Placental Glucose Transport and Regulatory Mechanisms

妊娠期胰岛素抵抗(IR)是一种适应性生理现象，但过度IR可导致妊娠期糖尿病(GDM)，增加母婴并发症风险。研究表明，炎症因子(如TNF-α、HMGB1)、脂肪因子(如瘦素、脂联素)及维生素D等通过调控胰岛素信号通路(如PI3K/Akt和Ras-MAPK途径)，影响GLUT的表达与功能，进而参与GDM的发生与发展。本文系统综述了妊娠期糖代谢的调控机制及其影响因素，为GDM的预防与治疗提供理论依据，并指出未来研究方向。Insulin resistance (IR) in pregnancy is an adaptive physiologic phenomenon, but excessive IR can lead to gestational diabetes mellitus (GDM) and increase the risk of maternal and infant complications. Studies have shown that inflammatory factors (e.g., TNF-α, HMGB1), adipokines (e.g., leptin, lipocalin), and vitamin D affect the expression and function of GLUT through the modulation of insulin signaling pathways (e.g., the PI3K/Akt and Ras-MAPK pathways), which are then involved in the occurrence and development of GDM. This paper systematically reviews the regulatory mechanisms of glucose metabolism and its influencing factors during pregnancy, provides a theoretical basis for the prevention and treatment of GDM, and points out the direction of future research.