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Endocrine Abstracts (2017) 49 S25.2 | DOI: 10.1530/endoabs.49.S25.2

ECE2017 Symposia HPA axis regulation during a woman's life: impact on metabolic outcomes (3 abstracts)

HPA axis, insulin resistance and adipocytokines in the fetal-maternal unit

George Mastorakos


Greece.


‘Stress’ is defined as a state of disharmony or threatened homeostasis. Pregnancy is a transient period of relative hypercortisolism. Chronic or acute stressors influence maternal and fetal Hypothalamus-Pituitary-Adrenal Axes (HPA) during pregnancy. Insulin sensitivity is a feature of normal pregnancy, possibly reflecting an adaptive phenomenon aiming at diverting maternal glucose towards fetal needs. We investigated the effect of maternal stress into maternal insulin sensitivity during pregnancy by employing state-trait anxiety inventory (STAI) trait and state questionnaires for stress assessment and we found that in normal pregnant women, enhanced long-term stress is associated with decreased insulin sensitivity. Both long- and short- term stress are associated with enhanced maternal HPA axis and increased placental CRH secretion. Furthermore the decrease in insulin sensitivity during pregnancy is paralleled by the progressive increase of maternal adipose tissue deposition. Throughout pregnancy maternal adipose tissue is metabolically active, producing adipocytokines involved in the process of insulin resistance. Visfatin concentrations in the 1st trimester positively predict insulin sensitivity during the 2nd trimester. Body fat mass during 1st trimester of pregnancy is negatively associated with insulin sensitivity during the 2nd trimester and should be kept under control. Furthermore, first trimester maternal BMI and serum visfatin seem to be strongly associated with fetal insulin secretion and final birth weight, respectively, suggesting a role of early-pregnancy maternal adipose tissue in the pregnancy metabolic environment. Interestingly, during pregnancy, maternal GLP1 might be involved in mechanisms that compensate for the pregnancy-related increase in glycemia and insulin resistance, suggesting a role of this peptide in maternal metabolism and weight and fetal growth. In conclusion, both maternal adipose tissue and stress-induced HPA activation influence directly and/or indirectly the development of insulin resistance during pregnancy.

Volume 49

19th European Congress of Endocrinology

Lisbon, Portugal
20 May 2017 - 23 May 2017

European Society of Endocrinology 

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