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Vol 7, No 5 (2018)
Review article
Published online: 2018-11-27

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Insulin resistance and adaptation of pancreatic beta cells during pregnancy

Anna Zielińska-Maciulewska1, Adam Krętowski1, Małgorzata Szelachowska1
DOI: 10.5603/DK.2018.0022
Clin Diabetol 2018;7(5):222-229.

Abstract

Insulin resistance is described as reduced sensitivity of the body tissues to insulin. In pregnant women insulin resistance increases during each trimester of pregnancy due to the hormones produced by the placenta and many other factors which are not yet fully recognised. Growing insulin resistance leads to an increase in beta cell mass and number and insulin secretion, which helps to maintain glucose homeostasis and normal foetal development. However, in cases of severe insulin resistance, insufficient compensation of pancreatic beta cells or reduced pancreatic beta-cell function, glycaemic levels are increased and gestational diabetes mellitus develops. The aim of the present review is to analyse the factors affecting insulin resistance and the adaptation of pancreatic beta cells during pregnancy and methods of insulin resistance assessment.

Keywords: insulin resistancepregnancyadipokinesgestational diabetes mellitusadaptation of pancreatic beta cells in pregnancy

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References

  1. Ryan EA, Enns L. Role of gestational hormones in the induction of insulin resistance. J Clin Endocrinol Metab. 1988; 67(2): 341–347.
    CrossRefPubMed
  2. Lacroix M, Kina E, Hivert MF. Maternal/fetal determinants of insulin resistance in women during pregnancy and in offspring over life. Curr Diab Rep. 2013; 13(2): 238–244.
    CrossRefPubMed
  3. Kirwan JP, Hauguel-De Mouzon S, Lepercq J, et al. TNF-alpha is a predictor of insulin resistance in human pregnancy. Diabetes. 2002; 51(7): 2207–2213.
    CrossRefPubMed
  4. Catalano PM, Hoegh M, Minium J, et al. Adiponectin in human pregnancy: implications for regulation of glucose and lipid metabolism. Diabetologia. 2006; 49(7): 1677–1685.
    CrossRefPubMed
  5. Kralisch S, Hoffmann A, Kratzsch J, et al. Serum levels of adipocyte fatty acid binding protein are increased in gestational diabetes mellitus. Eur J Endocrinol. 2009; 160(1): 33–38.
    CrossRefPubMed
  6. Bergman RN, Finegood DT, Ader M. Assessment of insulin sensitivity in vivo. Endocr Rev. 1985; 6(1): 45–86.
    CrossRefPubMed
  7. Matthews DR, Hosker JP, Rudenski AS, et al. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985; 28(7): 412–419.
    CrossRefPubMed
  8. Kirwan JP, Huston-Presley L, Kalhan SC, et al. Clinically useful estimates of insulin sensitivity during pregnancy: validation studies in women with normal glucose tolerance and gestational diabetes mellitus. Diabetes Care. 2001; 24(9): 1602–1607.
    CrossRefPubMed
  9. Matsuda M, DeFronzo RA. Insulin sensitivity indices obtained from oral glucose tolerance testing: comparison with the euglycemic insulin clamp. Diabetes Care. 1999; 22(9): 1462–1470.
    CrossRefPubMed
  10. Wagner R, Fritsche L, Heni M, et al. A novel insulin sensitivity index particularly suitable to measure insulin sensitivity during gestation. Acta Diabetol. 2016; 53(6): 1037–1044.
    CrossRefPubMed
  11. Catalano PM, Roman-Drago NM, Amini SB, et al. Longitudinal changes in body composition and energy balance in lean women with normal and abnormal glucose tolerance during pregnancy. Am J Obstet Gynecol. 1998; 179(1): 156–165.
    CrossRefPubMed
  12. McIntyre HD, Chang AM, Callaway LK, et al. Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Study Cooperative Research Group. Hormonal and metabolic factors associated with variations in insulin sensitivity in human pregnancy. Diabetes Care. 2010; 33(2): 356–360.
    CrossRefPubMed
  13. Retnakaran R, Qi Y, Sermer M, et al. Pre-gravid physical activity and reduced risk of glucose intolerance in pregnancy: the role of insulin sensitivity. Clin Endocrinol (Oxf). 2009; 70(4): 615–622.
