ABSTRACT
Muscle atrophy is a significant consequence of chronic kidney disease that increases a patient's risk of mortality and decreases their quality of life. The loss of lean body mass results, in part, from an increase in the rate of muscle protein degradation. In this review, the proteolytic systems that are activated during chronic kidney disease and the key insulin signaling pathways that regulate the protein degradative processes are described.
Subject(s)
Insulin/physiology , Kidney Diseases/complications , Muscular Atrophy/etiology , Signal Transduction , Acidosis/complications , Animals , Chronic Disease , Glucocorticoids/biosynthesis , Humans , Insulin Resistance , Insulin-Like Growth Factor I/metabolism , Muscle Proteins/metabolism , Peptide Hydrolases/metabolism , Phosphatidylinositol 3-Kinases/metabolism , Proto-Oncogene Proteins c-akt/metabolismABSTRACT
PURPOSE: Gestational diabetes mellitus (GDM) is a serious complication of pregnancy associated with increased risk of adverse outcomes for both mother and infant. This study assesses the association of maternal exercise during GDM pregnancy and selected maternal and infant adverse GDM-related outcomes. The analysis uses information derived from the 1988 National Maternal Infant Health Survey (NMIHS) data. METHODS: Women in the 1988 NMIHS database were identified and grouped as to having experienced a non-GDM (n = 2,952,482) or GDM (n = 105,600) pregnancy. Non-GDM and GDM groups were compared as to demographic and personal-attribute variables. The second part of this study focused on the women with GDM pregnancy, specifically a subset (n = 75,160) who met inclusion/exclusion criteria for the study of exercise during pregnancy. Each was categorized to either the exercise group or the nonexercise group. RESULTS: The non-GDM and GDM groups of pregnant women were not different as to the variables studied, except that older age and increased body mass index (BMI) were associated with GDM pregnancy. For the study of exercise during GDM pregnancy, the only variable that was associated with the exercise group was size of the infant. Participants in the exercise group were less likely than those in the nonexercise group to have delivered a large for gestational age (LGA) infant (F [1, 4314] = 9.82, p = .0017). IMPLICATIONS: The results of this study suggest that moderate maternal leisure time physical exercise during GDM pregnancy may reduce the risk of delivery of an LGA infant.