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Qian Y, Zhang Y, Fan X, Yan H, Li X, Fan Y, Song Y, Ma S, Hu Z, Gao X, Yang J. Nonalcoholic Fatty Liver Disease and Adverse Pregnancy Outcomes in Women With Normal Prepregnant Weight. J Clin Endocrinol Metab 2023; 108:463-471. [PMID: 36181486 DOI: 10.1210/clinem/dgac567] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 09/24/2022] [Indexed: 01/20/2023]
Abstract
CONTEXT Existing studies focusing on the effects of nonalcoholic fatty liver disease (NAFLD) combined with normal prepregnant weight on pregnancy outcomes are limited. OBJECTIVE This study aimed to explore the relationship between maternal NAFLD and adverse pregnancy outcomes in different body mass index (BMI) groups. METHODS Using an antenatal care and delivery database, we retrospectively analyzed women who delivered in Minhang Hospital affiliated to Fudan University, Shanghai, China from January 1, 2013, to June 30, 2020. NAFLD was confirmed by ultrasound in early pregnancy. A logistic regression model with adjustment for confounders was used to examine potential associations between NAFLD and pregnancy outcomes. RESULTS A total of 14 708 pregnant women (mean prepregnant BMI 21.0 [SD, 2.8] kg/m2) were included in our final study, of whom 554 (3.8%) had NAFLD. After fully adjusting for potential confounders, NAFLD significantly increased the risk of gestational diabetes mellitus (adjusted odds ratio 2.477; 95% CI, 1.885-3.254), gestational hypertension (3.054; 2.191-4.257), preeclampsia/eclampsia (3.994; 2.591-6.005), cesarean section (1.569; 1.315-1.872), preterm births (1.831; 1.229-2.727), and macrosomia (1.691; 1.300-2.198). It is notable that 83.9% (12 338) of women were of normal weight at the start of pregnancy (prepregnant 18.5 ≤ BMI < 24 kg/m2), and they still had higher odds of adverse pregnancy outcomes. CONCLUSION Women with NAFLD and a normal weight have a higher risk for adverse pregnancy outcomes. Pregnant women with NAFLD, regardless of obesity status, should be offered a more qualified surveillance to optimize pregnancy outcomes.
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Affiliation(s)
- Yiling Qian
- Department of Endocrinology and Metabolism, Minhang Hospital, Fudan University, Shanghai 201199, China
| | - Yu Zhang
- Department of Endocrinology and Metabolism, Minhang Hospital, Fudan University, Shanghai 201199, China
| | - Xiaofang Fan
- Department of Endocrinology and Metabolism, Minhang Hospital, Fudan University, Shanghai 201199, China
| | - Hongmei Yan
- Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Xuesong Li
- Department of Endocrinology and Metabolism, Minhang Hospital, Fudan University, Shanghai 201199, China
| | - Yujuan Fan
- Department of Endocrinology and Metabolism, Minhang Hospital, Fudan University, Shanghai 201199, China
| | - Yuping Song
- Department of Endocrinology and Metabolism, Minhang Hospital, Fudan University, Shanghai 201199, China
| | - Shuai Ma
- Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Zheng Hu
- Department of Obstetrics, Minhang Hospital, Fudan University, Shanghai 201199, China
| | - Xin Gao
- Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Jialin Yang
- Department of Endocrinology and Metabolism, Minhang Hospital, Fudan University, Shanghai 201199, China
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Stevanović-Silva J, Beleza J, Coxito P, Oliveira PJ, Ascensão A, Magalhães J. Gestational Exercise Antagonises the Impact of Maternal High-Fat High-Sucrose Diet on Liver Mitochondrial Alterations and Quality Control Signalling in Male Offspring. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1388. [PMID: 36674144 PMCID: PMC9858977 DOI: 10.3390/ijerph20021388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 01/03/2023] [Accepted: 01/09/2023] [Indexed: 06/17/2023]
Abstract
Maternal high-caloric nutrition and related gestational diabetes mellitus (GDM) are relevant modulators of the intrauterine environment, increasing the risk of liver metabolic alterations in mothers and offspring. In contrast, as a non-pharmacological approach against metabolic disorders, exercise is highly recommended in GDM treatment. We analysed whether gestational exercise (GE) protects mothers from diet-induced GDM metabolic consequences and mitigates liver mitochondrial deleterious alterations in their 6-week-old male offspring. Female Sprague Dawley rats were fed with control or high-fat high-sucrose (HFHS) diet and kept sedentary or submitted to GE. Male offspring were sedentary and fed with control diet. Sedentary HFHS mothers and their offspring showed impaired hepatic mitochondrial biogenesis and morphological evidence of mitochondrial remodelling. In contrast, GE-related beneficial effects were demonstrated by upregulation of mitochondrial biogenesis signalling markers and mitochondrial fusion proteins and downregulation of mitochondrial fission protein. Alterations in miR-34a, miR-130b, and miR-494, associated with epigenetic regulation of mitochondrial biogenesis, suggested that GE is a more critical modulator of intergenerational changes in miRs expression than the maternal diet. Our data showed that GE positively modulated the altered hepatic mitochondrial biogenesis and dynamics markers and quality control signalling associated with maternal HFHS-diet-related GDM in mothers and offspring.
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Affiliation(s)
- Jelena Stevanović-Silva
- Laboratory of Metabolism and Exercise (LaMetEx), Research Centre in Physical Activity, Health and Leisure (CIAFEL), Laboratory for Integrative and Translational Research in Population Health (ITR), Faculty of Sport, University of Porto, 4200-450 Porto, Portugal
| | - Jorge Beleza
- Department of Cell Biology, Physiology & Immunology, Faculty of Biology, University of Barcelona, 08028 Barcelona, Spain
| | - Pedro Coxito
- Laboratory of Metabolism and Exercise (LaMetEx), Research Centre in Physical Activity, Health and Leisure (CIAFEL), Laboratory for Integrative and Translational Research in Population Health (ITR), Faculty of Sport, University of Porto, 4200-450 Porto, Portugal
| | - Paulo J. Oliveira
- CNC—Center for Neuroscience and Cell Biology, CIBB—Centre for Innovative Biomedicine and Biotechnology, University of Coimbra, 3004-504 Coimbra, Portugal
| | - António Ascensão
- Laboratory of Metabolism and Exercise (LaMetEx), Research Centre in Physical Activity, Health and Leisure (CIAFEL), Laboratory for Integrative and Translational Research in Population Health (ITR), Faculty of Sport, University of Porto, 4200-450 Porto, Portugal
| | - José Magalhães
- Laboratory of Metabolism and Exercise (LaMetEx), Research Centre in Physical Activity, Health and Leisure (CIAFEL), Laboratory for Integrative and Translational Research in Population Health (ITR), Faculty of Sport, University of Porto, 4200-450 Porto, Portugal
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Bruxel MA, da Silva FN, da Silva RA, Zimath PL, Rojas A, Moreira ELG, Quesada I, Rafacho A. Preconception exposure to malathion and glucose homeostasis in rats: Effects on dams during pregnancy and post-term periods, and on their progeny. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2023; 316:120633. [PMID: 36370973 DOI: 10.1016/j.envpol.2022.120633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 11/07/2022] [Accepted: 11/08/2022] [Indexed: 06/16/2023]
Abstract
Understanding the individual and global impact of pesticides on human physiology and the different stages of life is still a challenge in environmental health. We analyzed here whether administration of the organophosphate insecticide malathion before pregnancy could affect glucose homeostasis during pregnancy and, in addition, generate possible later consequences in mothers and offspring. For this, adult Wistar rats were allocated into two groups and were treated daily (intragastric) with malathion (14 or 140 mg/kg, body mass (bm)) for 21-25 days. Corn oil was used as vehicle in the Control group. Subgroups were defined based on the absence (nulliparous) or presence (pregnant) of a copulatory plug. Pregnant rats were followed by an additional period of 2 months after the term (post-term), without continuing malathion treatment. Fetuses and adult offspring of males and females were also evaluated. We ran an additional experimental design with rats exposed to malathion before pregnancy at a dose of 0.1 mg/kg bm. Malathion exposure resulted in glucose intolerance in the mothers during pregnancy and post-term period, regardless of the exposure dose. This was accompanied by increased visceral adipose tissue mass, dyslipidemia, unchanged pancreatic β-cell mass, and varying insulin responses to glucose in vivo. The number of total newborns and birthweight was not affected by malathion exposure. Adult offspring from both sexes also became glucose-intolerant, regardless of the pesticide dose their dams were exposed to. This alteration could be associated with changes at the epigenomic level, as reduced hepatic mRNA content of DNA methylases and demethylases was found. We demonstrated that periconceptional exposure to malathion with doses aiming to mimic from work environment to indirect contamination predisposes progenitors and offspring rats to glucose intolerance. Thus, we conclude that subchronic exposure to malathion is a risk factor for gestational diabetes and prediabetes later in life.
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Affiliation(s)
- Maciel Alencar Bruxel
- Laboratory of Investigation in Chronic Diseases - LIDoC, Department of Physiological Sciences, Center of Biological Sciences, Federal University of Santa Catarina - UFSC, Florianópolis, Brazil; Multicenter Graduate Program in Physiological Sciences, Center of Biological Sciences, Federal University of Santa Catarina - UFSC, Florianópolis, Brazil
| | - Flávia Natividade da Silva
- Laboratory of Investigation in Chronic Diseases - LIDoC, Department of Physiological Sciences, Center of Biological Sciences, Federal University of Santa Catarina - UFSC, Florianópolis, Brazil; Graduate Program in Pharmacology, Center of Biological Sciences, Federal University of Santa Catarina - UFSC, Florianópolis, Brazil
| | - Rodrigo Augusto da Silva
- Center of Epigenetic Study and Gene Regulation - CEEpiRG, Program in Environmental and Experimental Pathology, Paulista University - UNIP, São Paulo, Brazil
| | - Priscila Laiz Zimath
- Laboratory of Investigation in Chronic Diseases - LIDoC, Department of Physiological Sciences, Center of Biological Sciences, Federal University of Santa Catarina - UFSC, Florianópolis, Brazil; Graduate Program in Pharmacology, Center of Biological Sciences, Federal University of Santa Catarina - UFSC, Florianópolis, Brazil
| | - Anabel Rojas
- Centro Andaluz de Biología Molecular y Medicina Regenerativa-CABIMER, Universidad Pablo de Olavide, Universidad de Sevilla, Consejo Superior de Investigaciones Científicas (CSIC), Seville, Spain; Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain
| | - Eduardo Luis Gasnhar Moreira
- Laboratory of Investigation in Chronic Diseases - LIDoC, Department of Physiological Sciences, Center of Biological Sciences, Federal University of Santa Catarina - UFSC, Florianópolis, Brazil; Multicenter Graduate Program in Physiological Sciences, Center of Biological Sciences, Federal University of Santa Catarina - UFSC, Florianópolis, Brazil
| | - Ivan Quesada
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain; Instituto de Investigación, Desarrollo e Innovación en Biotecnología Sanitaria de Elche (IDiBE), Universidad Miguel Hernández, Elche, Spain
| | - Alex Rafacho
- Laboratory of Investigation in Chronic Diseases - LIDoC, Department of Physiological Sciences, Center of Biological Sciences, Federal University of Santa Catarina - UFSC, Florianópolis, Brazil; Multicenter Graduate Program in Physiological Sciences, Center of Biological Sciences, Federal University of Santa Catarina - UFSC, Florianópolis, Brazil; Graduate Program in Pharmacology, Center of Biological Sciences, Federal University of Santa Catarina - UFSC, Florianópolis, Brazil.
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Cui Y, Cruz M, Palatnik A, Olivier-Van Stichelen S. O-GlcNAc transferase contributes to sex-specific placental deregulation in gestational diabetes. Placenta 2023; 131:1-12. [PMID: 36442303 PMCID: PMC9839643 DOI: 10.1016/j.placenta.2022.11.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 11/07/2022] [Accepted: 11/15/2022] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Gestational diabetes (GDM) is traditionally thought to emerge from placental endocrine dysregulations, but recent evidence suggests that fetal sex can also impact GDM development. Understanding the molecular mechanisms through which sex modulates placenta physiology can help identify novel molecular targets for future clinical care. Thus, we investigated the nutrient-sensing O-GlcNAc pathway as a potential mediator of sex-specific placenta dysfunction in GDM. METHODS Expression levels of O-GlcNAc enzymes were measured in male and female (n = 9+/gender) human placentas based on the maternal diagnosis of GDM. We then simulated the observed differences in both BeWo cells and human syncytiotrophoblasts primary cells (SCT) from male and female origins (n = 6/gender). RNA sequencing and targeted qPCR were performed to characterize the subsequent changes in the placenta transcriptome related to gestational diabetes. RESULTS O-GlcNAc transferase (OGT) expression was significantly reduced only in male placenta collected from mothers with GDM compared to healthy controls. Similar downregulation of OGT in trophoblast-like BeWo male cells demonstrated significant gene expression deregulations that overlapped with known GDM-related genes. Notably, placental growth hormone (GH) production was significantly elevated, while compensatory factors against GH-related insulin resistance were diminished. Inflammatory and immunologic factors with toxic effects on pancreatic β cell mass were also increased, altogether leaning toward a decompensatory diabetic profile. Similar changes in hormone expression were confirmed in male human primary SCTs transfected with siOGT. However, down-regulating OGT in female primary SCTs did not impact hormone production. CONCLUSION Our study demonstrated the significant deregulation of placental OGT levels in mothers with GDM carrying a male fetus. When simulated in vitro, such deregulation impacted hormonal production in BeWo trophoblast cells and primary SCTs purified from male placentas. Interestingly, female placentas were only modestly impacted by OGT downregulation, suggesting that the sex-specific presentation observed in gestational diabetes could be related to O-GlcNAc-mediated regulation of placental hormone production.
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Affiliation(s)
- Yiwen Cui
- Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee, WI, 53226, USA
| | - Meredith Cruz
- Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee, WI, 53226, USA
| | - Anna Palatnik
- Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee, WI, 53226, USA; Cardiovascular Center, Medical College of Wisconsin, Milwaukee, WI, 53226, USA
| | - Stephanie Olivier-Van Stichelen
- Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee, WI, 53226, USA; Cardiovascular Center, Medical College of Wisconsin, Milwaukee, WI, 53226, USA; Department of Biochemistry, Medical College of Wisconsin, Milwaukee, WI, 53226, USA.
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Duo Y, Song S, Zhang Y, Qiao X, Xu J, Zhang J, Peng Z, Chen Y, Nie X, Sun Q, Yang X, Wang A, Sun W, Fu Y, Dong Y, Lu Z, Yuan T, Zhao W. Predictability of HOMA-IR for Gestational Diabetes Mellitus in Early Pregnancy Based on Different First Trimester BMI Values. J Pers Med 2022; 13:jpm13010060. [PMID: 36675721 PMCID: PMC9866419 DOI: 10.3390/jpm13010060] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 12/24/2022] [Accepted: 12/27/2022] [Indexed: 12/29/2022] Open
Abstract
Objective: To investigate the ability of homeostasis model assessment of insulin resistance (HOMA-IR) in early pregnancy for predicting gestational diabetes mellitus (GDM) in Chinese women with different first-trimester body mass index (FT-BMI) values. Methods: Baseline characteristics and laboratory tests were collected at the first prenatal visit (6−12 weeks of gestation). GDM was diagnosed by a 75 g oral glucose tolerance test (OGTT) at 24−28 weeks of gestation. Partial correlation analysis and binary logistic regression were applied to identify the association between HOMA-IR and GDM. The cutoff points for predicting GDM were estimated using receiver operating characteristic (ROC) curve analysis. Results: Of the total of 1343 women, 300 (22.34%) were diagnosed with GDM in the 24−28 weeks of gestation. Partial correlation analysis and binary logistic regression verified HOMA-IR as a significant risk factor for GDM in the normal weight subgroup (FT-BMI < 24 kg/m2) (adjusted OR 2.941 [95% CI 2.153, 4.016], P < 0.001), overweight subgroup (24.0 kg/m2 ≤ FT-BMI < 28.0 kg/m2) (adjusted OR 3.188 [95% CI 2.011, 5.055], P < 0.001), and obese subgroup (FT-BMI ≥ 28.0 kg/m2) (adjusted OR 9.415 [95% CI 1.712, 51.770], p = 0.01). The cutoff values of HOMA-IR were 1.52 (area under the curve (AUC) 0.733, 95% CI 0.701−0.765, p < 0.001) for all participants, 1.43 (AUC 0.691, 95% CI 0.651−0.730, p < 0.001) for normal weight women, 2.27 (AUC 0.760, 95% CI 0.703−0.818, p < 0.001) for overweight women, and 2.31 (AUC 0.801, 95% CI 0.696−0.907, p < 0.001) for obese women. Conclusions: Increased HOMA-IR in early pregnancy is a risk factor for GDM, and HOMA-IR can be affected by body weight. The cutoff value of HOMA-IR to predict GDM should be distinguished by different FT-BMI values.