    CrossRefPubMed
  14. Ethridge JK, Catalano PM, Waters TP, et al. Subclinical abnormalities of glucose metabolism in subjects with previous gestational diabetes. Am J Obstet Gynecol. 1986; 155(6): 1255–1262.
    CrossRefPubMed
  15. Triantafyllou GA, Paschou SA, Mantzoros CS. Leptin and Hormones: Energy Homeostasis. Endocrinol Metab Clin North Am. 2016; 45(3): 633–645.
    CrossRefPubMed
  16. Powe CE. Early Pregnancy Biochemical Predictors of Gestational Diabetes Mellitus. Curr Diab Rep. 2017; 17(2): 12.
    CrossRefPubMed
  17. Brink HS, van der Lely AJ, van der Linden J. The potential role of biomarkers in predicting gestational diabetes. Endocr Connect. 2016; 5(5): R26–R34.
    CrossRefPubMed
  18. Briana DD, Malamitsi-Puchner A. Reviews: adipocytokines in normal and complicated pregnancies. Reprod Sci. 2009; 16(10): 921–937.
    CrossRefPubMed
  19. Wójcik M, Chmielewska-Kassassir M, Grzywnowicz K, et al. The relationship between adipose tissue-derived hormones and gestational diabetes mellitus (GDM). Endokrynol Pol. 2014; 65(2): 134–142.
    CrossRefPubMed
  20. Lacroix M, Battista MC, Doyon M, et al. Lower adiponectin levels at first trimester of pregnancy are associated with increased insulin resistance and higher risk of developing gestational diabetes mellitus. Diabetes Care. 2013; 36(6): 1577–1583.
    CrossRefPubMed
  21. Paradisi G, Ianniello F, Tomei C, et al. Longitudinal changes of adiponectin, carbohydrate and lipid metabolism in pregnant women at high risk for gestational diabetes. Gynecol Endocrinol. 2010; 26(7): 539–545.
    CrossRefPubMed
  22. Fuglsang J, Skjaerbaek C, Frystyk J, et al. A longitudinal study of serum adiponectin during normal pregnancy. BJOG. 2006; 113(1): 110–113.
    CrossRefPubMed
  23. Ferreira AF, Rezende JC, Vaikousi E, et al. Maternal serum visfatin at 11-13 weeks of gestation in gestational diabetes mellitus. Clin Chem. 2011; 57(4): 609–613.
    CrossRefPubMed
  24. Lain KY, Daftary AR, Ness RB, et al. First trimester adipocytokine concentrations and risk of developing gestational diabetes later in pregnancy. Clin Endocrinol (Oxf). 2008; 69(3): 407–411.
    CrossRefPubMed
  25. Williams MA, Qiu C, Muy-Rivera M, et al. Plasma adiponectin concentrations in early pregnancy and subsequent risk of gestational diabetes mellitus. J Clin Endocrinol Metab. 2004; 89(5): 2306–2311.
    CrossRefPubMed
  26. Iliodromiti S, Sassarini J, Kelsey TW, et al. Accuracy of circulating adiponectin for predicting gestational diabetes: a systematic review and meta-analysis. Diabetologia. 2016; 59(4): 692–699.
    CrossRefPubMed
  27. Thagaard IN, Krebs L, Holm JC, et al. Adiponectin and leptin as first trimester markers for gestational diabetes mellitus: a cohort study. Clin Chem Lab Med. 2017; 55(11): 1805–1812.
    CrossRefPubMed
  28. Cortelazzi D, Corbetta S, Ronzoni S, et al. Maternal and foetal resistin and adiponectin concentrations in normal and complicated pregnancies. Clin Endocrinol (Oxf). 2007; 66(3): 447–453.
    CrossRefPubMed
  29. Kuzmicki M, Telejko B, Szamatowicz J, et al. High resistin and interleukin-6 levels are associated with gestational diabetes mellitus. Gynecol Endocrinol. 2009; 25(4): 258–263.
    CrossRefPubMed
  30. Georgiou HM, Lappas M, Georgiou GM, et al. Screening for biomarkers predictive of gestational diabetes mellitus. Acta Diabetol. 2008; 45(3): 157–165.
    CrossRefPubMed
  31. Palik E, Baranyi E, Melczer Z, et al. Elevated serum acylated (biologically active) ghrelin and resistin levels associate with pregnancy-induced weight gain and insulin resistance. Diabetes Res Clin Pract. 2007; 76(3): 351–357.
