Epigenética no Diabetes Mellitus Gestacional: Da Programação Fetal às Doenças Metabólicas na Vida Adulta
DOI:
https://doi.org/10.36489/nursing.2026v32i341p22530-22547Palavras-chave:
Diabetes Gestacional, Epigênese Genética, Metabolômica, Desenvolvimento FetalResumo
Objetivo: Analisar criticamente as evidências sobre os mecanismos epigenéticos envolvidos na programação fetal induzida pelo diabetes mellitus gestacional (DMG) e suas repercussões metabólicas tardias na prole.
Método: Realizou-se revisão integrativa da literatura, com buscas nas bases PubMed/MEDLINE, Scopus e Web of Science, abrangendo estudos publicados entre 2016 e 2026, além de trabalhos clássicos relacionados ao conceito das Origens Desenvolvimentistas da Saúde e da Doença (DOHaD).
Resultados: As evidências indicam que alterações na metilação do DNA, modificações de histonas, RNAs não codificantes e perfis metabolômicos podem contribuir para mudanças persistentes na expressão gênica e no metabolismo energético. Contudo, esses efeitos resultam da interação entre ambiente intrauterino, predisposição genética e exposições pós-natais.
Conclusão: A integração de dados epigenéticos e metabolômicos amplia a compreensão do DMG e pode favorecer a identificação precoce de risco e o desenvolvimento de estratégias preventivas de precisão.
Referências
American Diabetes Association. 14. Management of diabetes in pregnancy: Standards of Medical Care in Diabetes-2019. Diabetes Care. 2019;42(Suppl 1):S165-72.
Barker DJ. The developmental origins of adult disease. J Am Coll Nutr. 2004;23(6 Suppl):588S-95S.
Gluckman PD, Hanson MA. Living with the past: evolution, development, and patterns of disease. Science. 2004;305(5691):1733-6.
Higa R, Leonardi ML, Jawerbaum A. Intrauterine programming of cardiovascular diseases in maternal diabetes. Front Physiol. 2021;12:760251.
Pal S, Firdous SM, Obi EA. Genetic and epigenetic insights into gestational diabetes mellitus: implications for early diagnosis and management. Precis Nutr Endocr Health. 2026:1-27.
Kinouchi K, Itoh H. Endocrinology in maternal-fetal synchronization and developmental origins of susceptibility to metabolic diseases. Endocr J. 2026;73(3):367-73.
Matera M, Biagioli V, Cavecchia I, Illiceto MT, Pennazzi L, Morandin M, et al. Maternal microbiome in fetal programming: a One Health perspective on translational implications for early-life health. Microorganisms. 2026;14(6):1214.
Plows JF, Stanley JL, Baker PN, Reynolds CM, Vickers MH. The pathophysiology of gestational diabetes mellitus. Int J Mol Sci. 2018;19(11):3342.
Johns EC, Denison FC, Norman JE, Reynolds RM. Gestational diabetes mellitus: mechanisms, treatment, and complications. Trends Endocrinol Metab. 2018;29(11):743-54.
Barbour LA, McCurdy CE, Hernandez TL, Kirwan JP, Catalano PM, Friedman JE. Cellular mechanisms for insulin resistance in normal pregnancy and gestational diabetes. Diabetes Care. 2007;30(Suppl 2):S112-9.
Desoye G, Nolan CJ. The fetal glucose steal: an underappreciated phenomenon in diabetic pregnancy. Diabetologia. 2016;59(6):1089-94.
Ruchat SM, Hivert MF, Bouchard L. Epigenetic programming of obesity and diabetes by in utero exposure to gestational diabetes mellitus. Nutr Rev. 2013;71(Suppl 1):S88-94.
Finer S, Mathews C, Lowe R, Smart M, Hillman S, Foo L, et al. Maternal gestational diabetes is associated with genome-wide DNA methylation variation in placenta and cord blood of exposed offspring. Hum Mol Genet. 2015;24(11):3021-9.
Trejo-Gonzalez NL, Palomar-Morales M, Baiza-Gutman LA, Diaz-Rosas G, Ortega-Camarillo C, Contreras-Ramos A. Circulating microRNAs associated with changes in the placenta and their possible role in the fetus during gestational diabetes mellitus: a review. Metabolites. 2025;15(6):367.
Fan Y, Chen X, Yang S, Tu H, Zhang Y, Wang M, et al. The value of lncRNAs as a biomarker for the diagnosis of gestational diabetes: a meta-analysis. Horm Metab Res. 2025;57(1):67-74.
Kouchaki R, Dermani FK, Datta I, Moghbelinejad S, Gheibi N, Movahed F, et al. Roles of long non-coding RNAs in gestational diabetes mellitus: mechanisms and biomarker potential. Clin Transl Discov. 2026;6(3):e70134.
Zhou J, Wang D, Yu M, Zhai X, Song Y, Liu J, et al. The role of exosomes in offspring metabolic programming in gestational diabetes: mechanisms and potential applications. Int J Biol Sci. 2026;22(8):4116.
Meek CL. An unwelcome inheritance: childhood obesity after diabetes in pregnancy. Diabetologia. 2023;66(11):1961-70.
Juan J, Tian Z, Lu Y, Shou C, Yang H. Long-term maternal and offspring adverse effects of gestational diabetes mellitus. Matern Fetal Med. 2023:10-1097.
Seneviratne SN, Rajindrajith S. Fetal programming of obesity and type 2 diabetes. World J Diabetes. 2022;13(7):482-97.
Sun B, Lo JC, Greenspan LC, King AS, Davis JN, Faith MS, et al. Fetal exposure to gestational diabetes severity and postnatal infant feeding in the first year of life associated with preadolescent obesity: a prospective cohort. Obesity (Silver Spring). 2025;33(5):996-1010.
Senesi P, Luzi L, Sonaglioni A, Alberti F, Cipponeri E, Ferrulli A. Gestational diabetes as an inter-generational cardiometabolic risk factor: spotlight on emerging exerkines. Cardiovasc Diabetol. 2026.
Foo RX, Ma JJ, Du R, Goh GBB, Chong YS, Zhang C, et al. Gestational diabetes mellitus and development of intergenerational non-alcoholic fatty liver disease (NAFLD) after delivery: a systematic review and meta-analysis. EClinicalMedicine. 2024;72:102625.
Dunne F, Newman C, Alvarez-Iglesias A, Ferguson J, Smyth A, Browne M, et al. Early metformin in gestational diabetes: a randomized clinical trial. JAMA. 2023;330(16):1547-56.
Sun L, Du P, Xi Z. Comparison of pregnancy outcomes and physical conditions of infants in patients with gestational diabetes mellitus treated with metformin and insulin: a meta-analysis study. BMC Pregnancy Childbirth. 2026;26(1):172.
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Copyright (c) 2026 Maria Eduarda Souza Ramos, Kethilyn Aparecida Ricardo, Lara Crystina da Silva Rabelo, Nayara de Assis Furtado da Silva, Giovanna do Valle Oliveira, Larissa Lima Fernandes de Miranda, Pedro Henrique Teixeira Marques dos Santos, Evelynn Dalila do Nascimento Melo; Gustavo Diniz

Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.







