in infants of diabetic mothers using tissue Doppler echocardiography / A. A. Sobeih, M. A. Sakr, R. K. Abolmaaty // Egypt Pediatric Association Gaz. – 2020. – Vol. 68. – Art. 10. https://doi.org/10.1186/s43054-020-00021-3
37. Subclinical decrease in myocardial function in asymptomatic infants of diabetic mothers: a tissue doppler study / J. E. Zablah [et al.] // Pediatr. Сardiol. – 2017. – Vol. 38, N 4. – P. 801–806. https://doi.org/10.1007/s00246-017-1584-y
38. Speckle tracking and myocardial tissue imaging in infant of diabetic mother with gestational and pregestational diabetes / M. Al-Biltagi [et al.] // Pediatr. Cardiol. – 2015. – Vol. 36, N 2. – P. 445–453. https://doi.org/10.1007/s00246-014-1033-0
39. Impaired left ventricular diastolic function in newborn infants of mothers with pregestational or gestational diabetes with good glycemic control / A. Kozák-Bárány [et al.] // Early Human Development. – 2004. – Vol. 77, N 1–2. – P. 13–22. https://doi.org/10.1016/j.earlhumdev.2003.11.006
40. Cardiac troponin I levels and its relation to echocardiographic findings in infants of diabetic mothers / A. Korraa [et al.] // Ital. J. Pediatr. – 2012. – Vol. 38. – Art. 39. https://doi.org/10.1186/1824-7288-38-39
41. De Lemos, J. A. B-type natriuretic peptide in cardiovascular disease / J. A. de Lemos, D. K. McGuire, M. H. Drazner // Lancet. – 2003. – Vol. 362, N 9380. – P. 316–322. https://doi.org/10.1016/S0140-6736(03)13976-1
42. Troponin T and pro-B-type natriuretic peptide in fetuses of type 1 diabetic mothers / N. E. Russell [et al.] // Diabetes Care. – 2009. – Vol. 32, N 11. – P. 2050–2055. https://doi.org/10.2337/dc09-0552
43. Maternal diabetes during pregnancy and early onset of cardiovascular disease in offspring: population based cohort study with 40 years of follow-up / Yu. Yongfu [et al.] // BMJ. – 2019. – Vol. 367. – Art. I6398. https://doi.org/10.1136/bmj.l6398
44. Programming of vascular dysfunction in the intrauterine milieu of diabetic pregnancies / N. A. Sallam [et al.] // Int. J. Mol. Sci. – 2018. – Vol. 19, N 11. – Art. 3665. https://doi.org/10.3390/ijms19113665
45. In utero exposure to maternal diabetes is associated with early abnormal vascular structure in offspring / A. Dib [et al.] // Front. Physiol. – 2018. – Vol. 9. – Art. 350. https://doi.org/10.3389/fphys.2018.00350