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Affiliation(s)
- Yanbei Duo
- Department of Endocrinology, Key Laboratory of Endocrinology of Ministry of Health, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100730, China
| | - Shuoning Song
- Department of Endocrinology, Key Laboratory of Endocrinology of Ministry of Health, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100730, China
| | - Yuemei Zhang
- Department of Obstetrics, Haidian District Maternal and Child Health Care Hospital, Beijing 100080, China
| | - Xiaolin Qiao
- Department of Obstetrics, Beijing Chaoyang District Maternal and Child Health Care Hospital, Beijing 100026, China
| | - Jiyu Xu
- Core Facility of Instrument, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing 100005, China
| | - Jing Zhang
- Department of Laboratory, Haidian District Maternal and Child Health Care Hospital, Beijing 100080, China
| | - Zhenyao Peng
- Department of Dean’s Office, Haidian District Maternal and Child Health Care Hospital, Beijing 100080, China
| | - Yan Chen
- Department of Obstetrics, Beijing Chaoyang District Maternal and Child Health Care Hospital, Beijing 100026, China
| | - Xiaorui Nie
- Department of Obstetrics, Beijing Chaoyang District Maternal and Child Health Care Hospital, Beijing 100026, China
| | - Qiujin Sun
- Department of Clinical Laboratory, Beijing Chaoyang District Maternal and Child Health Care Hospital, Beijing 100026, China
| | - Xianchun Yang
- Department of Clinical Laboratory, Beijing Chaoyang District Maternal and Child Health Care Hospital, Beijing 100026, China
| | - Ailing Wang
- National Center for Women and Children’s Health, China CDC, Beijing 100013, China
| | - Wei Sun
- Core Facility of Instrument, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing 100005, China
| | - Yong Fu
- Department of Endocrinology, Key Laboratory of Endocrinology of Ministry of Health, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100730, China
| | - Yingyue Dong
- Department of Endocrinology, Key Laboratory of Endocrinology of Ministry of Health, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100730, China
| | - Zechun Lu
- National Center for Women and Children’s Health, China CDC, Beijing 100013, China
| | - Tao Yuan
- Department of Endocrinology, Key Laboratory of Endocrinology of Ministry of Health, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100730, China
| | - Weigang Zhao
- Department of Endocrinology, Key Laboratory of Endocrinology of Ministry of Health, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100730, China
- Correspondence:
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Wilkie G, Leung K, Moore Simas TA, Tucker KL, Chasan-Taber L. The Association Between Acculturation and Diet and Physical Activity Among Pregnant Hispanic Women with Abnormal Glucose Tolerance. J Womens Health (Larchmt) 2022; 31:1791-1799. [PMID: 36040352 PMCID: PMC9805839 DOI: 10.1089/jwh.2022.0017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Background: Hispanic women are disproportionately affected by gestational diabetes mellitus (GDM), yet few studies have assessed the impact of acculturation on health behaviors that may reduce GDM risk. Materials and Methods: We assessed relationships between acculturation and meeting American Diabetes Association guidelines for macronutrient intake and American College of Obstetricians and Gynecologists guidelines for physical activity (PA) using baseline data from Estudio Project Aiming to Reduce Type twO diabetes, a randomized trial conducted in Massachusetts (2013-2017) among 255 Hispanic pregnant women with hyperglycemia. Acculturation was assessed via the Psychological Acculturation Scale, duration of time and generation in the continental United States, and language preference; diet with 24-hours dietary recalls; and PA with the Pregnancy Physical Activity Questionnaire (PPAQ). Results: The majority of participants who reported low psychological acculturation (74.9%), preferred English (78.4%), were continental U.S. born (58.0%), and lived in the continental United States ≥5 years (91.4%). A total of 44.8%, 81.8%, 22.9%, and 4.6% of women met guidelines for carbohydrate, protein, fat, and fiber intakes, respectively; 31.9% met guidelines for PA. Women with higher acculturation were less likely to meet carbohydrate guidelines (English preference: adjusted risk ratios [aRR] 0.45, 95% confidence intervals [CI] 0.23-0.75; U.S. born: aRR 0.60, 95% CI 0.36-0.91; duration of time in United States: aRR 0.96, 95% CI 0.92-0.99). Women with higher acculturation were more likely to meet PA guidelines (U.S. born: aRR 1.95, 95% CI 1.11-3.44). Conclusions: In summary, higher acculturation was associated with lower likelihood of meeting dietary guidelines but greater likelihood of meeting PA guidelines during pregnancy. Interventions aimed at reducing GDM in Hispanics should be culturally informed and incorporate acculturation. Clinical Trial Registration: clinicaltrials.gov NCT01679210.
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Affiliation(s)
- Gianna Wilkie
- Department of Obstetrics and Gynecology, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Katherine Leung
- Department of Obstetrics and Gynecology, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Tiffany A. Moore Simas
- Department of Obstetrics and Gynecology, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
- Department of Pediatrics, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
- Department of Psychiatry, and University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Katherine L. Tucker
- Department of Biomedical and Nutritional Sciences, University of Massachusetts Lowell, Lowell, Massachusetts, USA
| | - Lisa Chasan-Taber
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts, Amherst, Massachusetts, USA
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Titialii-Torres KF, Morris AC. Embryonic hyperglycemia perturbs the development of specific retinal cell types, including photoreceptors. J Cell Sci 2022; 135:jcs259187. [PMID: 34851372 PMCID: PMC8767273 DOI: 10.1242/jcs.259187] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 11/18/2021] [Indexed: 01/12/2023] Open
Abstract
Diabetes is linked to various long-term complications in adults, such as neuropathy, nephropathy and diabetic retinopathy. Diabetes poses additional risks for pregnant women, because glucose passes across the placenta, and excess maternal glucose can result in diabetic embryopathy. While many studies have examined the teratogenic effects of maternal diabetes on fetal heart development, little is known about the consequences of maternal hyperglycemia on the development of the embryonic retina. To address this question, we investigated retinal development in two models of embryonic hyperglycemia in zebrafish. Strikingly, we found that hyperglycemic larvae displayed a significant reduction in photoreceptors and horizontal cells, whereas other retinal neurons were not affected. We also observed reactive gliosis and abnormal optokinetic responses in hyperglycemic larvae. Further analysis revealed delayed retinal cell differentiation in hyperglycemic embryos that coincided with increased reactive oxygen species (ROS). Our results suggest that embryonic hyperglycemia causes abnormal retinal development via altered timing of cell differentiation and ROS production, which is accompanied by visual defects. Further studies using zebrafish models of hyperglycemia will allow us to understand the molecular mechanisms underlying these effects.
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Affiliation(s)
- Kayla F. Titialii-Torres
- Department of Biology, University of Kentucky, Lexington, KY 40506-0225, USA
- Center for Cancer Research, National Cancer Institute, National Institutes of Health, Frederick, MD 21702, USA
| | - Ann C. Morris
- Department of Biology, University of Kentucky, Lexington, KY 40506-0225, USA
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Kytö M, Markussen LT, Marttinen P, Jacucci G, Niinistö S, Virtanen SM, Korhonen TE, Sievänen H, Vähä-Ypyä H, Korhonen I, Heinonen S, Koivusalo SB. Comprehensive self-tracking of blood glucose and lifestyle with a mobile application in the management of gestational diabetes: a study protocol for a randomised controlled trial (eMOM GDM study). BMJ Open 2022; 12:e066292. [PMID: 36344008 PMCID: PMC9644362 DOI: 10.1136/bmjopen-2022-066292] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
INTRODUCTION Gestational diabetes (GDM) causes various adverse short-term and long-term consequences for the mother and child, and its incidence is increasing globally. So far, the most promising digital health interventions for GDM management have involved healthcare professionals to provide guidance and feedback. The principal aim of this study is to evaluate the effects of comprehensive and real-time self-tracking with eMOM GDM mobile application (app) on glucose levels in women with GDM, and more broadly, on different other maternal and neonatal outcomes. METHODS AND ANALYSIS This randomised controlled trial is carried out in Helsinki metropolitan area. We randomise 200 pregnant women with GDM into the intervention and the control group at gestational week (GW) 24-28 (baseline, BL). The intervention group receives standard antenatal care and the eMOM GDM app, while the control group will receive only standard care. Participants in the intervention group use the eMOM GDM app with continuous glucose metre (CGM) and activity bracelet for 1 week every month until delivery and an electronic 3-day food record every month until delivery. The follow-up visit after intervention takes place 3 months post partum for both groups. Data are collected by laboratory blood tests, clinical measurements, capillary glucose measures, wearable sensors, air displacement plethysmography and digital questionnaires. The primary outcome is fasting plasma glucose change from BL to GW 35-37. Secondary outcomes include, for example, self-tracked capillary fasting and postprandial glucose measures, change in gestational weight gain, change in nutrition quality, change in physical activity, medication use due to GDM, birth weight and fat percentage of the child. ETHICS AND DISSEMINATION The study has been approved by Ethics Committee of the Helsinki and Uusimaa Hospital District. The results will be presented in peer-reviewed journals and at conferences. TRIAL REGISTRATION NUMBER NCT04714762.
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Affiliation(s)
- Mikko Kytö
- Department of IT Management, Helsinki University Hospital, Helsinki, Finland
- Department of Computer Science, University of Helsinki, Helsinki, Finland
| | - Lisa Torsdatter Markussen
- Department of IT Management, Helsinki University Hospital, Helsinki, Finland
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Pekka Marttinen
- Department of Computer Science, Aalto University, Aalto, Finland
| | - Giulio Jacucci
- Department of Computer Science, University of Helsinki, Helsinki, Finland
| | - Sari Niinistö
- Department of Public Health, Welfare Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Suvi M Virtanen
- Department of Public Health and Welfare, The National Institute for Health and Welfare, Helsinki, Finland
- Faculty of Social Sciences, Unit of Health Sciences, University of Tampere, Tampere, Finland
| | - Tuuli E Korhonen
- Department of Public Health, Welfare Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Harri Sievänen
- UKK Institute for Health Promotion Research, Tampere, Finland
| | - Henri Vähä-Ypyä
- UKK Institute for Health Promotion Research, Tampere, Finland
| | - Ilkka Korhonen
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Seppo Heinonen
- Department of Obstetrics and Gynaecology, Helsinki University Central Hospital, Helsinki, Finland
| | - Saila B Koivusalo
- Department of Obstetrics and Gynaecology, Helsinki University Central Hospital, Helsinki, Finland
- Department of Obstetrics and Gynecology, Turku University Hospital, Turku, Finland
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Lin HY, Lin FJ, Katz AJ, Wang IT, Wu CH. Antipsychotic Use in Early Pregnancy and the Risk of Maternal and Neonatal Complications. Mayo Clin Proc 2022; 97:2086-2096. [PMID: 36210203 DOI: 10.1016/j.mayocp.2022.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 03/24/2022] [Accepted: 04/11/2022] [Indexed: 03/21/2023]
Abstract
OBJECTIVE To assess the association between antipsychotic use in early pregnancy and the risk of maternal and neonatal metabolic complications. METHODS We conducted a population-based retrospective cohort study (January 1, 2010, to December 31, 2016) using the Health and Welfare Database in Taiwan. Pregnant women (18 to 49 years of age) were grouped as antipsychotic users (ie, received oral antipsychotic monotherapy during the first 20 weeks of pregnancy) and nonusers. Antipsychotic users were further categorized into first-generation antipsychotic and second-generation antipsychotic users. Propensity score methods, including matching and inverse probability of treatment weighting, were used to balance covariates. Conditional logistic regression and Cox proportional hazards models were used to compare risks of maternal (gestational diabetes mellitus, preterm birth) and neonatal (low birth weight [LBW], macrosomia) outcomes. RESULTS Antipsychotic users had a notably higher risk of preterm birth compared with nonusers (adjusted HR, 1.29; 95% CI, 1.04 to 1.60), but the risk of gestational diabetes mellitus (HR, 1.21; 95% CI, 0.94 to 1.56), LBW (odds ratio [OR], 1.07; 95% CI, 0.84 to 1.37), and macrosomia (OR, 1.36; 95% CI, 0.63 to 2.92) did not differ between the two groups. Among women who received antipsychotics, the odds of LBW were significantly higher in second-generation antipsychotic users compared with first-generation antipsychotic users (adjusted OR, 1.32; 95% CI, 1.04 to 1.68). CONCLUSION This study found that using antipsychotics in early pregnancy did not result in a greater risk of metabolic complications both for mothers and newborns. For women requiring treatment with antipsychotics during pregnancy, they should be monitored for the risk of preterm birth and low infant birth weight.
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Affiliation(s)
- Hsuan-Yu Lin
- School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei City, Taiwan
| | - Fang-Ju Lin
- Department of Obstetrics and Gynecology, Taipei Medical University, Taipei City, Taiwan; Graduate Institute of Clinical Pharmacy and School of Pharmacy, College of Medicine, National Taiwan University; Department of Pharmacy, National Taiwan University Hospital
| | - Aaron J Katz
- Departments of Population Health and Radiation Oncology, University of Kansas School of Medicine, Kansas City, KS, USA; Department of Radiation Oncology, University of Kansas School of Medicine, Kansas City, KS, USA
| | - I-Te Wang
- Department of Obstetrics and Gynecology, Taipei Medical University, Taipei City, Taiwan; Department of Obstetrics and Gynecology, Taipei Medical University Hospital
| | - Chung-Hsuen Wu
- School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei City, Taiwan.
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Chemerin-Induced Down-Regulation of Placenta-Derived Exosomal miR-140-3p and miR-574-3p Promotes Umbilical Vein Endothelial Cells Proliferation, Migration, and Tube Formation in Gestational Diabetes Mellitus. Cells 2022; 11:cells11213457. [PMID: 36359855 PMCID: PMC9655594 DOI: 10.3390/cells11213457] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 10/28/2022] [Accepted: 10/31/2022] [Indexed: 11/06/2022] Open
Abstract
Gestational diabetes mellitus (GDM) leads to poor pregnancy outcomes and fetoplacental endothelial dysfunction; however, the underlying mechanisms remain unknown. This study aimed to investigate the effect of placenta-derived exosomal miRNAs on fetoplacental endothelial dysfunction in GDM, as well as to further explore the role of chemerin to this end. Placenta-derived exosomal miR-140-3p and miR-574-3p expression (next-generation sequencing, quantitative real-time PCR), its interactions with cell function (Cell Counting Kit-8, Transwell, tube formation assay), chemerin interactions (Western blotting), and placental inflammation (immunofluorescence staining, enzyme-linked immunosorbent assay) were investigated. Placenta-derived exosomal miR-140-3p and miR-574-3p were downregulated in GDM. Additionally, miR-140-3p and miR-574-3p inhibited the proliferation, migration, and tube formation ability of umbilical vein endothelial cells by targeting vascular endothelial growth factor. Interestingly, miR-140-3p and miR-574-3p expression levels were negatively correlated with chemerin, which induced placental inflammation through the recruitment of macrophage cells and release of IL-18 and IL-1β. These findings indicate that chemerin reduces placenta-derived exosomal miR-140-3p and miR-574-3p levels by inducing placental inflammation, thereby promoting the proliferation, migration, and tube formation of umbilical vein endothelial cells in GDM, providing a novel perspective on the underlying pathogenesis and therapeutic targets for GDM and its offspring complications.
