INHERITED RISK OR MODIFIABLE CHOICES? EXPLORING THE CONTRIBUTIONS OF MATERNAL GENETICS AND LIFESTYLE TO GESTATIONAL DIABETES
Main Article Content
Keywords
Gestational diabetes, heredity, environment, risk factor, gene-environment interaction, prevention, diet, obesity, exercise
Abstract
Background:
Gestational diabetes (GD) is an important complication of pregnancy that has deleterious effects on both maternal and fetal health, and has increasing prevalence worldwide. The pathogenesis of GD is associated with genetic susceptibility, as well as modifiable lifestyle factors; however, the contribution of these factors to disease remains ill-defined. The focus of this review is to assess the interplay of maternal genetic and lifestyle factors in GD risk, including their independent and joint effects.
Methods:
Through a systematic review of the literature, which involved meta-analyses and cohort studies, we have also recollected findings of maternal genetic variants for GD and lifestyle related components like diet, physical activity, and weight maintenance. We find studies that assess gene-environment interactions and their impact on the risk for developing GD.
Results:
Genetic factors, including genetic polymorphisms in insulin-related genes, were significantly related to GD. Furthermore, maternal diet (high sugar and fat consumption), sedentary behavior and obese state were determined as lifestyle-related modifiable risk factors. A number of studies described significant gene/environment interactions, such that unhealthy lifestyle choices amplified genetic risk. However, the effectiveness of lifestyle intervention on genetically susceptible individuals is less established.
Conclusion:
Gestational diabetes is due to a combination of inherited genetic risks and environmental influences. Although heredity is a decisive factor, the risk can be reduced by lifestyle interventions, especially in genetically predisposed women. Subsequent studies will need to target individualized preventive approaches by integrating genetic screening with lifestyle changes in order to lower the burden of GD.
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Dr. Amber Shams
Liaquat University of Medical and Health Sciences, Jamshoro
Dr Rabia Bibi
Liaquat University of Medical and Health Sciences, Jamshoro
Dr Maryam Anwar
MBBS, FCPS (OBGY) Fatima Jinnah Medical University Lahore
Dr Maham Zulqarnain
University of Health Sciences Lahore