ENDOTHELIAL DYSFUNCTION AND ITS ROLE IN THE DEVELOPMENT OF GESTATIONAL DIABETES (LITERATURE REVIEW)
DOI:
https://doi.org/10.32782/pub.health.2025.1.15Keywords:
pregnancy, gestational diabetes mellitus, endothelial dysfunction, nitric oxide, endothelin-1Abstract
Topicality. Gestational diabetes mellitus (GDM) is a carbohydrate metabolism disorder that is first diagnosed during pregnancy and usually resolves after childbirth. The prevalence of GDM varies depending on the population, diagnostic criteria, and risk factors. According to the WHO and IADPSG (International Association of Diabetes and Pregnancy Study Groups) criteria, the prevalence can reach 10–18 %. In Ukraine and European countries, this rateranges from 5 % to 12 %.In recent years, the investigation of the relationship between gestational diabetes and endothelial dysfunction has become increasingly relevant, as it may improve the management of this condition.The goal. To conduct a comprehensive analysis and summarize the literature to identify the main mechanisms of gestational diabetes development under conditions of endothelial dysfunction. Materials and Methods. A systematic literature search was conducted. The data were grouped by thematic areas foranalysis and synthesis of current knowledge.Results. A high blood glucose level leads to increased production of free radicals, which damage the endothelium and reduce nitric oxide (NO) synthesis, a key factor in vascular relaxation. In GDM, insulin resistance develops, impairing itsability to stimulate NO production, thereby enhancing vasoconstriction and endothelial dysfunction. Studies have shownthat ET-1 may contribute to the development of insulin resistance, which is a key pathogenic mechanism of gestational diabetes. Additionally, inflammation and activation of pro-inflammatory cytokines occur. Women with GDM exhibit elevated levels of inflammatory factors (IL-6, TNF-α), which contribute to endothelial damage and vascular dysfunction.Conclusion. Thus, gestational diabetes not only increases the risk of complications during pregnancy but also has long-term consequences due to endothelial dysfunction. This pressing issue holds significant clinical relevance and warrantscomprehensive, in-depth research to better understand its underlying mechanisms and potential therapeutic approaches.
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