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Role of the Gut Microbiota in the Increased Infant Body Mass Index Induced by Gestational Diabetes Mellitus. mSystems 2022; 7:e0046522. [PMID: 36154141 PMCID: PMC9601173 DOI: 10.1128/msystems.00465-22] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
The connection between gestational diabetes mellitus (GDM) and the offspring's development, such as obesity, is well established. Emerging evidence indicates that the microbiota of the neonate's meconium is associated with maternal GDM status. To explore whether the association between GDM and infant body mass index (BMI) in early childhood is affected by the meconium microbiota, we recruited 120 mothers (60 healthy women and 60 with GDM) and their newborns from the Women's Hospital of Nanjing Medical University. Meconium of 120 neonates was collected within a few hours after birth and sequenced using 16S rRNA sequencing analysis. Children's BMI was measured at 12 months of age. The results revealed that infants born to mothers with GDM had increased BMI Z-scores at 12 months old and that the β-diversity of their meconium microbiota was reduced. Several genera were observed to be significantly different between the GDM and control groups. The genus Burkholderia-Caballeronia-Paraburkholderia and an untitled genus in the family Enterobacteriaceae enriched in neonates born to healthy mothers were found to be negatively associated with infant BMI by using regression analysis. A coabundance group depleted in the GDM group was correlated negatively with 12-month BMI and mediated 21.65% of the association between GDM and infant BMI by mediation analyses. This study provided evidence for the associations among maternal GDM, the meconium microbiota, and infant BMI. Maternal GDM was demonstrated to affect infant BMI, mediated by the gut microbiome. Gut microbiome interventions might represent a novel technique to decrease the risk of GDM-induced childhood obesity. IMPORTANCE Using 16S rRNA sequencing analysis, regression analysis and mediation analysis were used to explore whether maternal gestational diabetes mellitus (GDM) changed the function and composition of the meconium microbiota and whether this explained the GDM-induced alterations of infant body mass index (BMI). This study showed that gut microbiome dysbiosis induced by maternal GDM might play an important role in the increased infant BMI during the first 12 months of life. Therefore, gut microbiome interventions might represent a novel technique to decrease the risk of GDM-induced childhood obesity.
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Mo J, Liu X, Huang Y, He R, Zhang Y, Huang H. Developmental origins of adult diseases. MEDICAL REVIEW (BERLIN, GERMANY) 2022; 2:450-470. [PMID: 37724166 PMCID: PMC10388800 DOI: 10.1515/mr-2022-0027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 10/11/2022] [Indexed: 09/20/2023]
Abstract
The occurrence and mechanisms of developmental adult diseases have gradually attracted attention in recent years. Exposure of gametes and embryos to adverse environments, especially during plastic development, can alter the expression of certain tissue-specific genes, leading to increased susceptibility to certain diseases in adulthood, such as diabetes, cardiovascular disease, neuropsychiatric, and reproductive system diseases, etc. The occurrence of chronic disease in adulthood is partly due to genetic factors, and the remaining risk is partly due to environmental-dependent epigenetic information alteration, including DNA methylation, histone modifications, and noncoding RNAs. Changes in this epigenetic information potentially damage our health, which has also been supported by numerous epidemiological and animal studies in recent years. Environmental factors functionally affect embryo development through epimutation, transmitting diseases to offspring and even later generations. This review mainly elaborated on the concept of developmental origins of adult diseases, and revealed the epigenetic mechanisms underlying these events, discussed the theoretical basis for the prevention and treatment of related diseases.
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Affiliation(s)
- Jiaying Mo
- Department of Obstetrics and Gynecology, The Fourth Affiliated Hospital, International Institutes of Medicine, Zhejiang University School of Medicine, Yiwu, Zhejiang Province, China
- The Key Laboratory of Reproductive Genetics (Zhejiang University), Ministry of Education, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
| | - Xuanqi Liu
- The Key Laboratory of Reproductive Genetics (Zhejiang University), Ministry of Education, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
| | - Yutong Huang
- The Key Laboratory of Reproductive Genetics (Zhejiang University), Ministry of Education, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
| | - Renke He
- Department of Obstetrics and Gynecology, The Fourth Affiliated Hospital, International Institutes of Medicine, Zhejiang University School of Medicine, Yiwu, Zhejiang Province, China
- The Key Laboratory of Reproductive Genetics (Zhejiang University), Ministry of Education, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
| | - Yu Zhang
- Obstetrics and Gynecology Hospital, Institute of Reproduction and Development, Fudan University, Shanghai, China
| | - Hefeng Huang
- Department of Obstetrics and Gynecology, The Fourth Affiliated Hospital, International Institutes of Medicine, Zhejiang University School of Medicine, Yiwu, Zhejiang Province, China
- The Key Laboratory of Reproductive Genetics (Zhejiang University), Ministry of Education, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
- Obstetrics and Gynecology Hospital, Institute of Reproduction and Development, Fudan University, Shanghai, China
- Research Units of Embryo Original Diseases, Chinese Academy of Medical Sciences (No. 2019RU056), Shanghai, China
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Berlanga-Acosta J, Fernandez-Mayola M, Mendoza-Mari Y, Garcia-Ojalvo A, Martinez-Jimenez I, Rodriguez-Rodriguez N, Garcia del Barco Herrera D, Guillén-Nieto G. Cell-Free Filtrates (CFF) as Vectors of a Transmissible Pathologic Tissue Memory Code: A Hypothetical and Narrative Review. Int J Mol Sci 2022; 23:11575. [PMID: 36232877 PMCID: PMC9570059 DOI: 10.3390/ijms231911575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 09/20/2022] [Accepted: 09/22/2022] [Indexed: 11/17/2022] Open
Abstract
Cellular memory is a controversial concept representing the ability of cells to "write and memorize" stressful experiences via epigenetic operators. The progressive course of chronic, non-communicable diseases such as type 2 diabetes mellitus, cancer, and arteriosclerosis, is likely driven through an abnormal epigenetic reprogramming, fostering the hypothesis of a cellular pathologic memory. Accordingly, cultured diabetic and cancer patient-derived cells recall behavioral traits as when in the donor's organism irrespective to culture time and conditions. Here, we analyze the data of studies conducted by our group and led by a cascade of hypothesis, in which we aimed to validate the hypothetical existence and transmissibility of a cellular pathologic memory in diabetes, arteriosclerotic peripheral arterial disease, and cancer. These experiments were based on the administration to otherwise healthy animals of cell-free filtrates prepared from human pathologic tissue samples representative of each disease condition. The administration of each pathologic tissue homogenate consistently induced the faithful recapitulation of: (1) Diabetic archetypical changes in cutaneous arterioles and nerves. (2) Non-thrombotic arteriosclerotic thickening, collagenous arterial encroachment, aberrant angiogenesis, and vascular remodeling. (3) Pre-malignant and malignant epithelial and mesenchymal tumors in different organs; all evocative of the donor's tissue histopathology and with no barriers for interspecies transmission. We hypothesize that homogenates contain pathologic tissue memory codes represented in soluble drivers that "infiltrate" host's animal cells, and ultimately impose their phenotypic signatures. The identification and validation of the actors in behind may pave the way for future therapies.
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Affiliation(s)
- Jorge Berlanga-Acosta
- Tissue Repair, Wound Healing and Cytoprotection Research Group, Biomedical Research Direction, Center for Genetic Engineering and Biotechnology, Ave. 31 S/N. e/ 158 and 190, Cubanacán, Playa, Havana 10600, Cuba
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Stevanović-Silva J, Beleza J, Coxito P, Rocha H, Gaspar TB, Gärtner F, Correia R, Fernandes R, Oliveira PJ, Ascensão A, Magalhães J. Exercise performed during pregnancy positively modulates liver metabolism and promotes mitochondrial biogenesis of female offspring in a rat model of diet-induced gestational diabetes. Biochim Biophys Acta Mol Basis Dis 2022; 1868:166526. [PMID: 35995315 DOI: 10.1016/j.bbadis.2022.166526] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 07/26/2022] [Accepted: 08/15/2022] [Indexed: 01/01/2023]
Abstract
Gestational diabetes mellitus (GDM) is associated with a high-risk for metabolic complications in offspring. However, exercise is recognized as a non-pharmacological strategy against metabolic disorders and is recommended in GDM treatment. This study aimed to investigate whether gestational exercise (GE) could modulate maternal high-fat high-sucrose (HFHS) diet-related hepatic metabolic and mitochondrial outcomes in female offspring of mothers with HFHS-induced GDM. Female Sprague-Dawley rats were fed with control or HFHS diet and kept sedentary or submitted to GE. Their female offspring were fed with control diet and kept sedentary. Hepatic lipid accumulation, lipid metabolism regulators, mitochondrial biogenesis and dynamics markers, and microRNAs associated to the regulation of these markers were evaluated. Female offspring of GDM mothers showed increased body weight at early age, whereas GE prevented this effect of maternal HFHS-feeding and reduced hepatic lipid accumulation. GE stimulated hepatic mRNA transcription and protein expression of mitochondrial biogenesis markers (peroxisome proliferator-activated receptor-gamma co-activator-1alpha and mitochondrial transcription factor A) and mRNA transcription of mitochondrial dynamics markers (mitofusin-1, mitofusin-2, and dynamin-related protein-1) that were altered by maternal GDM, while mitochondrial dynamics markers protein expression was not affected by maternal diet/GE except for optic atrophy-1. MicroRNAs associated with these processes (miR-122, miR-34a, miR-130b, miR-494), and the expression of auto/mitophagy- and apoptosis-related proteins were not substantially influenced by altered intrauterine environment. Our findings suggest that GE is an important regulator of the intrauterine environment positively affecting liver metabolism and promoting liver mitochondrial biogenesis in female offspring despite eventual effects of maternal HFHS-feeding and related GDM.
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Affiliation(s)
- Jelena Stevanović-Silva
- Laboratory of Metabolism and Exercise (LaMetEx), Research Centre in Physical Activity, Health and Leisure (CIAFEL), Laboratory for Integrative and Translational Research in Population Health (ITR), Faculty of Sport, University of Porto, 4200-450 Porto, Portugal.
| | - Jorge Beleza
- Department of Cell Biology, Physiology & Immunology, Faculty of Biology, University of Barcelona, Barcelona, Spain
| | - Pedro Coxito
- Laboratory of Metabolism and Exercise (LaMetEx), Research Centre in Physical Activity, Health and Leisure (CIAFEL), Laboratory for Integrative and Translational Research in Population Health (ITR), Faculty of Sport, University of Porto, 4200-450 Porto, Portugal
| | - Hugo Rocha
- Newborn Screening, Metabolism and Genetics Unit, Human Genetics Department, National Institute of Health Doutor Ricardo Jorge, 4000-053 Porto, Portugal
| | - Tiago Bordeira Gaspar
- Instituto de Investigação e Inovação em Saúde (i3S), University of Porto, 4200-135 Porto, Portugal; Cancer Signalling and Metabolism Group, Institute of Molecular Pathology and Immunology of the University of Porto (Ipatimup), 4200-135 Porto, Portugal; Medical Faculty of University of Porto (FMUP), 4200-139 Porto, Portugal; Abel Salazar Biomedical Sciences Institute (ICBAS), University of Porto, 4050-313 Porto, Portugal
| | - Fátima Gärtner
- Instituto de Investigação e Inovação em Saúde (i3S), University of Porto, 4200-135 Porto, Portugal; Department of Molecular Pathology and Immunology, Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, 4050-313 Porto, Portugal; Glycobiology in Cancer Group, Institute of Molecular Pathology and Immunology of University of Porto (Ipatimup), University of Porto, 4200-135, Porto, Portugal
| | - Rossana Correia
- HEMS - Histology and Electron Microscopy Institute for Research and Innovation in Health Sciences (i3S), University of Porto, 4200-135 Porto, Portugal; Ipatimup - Institute of Molecular Pathology and Immunology of the University of Porto, 4200-135 Porto, Portugal
| | - Rui Fernandes
- HEMS - Histology and Electron Microscopy Institute for Research and Innovation in Health Sciences (i3S), University of Porto, 4200-135 Porto, Portugal; IBMC - Institute for molecular and Cell biology of Porto, 4200-135 Porto, Portugal
| | - Paulo J Oliveira
- CNC-Center for Neuroscience and Cell Biology, CIBB - Centre for Innovative Biomedicine and Biotechnology, University of Coimbra, 3004-504 Coimbra, Portugal
| | - António Ascensão
- Laboratory of Metabolism and Exercise (LaMetEx), Research Centre in Physical Activity, Health and Leisure (CIAFEL), Laboratory for Integrative and Translational Research in Population Health (ITR), Faculty of Sport, University of Porto, 4200-450 Porto, Portugal
| | - José Magalhães
- Laboratory of Metabolism and Exercise (LaMetEx), Research Centre in Physical Activity, Health and Leisure (CIAFEL), Laboratory for Integrative and Translational Research in Population Health (ITR), Faculty of Sport, University of Porto, 4200-450 Porto, Portugal
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Chen X, Du Y, Xia S, Li Z, Liu J. Vitamin B 12 and gestational diabetes mellitus: a systematic review and meta-analysis. Br J Nutr 2022; 129:1-8. [PMID: 35915058 DOI: 10.1017/s000711452200246x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The relationship between vitamin B12 and gestational diabetes mellitus (GDM) remains controversial. To comprehensively evaluate the relationship between vitamin B12 and GDM, and to provide more information on GDM prevention, this study provides a systematic review and meta-analysis of vitamin B12 and GDM. As of September 22, 2021, 304 articles were searched in PubMed, Web of Science, EMBASE, and Cochrane databases, of which 15 studies met the inclusion criteria. Results presented there was no association between maternal vitamin B12 concentration during the first trimester with GDM, however, low vitamin B12 concentration in the second or third trimester of pregnancy was related to an increased risk of GDM. Compared with the non-GDM group, the vitamin B12 concentration in the GDM group was remarkably decreased (MD: -10·79; 95%CI: -21·37, -0·21), and vitamin B12 deficiency increased the risk for GDM (OR: 1·59; 95%CI: 1·10, 2·29). These effects were more significant among Asians. In addition, an increased ratio of high folate to low vitamin B12 in serum also increased the risk of GDM (OR: 1·87; 95% CI: 1·46, 2·41). These results suggest that more vitamin B12 may need to be provided during pregnancy.
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Affiliation(s)
- Xue Chen
- School of Public Health, Bengbu Medical College, Bengbu, Anhui Province, 233030, People's Republic of China
- Institute of Reproductive and Child Health, Key Laboratory of Reproductive Health, National Health Commission of People's Republic of China, Beijing, People's Republic of China
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, People's Republic of China
| | - Yushan Du
- Institute of Reproductive and Child Health, Key Laboratory of Reproductive Health, National Health Commission of People's Republic of China, Beijing, People's Republic of China
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, People's Republic of China
| | - Shuangbo Xia
- Institute of Reproductive and Child Health, Key Laboratory of Reproductive Health, National Health Commission of People's Republic of China, Beijing, People's Republic of China
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, People's Republic of China
| | - Zhiwen Li
- Institute of Reproductive and Child Health, Key Laboratory of Reproductive Health, National Health Commission of People's Republic of China, Beijing, People's Republic of China
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, People's Republic of China
| | - Jufen Liu
- Institute of Reproductive and Child Health, Key Laboratory of Reproductive Health, National Health Commission of People's Republic of China, Beijing, People's Republic of China
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, People's Republic of China
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Seneviratne SN, Rajindrajith S. Fetal programming of obesity and type 2 diabetes. World J Diabetes 2022; 13:482-497. [PMID: 36051425 PMCID: PMC9329845 DOI: 10.4239/wjd.v13.i7.482] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 08/18/2021] [Accepted: 06/03/2022] [Indexed: 02/06/2023] Open
Abstract
The prevalence of obesity and type 2 diabetes mellitus has increased rapidly over the past few decades, and prevention efforts have not been successful. Fetal programming involves the earliest stage of obesity development, and provides a novel concept to complement other strategies for lifelong prevention of obesity and type 2 diabetes mellitus. The World Health Organization now advocates a life-course approach to prevent/control obesity, starting with pre-conceptional and antenatal maternal health. Maternal overnutrition, gestational diabetes mellitus and excessive gestational weight gain lead to fetal overgrowth, and “programs” the offspring with an increased risk of obesity and type 2 diabetes mellitus in childhood and adulthood. This review summarizes current data on fetal programming of obesity and type 2 diabetes mellitus including potential causative factors, mechanisms and interventions to reduce its impact.