    CrossRefPubMed
  32. Lowe LP, Metzger BE, Lowe WL, et al. HAPO Study Cooperative Research Group. Inflammatory mediators and glucose in pregnancy: results from a subset of the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Study. J Clin Endocrinol Metab. 2010; 95(12): 5427–5434.
    CrossRefPubMed
  33. Megia A, Vendrell J, Gutierrez C, et al. Insulin sensitivity and resistin levels in gestational diabetes mellitus and after parturition. Eur J Endocrinol. 2008; 158(2): 173–178.
    CrossRefPubMed
  34. Lobo TF, Torloni MR, Gueuvoghlanian-Silva BY, et al. Resistin concentration and gestational diabetes: a systematic review of the literature. J Reprod Immunol. 2013; 97(1): 120–127.
    CrossRefPubMed
  35. Gao Xl, Yang Hx, Zhao Yi. Variations of tumor necrosis factor-alpha, leptin and adiponectin in mid-trimester of gestational diabetes mellitus. Chin Med J (Engl). 2008; 121(8): 701–705.
    PubMed
  36. López-Tinoco C, Roca M, Fernández-Deudero A, et al. Cytokine profile, metabolic syndrome and cardiovascular disease risk in women with late-onset gestational diabetes mellitus. Cytokine. 2012; 58(1): 14–19.
    CrossRefPubMed
  37. Atègbo JM, Grissa O, Yessoufou A, et al. Modulation of adipokines and cytokines in gestational diabetes and macrosomia. J Clin Endocrinol Metab. 2006; 91(10): 4137–4143.
    CrossRefPubMed
  38. Zhang R, Abou-Samra AB. A dual role of lipasin (betatrophin) in lipid metabolism and glucose homeostasis: consensus and controversy. Cardiovasc Diabetol. 2014; 13: 133.
    CrossRefPubMed
  39. Chen Xi, Lu P, He W, et al. Circulating betatrophin levels are increased in patients with type 2 diabetes and associated with insulin resistance. J Clin Endocrinol Metab. 2015; 100(1): E96–E100.
    CrossRefPubMed
  40. Zhang R. The ANGPTL3-4-8 model, a molecular mechanism for triglyceride trafficking. Open Biol. 2016; 6(4): 150272.
    CrossRefPubMed
  41. Wawrusiewicz-Kurylonek N, Telejko B, Kuzmicki M, et al. Increased Maternal and Cord Blood Betatrophin in Gestational Diabetes. PLoS One. 2015; 10(6): e0131171.
    CrossRefPubMed
  42. Abu-Farha M, Abubaker J, Noronha F, et al. Higher plasma betatrophin/ANGPTL8 level in Type 2 Diabetes subjects does not correlate with blood glucose or insulin resistance. Sci Rep. 2015; 5: 10949.
    CrossRefPubMed
  43. Ebert T, Kralisch S, Wurst U, et al. Betatrophin levels are increased in women with gestational diabetes mellitus compared to healthy pregnant controls. Eur J Endocrinol. 2015; 173(1): 1–7.
    CrossRefPubMed
  44. Espes D, Martinell M, Carlsson PO. Increased circulating betatrophin concentrations in patients with type 2 diabetes. Int J Endocrinol. 2014; 2014: 323407.
    CrossRefPubMed
  45. Fu Z, Berhane F, Fite A, et al. Elevated circulating lipasin/betatrophin in human type 2 diabetes and obesity. Scientific Reports. 2014; 4(1).
    CrossRef
  46. Hu H, Sun W, Yu S, et al. Increased circulating levels of betatrophin in newly diagnosed type 2 diabetic patients. Diabetes Care. 2014; 37(10): 2718–2722.
    CrossRefPubMed
  47. Zielińska A, Maciulewski R, Siewko K, et al. Levels of betatrophin decrease during pregnancy despite increased insulin resistance, beta-cell function and triglyceride levels. Diabetes Metab. 2016; 42(6): 409–415.
    CrossRefPubMed
  48. Li Yy, Xiao R, Li Cp, et al. Increased plasma levels of FABP4 and PTEN is associated with more severe insulin resistance in women with gestational diabetes mellitus. Med Sci Monit. 2015; 21: 426–431.
