Skeletal muscle as a protagonist in the pregnancy metabolic syndrome

The pregnant woman normally shows clinical manifestations similar to a metabolic syndrome (MS), due to her metabolic and hemodynamic adaptations in order to share nutrients with the child. If those adjustments are surpassed, a kind of pregnancy MS (PregMS) could appear, characterized by excessive in...

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Bibliographic Details
Published in:Medical hypotheses 2019-05, Vol.126, p.26-37
Main Authors: Narvaez-Sanchez, Raul, Calderón, Juan C., Vega, Gloria, Trillos, Maria Camila, Ospina, Sara
Format: Article
Language:English
Subjects:
Blood Glucose - metabolism
Body Composition
Exercise
Female
Hemodynamics
High intensity interval training
Humans
Insulin - metabolism
Insulin Resistance
Metabolic syndrome
Metabolic Syndrome - physiopathology
Models, Biological
Muscle Strength
Muscle, Skeletal - physiopathology
Myokines
Pregnancy
Pregnancy Complications - psychology
Pregnant women
Sedentary Behavior
Skeletal muscle
Vascular function
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Summary:The pregnant woman normally shows clinical manifestations similar to a metabolic syndrome (MS), due to her metabolic and hemodynamic adaptations in order to share nutrients with the child. If those adjustments are surpassed, a kind of pregnancy MS (PregMS) could appear, characterized by excessive insulin resistance and vascular maladaptation. Skeletal muscle (SKM) must be a protagonist in the PregMS: SKM strength and mass have been associated inversely with MS incidence in non-pregnant patients, and in pregnant women muscular activity modulates metabolic and vascular adaptations that favor better outcomes. Of note, a sedentary lifestyle affects exactly in the other way. Those effects may be explained not only by the old paradigm of SKM being a great energy consumer and store, but because it is an endocrine organ whose chronic activity or deconditioning correspondingly releases myokines modulating insulin sensitivity and cardiovascular adaptation, by direct or indirect mechanisms not well understood. In this document, we present evidence to support the concept of a PregMS and hypothesize on the role of the SKM mass, fiber types composition and myokines in its pathophysiology. Also, we discuss some exercise interventions in pregnancy as a way to test our hypotheses.
ISSN:0306-9877
1532-2777
DOI:10.1016/j.mehy.2019.02.049