Document Type : Review Article
Authors
1
1. Assistant Professor, Department of Nutrition, Clinical Biochemistry and Food Sciences, Faculty of Medicine, Gonabad University of Medical Sciences, Gonabad, Iran
2
2. M.Sc. Biochemistry department, Mashhad University of Payam Noor, Mashhad, Iran
3
3. Assistant Professor. Department of Physiology, Faculty of medicine, Gonabad University of Medical Sciences, Gonabad, Iran
10.22038/nnj.2024.75101.1418
Abstract
Vasopressin is one of the hormones produced in the hypothalamus, which is secreted from the posterior pituitary following the reduction of body water and the increase of plasma osmolality and affects the blood vessels and kidneys. Diabetes insipidus is a rare complication and various factors play a role in this disorder. The aim of this study is to find out the pathophysiological mechanisms for the development of gestational diabetes insipidus, diagnosis and treatment based on vasopressinase enzyme. In this review, keywords including diabetes insipidus, pregnancy, vasopressin, vasopressinase, ADH, AVP, and gestation searched and collected in Web of Science, Scopus, Google Scholar, PubMed and Magiran databases until 2022. 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. Gestational diabetes insipidus has various causes, the most common of which is vasopressinase overactivity. Placental trophoblast produces vasopressinase and its level increases during pregnancy. Because desmopressin is deaminated at the N-terminus, it is resistant to the action of vasopressin and is therefore the treatment of choice for gestational diabetes insipidus.
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