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Affiliation(s)
| | - Shaman Rajindrajith
- Department of Paediatrics, Faculty of Medicine, University of Colombo, Colombo 08, Sri Lanka
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Iskender C, Yakut Yücel K, Dereli ML, Sağlam E, Çelen Ş, Çağlar T, Engin-Üstün Y. Increased fetal epicardial fat thickness: A reflecting finding for GDM and perinatal outcomes. Echocardiography 2022; 39:1082-1088. [PMID: 35808919 DOI: 10.1111/echo.15416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 05/25/2022] [Accepted: 06/07/2022] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE To study the value of fetal epicardial fat thickness (EFT) in gestational diabetes mellitus in the third trimester of pregnancy and its relationship with clinical parameters and perinatal outcomes. METHODS A total of 80 participants, including 40 with diagnosed GDM and 40 healthy pregnant women, were included in the study. Demographic data were obtained from medical records. Sonographic examinations were performed, such as amniotic fluid value, fetal biometric measurements, and Doppler parameters of the umbilical artery. Fetal EFT values were measured at the free wall of the right ventricle using a reference line with echocardiographic methods. Correlation tests were performed to evaluate the relationship between fetal EFT and clinical and perinatal parameters. p < .05 were interpreted as statistically significant. RESULTS The fetal EFT value was statistically higher in the GDM group than in the control group (p: .000). Spearman and Pearson correlation tests revealed statistically significant but weak positive correlations between fetal EFT value, 1-h 100-g OGTT, birth weight, and BMI (r: .198, p: .047; r: .395, p: .012; r: .360, p: .042, respectively). The optimal fetal EFT threshold for predicting GDM disease was found as 1.55 mm, with a specificity of 74.4% and sensitivity of 75.0%. Statistically significant differences between the two groups in umbilical artery Doppler resistance index (RI), pulsatility index (PI), and systolic/diastolic ratio (S/D) were not found (p: .337; p: .503; p: .155;). BMI and amniotic fluid volume were higher in the GDM group compared to the control group (p: .009; p < .01). CONCLUSION This study demonstrated that increased fetal EFT may occur as a reflection of changes in glucose metabolism in intrauterine life. Future studies with larger series, including the study of neonatal metabolic parameters, will contribute to the understanding of the importance of fetal EFT in determining the metabolic status of the fetus.
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Affiliation(s)
- Cantekin Iskender
- Department of Perinatology, Etlik Zübeyde Hanım Maternity and Women's Health, Teaching and Research Hospital, Ankara, Turkey
| | - Kadriye Yakut Yücel
- Department of Perinatology, Etlik Zübeyde Hanım Maternity and Women's Health, Teaching and Research Hospital, Ankara, Turkey
| | - Murat Levent Dereli
- Department of Perinatology, Etlik Zübeyde Hanım Maternity and Women's Health, Teaching and Research Hospital, Ankara, Turkey
| | - Erkan Sağlam
- Department of Perinatology, Etlik Zübeyde Hanım Maternity and Women's Health, Teaching and Research Hospital, Ankara, Turkey
| | - Şevki Çelen
- Department of Perinatology, Etlik Zübeyde Hanım Maternity and Women's Health, Teaching and Research Hospital, Ankara, Turkey
| | - Turhan Çağlar
- Department of Perinatology, Etlik Zübeyde Hanım Maternity and Women's Health, Teaching and Research Hospital, Ankara, Turkey
| | - Yaprak Engin-Üstün
- Department of Perinatology, Etlik Zübeyde Hanım Maternity and Women's Health, Teaching and Research Hospital, Ankara, Turkey
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Coetzee A, Hall DR, Conradie M. Hyperglycemia First Detected in Pregnancy in South Africa: Facts, Gaps, and Opportunities. FRONTIERS IN CLINICAL DIABETES AND HEALTHCARE 2022; 3:895743. [PMID: 36992779 PMCID: PMC10012101 DOI: 10.3389/fcdhc.2022.895743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 04/01/2022] [Indexed: 06/19/2023]
Abstract
This review contextualizes hyperglycemia in pregnancy from a South-African perspective. It aims to create awareness of the importance of hyperglycemia in pregnancy in low-middle-income countries. We address unanswered questions to guide future research on sub-Saharan African women with hyperglycemia first detected in pregnancy (HFDP). South African women of childbearing age have the highest prevalence of obesity in sub-Saharan Africa. They are predisposed to Type 2 diabetes (T2DM), the leading cause of death in South African women. T2DM remains undiagnosed in many African countries, with two-thirds of people living with diabetes unaware. With the South African health policy's increased focus on improving antenatal care, women often gain access to screening for non-communicable diseases for the first time in pregnancy. While screening practices and diagnostic criteria for gestational diabetes mellitus (GDM) differ amongst geographical areas in South Africa (SA), hyperglycemia of varying degrees is often first detected in pregnancy. This is often erroneously ascribed to GDM, irrespective of the degree of hyperglycemia and not overt diabetes. T2DM and GDM convey a graded increased risk for the mother and fetus during and after pregnancy, with cardiometabolic risk accumulating across the lifespan. Resource limitations and high patient burden have hampered the opportunity to implement accessible preventative care in young women at increased risk of developing T2DM in the broader public health system in SA. All women with HFDP, including those with true GDM, should be followed and undergo glucose assessment postpartum. In SA, studies conducted early postpartum have noted persistent hyperglycemia in a third of women after GDM. Interpregnancy care is advantageous and may attain a favourable metabolic legacy in these young women, but the yield of return following delivery is suboptimal. We review the current best evidence regarding HFDP and contextualize the applicability in SA and other African or low-middle-income countries. The review identifies gaps and shares pragmatic solutions regarding clinical factors that may improve awareness, identification, diagnosis, and management of women with HFDP.
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Affiliation(s)
- Ankia Coetzee
- Department of Medicine, Division of Endocrinology Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa
| | - David R. Hall
- Department of Obstetrics and Gynecology, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa
| | - Magda Conradie
- Department of Medicine, Division of Endocrinology Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa
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Han Y, Zhang M, Duan J, Li L, Du J, Cheng H, Zhang S, Zhai Y, An X, Li Q, Zhang X, Li Z, Tang B. Maternal Prepregnancy 5-Hydroxytryptamine Exposure Affects the Early Development of the Fetus. Front Physiol 2022; 13:761357. [PMID: 35370795 PMCID: PMC8969228 DOI: 10.3389/fphys.2022.761357] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 01/31/2022] [Indexed: 11/29/2022] Open
Abstract
In recent decades, the increasing incidence of depression has contributed to an increase in the use of serotonergic drugs, such as antidepressants, which predisposes humans to serotonin syndrome. Serotonin syndrome is caused by elevated serotonin levels in the central and peripheral nervous systems. It has been well documented that the development of offspring can be affected by maternal exposure to environmental challenges, such as stress, diseases, or an unhealthy diet during pregnancy. Serotonin, also called 5-hydroxytryptamine (5-HT), is widely expressed in the female reproductive system and plays an important role in the development of follicles and embryos. However, whether the suffering of the mother from serotonin syndrome before pregnancy affects fetal development is still uncertain. In the present study, to explore the effect of maternal prepregnancy 5-HT exposure on the fetus, intraperitoneal injection of 5-HT was used to change maternal prepregnancy 5-HT levels. It was found that maternal prepregnancy 5-HT exposure significantly reduced the body weight and liver weight and the levels of estrogen and progesterone in female mice. Although there was no significant difference in the cleavage rate and blastocyst rate between the 5-HT and control groups, maternal prepregnancy 5-HT exposure increased the percentage of embryo resorption, decreased placental weight, and led to placental inflammation at E13.5. Notably, 5-HT exposure caused weight loss in the offspring at 2 weeks. These results suggested that maternal prepregnancy 5-HT exposure could affect the development of the offspring, which was partly caused by reduced hormonal secretion and placental inflammation.
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Affiliation(s)
- Yu Han
- College of Veterinary Medicine, Jilin University, Changchun, China
| | - Meng Zhang
- Academy of Translational Medicine, First Hospital, Jilin University, Changchun, China
| | - Jiahui Duan
- College of Veterinary Medicine, Jilin University, Changchun, China
| | - Leyi Li
- College of Veterinary Medicine, Jilin University, Changchun, China
| | - Jinge Du
- College of Veterinary Medicine, Jilin University, Changchun, China
| | - Hui Cheng
- College of Veterinary Medicine, Jilin University, Changchun, China
| | - Sheng Zhang
- Academy of Translational Medicine, First Hospital, Jilin University, Changchun, China
| | - Yanhui Zhai
- Academy of Translational Medicine, First Hospital, Jilin University, Changchun, China
| | - Xinglan An
- Academy of Translational Medicine, First Hospital, Jilin University, Changchun, China
| | - Qi Li
- Academy of Translational Medicine, First Hospital, Jilin University, Changchun, China
| | - Xueming Zhang
- College of Veterinary Medicine, Jilin University, Changchun, China
| | - Ziyi Li
- Academy of Translational Medicine, First Hospital, Jilin University, Changchun, China
| | - Bo Tang
- College of Veterinary Medicine, Jilin University, Changchun, China
- *Correspondence: Bo Tang,
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Placental Insulin Receptor Transiently Regulates Glucose Homeostasis in the Adult Mouse Offspring of Multiparous Dams. Biomedicines 2022; 10:biomedicines10030575. [PMID: 35327377 PMCID: PMC8945682 DOI: 10.3390/biomedicines10030575] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 02/25/2022] [Accepted: 02/27/2022] [Indexed: 02/04/2023] Open
Abstract
In pregnancies complicated by maternal obesity and gestational diabetes mellitus, there is strong evidence to suggest that the insulin signaling pathway in the placenta may be impaired. This may have potential effects on the programming of the metabolic health in the offspring; however, a direct link between the placental insulin signaling pathway and the offspring health remains unknown. Here, we aimed to understand whether specific placental loss of the insulin receptor (InsR) has a lasting effect on the offspring health in mice. Obesity and glucose homeostasis were assessed in the adult mouse offspring on a normal chow diet (NCD) followed by a high-fat diet (HFD) challenge. Compared to their littermate controls, InsR KOplacenta offspring were born with normal body weight and pancreatic β-cell mass. Adult InsR KOplacenta mice exhibited normal glucose homeostasis on an NCD. Interestingly, under a HFD challenge, adult male InsR KOplacenta offspring demonstrated lower body weight and a mildly improved glucose homeostasis associated with parity. Together, our data show that placenta-specific insulin receptor deletion does not adversely affect offspring glucose homeostasis during adulthood. Rather, there may potentially be a mild and transient protective effect in the mouse offspring of multiparous dams under the condition of a diet-induced obesogenic challenge.
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71
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Zheng Y, Hu Q, Wu J. Adiponectin ameliorates placental injury in gestational diabetes mice by correcting fatty acid oxidation/peroxide imbalance-induced ferroptosis via restoration of CPT-1 activity. Endocrine 2022; 75:781-793. [PMID: 34859390 DOI: 10.1007/s12020-021-02933-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Accepted: 10/28/2021] [Indexed: 01/18/2023]
Abstract
PURPOSE In gestational diabetes (GDM), abnormalities occur not only in glucose metabolism, but also in lipid metabolism. Adiponectin (ADPN) plays an important role in the regulation of lipid metabolism. In this paper, the role and mechanism of ADPN in GDM are discussed. METHODS GDM model was formed in pregnant mice induced by high-fat diet and streptozotocin, and blood glucose level was detected after ADPN treatment. The levels of TG, TC, HDL-C, and LDL-C in blood lipid of mice were detected by biochemical apparatus. HE staining was used to detect the placenta damage in mice. The expression of oxidative stress-related indexes in placental tissues was also detected by ELISA. Placental iron deposition was detected by Prussian blue staining. Redox capacity of placental tissue was detected by ELISA. Western blot was used to detect the expression of ferroptosis-related proteins in placental tissues. The expression of ADPN in placenta and peripheral blood was detected by ELISA, and the expression of ADPNR, downstream CPT-1, and GLUT4 of placenta were detected by RT-qPCR and western blot. Subsequently, trophoblast cells were induced by palmitic acid and glucose, and the cell activity was detected by CCK-8. The results in animal experiments were verified in cell experiments by RT-qPCR, western blot, and fluorescence labeling of iron ions. Finally, ADPN and CPT-1 inhibitor PM were given to trophoblast cells to further explore the mechanism. RESULTS ADPN inhibited blood glucose and lipid levels in GDM mice. ADPN inhibited oxidation/peroxide imbalance-induced ferroptosis in placental tissues of GDM mice. ADPN inhibited the expression of CPT-1 and GLUT4 in placental tissues of GDM mice. This result was also confirmed in cell experiments, and this process may be achieved by regulating CPT-1. CONCLUSIONS ADPN ameliorated placental injury in GDM by correcting fatty acid oxidation/peroxide imbalance-induced ferroptosis via restoration of CPT-1 activity.
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Affiliation(s)
- Yifang Zheng
- Department of Obstetrics and Gynecology, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, Shanxi, 030002, China
| | - Qiaosheng Hu
- Department of Nutrition, Lianshui County People's Hospital, Lianshui, Jiangsu, 223400, China
| | - Jieli Wu
- Department of Obstetrics and Gynecology, Wenzhou Central Hospital, Wenzhou, Zhejiang, 325000, China.
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Sharma S, Banerjee S, Krueger PM, Blois SM. Immunobiology of Gestational Diabetes Mellitus in Post-Medawar Era. Front Immunol 2022; 12:758267. [PMID: 35046934 PMCID: PMC8761800 DOI: 10.3389/fimmu.2021.758267] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 12/07/2021] [Indexed: 12/16/2022] Open
Abstract
Although the concepts related to fetal immune tolerance proposed by Sir Peter Medawar in the 1950s have not withstood the test of time, they revolutionized our current understanding of the immunity at the maternal-fetal interface. An important extension of the original Medawar paradigm is the investigation into the underlying mechanisms for adverse pregnancy outcomes, including recurrent spontaneous abortion, preterm birth, preeclampsia and gestational diabetes mellitus (GDM). Although a common pregnancy complication with systemic symptoms, GDM still lacks understanding of immunological perturbations associated with the pathological processes, particularly at the maternal-fetal interface. GDM has been characterized by low grade systemic inflammation that exacerbates maternal immune responses. In this regard, GDM may also entail mild autoimmune pathology by dysregulating circulating and uterine regulatory T cells (Tregs). The aim of this review article is to focus on maternal-fetal immunological tolerance phenomenon and discuss how local or systemic inflammation has been programmed in GDM. Specifically, this review addresses the following questions: Does the inflammatory or exhausted Treg population affecting the Th17:Treg ratio lead to the propensity of a pro-inflammatory environment? Do glycans and glycan-binding proteins (mainly galectins) contribute to the biology of immune responses in GDM? Our understanding of these important questions is still elementary as there are no well-defined animal models that mimic all the features of GDM or can be used to better understand the mechanistic underpinnings associated with this common pregnancy complication. In this review, we will leverage our preliminary studies and the literature to provide a conceptualized discussion on the immunobiology of GDM.
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Affiliation(s)
- Surendra Sharma
- Department of Pediatrics, Women and Infants Hospital-Warren Alpert Medical School of Brown University, Providence, RI, United States
| | - Sayani Banerjee
- Department of Pediatrics, Women and Infants Hospital-Warren Alpert Medical School of Brown University, Providence, RI, United States
| | - Paula M Krueger
- Department of Pediatrics, Women and Infants Hospital-Warren Alpert Medical School of Brown University, Providence, RI, United States
| | - Sandra M Blois
- Department of Obstetrics and Fetal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Zhang F, Ying L, Zhang Q, Wang F, Qu F. Association between maternal polycystic ovary syndrome and early childhood growth: a continuous observation from 3 months to 6 years of age. J Assist Reprod Genet 2022; 39:461-471. [PMID: 35048272 PMCID: PMC8956758 DOI: 10.1007/s10815-021-02378-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 12/08/2021] [Indexed: 02/03/2023] Open
Abstract
PURPOSE To investigate whether maternal PCOS could impact growth and development in offspring at an early age through continuous observation from age 3 months to 6 years. METHODS This prospective study was conducted in 198 children born to mothers with PCOS and 227 children born to healthy mothers in Ningbo (Zhejiang Province, China) between October 2012 and July 2015. Measurements of offspring height, weight, head circumference, and teething were examined by trained professionals through age 6 years. Height, weight, and body mass index (BMI) were analysed using repeated measures analysis of variance between the PCOS and control groups. RESULTS Offspring born to women with PCOS showed significantly higher BMI at age 12, 18, and 30 months and 5 years (P = 0.040, P = 0.000, P = 0.000, and P = 0.023, respectively). Female offspring born to women with PCOS showed significantly increased body weight at 3, 8, 12, 18, and 30 months, and 3 and 6 years (P = 0.027, P = 0.008, P = 0.010, P = 0.034, P = 0.047, P = 0.040, and P = 0.035, respectively) and significantly higher BMI at 3, 8, 12, 18, and 30 months (P = 0.009, P = 0.016, P = 0.029, P = 0.000, and P = 0.000, respectively). After adjusting for maternal, paternal, and pregnancy confounders, PCOS status presented significant associations with weight at age 3, 8, and 12 months and 3 years (P = 0.005, P = 0.004, P = 0.021, P = 0.035 respectively), and with BMI at age 3 and 8 months (P = 0.011 and P = 0.014) in female offspring. CONCLUSIONS Maternal PCOS is associated with an increased risk of developing obesity in female offspring.
