Role of insulin resistance in the mechanisms of adaptation and development of disease in postpartum and early neonatal periods


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Abstract

The medical community has currently accumulated significant reliable scientific facts about the relationship of physiological and pathological insulin resistance (IR), compensatory and chronic hyperinsulinemia (HI) before conception and during pregnancy to the adaptive mechanisms of the formation of the biological mother-newborn system and to the development of postpartum diseases. Numerous studies have provided evidence that gestational IR and HI can lead to metabolic dysfunction in both the mother and the newborn with impaired lactogenesis, lactopoiesis, the development of infectious and inflammatory diseases, the transformation of gestational diabetes mellitus (DM) to type 2 DM, hypertension, obesity, metabolic syndrome, chronic kidney disease, which requires timely diagnosis. The methodological basis of the analysis was the study of the scientific literature of Russian and foreign databases over the past seven years. The review article presents all known aspects of the role of IR in the processes of postpartum adjustment and in the development of diseases in the puerperal and neonatal periods. Conclusion: Knowledge of the causes and formation of pathological IR and chronic HI and their consequences for the development of female reproductive system diseases in all periods of life necessitates an interdisciplinary approach to developing personalized programs for stratification prediction, primary prevention and rehabilitation aimed at reducing the phenotypic manifestations of hereditary and acquired high risk factors.

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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

Yurii V. Tezikov

Samara State Medical University, Ministry of Health of Russia

Email: yra.75@inbox.ru
Professor, MD, PhD, Head of the Department of Obstetrics and Gynecology No. 1

Victor L. Tyutyunnik

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

Email: tioutiounnik@mail.ru
Professor, MD, PhD, Leading Researcher of Research and Development Service

Natalia E. Kan

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

Email: kan-med@mail.ru
Professor, MD, PhD, Deputy Director of Science

Alina I. Kuzmina

Samara State Medical University, Ministry of Health of Russia

Email: alina.cuzmina555@mail.ru
6th year student of the Institute of Clinical Medicine

Ellina M. Zumorina

V.D. Seredavin Samara Regional Clinical Hospital

Email: ehina.zumorina@yandex.ru
doctor obstetrician-gynecologist, Perinatal Center

Anastasia O. Yakusheva

Samara State Medical University, Ministry of Health of Russia

Email: yakusheva.nastya1996@gmail.com
Resident of the Department of Obstetrics and Gynecology of the Institute of Clinical Medicine

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