    CrossRefPubMed
  49. Zhang Y, Zhang HH, Lu JH, et al. Changes in serum adipocyte fatty acid-binding protein in women with gestational diabetes mellitus and normal pregnant women during mid- and late pregnancy. J Diabetes Investig. 2016; 7(5): 797–804.
    CrossRefPubMed
  50. Ning H, Tao H, Weng Z, et al. Plasma fatty acid-binding protein 4 (FABP4) as a novel biomarker to predict gestational diabetes mellitus. Acta Diabetol. 2016; 53(6): 891–898.
    CrossRefPubMed
  51. Tu WJ, Guo M, Shi XD, et al. First-Trimester Serum Fatty Acid-Binding Protein 4 and Subsequent Gestational Diabetes Mellitus. Obstet Gynecol. 2017; 130(5): 1011–1016.
    CrossRefPubMed
  52. Wang D, Zhu W, Li J, et al. Serum concentrations of fibroblast growth factors 19 and 21 in women with gestational diabetes mellitus: association with insulin resistance, adiponectin, and polycystic ovary syndrome history. PLoS One. 2013; 8(11): e81190.
    CrossRefPubMed
  53. Stein S, Stepan H, Kratzsch J, et al. Serum fibroblast growth factor 21 levels in gestational diabetes mellitus in relation to insulin resistance and dyslipidemia. Metabolism. 2010; 59(1): 33–37.
    CrossRefPubMed
  54. Dekker Nitert M, Barrett HL, Kubala MH, et al. Increased placental expression of fibroblast growth factor 21 in gestational diabetes mellitus. J Clin Endocrinol Metab. 2014; 99(4): E591–E598.
    CrossRefPubMed
  55. Megia A, Gil-Lluis P, Näf S, et al. Cord blood FGF21 in gestational diabetes and its relationship with postnatal growth. Acta Diabetol. 2015; 52(4): 693–700.
    CrossRefPubMed
  56. Abetew DF, Qiu C, Fida NG, et al. Association of retinol binding protein 4 with risk of gestational diabetes. Diabetes Res Clin Pract. 2013; 99(1): 48–53.
    CrossRefPubMed
  57. Zhaoxia L, Mengkai Du, Qin F, et al. Significance of RBP4 in patients with gestational diabetes mellitus: a case-control study of Han Chinese women. Gynecol Endocrinol. 2014; 30(2): 161–164.
    CrossRefPubMed
  58. Chan TF, Chen HS, Chen YC, et al. Increased serum retinol-binding protein 4 concentrations in women with gestational diabetes mellitus. Reprod Sci. 2007; 14(2): 169–174.
    CrossRefPubMed
  59. Krzyzanowska K, Zemany L, Krugluger W, et al. Serum concentrations of retinol-binding protein 4 in women with and without gestational diabetes. Diabetologia. 2008; 51(7): 1115–1122.
    CrossRefPubMed
  60. Choi SH, Kwak SH, Youn BS, et al. High plasma retinol binding protein-4 and low plasma adiponectin concentrations are associated with severity of glucose intolerance in women with previous gestational diabetes mellitus. J Clin Endocrinol Metab. 2008; 93(8): 3142–3148.
    CrossRefPubMed
  61. Maghbooli Z, Hossein-Nezhad A, Mirzaei K, et al. Association between retinol-binding protein 4 concentrations and gestational diabetes mellitus and risk of developing metabolic syndrome after pregnancy. Reprod Sci. 2010; 17(2): 196–201.
    CrossRefPubMed
  62. Klein K, Bancher-Todesca D, Leipold H, et al. Retinol-binding protein 4 in patients with gestational diabetes mellitus. J Womens Health (Larchmt). 2010; 19(3): 517–521.
    CrossRefPubMed
  63. Su YX, Hong J, Yan Q, et al. Increased serum retinol-binding protein-4 levels in pregnant women with and without gestational diabetes mellitus. Diabetes Metab. 2010; 36(6 Pt 1): 470–475.
    CrossRefPubMed
  64. Khovidhunkit W, Pruksakorn P, Plengpanich W, et al. Retinol-binding protein 4 is not associated with insulin resistance in pregnancy. Metabolism. 2012; 61(1): 65–69.