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Affiliation(s)
- Fangfang Zhang
- grid.13402.340000 0004 1759 700XWomen’s Hospital, School of Medicine, Zhejiang University, 1 Xueshi Road, Hangzhou, 310006 People’s Republic of China
| | - Liying Ying
- grid.13402.340000 0004 1759 700XWomen’s Hospital, School of Medicine, Zhejiang University, 1 Xueshi Road, Hangzhou, 310006 People’s Republic of China ,Ningbo Yinzhou No.2 Hospital, Ningbo, Zhejiang 315100 People’s Republic of China
| | - Qing Zhang
- grid.13402.340000 0004 1759 700XWomen’s Hospital, School of Medicine, Zhejiang University, 1 Xueshi Road, Hangzhou, 310006 People’s Republic of China
| | - Fangfang Wang
- grid.13402.340000 0004 1759 700XWomen’s Hospital, School of Medicine, Zhejiang University, 1 Xueshi Road, Hangzhou, 310006 People’s Republic of China
| | - Fan Qu
- grid.13402.340000 0004 1759 700XWomen’s Hospital, School of Medicine, Zhejiang University, 1 Xueshi Road, Hangzhou, 310006 People’s Republic of China
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Zhang Y, Lan X, Li F, Sun H, Zhang J, Li R, Gao Y, Dong H, Cai C, Zeng G. Dietary cholesterol and egg intake are associated with the risk of gestational diabetes: a prospective study from Southwest China. BMC Pregnancy Childbirth 2022; 22:45. [PMID: 35038995 PMCID: PMC8764826 DOI: 10.1186/s12884-022-04382-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 01/05/2022] [Indexed: 12/24/2022] Open
Abstract
Background An increasing body of evidence suggests that cholesterol intake increases during pregnancy and may influence the risk of gestational diabetes mellitus (GDM). However, existing evidence remains controversial and limited. The present study aimed to determine the relation among dietary cholesterol, specifically egg consumption, in pregnant Chinese women and their risk of GDM. Methods A population-based study that included 1617 pregnant women was conducted in 2017. At baseline, dietary information was collected by 24-hour dietary recalls over three days. GDM was diagnosed by a 75 g 2-hr oral glucose tolerance test (OGTT) at 24-28 weeks of gestation. Logistic regression models were used to examine the associations of dietary cholesterol and egg intake with GDM. In addition, path analysis including cholesterol intake, plasma lipid profiles and GDM risk was conducted. Results The average total cholesterol intake was 340.8 mg/d, and cholesterol from eggs accounted for 59.2%. The odds ratio (OR) of GDM risk was 1.48 for the highest quartile of total cholesterol intake compared to the lowest quartile (95% CI 1.10-2.00; Ptrend = 0.015) after adjustment for potential risk factors for GDM. Moreover, cholesterol from eggs rather than from other foods was positively associated with incident GDM (OR=1.09, 95% CI 1.03-1.17). Each additional egg consumed per day was positively correlated with a higher risk of GDM (OR=1.32, 95% CI 1.11-1.58). Path analysis indicated that cholesterol intake not only increased the risk of GDM by elevating plasma total cholesterol (TC), but also increased the risk of GDM through other non hyperlipidemia pathways. Conclusions Maternal dietary cholesterol intake was significantly associated with incident GDM, and egg consumption was a major driver of the association in this population. More studies are needed to substantiate these findings and to explore the underlying mechanisms. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-022-04382-y.
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Affiliation(s)
- Yiqi Zhang
- Department of Nutrition and Food Safety, West China School of Public Health and West China Fourth Hospital, Sichuan University, No. 16, Section 3, Renmin Nan Road, Chengdu, 610041, Sichuan, China
| | - Xi Lan
- Department of Nutrition and Food Safety, West China School of Public Health and West China Fourth Hospital, Sichuan University, No. 16, Section 3, Renmin Nan Road, Chengdu, 610041, Sichuan, China
| | - Fei Li
- Department of Nutrition and Food Safety, West China School of Public Health and West China Fourth Hospital, Sichuan University, No. 16, Section 3, Renmin Nan Road, Chengdu, 610041, Sichuan, China
| | - Hong Sun
- Department of Nutrition and Food Safety, West China School of Public Health and West China Fourth Hospital, Sichuan University, No. 16, Section 3, Renmin Nan Road, Chengdu, 610041, Sichuan, China
| | - Ju Zhang
- Department of Clinical Nutrition, Sichuan Provincial Hospital for Women and Children, Chengdu, 610000, Sichuan, China
| | - Run Li
- Department of Clinical Nutrition, Sichuan Provincial Hospital for Women and Children, Chengdu, 610000, Sichuan, China
| | - Yan Gao
- Department of Obstetrics, Sichuan Provincial Hospital for Women and Children, Chengdu, 610000, Sichuan, China
| | - Hongli Dong
- Department of Nutrition and Food Safety, West China School of Public Health and West China Fourth Hospital, Sichuan University, No. 16, Section 3, Renmin Nan Road, Chengdu, 610041, Sichuan, China
| | - Congjie Cai
- Department of Nutrition and Food Safety, West China School of Public Health and West China Fourth Hospital, Sichuan University, No. 16, Section 3, Renmin Nan Road, Chengdu, 610041, Sichuan, China
| | - Guo Zeng
- Department of Nutrition and Food Safety, West China School of Public Health and West China Fourth Hospital, Sichuan University, No. 16, Section 3, Renmin Nan Road, Chengdu, 610041, Sichuan, China.
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Timsit J, Ciangura C, Dubois-Laforgue D, Saint-Martin C, Bellanne-Chantelot C. Pregnancy in Women With Monogenic Diabetes due to Pathogenic Variants of the Glucokinase Gene: Lessons and Challenges. Front Endocrinol (Lausanne) 2022; 12:802423. [PMID: 35069449 PMCID: PMC8766338 DOI: 10.3389/fendo.2021.802423] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 12/13/2021] [Indexed: 12/12/2022] Open
Abstract
Heterozygous loss-of-function variants of the glucokinase (GCK) gene are responsible for a subtype of maturity-onset diabetes of the young (MODY). GCK-MODY is characterized by a mild hyperglycemia, mainly due to a higher blood glucose threshold for insulin secretion, and an up-regulated glucose counterregulation. GCK-MODY patients are asymptomatic, are not exposed to diabetes long-term complications, and do not require treatment. The diagnosis of GCK-MODY is made on the discovery of hyperglycemia by systematic screening, or by family screening. The situation is peculiar in GCK-MODY women during pregnancy for three reasons: 1. the degree of maternal hyperglycemia is sufficient to induce pregnancy adverse outcomes, as in pregestational or gestational diabetes; 2. the probability that a fetus inherits the maternal mutation is 50% and; 3. fetal insulin secretion is a major stimulus of fetal growth. Consequently, when the fetus has not inherited the maternal mutation, maternal hyperglycemia will trigger increased fetal insulin secretion and growth, with a high risk of macrosomia. By contrast, when the fetus has inherited the maternal mutation, its insulin secretion is set at the same threshold as the mother's, and no fetal growth excess will occur. Thus, treatment of maternal hyperglycemia is necessary only in the former situation, and will lead to a risk of fetal growth restriction in the latter. It has been recommended that the management of diabetes in GCK-MODY pregnant women should be guided by assessment of fetal growth by serial ultrasounds, and institution of insulin therapy when the abdominal circumference is ≥ 75th percentile, considered as a surrogate for the fetal genotype. This strategy has not been validated in women with in GCK-MODY. Recently, the feasibility of non-invasive fetal genotyping has been demonstrated, that will improve the care of these women. Several challenges persist, including the identification of women with GCK-MODY before or early in pregnancy, and the modalities of insulin therapy. Yet, retrospective observational studies have shown that fetal genotype, not maternal treatment with insulin, is the main determinant of fetal growth and of the risk of macrosomia. Thus, further studies are needed to specify the management of GCK-MODY pregnant women during pregnancy.
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Affiliation(s)
- José Timsit
- Department of Diabetology, Université de Paris, AP-HP, Cochin-Port-Royal Hospital, DMU ENDROMED, Paris, France
- PRISIS National Reference Center for Rare Diseases of Insulin Secretion and Insulin Sensitivity, Department of Endocrinology, Diabetology and Reproductive Endocrinology, Assistance Publique-Hôpitaux de Paris, Saint-Antoine University Hospital, Paris, France
- Monogenic Diabetes Study Group of the Société Francophone du Diabète, Paris, France
| | - Cécile Ciangura
- PRISIS National Reference Center for Rare Diseases of Insulin Secretion and Insulin Sensitivity, Department of Endocrinology, Diabetology and Reproductive Endocrinology, Assistance Publique-Hôpitaux de Paris, Saint-Antoine University Hospital, Paris, France
- Monogenic Diabetes Study Group of the Société Francophone du Diabète, Paris, France
- Department of Diabetology, Sorbonne Université, AP-HP, Pitié-Salpêtrière Hospital, Paris, France
| | - Danièle Dubois-Laforgue
- Department of Diabetology, Université de Paris, AP-HP, Cochin-Port-Royal Hospital, DMU ENDROMED, Paris, France
- PRISIS National Reference Center for Rare Diseases of Insulin Secretion and Insulin Sensitivity, Department of Endocrinology, Diabetology and Reproductive Endocrinology, Assistance Publique-Hôpitaux de Paris, Saint-Antoine University Hospital, Paris, France
- Monogenic Diabetes Study Group of the Société Francophone du Diabète, Paris, France
- INSERM U1016, Cochin Hospital, Paris, France
| | - Cécile Saint-Martin
- PRISIS National Reference Center for Rare Diseases of Insulin Secretion and Insulin Sensitivity, Department of Endocrinology, Diabetology and Reproductive Endocrinology, Assistance Publique-Hôpitaux de Paris, Saint-Antoine University Hospital, Paris, France
- Department of Medical Genetics, Sorbonne Université, AP-HP, Pitié-Salpêtrière Hospital, DMU BioGeM, Paris, France
| | - Christine Bellanne-Chantelot
- PRISIS National Reference Center for Rare Diseases of Insulin Secretion and Insulin Sensitivity, Department of Endocrinology, Diabetology and Reproductive Endocrinology, Assistance Publique-Hôpitaux de Paris, Saint-Antoine University Hospital, Paris, France
- Monogenic Diabetes Study Group of the Société Francophone du Diabète, Paris, France
- Department of Medical Genetics, Sorbonne Université, AP-HP, Pitié-Salpêtrière Hospital, DMU BioGeM, Paris, France
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Song T, Su G, Chi Y, Wu T, Xu Y, Chen C. Triglyceride-glucose index predicts the risk of gestational diabetes mellitus: a systematic review and meta-analysis. Gynecol Endocrinol 2022; 38:10-15. [PMID: 34184968 DOI: 10.1080/09513590.2021.1940932] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
AIMS We aimed to investigate the potential predictive efficacy of triglyceride-glucose (T/Gly) index for gestational diabetes mellitus (GDM) in a systematic review and meta-analysis. MATERIALS AND METHODS Cohort studies demonstrating the association between T/Gly index measured at the first trimester or before pregnancy and the subsequent incidence of GDM were identified by search of PubMed, Embase, China National Knowledge Infrastructure, and WanFang databases. A random-effect model incorporating the heterogeneity was applied to pool the results. Five cohort studies including 382,213 women were included in this meta-analysis. RESULTS Compared to those with the lowest category of T/Gly index, women with the highest category of T/Gly index were independently associated with higher risk of subsequent GDM (odds ratio [OR]: 2.52, 95% confidence interval [CI]: 1.33 ∼ 4.67, I2=65%, p=.004) after adjustment of potential confounding factors including age, body mass index, and family history of diabetes. The association was stronger in prospective cohort studies than retrospective cohort studies (p for subgroup difference=.007), and a significant association was detected in Asian women (OR: 3.30, 95% CI: 1.50-7.28, p =.003), but not in non-Asian women (OR: 0.96, 95% CI: 0.35-2.63, p=.94). CONCLUSIONS Higher T/Gly index may independently predict the risk of GDM in Asian women.
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Affiliation(s)
- Tianrong Song
- Department of Obstetrics and Gynecology, Distinct Healthcare, Shenzhen, P. R. China
| | - Guidong Su
- Department of Obstetrics and Gynecology, Nanfang Hospital Affiliated to Southern Medical University, Guangzhou, P. R. China
| | - Yali Chi
- Department of Obstetrics and Gynecology, Nanfang Hospital Affiliated to Southern Medical University, Guangzhou, P. R. China
| | - Ting Wu
- Department of Obstetrics and Gynecology, University of Hong Kong Shenzhen Hospital, Shenzhen, P. R. China
| | - Yue Xu
- Department of Obstetrics and Gynecology, University of Hong Kong Shenzhen Hospital, Shenzhen, P. R. China
| | - Chunchun Chen
- Department of Obstetrics and Gynecology, University of Hong Kong Shenzhen Hospital, Shenzhen, P. R. China
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Chen H, He Y, Zeng X, Chen Q, Zhou N, Yang H, Zhou W, Zhang L, Yang R, Huang Q, Zhang H. Sleep Quality is an Independent Predictor of Blood Glucose and Gestational Diabetes Mellitus: A Longitudinal Study of 4550 Chinese Women. Nat Sci Sleep 2022; 14:609-620. [PMID: 35431589 PMCID: PMC9012300 DOI: 10.2147/nss.s353742] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 03/24/2022] [Indexed: 01/12/2023] Open
Abstract
PURPOSE To investigate whether pregnant women's subjective sleep quality during the first trimester independently predicted blood glucose and gestational diabetes mellitus (GDM). METHODS A total of 4550 pregnant women in the first trimester were enrolled in Chongqing Health Center for Women and Children, China, from January to October 2020.The Pittsburgh Sleep Quality Index (PSQI) was used to measure subjective sleep quality. Depression symptoms and anxiety were measured with the Patient Health Questionnaire-9 (PHQ-9) and General Anxiety Disorder-7 (GAD-7). Oral glucose tolerance tests (OGTT) and blood glucose area under the curve (AUC) were used for estimation of blood glucose and diagnosis of GDM during the second trimester. Linear, mixed model, and logistic regression were used to analyze the association between PSQI and blood glucose as well as GDM. RESULTS 946/4550 were diagnosed with GDM (20.8%). In the mixed model analysis, the blood glucose level of the highest-scoring group (PSQI score = 18) was 1.94 (95% CI: 0.45~3.43, P = 0.011) mmol/L higher than that of the lowest-scoring group (PSQI score = 0). After adjusting for potential confounders, a one-point PSQI score increase was associated with a 0.014 (95% CI: 0.001~0.027, P = 0.039) mmol/L increase in blood glucose level. Blood glucose AUC was also positively associated with PSQI scores (β = 0.034, 95% CI: 0.003~0.064, P = 0.030). The results for the logistic regression model showed that PSQI was marginal positively correlated with GDM (OR = 1.146, 95% CI: 0.995~1.321, P = 0.059) when age and BMI were not controlled for. When investigating the association between PSQI and the GDM-diagnosed time window, the 1-h diagnosed GDM had a borderline positive correlation with PSQI (OR = 1.182, 95% CI: 0.993~1.405, P = 0.060). CONCLUSION Sleep quality during the first trimester may be a risk factor for elevated blood glucose and GDM later in gestation.
