Morphological analysis and gene expression of fiber types and extracellular matrix in retus abdominis muscle of pregnant women with hyperglycemia and urinary incontinence: translational study

Abstract

The associations between hyperglycemia and urinary incontinence (UI) and between pregnancy and IU are well established, though the association between gestational hyperglycemia and UI is scarce in the literature. Our academic research group "Diabetes and Pregnancy - Clinical and Experimental", from Botucatu Medical School, UNESP, has studied the translational aspects of gestational hyperglycemia related to urinary incontinence in females and in animal models. The results help to elucidate the pathophysiological mechanisms that lead to female pelvic floor disorders in women with gestational hyperglycemia, but there is need for further research to expand the understanding of the phenomena that result in better care for patients. Using the morphological knowledge, that has ever been done in previous studies, for women with gestational diabetes or mild gestational hyperglycemia and prove that it also happens in the human species is to be consolidated step in translational research. Thus , the aim of this study is to analyze the effects of hyperglycemia and urinary incontinence during pregnancy on the rectus abdominis muscle at the time of cesarean section; define the morphology of the rectus abdominis; type and location of fast and slow muscle fibers of the rectus abdominis; identifying changes in the expression pattern of MHC7, MHCI, MHCIIx/d, COL1A2, COL3A , MMP1, MMP2, MMP3, MMP9, TIMP1, TIMP2 and TIMP3 genes , and defining and comparing gene expression patterns between groups of pregnant women (group not diabetic, diabetic and mild gestational hyperglycemia) . The results allow the development of therapeutic strategies to improve the quality of life of diabetic women, reduce the costs of health care and these tools may allow in the future beyond the advancement of knowledge, the development of new strategies for treating UI responsible for cost high health care in Brazil and worldwide. (AU)