Department of Pediatrics, University of Colorado Health Sciences Center, Aurora, USA.
Exp Biol Med (Maywood). 2010 Aug;235(8):999-1006. doi: 10.1258/ebm.2010.009360. Epub 2010 Jun 24.
In an ovine model of placental insufficiency-induced intrauterine growth retardation (PI-IUGR), characterized by hypoxia, hypoglycemia and a significant reduction in fetal weight, we assessed alterations in fetal and placental polyols. Arterial maternal-fetal concentration differences of glucose and mannose were greater in the PI-IUGR fetus; glucose: C (n = 7), 2.68 +/- 0.14 mmol/L versus PI-IUGR (n = 9), 3.18 +/- 0.16 mmol/L (P < 0.02) and mannose: C, 42.9 +/- 8.1 micromol/L versus PI-IUGR, 68.5 +/- 19.1 micromol/L (P < 0.001). For PI-IUGR fetuses, fetal arterial plasma myo-inositol concentrations were significantly increased (P < 0.001). The concentrations of sorbitol, glucose and fructose were significantly reduced (P < 0.03, 0.01, 0.02, respectively). The cotyledons of IUGR placentas had a significantly increased concentration of myo-inositol (P < 0.003) and decreased concentrations of sorbitol, fructose and glycerol (P < 0.01, 0.02, 0.01, respectively). Fetal hepatic concentrations of sorbitol (P < 0.001) and fructose (P < 0.03) were also significantly reduced. These profound changes in both placental and fetal concentrations of polyols and sugars in sheep PI-IUGR pregnancies support the conclusion that within the PI-IUGR placenta there is an increased flux through the glucose 6-P:inositol 1-P cyclase system and decreased flux through the polyol dehydrogenase system, leading to increased placental myo-inositol production and decreased sorbitol production. The decreased placental supply of sorbitol to the fetal liver may lead to decreased fetal hepatic fructose production. These observations highlight that, in association with hypoxic and hypoglycemic PI-IUGR fetuses, there are major placental and fetal alterations in polyol production. The manner in which these alterations in fetoplacental carbohydrate metabolism contribute to the pathophysiology of PI-IUGR is currently unknown.
在胎盘功能不全导致的宫内生长受限(PI-IUGR)的绵羊模型中,胎儿表现为缺氧、低血糖和体重显著减轻,我们评估了胎儿和胎盘多元醇的变化。PI-IUGR 胎儿的动脉母体-胎儿葡萄糖和甘露糖浓度差异更大;葡萄糖:C(n = 7),2.68 +/- 0.14 mmol/L 与 PI-IUGR(n = 9),3.18 +/- 0.16 mmol/L(P < 0.02)和甘露糖:C,42.9 +/- 8.1 微摩尔/ L 与 PI-IUGR,68.5 +/- 19.1 微摩尔/ L(P < 0.001)。对于 PI-IUGR 胎儿,胎儿动脉血浆肌醇浓度显著升高(P < 0.001)。山梨醇、葡萄糖和果糖浓度显著降低(P < 0.03、0.01、0.02,分别)。IUGR 胎盘的子叶中肌醇浓度显著增加(P < 0.003),山梨醇、果糖和甘油浓度降低(P < 0.01、0.02、0.01,分别)。胎儿肝中山梨醇(P < 0.001)和果糖(P < 0.03)浓度也显著降低。在绵羊 PI-IUGR 妊娠中,胎盘和胎儿多元醇和糖浓度均发生了这些深刻的变化,支持这样的结论:在 PI-IUGR 胎盘中,葡萄糖 6-P:肌醇 1-P 环化酶系统的通量增加,多元醇脱氢酶系统的通量减少,导致胎盘肌醇产量增加,山梨醇产量减少。胎盘向胎儿肝脏供应的山梨醇减少可能导致胎儿肝果糖产量减少。这些观察结果强调,与缺氧和低血糖的 PI-IUGR 胎儿相关,胎盘和胎儿多元醇的产生有重大变化。这些胎-胎盘碳水化合物代谢变化如何导致 PI-IUGR 的病理生理学目前尚不清楚。