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Affiliation(s)
- Hongyan Chen
- Quality Management Department, Chongqing Health Center for Women and Children, Chongqing, People's Republic of China
| | - Yang He
- Operating Room, Chongqing Health Center for Women and Children, Chongqing, People's Republic of China
| | - Xiaoling Zeng
- Key Lab of Medical Protection for Electromagnetic Radiation, Ministry of Education of China, Institute of Toxicology, College of Preventive Medicine, Third Military Medical University (Army Medical University), Chongqing, People's Republic of China
| | - Qing Chen
- Key Lab of Medical Protection for Electromagnetic Radiation, Ministry of Education of China, Institute of Toxicology, College of Preventive Medicine, Third Military Medical University (Army Medical University), Chongqing, People's Republic of China
| | - Niya Zhou
- Key Lab of Medical Protection for Electromagnetic Radiation, Ministry of Education of China, Institute of Toxicology, College of Preventive Medicine, Third Military Medical University (Army Medical University), Chongqing, People's Republic of China
| | - Huan Yang
- Key Lab of Medical Protection for Electromagnetic Radiation, Ministry of Education of China, Institute of Toxicology, College of Preventive Medicine, Third Military Medical University (Army Medical University), Chongqing, People's Republic of China
| | - Wenzheng Zhou
- Quality Management Department, Chongqing Health Center for Women and Children, Chongqing, People's Republic of China
| | - Liwen Zhang
- Key Lab of Medical Protection for Electromagnetic Radiation, Ministry of Education of China, Institute of Toxicology, College of Preventive Medicine, Third Military Medical University (Army Medical University), Chongqing, People's Republic of China
| | - Rong Yang
- Obstetric Outpatient Department, Chongqing Health Center for Women and Children, Chongqing, People's Republic of China
| | - Qiao Huang
- Obstetric Outpatient Department, Chongqing Health Center for Women and Children, Chongqing, People's Republic of China
| | - Hua Zhang
- Administration Office, Chongqing Health Center for Women and Children, Chongqing, People's Republic of China
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Sun Y, Zhu B, Meng X, Yin B, Wu K, Liu Y, Zou D, Xue J, Sun X, Zhang D, Ma Z. Effect of maternal body mass index on the steroid profile in women with gestational diabetes mellitus. Front Endocrinol (Lausanne) 2022; 13:999154. [PMID: 36440200 PMCID: PMC9681895 DOI: 10.3389/fendo.2022.999154] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 10/24/2022] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVE To explore the effect of maternal body mass index (BMI) on steroid hormone profiles in women with gestational diabetes mellitus (GDM) and those with normal glucose tolerance (NGT). METHODS We enrolled 79 women with NGT and 80 women with GDM who had a gestational age of 24-28 weeks. The participants were grouped according to their BMI. We quantified 11 steroid hormones profiles by liquid chromatography-tandem mass spectrometry and calculated the product-to-precursor ratios in the steroidogenic pathway. RESULTS Women with GDM and BMI<25kg/m2 showed higher concentrations of dehydroepiandrosterone (DHEA) (p<0.001), testosterone (T) (p=0.020), estrone (E1) (p=0.010) and estradiol (E2) (p=0.040) and lower Matsuda index and HOMA-β than women with NGT and BMI<25kg/m2. In women with GDM, concentrations of E1 (p=0.006) and E2 (p=0.009) declined, accompanied by reduced E2/T (p=0.008) and E1/androstenedione (A4) (p=0.010) in the BMI>25 kg/m2 group, when compared to that in the BMI<25 kg/m2 group. The values of E2/T and E1/A4 were used to evaluate the cytochrome P450 aromatase enzyme activity in the steroidogenic pathway. Both aromatase activities negatively correlated with the maternal BMI and positively correlated with the Matsuda index in women with GDM. CONCLUSIONS NGT women and GDM women with normal weight presented with different steroid hormone profiles. Steroidogenic pathway profiling of sex hormones synthesis showed a significant increase in the production of DHEA, T, E1, and E2 in GDM women with normal weight. Additionally, the alteration of steroid hormone metabolism was related to maternal BMI in women with GDM, and GDM women with overweight showed reduced estrogen production and decreased insulin sensitivity compared with GDM women with normal weight.
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Affiliation(s)
- Yanni Sun
- Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, China
- Clinical Prenatal Diagnosis Center, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Bo Zhu
- Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, China
- Clinical Prenatal Diagnosis Center, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Xingjun Meng
- Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, China
- Clinical Prenatal Diagnosis Center, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Binbin Yin
- Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, China
- Clinical Prenatal Diagnosis Center, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Kaiqi Wu
- Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, China
- Clinical Prenatal Diagnosis Center, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yifeng Liu
- Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, China
- Key Laboratory of Women’s Reproductive Health of Zhejiang Province, and Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Dandan Zou
- Hangzhou BIOZON Medical Laboratory co. Ltd., Hangzhou, Zhejiang, China
| | - Jianyou Xue
- Hangzhou BIOZON Medical Laboratory co. Ltd., Hangzhou, Zhejiang, China
| | - Xiao Sun
- Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, China
- Key Laboratory of Women’s Reproductive Health of Zhejiang Province, and Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Dan Zhang
- Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, China
- Key Laboratory of Women’s Reproductive Health of Zhejiang Province, and Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, China
- *Correspondence: Zhixin Ma, ; Dan Zhang,
| | - Zhixin Ma
- Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, China
- Clinical Prenatal Diagnosis Center, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, China
- *Correspondence: Zhixin Ma, ; Dan Zhang,
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79
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A low-carbohydrate dietary pattern characterised by high animal fat and protein during the first trimester is associated with an increased risk of gestational diabetes mellitus in Chinese women: a prospective cohort study. Br J Nutr 2021; 126:1872-1880. [PMID: 33597060 DOI: 10.1017/s0007114521000611] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
We aimed to examine the association between low-carbohydrate diet (LCD) scores during the first trimester and gestational diabetes mellitus (GDM) risk in a Chinese population. A total of 1455 women were included in 2017. Dietary information during the first trimester was collected by 24-h dietary recalls for 3 d. The overall, animal and plant LCD scores, which indicated adherence to different low-carbohydrate dietary patterns, were calculated. GDM was diagnosed based on the results of a 75-g, 2-h oral glucose tolerance test at 24-28 weeks gestation. Log-binomial models were used to estimate relative risks (RR) and 95 % CI. The results showed that the multivariable-adjusted RR of GDM from the lowest to the highest quartiles of the overall LCD score were 1·00 (reference), 1·15 (95 % CI 0·92, 1·42), 1·30 (95 % CI 1·06, 1·60) and 1·24 (95 % CI 1·01, 1·52) (P = 0·026 for trend). Multivariable-adjusted RR (95 % CI) of GDM from the lowest to the highest quartiles of the animal LCD score were 1·00 (reference), 1·20 (95 % CI 0·96, 1·50), 1·41 (95 % CI 1·14, 1·73) and 1·29 (95 % CI 1·04, 1·59) (P = 0·002 for trend). After additional adjustment for gestational weight gain before GDM diagnosis, the association of the overall LCD score with GDM risk was non-significant, while the association of animal LCD score with GDM risk remained significant. In conclusion, a low-carbohydrate dietary pattern characterised by high animal fat and protein during the first trimester is associated with an increased risk of GDM in Chinese women.
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80
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Sinha N, Lydia Walker G, Sen A. Looking at the Future Through the Mother's Womb: Gestational Diabetes and Offspring Fertility. Endocrinology 2021; 162:6379047. [PMID: 34597389 PMCID: PMC8520322 DOI: 10.1210/endocr/bqab209] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Indexed: 12/12/2022]
Abstract
Altered nutrition or intrauterine exposure to various adverse conditions during fetal development or earlier in a mother's life can lead to epigenetic changes in fetal tissues, predisposing those tissues to diseases that manifest when offspring become adults. An example is a maternal obesity associated with gestational diabetes (GDM), where fetal exposure to a hyperglycemic, hyperinsulinemic, and/or hyperlipidemic gestational environment can provoke epigenetic changes that predispose offspring to various diseased conditions later in life. While it is now well established that offspring exposed to GDM have an increased risk of developing obesity, metabolic disorders, and/or cardiovascular disease in adult life, there are limited studies assessing the reproductive health of these offspring. This mini-review discusses the long-term effect of in utero exposure to GDM-associated adverse prenatal environment on the reproductive health of the offspring. Moreover, using evidence from various animal models and human epidemiological studies, this review offers molecular insight and understanding of how epigenetic reprogramming of genes culminates in reproductive dysfunction and the development of subfertility or infertility later in adult life.
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Affiliation(s)
- Niharika Sinha
- Reproductive and Developmental Sciences Program, East Lansing, Michigan 48824, USA
- Department of Animal Sciences, Michigan State University, East Lansing, Michigan 48824, USA
| | - Gretchen Lydia Walker
- Reproductive and Developmental Sciences Program, East Lansing, Michigan 48824, USA
- Department of Animal Sciences, Michigan State University, East Lansing, Michigan 48824, USA
| | - Aritro Sen
- Reproductive and Developmental Sciences Program, East Lansing, Michigan 48824, USA
- Department of Animal Sciences, Michigan State University, East Lansing, Michigan 48824, USA
- Correspondence: Aritro Sen, PhD, Reproductive and Developmental Sciences Program, 3013 Interdisciplinary Science & Technology Building, Michigan State University, 766 Service Rd, East Lansing, MI 48824, USA.
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81
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Szoke D, Borille S, Cardellicchio M, Spadaccini G, Taricco E, Vignali M, Cetin I, Birindelli S, Panteghini M. Impact of optimizing pre-analytical phase on the diagnosis of gestational diabetes and related outcomes. Clin Chem Lab Med 2021; 59:1981-1987. [PMID: 34449173 DOI: 10.1515/cclm-2021-0706] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 08/10/2021] [Indexed: 12/30/2022]
Abstract
OBJECTIVES Pre-analytical plasma glucose (PG) sampling methodology may significantly affect gestational diabetes mellitus (GDM) incidence, but no studies directly examined the impact on perinatal outcomes. We compared the effect on oral glucose tolerance test (OGTT) results of using for blood sampling the traditional sodium fluoride (NaF) tubes, batched at controlled temperature, and the more effective citrate-buffered tubes, in terms of GDM diagnosis and related outcomes. METHODS We evaluated 578 pregnant women performing OGTT between 24- and 28-weeks' gestation. Paired NaF and citrate blood samples were drawn and analyzed for PG. GDM diagnosis was made by applying the 'one-step' American Diabetes Association strategy. Data on perinatal outcomes were collected in a subset of 330 women who delivered in our hospital network. RESULTS Using the standard NaF approach, 69 (11.9%) GDM women were detected. Using citrate PG values, 90 women were additionally identified as GDM, increasing the GDM prevalence to 27.5%. Perinatal outcomes were analyzed according to the different diagnostic allocation (NaF-diagnosed GDM, additional citrate-diagnosed GDM, and no GDM). NaF-diagnosed GDM showed a higher incidence of large for gestational age (LGA) (p=0.034), and of cesarean and preterm delivery (p<0.01) vs. no GDM. The only outcome remaining more frequent in the additional citrate diagnosed GDM when compared with no GDM group was LGA (17.2 vs. 6.8%, p=0.025). CONCLUSIONS If a health care system plans to use citrate tubes for GDM diagnosis, considerations about clinical implications are mandatory by balancing higher sensitivity in detecting a poor glycemic control with effects on outcomes to avoid "overdiagnosis".
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Affiliation(s)
| | | | | | | | - Emanuela Taricco
- UOC Ostetricia e Ginecologia Presidio Vittore Buzzi, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Michele Vignali
- UOC Ostetricia e Ginecologia Presidio Macedonio Melloni, Milan, Italy.,Dipartimento di Scienze Biomediche per la Salute, Milan, Italy
| | - Irene Cetin
- UOC Ostetricia e Ginecologia Presidio Luigi Sacco, Milan, Italy.,UOC Ostetricia e Ginecologia Presidio Vittore Buzzi, ASST Fatebenefratelli-Sacco, Milan, Italy.,Dipartimento di Scienze Biomediche e Cliniche "Luigi Sacco", Università degli Studi, Milan, Italy
| | | | - Mauro Panteghini
- UOC Patologia Clinica, Milan, Italy.,Dipartimento di Scienze Biomediche e Cliniche "Luigi Sacco", Università degli Studi, Milan, Italy
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82
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Beetch M, Alejandro EU. Placental mTOR Signaling and Sexual Dimorphism in Metabolic Health across the Lifespan of Offspring. CHILDREN 2021; 8:children8110970. [PMID: 34828683 PMCID: PMC8619510 DOI: 10.3390/children8110970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 10/23/2021] [Accepted: 10/24/2021] [Indexed: 11/17/2022]
Abstract
Robust evidence of fetal programming of adult disease has surfaced in the last several decades. Human and preclinical investigations of intrauterine insults report perturbations in placental nutrient sensing by the mechanistic target of rapamycin (mTOR). This review focuses on pregnancy complications associated with placental mTOR regulation, such as fetal growth restriction (FGR), fetal overgrowth, gestational diabetes mellitus (GDM), polycystic ovarian syndrome (PCOS), maternal nutrient restriction (MNR), preeclampsia (PE), maternal smoking, and related effects on offspring birthweight. The link between mTOR-associated birthweight outcomes and offspring metabolic health trajectory with a focus on sexual dimorphism are discussed. Both human physiology and animal models are summarized to facilitate in depth understanding. GDM, PCOS and fetal overgrowth are associated with increased placental mTOR, whereas FGR, MNR and maternal smoking are linked to decreased placental mTOR activity. Generally, birth weight is reduced in complications with decreased mTOR (i.e., FGR, MNR, maternal smoking) and higher with increased mTOR (GDM, PCOS). Offspring display obesity or a higher body mass index in childhood and adulthood, impaired glucose and insulin tolerance in adulthood, and deficiencies in pancreatic beta-cell mass and function compared to offspring from uncomplicated pregnancies. Defining causal players in the fetal programming of offspring metabolic health across the lifespan will aid in stopping the vicious cycle of obesity and type II diabetes.
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83
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Blais K, Arguin M, Allard C, Doyon M, Dolinsky VW, Bouchard L, Hivert MF, Perron P. Maternal glucose in pregnancy is associated with child's adiposity and leptin at 5 years of age. Pediatr Obes 2021; 16:e12788. [PMID: 33728816 DOI: 10.1111/ijpo.12788] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 01/31/2021] [Accepted: 02/23/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND Exposure to maternal hyperglycaemia in pregnancy has been associated with childhood obesity. Leptin regulation might be involved in this 'adiposity programming' and may depend on timing of exposure. OBJECTIVES To investigate associations of maternal glycaemia at different periods in pregnancy with childhood adiposity and leptin levels at 5 years of age. METHODS In a prospective pre-birth cohort, we measured maternal glucose levels after a 50 g oral glucose challenge test at first trimester (9.8 ± 2.3 weeks) and during a 75 g oral glucose tolerance test at second trimester (26.5 ± 0.9 weeks). We followed up children at 5 years; we measured anthropometry and body composition using dual-energy X-ray absorptiometry (DXA). We measured fasting leptin levels using immunoassays (Luminex) in 328 children. We conducted linear regression analyses, adjusting for potential confounders. RESULTS Maternal glycaemia at first trimester was associated with childhood leptin levels at 5 years, independently of maternal pre-pregnancy BMI and other confounders (β = .09 ± .04; P = .03). Higher post-load glucose levels at second trimester were associated with greater total body fat percentage measured by DXA (1 hour-glucose: β = .010 ± .004; P = .03 and 2 hours-glucose: β = .016 ± .005; P = .002), but not with leptin levels. CONCLUSIONS Our results suggest that programming of leptin regulation may be sensitive to maternal hyperglycaemia specifically in early pregnancy.
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Affiliation(s)
- Kasandra Blais
- Faculty of Medicine and Health Sciences, Department of Medicine, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Mélina Arguin
- Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Québec, Canada
| | - Catherine Allard
- Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Québec, Canada
| | - Myriam Doyon
- Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Québec, Canada
| | - Vernon W Dolinsky
- Department of Pharmacology and Therapeutics, Children's Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Luigi Bouchard
- Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Québec, Canada.,Faculty of Medicine and Health Sciences, Department of Biochemistry and Functional Genomics, Université de Sherbrooke, Sherbrooke, Québec, Canada.,Department of Medical Biology, CIUSSS of Saguenay-Lac-Saint-Jean, Saguenay, Québec, Canada
| | - Marie-France Hivert
- Faculty of Medicine and Health Sciences, Department of Medicine, Université de Sherbrooke, Sherbrooke, Québec, Canada.,Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Québec, Canada.,Department of Population Medicine, Harvard Pilgrim Health Care Institute, Harvard Medical School, Boston, Massachusetts, USA.,Diabetes Unit, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Patrice Perron
- Faculty of Medicine and Health Sciences, Department of Medicine, Université de Sherbrooke, Sherbrooke, Québec, Canada.,Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Québec, Canada
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84
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Wang GH, Jin J, Liu YQ, Yang FY, Shi D, Zhang Y, Zhao YM, Wang Y. The changes of Lp-PLA2 in patients with gestational diabetes and its clinical significance. Medicine (Baltimore) 2021; 100:e26786. [PMID: 34397729 PMCID: PMC8322476 DOI: 10.1097/md.0000000000026786] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 06/18/2021] [Indexed: 01/04/2023] Open
Abstract
Gestational diabetes mellitus (GDM) is one of the most common complications of pregnancy and associated with adverse pregnancy outcomes. The aim of this study was to investigate the changes of lipoprotein-associated phospholipaseA2 (Lp-PLA2) level and its correlation with biochemical indexes in patients with GDM.This observational cross-sectional study was performed among 52 GDM and 48 healthy pregnant women. Automatic biochemical analyzer was employed to test the biochemical indexes, including fasting plasma glucose (FPG), Hemoglobin A1c (HbA1c), total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C). The lipoprotein-associated phospholipaseA2 (Lp-PLA2) level was evaluated by enzyme-linked immunosorbent assay, and homeostatic model assessment for insulin resistance (HOMA-IR) was calculated.The levels of FPG, HbA1c, HOMA-IR, TG, TC and LDL-C were significantly increased while high-density lipoprotein cholesterol (HDL-C) level was significantly decreased in the GDM group when compared with those in the control group. Lp-PLA2 level in maternal blood in the GDM group was significantly higher than that in the control group (199.125 ± 23.494 vs165.825 ± 15.576 ng/mL, P < .05) and logistic regression analysis further confirmed the association of Lp-PLA2 levels with GDM. Furthermore, Lp-PLA2 positively correlated with HOMA-IR, TC, and LDL-C.Our results confirmed the association of Lp-PLA2 with GDM. This broadens our knowledge on the pathophysiology of GDM and provides insights into the development of new targets for the prevention and treatment of GDM.
