Gestational diabetes insipidus and vasopressinase enzyme role; review article

Document Type : Review Article

Authors

1 Assistant Professor, Department of Nutrition, Clinical Biochemistry and Food Sciences, Faculty of Medicine, Gonabad University of Medical Sciences, Gonabad, Iran

2 M.Sc. Biochemistry department, Mashhad University of Payam Noor, Mashhad, Iran

3 Assistant Professor. Department of Physiology, Faculty of medicine, Gonabad University of Medical Sciences, Gonabad, Iran

10.22038/nnj.2024.75101.1418

Abstract

Background and Aims: Vasopressin is one of the hormones produced in the hypothalamus, secreted from the posterior pituitary following the reduction of body water and the increase of plasma osmolality which affects the blood vessels and kidneys. Diabetes insipidus is a rare complication and various factors play a role in this disorder. This study aimed to review the pathophysiological mechanisms for developing gestational diabetes insipidus, diagnosis, and treatment based on vasopressinase enzyme.
Materials and Methods: In this review article, articles using the keywords "diabetes insipidus, pregnancy, vasopressin, vasopressinase, ADH, AVP and gestation" in Web of Science, Scopus, Google Scholar, PubMed, and Magiran databases. It was collected and reviewed until 2022.
Results: Diabetes insipidus can include hormone secretion disorder (neurogenic diabetes insipidus), hormone receptor disorder (nephrogenic diabetes insipidus), excessive fluid intake (primary polydipsia), and increased hormone catabolism (gestational diabetes insipidus). The most common cause of gestational diabetes insipidus is the excessive activity of the vasopressinase enzyme, which leads to the destruction of the vasopressin hormone. Diagnosing diabetes insipidus in pregnancy can be challenging because it usually presents with symptoms of polydipsia and polyuria, which are often attributed to a normal pregnancy.
Conclusion: Gestational diabetes insipidus has various causes, the most common of which is excessive vasopressin activity. Placental trophoblasts produce vasopressin and its level increases during pregnancy. Because desmopressin is N-terminally deaminated, it is resistant to vasopressin and is, therefore, the treatment of choice for gestational diabetes insipidus.

Keywords

References

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Navid No
Volume 27, Issue 90
September 2024
Pages 51-59

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