    CrossRefPubMed
  65. Hu S, Liu Q, Huang X, et al. Serum level and polymorphisms of retinol-binding protein-4 and risk for gestational diabetes mellitus: a meta-analysis. BMC Pregnancy Childbirth. 2016; 16: 1–11.
    CrossRefPubMed
  66. Huang QT, Huang Q, Luo W, et al. Circulating retinol-binding protein 4 levels in gestational diabetes mellitus: a meta-analysis of observational studies. Gynecol Endocrinol. 2015; 31(5): 337–344.
    CrossRefPubMed
  67. Abell SK, Shorakae S, Harrison CL, et al. The association between dysregulated adipocytokines in early pregnancy and development of gestational diabetes. Diabetes Metab Res Rev. 2017; 33(8): e2926.
    CrossRefPubMed
  68. Lis I, Pilarski Ł, Bogdański P. Omentin – a newly-discovered adipocytokine in insulin resistance pathogenesis. Pol Merkur Lekarski. 2015; 39(229): 56–60.
    PubMed
  69. Aktas G, Alcelik A, Ozlu T, et al. Association between omentin levels and insulin resistance in pregnancy. Exp Clin Endocrinol Diabetes. 2014; 122(3): 163–166.
    CrossRefPubMed
  70. Abell SK, De Courten B, Boyle JA, et al. Inflammatory and Other Biomarkers: Role in Pathophysiology and Prediction of Gestational Diabetes Mellitus. Int J Mol Sci. 2015; 16(6): 13442–13473.
    CrossRefPubMed
  71. Barker G, Lim R, Georgiou HM, et al. Omentin-1 is decreased in maternal plasma, placenta and adipose tissue of women with pre-existing obesity. PLoS One. 2012; 7(8): e42943.
    CrossRefPubMed
  72. Franz M, Polterauer M, Springer S, et al. Maternal and neonatal omentin-1 levels in gestational diabetes. Arch Gynecol Obstet. 2018; 297(4): 885–889.
    CrossRefPubMed
  73. Görkem Ü, Küçükler FK, Toğrul C, et al. Are adipokines associated with gestational diabetes mellitus? J Turk Ger Gynecol Assoc. 2016; 17(4): 186–190.
    CrossRefPubMed
  74. van Poppel MNM, Zeck W, Ulrich D, et al. Cord blood chemerin: differential effects of gestational diabetes mellitus and maternal obesity. Clin Endocrinol (Oxf). 2014; 80(1): 65–72.
    CrossRefPubMed
  75. Hare KJ, Bonde L, Svare JA, et al. Decreased plasma chemerin levels in women with gestational diabetes mellitus. Diabet Med. 2014; 31(8): 936–940.
    CrossRefPubMed
  76. Zhang J, Chi H, Xiao H, et al. Interleukin 6 (IL-6) and Tumor Necrosis Factor α (TNF-α) Single Nucleotide Polymorphisms (SNPs), Inflammation and Metabolism in Gestational Diabetes Mellitus in Inner Mongolia. Med Sci Monit. 2017; 23: 4149–4157.
    CrossRefPubMed
  77. Li XM, Ji H, Li CJ, et al. Chemerin expression in Chinese pregnant women with and without gestational diabetes mellitus. Ann Endocrinol (Paris). 2015; 76(1): 19–24.
    CrossRefPubMed
  78. Yang X, Quan X, Lan Y, et al. Serum chemerin level during the first trimester of pregnancy and the risk of gestational diabetes mellitus. Gynecol Endocrinol. 2017; 33(10): 770–773.
    CrossRefPubMed
  79. Pfau D, Stepan H, Kratzsch J, et al. Circulating levels of the adipokine chemerin in gestational diabetes mellitus. Horm Res Paediatr. 2010; 74(1): 56–61.
    CrossRefPubMed
  80. Fatima SS, Alam F, Chaudhry B, et al. Elevated levels of chemerin, leptin, and interleukin-18 in gestational diabetes mellitus. J Matern Fetal Neonatal Med. 2017; 30(9): 1023–1028.
    CrossRefPubMed
  81. Liang Z, Zhou M, Xu XK, et al. Is Chemerin associated with gestational diabetes mellitus? An evidence-based clinical research from Chinese women. J Obstet Gynaecol. 2018; 38(4): 482–487.
