Placental glycogen metabolism in diabetic pregnancy.
Glycogen content in the normal placenta decreases gradually towards term. However, in human diabetes and in rat streptozotocin diabetes two- to tenfold increases in placental glycogen level were found during the pregnancy. This elevation was evident in rats per tissue weight, protein or DNA content and was also seen in insulin-treated and gestational diabetics. Electron microscopic investigation of diabetic rat placenta revealed glycogen deposition in the typical glycogen cells, also in junctional zone cells and in all cells of the placental labyrinth. Placental glycogen accumulation in diabetes occurs in marked contrast to other tissues, such as maternal liver, from which glycogen disappears. Liver and muscle glycogenesis and glycogenolysis are under insulin control, by regulation of the activities of glycogen synthase and phosphorylase. However, in the placenta these enzymes are not meaningfully influenced by insulin in in vivo and in vitro studies. In our and other laboratories the activities of both enzymes somewhat increased or decreased, showing no trend conducive to glycogen accumulation. Placenta is glucose dependent, but the role of insulin in its carbohydrate metabolism is doubtful. Despite the high placental concentration of insulin receptors no metabolic outcome has yet been pointed out. Glycogen accumulation in the placenta of diabetic rats was found to be related to the extent of maternal hyperglycemia. The resultant markedly increased intracellular level of glucose-6-phosphate accelerates glycogen synthesis b. Glucose itself activates glycogen synthase and deactivates glycogen phosphorylase. Continuous glucose infusion to non-diabetic pregnant rats on gestation days 18-21 likewise also caused an increase in placental glycogen in correlation with hyperglycemia. The possibility that placental glycogen is under the control of fetal rather than maternal insulin was explored by producing insulin deficiency through intrafetal streptozotocin injection. There was no effect of fetal "diabetes" on placental glycogen synthesis or on the distribution of placental glycogen between the maternal and fetal segments of the placenta, while it caused a marked decrease in the fetal liver glycogen content and fetal body weight. To assess the availability of placental glycogen as an energy source the placental glycogenolysis was investigated after hormonal stimulation. Catecholamines were effective in inducing lactate formation both in vivo and in vitro in nondiabetic and diabetic rats. Protracted activation of the adenylate cyclase system by cholera toxin administration pronouncedly reduced placental glycogen in vivo.