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Affiliation(s)
- Guo-Hua Wang
- Department of Obstetrics, The Affiliated Lianyungang Hospital of Xuzhou Medical University, Lianyungang, Jiangsu, China
| | - Jun Jin
- Department of Clinical Laboratory, The Affiliated Lianyungang Hospital of Xuzhou Medical University, Lianyungang, Jiangsu, China
| | - Ya-Qiong Liu
- Department of Obstetrics, The Affiliated Lianyungang Hospital of Xuzhou Medical University, Lianyungang, Jiangsu, China
| | - Fu-Yan Yang
- Department of Obstetrics, The Affiliated Lianyungang Hospital of Xuzhou Medical University, Lianyungang, Jiangsu, China
| | - Dan Shi
- Department of Obstetrics, The Affiliated Lianyungang Hospital of Xuzhou Medical University, Lianyungang, Jiangsu, China
| | - Yi Zhang
- Department of Obstetrics, The Affiliated Lianyungang Hospital of Xuzhou Medical University, Lianyungang, Jiangsu, China
| | - Yi-Mei Zhao
- Department of Obstetrics, The Affiliated Lianyungang Hospital of Xuzhou Medical University, Lianyungang, Jiangsu, China
| | - Yang Wang
- Department of Physical Examination Center, The Affiliated Lianyungang Hospital of Xuzhou Medical University, Lianyungang, Jiangsu, China
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85
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Olmos-Ortiz A, Flores-Espinosa P, Díaz L, Velázquez P, Ramírez-Isarraraz C, Zaga-Clavellina V. Immunoendocrine Dysregulation during Gestational Diabetes Mellitus: The Central Role of the Placenta. Int J Mol Sci 2021; 22:8087. [PMID: 34360849 PMCID: PMC8348825 DOI: 10.3390/ijms22158087] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 07/15/2021] [Accepted: 07/26/2021] [Indexed: 02/07/2023] Open
Abstract
Gestational Diabetes Mellitus (GDM) is a transitory metabolic condition caused by dysregulation triggered by intolerance to carbohydrates, dysfunction of beta-pancreatic and endothelial cells, and insulin resistance during pregnancy. However, this disease includes not only changes related to metabolic distress but also placental immunoendocrine adaptations, resulting in harmful effects to the mother and fetus. In this review, we focus on the placenta as an immuno-endocrine organ that can recognize and respond to the hyperglycemic environment. It synthesizes diverse chemicals that play a role in inflammation, innate defense, endocrine response, oxidative stress, and angiogenesis, all associated with different perinatal outcomes.
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Affiliation(s)
- Andrea Olmos-Ortiz
- Departamento de Inmunobioquímica, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes (INPer), Ciudad de México 11000, Mexico; (A.O.-O.); (P.F.-E.)
| | - Pilar Flores-Espinosa
- Departamento de Inmunobioquímica, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes (INPer), Ciudad de México 11000, Mexico; (A.O.-O.); (P.F.-E.)
| | - Lorenza Díaz
- Departamento de Biología de la Reproducción, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México 14080, Mexico;
| | - Pilar Velázquez
- Departamento de Ginecología y Obstetricia, Hospital Ángeles México, Ciudad de México 11800, Mexico;
| | - Carlos Ramírez-Isarraraz
- Clínica de Urología Ginecológica, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes (INPer), Ciudad de México 11000, Mexico;
| | - Verónica Zaga-Clavellina
- Departamento de Fisiología y Desarrollo Celular, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes (INPer), Ciudad de México 11000, Mexico
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86
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Pham TTM, Huang YL, Chao JCJ, Chang JS, Chen YC, Wang FF, Bai CH. Plasma 25(OH)D Concentrations and Gestational Diabetes Mellitus among Pregnant Women in Taiwan. Nutrients 2021; 13:nu13082538. [PMID: 34444700 PMCID: PMC8398607 DOI: 10.3390/nu13082538] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 07/22/2021] [Accepted: 07/23/2021] [Indexed: 12/15/2022] Open
Abstract
Vitamin D’s function in the development of gestational diabetes mellitus (GDM) is not consistent in the literature. We examined the association between maternal plasma 25(OH)D concentration and GDM risk. A national cross-sectional study (1497 pregnant women) was conducted between 2017 and 2019 across Taiwan. Blood samples were drawn at recruitment to assess 25(OH)D concentrations, including vitamin D deficiency (VDD) (<20 ng/mL), insufficiency (<32 ng/mL), and sufficiency (≥32 ng/mL). GDM was detected from 24 to 28 weeks of gestation with the results extracted from the antenatal visit records. The prevalence of GDM was 2.9%. Logistic model analysis showed that 25(OH)D concentrations were not significantly associated with the risk of GDM (adjusted odds ratio (AOR) = 0.97, p = 0.144). However, subjects with VDD had a significantly greater risk of GDM (AOR = 2.26, p = 0.041), but not in those with vitamin D insufficiency (AOR = 1.20, p = 0.655). Furthermore, cubic piecewise spline regression was used to explore the relationship between five-unit intervals of 25(OH)D and the predicted probability of GDM. As the proportion of GDM increased for low 25(OH)D concentrations, it decreased at moderate concentrations and increased again at higher concentrations. These findings revealed a nonlinear relationship between 25(OH)D and GDM risk. VDD would be risky for GDM occurrence.
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Affiliation(s)
- Thu T. M. Pham
- School of Public Health, College of Public Health, Taipei Medical University, Taipei 110-31, Taiwan;
- Faculty of Public Health, Hai Phong University of Medicine and Pharmacy, Hai Phong 042-12, Vietnam
| | - Ya-Li Huang
- Department of Public Health, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110-31, Taiwan;
| | - Jane C.-J. Chao
- School of Nutrition and Health Sciences, Taipei Medical University, Taipei 110-31, Taiwan; (J.C.-J.C.); (J.-S.C.); (Y.-C.C.)
- Nutrition Research Center, Taipei Medical University Hospital, Taipei 110-31, Taiwan
- Master Program in Global Health and Development, College of Public Health, Taipei Medical University, Taipei 110-31, Taiwan
| | - Jung-Su Chang
- School of Nutrition and Health Sciences, Taipei Medical University, Taipei 110-31, Taiwan; (J.C.-J.C.); (J.-S.C.); (Y.-C.C.)
- Nutrition Research Center, Taipei Medical University Hospital, Taipei 110-31, Taiwan
- Graduate Institute of Metabolism and Obesity Sciences, College of Nutrition, Taipei Medical University, Taipei 110-31, Taiwan
- Chinese Taipei Society for the Study of Obesity (CTSSO), Taipei 110-31, Taiwan
| | - Yi-Chun Chen
- School of Nutrition and Health Sciences, Taipei Medical University, Taipei 110-31, Taiwan; (J.C.-J.C.); (J.-S.C.); (Y.-C.C.)
- Master Program in Food Safety, College of Nutrition, Taipei Medical University, Taipei 110-31, Taiwan
| | - Fan-Fen Wang
- Division of Endocrinology and Metabolism, Department of Medicine, Taipei Veterans General Hospital, Taipei 110-31, Taiwan;
- Department of Medicine, Yangming Branch, Taipei City Hospital, Taipei 111-31, Taiwan
| | - Chyi-Huey Bai
- School of Public Health, College of Public Health, Taipei Medical University, Taipei 110-31, Taiwan;
- Department of Public Health, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110-31, Taiwan;
- Nutrition Research Center, Taipei Medical University Hospital, Taipei 110-31, Taiwan
- Correspondence: ; Tel.: +886-2-2736-1661 (ext. 6510)
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87
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Correa‐da‐Silva F, Fliers E, Swaab DF, Yi C. Hypothalamic neuropeptides and neurocircuitries in Prader Willi syndrome. J Neuroendocrinol 2021; 33:e12994. [PMID: 34156126 PMCID: PMC8365683 DOI: 10.1111/jne.12994] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 04/19/2021] [Accepted: 05/04/2021] [Indexed: 02/06/2023]
Abstract
Prader-Willi Syndrome (PWS) is a rare and incurable congenital neurodevelopmental disorder, resulting from the absence of expression of a group of genes on the paternally acquired chromosome 15q11-q13. Phenotypical characteristics of PWS include infantile hypotonia, short stature, incomplete pubertal development, hyperphagia and morbid obesity. Hypothalamic dysfunction in controlling body weight and food intake is a hallmark of PWS. Neuroimaging studies have demonstrated that PWS subjects have abnormal neurocircuitry engaged in the hedonic and physiological control of feeding behavior. This is translated into diminished production of hypothalamic effector peptides which are responsible for the coordination of energy homeostasis and satiety. So far, studies with animal models for PWS and with human post-mortem hypothalamic specimens demonstrated changes particularly in the infundibular and the paraventricular nuclei of the hypothalamus, both in orexigenic and anorexigenic neural populations. Moreover, many PWS patients have a severe endocrine dysfunction, e.g. central hypogonadism and/or growth hormone deficiency, which may contribute to the development of increased fat mass, especially if left untreated. Additionally, the role of non-neuronal cells, such as astrocytes and microglia in the hypothalamic dysregulation in PWS is yet to be determined. Notably, microglial activation is persistently present in non-genetic obesity. To what extent microglia, and other glial cells, are affected in PWS is poorly understood. The elucidation of the hypothalamic dysfunction in PWS could prove to be a key feature of rational therapeutic management in this syndrome. This review aims to examine the evidence for hypothalamic dysfunction, both at the neuropeptidergic and circuitry levels, and its correlation with the pathophysiology of PWS.
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Affiliation(s)
- Felipe Correa‐da‐Silva
- Department of Endocrinology and MetabolismAmsterdam Gastroenterology Endocrinology and MetabolismAmsterdam University Medical Center (UMC)University of AmsterdamAmsterdamThe Netherlands
- Laboratory of EndocrinologyAmsterdam University Medical Center (UMC)University of AmsterdamAmsterdamThe Netherlands
- Department of Neuropsychiatric DisordersNetherlands Institute for NeuroscienceAn Institute of the Royal Netherlands Academy of Arts and SciencesAmsterdamThe Netherlands
| | - Eric Fliers
- Department of Endocrinology and MetabolismAmsterdam Gastroenterology Endocrinology and MetabolismAmsterdam University Medical Center (UMC)University of AmsterdamAmsterdamThe Netherlands
| | - Dick F. Swaab
- Department of Neuropsychiatric DisordersNetherlands Institute for NeuroscienceAn Institute of the Royal Netherlands Academy of Arts and SciencesAmsterdamThe Netherlands
| | - Chun‐Xia Yi
- Department of Endocrinology and MetabolismAmsterdam Gastroenterology Endocrinology and MetabolismAmsterdam University Medical Center (UMC)University of AmsterdamAmsterdamThe Netherlands
- Laboratory of EndocrinologyAmsterdam University Medical Center (UMC)University of AmsterdamAmsterdamThe Netherlands
- Department of Neuropsychiatric DisordersNetherlands Institute for NeuroscienceAn Institute of the Royal Netherlands Academy of Arts and SciencesAmsterdamThe Netherlands
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88
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Linenberg I, Fornes D, Higa R, Jawerbaum A, Capobianco E. Intergenerational effects of the antioxidant Idebenone on the placentas of rats with gestational diabetes mellitus. Reprod Toxicol 2021; 104:16-26. [PMID: 34175429 DOI: 10.1016/j.reprotox.2021.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 06/18/2021] [Accepted: 06/21/2021] [Indexed: 11/27/2022]
Abstract
Experimental models of maternal diabetes lead to the intrauterine programming of Gestational Diabetes Mellitus (GDM) in the offspring, together with an intrauterine proinflammatory environment, feto-placental metabolic alterations and fetal overgrowth. The aim of this work was to evaluate the effect of the mitochondrial antioxidant Idebenone given to F0 mild pregestational diabetic rats on the development of GDM in their F1 offspring and the intergenerational programming of a pro-oxidant/proinflammatory environment that affects the placentas of F2 fetuses. Control and mild pregestational diabetic female rats (F0) were mated with control males, and Idebenone or vehicle was administered to diabetic rats from day 1 of gestation to term. The F1 female offspring were mated with control males and maternal and fetal plasma samples were obtained for metabolic determinations at term. The F2 fetuses and placentas were weighed, and placental protein levels and peroxynitrite-induced damage (immunohistochemistry), mRNA levels (PCR), nitric oxide production (Griess reaction), and number of apoptotic cells (TUNEL) were evaluated. The F1 offspring of F0 diabetic rats (treated or not with Idebenone) developed GDM. The placentas of GDM rats showed a decrease in the mRNA levels of manganese superoxide dismutase and an increase in the production of nitric oxide, peroxynitrite-induced damage, and connective tissue growth factor levels, alterations that were prevented by the maternal Idebenone treatment in F0 rats. In conclusion, the maternal treatment with Idebenone in pregestational diabetic F0 rats ameliorates the pro-oxidant/proinflammatory environment that affects the placentas of F2 fetuses, although it does not prevent F1 rats from developing GDM.
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Affiliation(s)
- Ivana Linenberg
- Laboratory of Reproduction and Metabolism, CEFYBO-CONICET, School of Medicine, University of Buenos Aires, Buenos Aires, Argentina; Instituto de Investigación en Biomedicina de Buenos Aires (IBioBA) - CONICET - Partner Institute of the Max Planck Society, Buenos Aires, Argentina
| | - Daiana Fornes
- Laboratory of Reproduction and Metabolism, CEFYBO-CONICET, School of Medicine, University of Buenos Aires, Buenos Aires, Argentina
| | - Romina Higa
- Laboratory of Reproduction and Metabolism, CEFYBO-CONICET, School of Medicine, University of Buenos Aires, Buenos Aires, Argentina
| | - Alicia Jawerbaum
- Laboratory of Reproduction and Metabolism, CEFYBO-CONICET, School of Medicine, University of Buenos Aires, Buenos Aires, Argentina
| | - Evangelina Capobianco
- Laboratory of Reproduction and Metabolism, CEFYBO-CONICET, School of Medicine, University of Buenos Aires, Buenos Aires, Argentina.
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89
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Kousta E, Kontogeorgi A, Robinson S, Johnston DG. Long-Term Metabolic Consequences in Patients with a History of Gestational Diabetes. Curr Pharm Des 2021; 26:5564-5572. [PMID: 33155900 DOI: 10.2174/1381612826666201106092423] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 08/15/2020] [Indexed: 11/22/2022]
Abstract
Gestational diabetes mellitus is a common metabolic complication of pregnancy. Universal guidelines on gestational diabetes have been impeded by the long-term controversies on its definition and screening strategies. The prevalence of gestational diabetes is rising all over the world, is significantly influenced by ethnicity and its rise is mainly attributed to increasing maternal obesity and age. Gestational diabetes mellitus has important long-term implications, including gestational diabetes recurrence, increased risk for developing type 2 diabetes, metabolic syndrome and cardiovascular disease for the mother. Gestational diabetes mellitus may be viewed as a chronic metabolic disorder that is identified in women during gestation and may provide a unique opportunity for the early identification and primary prevention of type 2 diabetes mellitus and cardiovascular disease in these women. In this mini-review, the evolution of screening tests for gestational diabetes and guidelines are briefly described and metabolic and cardiovascular long-term consequences of women with a history of gestational diabetes are summarized. A summary of our own St. Mary's Hospital-UK Research series on long-term metabolic consequences of 368 women with a history of gestational diabetes of 3 different ethnic groups and 482 control women is also included. We found that approximately 2 years following delivery, 37% of women with a history of gestational diabetes had abnormal glucose concentrations, but, most importantly, even those who were normoglycaemic, postpartum displayed metabolic abnormalities on detailed testing. Future research needs to focus on the prevention of gestational diabetes long-term complications, but also in identification of pre-pregnancy predictors and risk reduction before conception.