    CrossRefPubMed
  82. Iyidir OT, Degertekin CK, Yilmaz BA, et al. Serum levels of fetuin A are increased in women with gestational diabetes mellitus. Arch Gynecol Obstet. 2015; 291(4): 933–937.
    CrossRefPubMed
  83. Kralisch S, Hoffmann A, Lössner U, et al. Regulation of the novel adipokines/hepatokines fetuin A and fetuin B in gestational diabetes mellitus. Metabolism. 2017; 68: 88–94.
    CrossRefPubMed
  84. Gu Y, Li H, Bao X, et al. The relationship between thyroid function and the prevalence of type 2 diabetes mellitus in euthyroid subjects. J Clin Endocrinol Metab. 2017; 102(2): 434–442.
    CrossRefPubMed
  85. Yang S, Shi FT, Leung PCK, et al. Low Thyroid Hormone in Early Pregnancy Is Associated With an Increased Risk of Gestational Diabetes Mellitus. J Clin Endocrinol Metab. 2016; 101(11): 4237–4243.
    CrossRefPubMed
  86. Maleki N, Tavosi Z. Evaluation of thyroid dysfunction and autoimmunity in gestational diabetes mellitus and its relationship with postpartum thyroiditis. Diabet Med. 2015; 32(2): 206–212.
    CrossRefPubMed
  87. Baeyens L, Hindi S, Sorenson RL, et al. β-Cell adaptation in pregnancy. Diabetes Obes Metab. 2016; 18(Suppl 1): 63–70.
    CrossRefPubMed
  88. Parsons JA, Brelje TC, Sorenson RL. Adaptation of islets of Langerhans to pregnancy: increased islet cell proliferation and insulin secretion correlates with the onset of placental lactogen secretion. Endocrinology. 1992; 130(3): 1459–1466.
    CrossRefPubMed
  89. Scaglia L, Smith FE, Bonner-Weir S. Apoptosis contributes to the involution of beta cell mass in the post partum rat pancreas. Endocrinology. 1995; 136(12): 5461–5468.
    CrossRefPubMed
  90. Karnik SK, Chen H, McLean GW, et al. Menin controls growth of pancreatic beta-cells in pregnant mice and promotes gestational diabetes mellitus. Science. 2007; 318(5851): 806–809.
    CrossRefPubMed
  91. Van Assche FA, Aerts L, De Prins F. A morphological study of the endocrine pancreas in human pregnancy. Br J Obstet Gynaecol. 1978; 85(11): 818–820.
    CrossRefPubMed
  92. Butler AE, Cao-Minh L, Galasso R, et al. Adaptive changes in pancreatic beta cell fractional area and beta cell turnover in human pregnancy. Diabetologia. 2010; 53(10): 2167–2176.
    CrossRefPubMed
  93. Huang C, Snider F, Cross JC. Prolactin receptor is required for normal glucose homeostasis and modulation of beta-cell mass during pregnancy. Endocrinology. 2009; 150(4): 1618–1626.
    CrossRefPubMed
  94. Goyvaerts L, Lemaire K, Arijs I, et al. Prolactin receptors and placental lactogen drive male mouse pancreatic islets to pregnancy-related mRNA changes. PLoS One. 2015; 10(3): e0121868.
    CrossRefPubMed
  95. Kim H, Toyofuku Y, Lynn FC, et al. Serotonin regulates pancreatic beta cell mass during pregnancy. Nat Med. 2010; 16(7): 804–808.
    CrossRefPubMed
  96. Ohara-Imaizumi M, Kim H, Yoshida M, et al. Serotonin regulates glucose-stimulated insulin secretion from pancreatic β cells during pregnancy. Proc Natl Acad Sci U S A. 2013; 110(48): 19420–19425.
    CrossRefPubMed
  97. Berger M, Scheel DW, Macias H, et al. Gαi/o-coupled receptor signaling restricts pancreatic β-cell expansion. Proc Natl Acad Sci U S A. 2015; 112(9): 2888–2893.
    CrossRefPubMed
  98. Brelje TC, Scharp DW, Lacy PE, et al. Effect of homologous placental lactogens, prolactins, and growth hormones on islet B-cell division and insulin secretion in rat, mouse, and human islets: implication for placental lactogen regulation of islet function during pregnancy. Endocrinology. 1993; 132(2): 879–887.
    CrossRefPubMed

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