Chapter 5 Pro-Inflammatory Cytokines, Lipid Metabolism and Inflammation in Gestational Diabetes Mellitus as Cause of Insulin Resistance

1. Introduction

1.1. The main objectives of this review are to draw attention to

2. Epidemiology of gestational diabetes mellitus

2.1. Diagnostic criteria of gestational diabetes mellitus (GDM)

2.2. Non-genetic factors

2.3. Postpartum diabetes mellitus

2.4. Genetics of GDM

3. Lipid metabolism and gestational diabetes mellitus

3.1. Lipid and lipoproteins

3.2. Free fatty acids

3.3. Effects of lipid peroxidation

3.4. Effect of lipid metabolism on neonatal outcome

3.5. Adipose tissue as an endocrine organ

4. Immunology of gestational diabetes

4.1. Humoral reactivity in pregnancy

4.2. Autoimmune GDM

4.3. Cellular immune response and gestational diabetes

5. The placenta is a target of cytokines: maternal and fetal influences

5.1. Bidirectional nature of cytokine at the fetal-maternal interface

5.2. The role of adipokines and other inflammatory markers

5.3. Adiponectin

5.4. Leptin

5.5. Association between leptin and TNF-alpha and insulin resistance

5.6. Inflammatory mediators in diabetes mellitus

6. Link between inflammation and insulin resistance

6.1. Mechanisms of insulin resistance by pro-inflammatory cytokines

6.2. Transcription versus phosphorylation in the pathogenesis of insulin resistance

6.3. IKK β signaling pathway and insulin resistance

6.4. Oxidative stress and activation of JNK and NF-κB pathways

7. Health implications of cytokines, lipid metabolism, inflammation and GDM

8. Intervention strategies

8.1. Lifestyle modification

8.2. Breast-feeding

8.3. Pharmacologic interventions

9. Concluding remarks

9.1. Future directions

Author details

References