Maternal Beslenme, Tip 2 Diyabet ve Epigenetik

Tip 2 diyabet farklı etiyolojik mekanizmalara sahip olan multifaktöriyel bir hastalıktır. Beslenme durumu ve diyet örüntüsünün tip 2 diyabet gelişiminde önemli bir etmen olduğu uzun yıllardır bilinmektedir. Beslenme ve çevresel etmenlerin gen ekspresyonu ile etkileşimi sonucunda ortaya çıkan epigenetik mekanizmalar da son yıllarda tip 2 diyabet ile ilişkilendirilmektedir. Epigenetik modifikasyonların temeli büyük oranda fetal yaşamda maruz kalınan rahim içi ortamda belirlenir. Maternal beslenmenin bu noktada önemli bir belirleyici olduğuna dair elde edilen veriler giderek artmaktadır. Elde edilen bulgular hem yetersiz maternal beslenme durumunun hem de gestasyonel diyabet ve fazla beslenmenin sonraki jenerasyonların diyabet etiyolojisinde etkisi olduğu düşünülen gen ekspresyonları üzerinde farklı etkiler ortaya çıkardığını göstermektedir. Epigenetik mekanizmalarda değişikliklere neden olan beslenme ile ilişkili moleküler süreçlerin belirlenmesi, tip 2 diyabet gibi kronik hastalıkların önlenmesinde, tedavi edilmesinde ve komplikasyonlarının geciktirilmesinde yararlı etkiler sağlayacaktır. Günümüzde gebelik öncesi dönemde, gebelik döneminde ve doğum sonrasında maternal beslenme durumunun, vücut ağırlığının ve gestasyonel diyabete yönelik parametrelerin izlenmesi ve değerlendirilmesi epigenetik mekanizmaların düzenlenmesinde etkin uygulamalardır

Maternal Nutrition, Type 2 Diabetes and Epigenetics

Type 2 diabetes is a multifactorial disease with numerous pathways. Large body of evidence has shown that nutritional status and dietary patterns have deterministic effects on the development of type 2 diabetes. Recently, epigenetic mechanisms that occur through the interaction between nutrition and environmental factors are also shown to be associated with type 2 diabetes. The basis of epigenetic modifications is determined during fetal life, largely. Evidence suggests that maternal nutrition may play crucial role on these processes. Both maternal under nutrition in starvation cohorts and obesity in gestational diabetes or over nutrition have been related with different effects on next generation’s gene expressions that are associated with diabetes. Understanding the epigenetic mechanisms that underlie the interactions between nutrition and molecular events will significantly contribute to prevention, treatment and retardation of complications in type 2 diabetes. Currently, monitoring nutrition, body weight and prevention or treatment strategies in gestational diabetes during pre-gestation, gestation and post-gestation periods are efficient interventions for regulating epigenetic mechanisms

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