Role of insulin resistance in the mechanisms of adaptation and development of female reproductive system disease


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Abstract

The paper analyzes modern literature data on the impact of Insulin resistance (IR) on adaptation processes and development of female reproductive system disorders. The key role of IR is obvious as the integrator of energy exchange, metabolism, growth, and life span, which is phylogenetically fixed and affects all types of metabolism, fluid homeostasis, ion transport and osmotic pressure, vascular tone maintenance, cytokine balance, the intestinal microbiota state, replicative cell senescence, and other functions. Numerous studies are devoted to the study of the impact of IR on adaptation processes and development of reproductive system disease, its involvement in metabolic, endocrine, cardiovascular disorders, oncogenesis, to the participation in the development of hypertension in pregnant women, gestational diabetes mellitus, and energy-plastic supply of the fetus. The methodological basis for the analysis carried out was the study of the scientific literature of Russian and foreign databases over the past seven years. The review article presents various aspects of the problem of “IR and impaired reproduction” from molecular mechanisms to pathogenesis and summarizes the current achievements in understanding pathophysiological, compensatory and adaptive processes. Despite significant achievements and higher interest in the problem, it is important to understand that much remains to be learned in this direction in order to improve approaches to predicting, preventing, personalizing the treatment of IR-associated diseases, that is, to fully implement the 5P’s model of the current stage of medicine. Conclusion: The general biological approach to considering the role of the IR phenomenon that is vital for the balance of reciprocal relationships in a complex hierarchically built reproductive system and for the normal functioning of the mother-placenta-fetus system allows a more in-depth explanation of adaptation processes and pathogenetic mechanisms for the development of gynecological and obstetric disease and permits the formation of a holistic view from the standpoint of the closely interrelated functioning of individual body systems.

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About the authors

Igor S. Lipatov

Samara State Medical University Ministry of Health of Russia

Email: i.lipatoff2012@yandex.ru
Professor, MD, PhD; Professor at the Department of Obstetrics and Gynecology No. 1 443099, Russia, Samara, Chapaevskaya str., 89

Yurii V. Tezikov

Samara State Medical University Ministry of Health of Russia

Email: yra.75@inboxru
Professor, MD, PhD; Head of the Department of Obstetrics and Gynecology No. 1 443099, Russia, Samara, Chapaevskaya str., 89

Victor L. Tyutyunnik

Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology and Perinatology Ministry of Health of Russia

Email: tioutiounnik@mailru
Professor, MD, PhD; Leading Researcher of Research and Development Service 117997, Russia, Moscow, Ac. Oparina str., 4

Natalia E. Kan

Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology and Perinatology Ministry of Health of Russia

Email: kan-med@mailru
Professor, MD, PhD; Deputy Director of Science 117997, Russia, Moscow, Ac. Oparina str., 4

Alina I. Kuzmina

Samara State Medical University Ministry of Health of Russia

Email: alina.cuzmina555@mailru
6th year student of the Institute of Clinical Medicine 443099, Russia, Samara, Chapaevskaya str., 89

Ellina M. Zumorina

V.D. Seredavin Samara Regional Clinical Hospital

Email: ellinazumorina@yandex.ru
doctor obstetrician-gynecologist; Perinatal Center 443095, Russia, Samara, Tashkentskaya str., 159

Mikhail S. Amosov

V.D. Seredavin Samara Regional Clinical Hospital

Email: jyckee@mail.ru
doctor obstetrician-gynecologist; Perinatal Center 443095, Russia, Samara, Tashkentskaya str., 159

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