臨床婦人科産科72巻10号

2018年10月発行

今月の臨床 糖代謝異常合併妊娠のベストマネジメント─成因から管理法，母児の予後まで

成因

妊娠におけるインスリン抵抗性の発症機序─その生理的意義と産科合併症への関与

著者： 安日一郎¹

所属機関： ¹国立病院機構長崎医療センター産婦人科

ページ範囲：P.950 - P.957

文献概要

●妊娠は唯一，生理的なインスリン抵抗性の発現を惹起する現象であり，母体におけるその発現は胎児発育と母体のエネルギー蓄積を保障するため合目的的な変化である．

●妊娠による生理的インスリン抵抗性は非妊時の1.5〜2倍に達し，その発現には胎盤性の種々のホルモンやアディポカインが関与している．

●インスリン抵抗性の過剰な発現は，妊娠糖尿病，妊娠高血圧症候群，巨大児などの周産期合併症の発症に関与し，特に肥満妊婦では相乗的に作用する．

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