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Affiliation(s)
- Eleni Kousta
- Research in Female Reproduction Postgraduate Course, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Adamantia Kontogeorgi
- Research in Female Reproduction Postgraduate Course, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Stephen Robinson
- Division of Diabetes, Endocrinology and Metabolism, Imperial College London, St. Mary's Campus, Norfolk Place, London W2 1PG, United Kingdom
| | - Desmond G Johnston
- Division of Diabetes, Endocrinology and Metabolism, Imperial College London, St. Mary's Campus, Norfolk Place, London W2 1PG, United Kingdom
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90
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Zukin H, Eskenazi B, Holland N, Harley KG. Prenatal exposure to phthalates and maternal metabolic outcomes in a high-risk pregnant Latina population. ENVIRONMENTAL RESEARCH 2021; 194:110712. [PMID: 33460632 PMCID: PMC7946766 DOI: 10.1016/j.envres.2021.110712] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 12/03/2020] [Accepted: 01/01/2021] [Indexed: 05/26/2023]
Abstract
BACKGROUND Phthalates are a group of endocrine disrupting chemicals that are heavily used throughout industry in flexible plastic and personal-care products. As a result, detectable levels of their metabolites are readily found in humans. Some studies have shown associations of phthalates with diabetes, but associations with gestational diabetes mellitus (GDM) are less clear. OBJECTIVE To investigate the association of 11 prenatal urinary phthalate metabolites and development of GDM, impaired glucose tolerance (IGT), continuous plasma glucose level, and excessive gestational weight gain (GWG) in a population of pregnant Latina women (N = 415) enrolled in the Center for the Health Assessment of Mothers and Children of Salinas (CHAMACOS) cohort study. METHODS Phthalate metabolite levels were measured via mass spectrometry from two urine samples collected in the end of the first and second trimester. Maternal plasma glucose levels, prior diabetes diagnosis, GDM diagnosis, and weight gain were abstracted from medical records. Multiple regression was used to evaluate the association between the average of the two urinary phthalate metabolites levels and maternal metabolic outcomes. In our sensitivity analysis, phthalate levels were categorized by level (as quartiles of exposure) and by timing of urine sample collection (as taken in first and second half of pregnancy). RESULTS Consistent with findings from a nationally representative sample, all of the individual phthalate metabolites were detected in majority of mothers. Thirty-one mothers (7.5%) were diagnosed with GDM, 49 mothers (14.7%) displayed IGT, and 223 mothers (55.1%) gained an excessive amount of weight during their pregnancy. MEP concentrations were associated with an increased odds of excessive GWG (OR: 1.1, 95% CI: 1.0 to 1.3). We did not find an association between any phthalate metabolite and any maternal glucose outcome. CONCLUSION Contrary to previous studies, our findings do not support an association of prenatal phthalate levels and increased odds for hyperglycemia, IGT, or GDM. But, we did find an increased odds of excessive GWG, a well-known risk factor for GDM.
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Affiliation(s)
- Helen Zukin
- Center for Environmental Research and Children's Health (CERCH), School of Public Health, University of California, Berkeley, CA, USA
| | - Brenda Eskenazi
- Center for Environmental Research and Children's Health (CERCH), School of Public Health, University of California, Berkeley, CA, USA
| | - Nina Holland
- Center for Environmental Research and Children's Health (CERCH), School of Public Health, University of California, Berkeley, CA, USA
| | - Kim G Harley
- Center for Environmental Research and Children's Health (CERCH), School of Public Health, University of California, Berkeley, CA, USA.
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91
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Ding B, Gou B, Guan H, Wang J, Bi Y, Hong Z. WeChat-assisted dietary and exercise intervention for prevention of gestational diabetes mellitus in overweight/obese pregnant women: a two-arm randomized clinical trial. Arch Gynecol Obstet 2021; 304:609-618. [PMID: 33570656 DOI: 10.1007/s00404-021-05984-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 01/19/2021] [Indexed: 12/16/2022]
Abstract
PURPOSE This study aimed to examine the influence of a WeChat-based dietary and exercise intervention on gestational diabetes mellitus (GDM) prevention in overweight/obese pregnant women in Beijing. METHODS Overweight/obese pregnant women were recruited in the early stages of pregnancy. After screening by include and exclude standards, eligible women were randomly divided into two groups, intervention and control groups. The control group received a general advice session about pregnancy nutrition and weight management. The intervention group received three face-to-face sessions about personalized dietary and exercise intervention, with the help of WeChat as a monitoring tool to promote treatment plan adherence. At 24-28 weeks of pregnancy, GDM was diagnosed according to the International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria. Gestational weight gain (GWG), maternal and neonatal outcomes were also collected. RESULTS This study analyzed 215 participants. At the mid-trimester, 42 (37.8%) women in the control group were diagnosed with GDM (n = 111) versus 25 (24.5%) in the intervention group (n = 104; p < 0.05). The intervention group gained 11.2 ± 4.9 kg during the whole gestation period, with 4.9 ± 3.1 kg-weight increment in the first 25 weeks of pregnancy, versus 13.4 ± 5.0 kg and 6.9 ± 3.2 kg in the first 25 weeks in the control group (between groups: p < 0.001/p = 0.002). Incidence of macrosomia was not significantly lower in the intervention group than in the control group (8/7.9% vs 11/9.9%) (p > 0.05). No significant difference was found in the rate of natural labor and occurrence of perinatal complications (e.g., preterm birth, gestational hypertension, and preeclampsia) between the groups (p > 0.05). CONCLUSIONS The WeChat-assisted dietary and exercise intervention was effective in reducing the occurrence of GDM and excessive weight gain in overweight/obese pregnant women. Disseminating knowledge of pregnancy and childbirth through social media platforms like WeChat could be an important part of antenatal care.
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Affiliation(s)
- Bingjie Ding
- Department of Clinical Nutrition, Beijing Friendship Hospital, Capital Medical University, Beijing, 10050, China
| | - Baohua Gou
- Department of Gynecology and Obstetrics, Beijing Friendship Hospital, Capital Medical University, No. 95 Yongan Road, Xicheng District, Beijing, 10050, People's Republic of China
| | - Huimin Guan
- Department of Gynecology and Obstetrics, Beijing Friendship Hospital, Capital Medical University, No. 95 Yongan Road, Xicheng District, Beijing, 10050, People's Republic of China
| | - Jia Wang
- Department of Clinical Nutrition, Beijing Friendship Hospital, Capital Medical University, Beijing, 10050, China
| | - Yanxia Bi
- Department of Clinical Nutrition, Beijing Friendship Hospital, Capital Medical University, Beijing, 10050, China
| | - Zhongxin Hong
- Department of Clinical Nutrition, Beijing Friendship Hospital, Capital Medical University, Beijing, 10050, China.
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92
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The overall plant-based diet index during pregnancy and risk of gestational diabetes mellitus: a prospective cohort study in China. Br J Nutr 2021; 126:1519-1528. [PMID: 33468274 DOI: 10.1017/s0007114521000234] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The high overall plant-based diet index (PDI) is considered to protect against type 2 diabetes in the general population. However, whether the PDI affects gestational diabetes mellitus (GDM) risk among pregnant women is still unclear. We evaluated the association between PDI and GDM risk based on a Chinese large prospective cohort - the Tongji Maternal and Child Health Cohort. Dietary data were collected at 13-28 weeks of pregnancy by a validated semi-quantitative FFQ. The PDI was obtained by assigning plant food groups positive scores while assigning animal food groups reverse scores. GDM was diagnosed by a 75 g 2-h oral glucose tolerance test at 24-28 weeks of gestation. Logistic regression models were fitted to estimate OR of GDM, with associated 95 % CI, comparing women in different PDI quartiles. Among the total 2099 participants, 169 (8·1 %) were diagnosed with GDM. The PDI ranged from 21·0 to 52·0 with a median of 36·0 (interquartile range (IQR) 33·0-39·0). After adjusting for social-demographic characteristics and lifestyle factors etc., the participants with the highest quartile of PDI were associated with 57 % reduced odds of GDM compared with women in the lowest quartile of PDI (adjusted OR 0·43; 95 % CI 0·24, 0·77; Pfor trend = 0·005). An IQR increment in PDI was associated with 29 % decreased odds of GDM (adjusted OR 0·71; 95 % CI 0·56, 0·90). Findings suggest that adopting a plant-based diet during pregnancy could reduce GDM risk among Chinese women, which may be valuable for dietary counselling during pregnancy.
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93
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Hu J, Liu Y, Wei X, Li L, Gao M, Liu Y, Ma Y, Wen D. Association of gestational diabetes mellitus with offspring weight status across infancy: a prospective birth cohort study in China. BMC Pregnancy Childbirth 2021; 21:21. [PMID: 33407256 PMCID: PMC7789150 DOI: 10.1186/s12884-020-03494-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Accepted: 12/11/2020] [Indexed: 01/22/2023] Open
Abstract
Background The association between gestational diabetes mellitus (GDM) and childhood body weight remains controversial, and additional study is needed, especially in Asian populations. Methods This prospective study investigated the association between maternal glucose concentration, and GDM status and infant body weight from birth to 12 months of age. Linear mixed effects (LME) models and multiple linear regression were used to assess the longitudinal association of GDM with infant growth measured by weight-for-length z-scores (WFLZ), weight-for-age z-scores (WFAZ), and length-for-age z-scores (LFAZ) at birth, 1, 3, 6, 8, and 12 months of age. Results Offspring born to mothers with GDM had higher WFLZ [β: 0.26 SD units (95% CI: 0.13–0.40)] across infancy than those of mothers without GDM. When stratified analysis by maternal pre-pregnancy body mass index (BMI) status, the association was pronounced in normal-weight [β:0.28 SD units (95% CI: 0.11–0.45)] and overweight/obese women [β: 0.34 SD units (95% CI: 0.09–0.58)] but not in underweight women (P for interaction < 0.05). Multiple linear regression found that the effect estimate of GDM on infant WFLZ was highest at birth [β: 0.36 SD units (95% CI: 0.11–0.61)], remained significant at 1 [β: 0.22 SD units (95% CI: 0.03–0.41)] and 3 [β:0.19 SD units (95% CI: 0.01–0.37)] months of age and decreased across infancy. Maternal GDM status was not associated with infant WFAZ or LFAZ. Conclusions Maternal GDM status was associated with infant WFLZ, but not WFAZ or LFAZ. The association between GDM status and offspring WFLZ was more pronounced in early infancy or in normal-weight and overweight/obese women. Increased public health efforts to prevent GDM in normal-weight and overweight/obese pre-pregnancy mothers are recommended to control offspring overweight or obesity. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-020-03494-7.
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Affiliation(s)
- Jiajin Hu
- Institute of Health Sciences, China Medical University, Shenyang, 110122, Liaoning, China.,Research Center of China Medical University Birth Cohort, China Medical University, Shenyang, 110122, Liaoning, China.,Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School, Boston, MA, 02215, USA
| | - Yilin Liu
- Institute of Health Sciences, China Medical University, Shenyang, 110122, Liaoning, China
| | - Xiaotong Wei
- Institute of Health Sciences, China Medical University, Shenyang, 110122, Liaoning, China
| | - Lin Li
- Institute of Health Sciences, China Medical University, Shenyang, 110122, Liaoning, China
| | - Ming Gao
- Institute of Health Sciences, China Medical University, Shenyang, 110122, Liaoning, China
| | - Yang Liu
- Institute of Health Sciences, China Medical University, Shenyang, 110122, Liaoning, China
| | - Yanan Ma
- Department of Epidemiology and Health Statistics, School of Public Health, China Medical University, Shenyang, 110122, Liaoning, China
| | - Deliang Wen
- Institute of Health Sciences, China Medical University, Shenyang, 110122, Liaoning, China.
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94
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Carroll DT, Sassin AM, Aagaard KM, Gannon M. Developmental effects of in utero metformin exposure. TRENDS IN DEVELOPMENTAL BIOLOGY 2021; 14:1-17. [PMID: 36589485 PMCID: PMC9802655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
According to the Developmental Origins of Health and Disease (DOHaD) hypothesis, the intrauterine environment influences fetal programming and development, affecting offspring disease susceptibility in adulthood. In recent years, therapeutic use of the Type 2 diabetes drug metformin has expanded to the treatment of pre-diabetes, polycystic ovarian syndrome, and gestational diabetes. Because metformin both undergoes renal excretion and binds to receptors on the placenta, the fetus receives equivalent maternal dosing. Although no teratogenic nor short-term harmful fetal impact of metformin is known to occur, the effects of metformin exposure on longer-range offspring development have not yet been fully elucidated. This review encapsulates the (albeit limited) existing knowledge regarding the potential longer-term impact of intrauterine metformin exposure on the development of key organs including the liver, central nervous system, heart, gut, and endocrine pancreas in animal models and humans. We discuss molecular and cellular mechanisms that would be altered in response to treatment and describe the potential consequences of these developmental changes on postnatal health. Further studies regarding the influence of metformin exposure on fetal programming and adult metabolic health will provide necessary insight to its long-term risks, benefits, and limitations in order to guide decisions for use of metformin during pregnancy.
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Affiliation(s)
- Darian T. Carroll
- Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, TN
| | - Alexa M. Sassin
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, and Departments of Molecular and Human Genetics, and Molecular and Cell Biology, Baylor College of Medicine and Texas Children’s Hospital, Houston, TX
| | - Kjersti M. Aagaard
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, and Departments of Molecular and Human Genetics, and Molecular and Cell Biology, Baylor College of Medicine and Texas Children’s Hospital, Houston, TX
| | - Maureen Gannon
- Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, TN
- Department of Veterans Affairs Tennessee Valley, Nashville, TN
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN
- Department of Cell and Developmental Biology, Vanderbilt University, Nashville, TN, USA
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95
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Moreno-Fernandez J, Ochoa JJ, Lopez-Frias M, Diaz-Castro J. Impact of Early Nutrition, Physical Activity and Sleep on the Fetal Programming of Disease in the Pregnancy: A Narrative Review. Nutrients 2020; 12:nu12123900. [PMID: 33419354 PMCID: PMC7766505 DOI: 10.3390/nu12123900] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 12/17/2020] [Accepted: 12/18/2020] [Indexed: 12/13/2022] Open
Abstract
Early programming is the adaptation process by which nutrition and environmental factors alter development pathways during prenatal growth, inducing changes in postnatal metabolism and diseases. The aim of this narrative review, is evaluating the current knowledge in the scientific literature on the effects of nutrition, environmental factors, physical activity and sleep on development pathways. If in utero adaptations were incorrect, this would cause a mismatch between prenatal programming and adulthood. Adequate caloric intake, protein, mineral, vitamin, and long-chain fatty acids, have been noted for their relevance in the offspring brain functions and behavior. Fetus undernutrition/malnutrition causes a delay in growth and have detrimental effects on the development and subsequent functioning of the organs. Pregnancy is a particularly vulnerable period for the development of food preferences and for modifications in the emotional response. Maternal obesity increases the risk of developing perinatal complications and delivery by cesarean section and has long-term implications in the development of metabolic diseases. Physical exercise during pregnancy contributes to overall improved health post-partum. It is also interesting to highlight the relevance of sleep problems during pregnancy, which influence adequate growth and fetal development. Taking into account these considerations, we conclude that nutrition and metabolic factors during early life play a key role of health promotion and public health nutrition programs worldwide to improve the health of the offspring and the health costs of hospitalization.
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Affiliation(s)
- Jorge Moreno-Fernandez
- Department of Physiology, Faculty of Pharmacy, Campus Universitario de Cartuja, E-18071 Granada, Spain; (J.M.-F.); (M.L.-F.); (J.D.-C.)
- Institute of Nutrition and Food Technology “José Mataix Verdú”, University of Granada, E-18071 Granada, Spain
| | - Julio J. Ochoa
- Department of Physiology, Faculty of Pharmacy, Campus Universitario de Cartuja, E-18071 Granada, Spain; (J.M.-F.); (M.L.-F.); (J.D.-C.)
- Institute of Nutrition and Food Technology “José Mataix Verdú”, University of Granada, E-18071 Granada, Spain
- Correspondence: ; Tel.: +34-958-241-000 (ext. 20317)
| | - Magdalena Lopez-Frias
- Department of Physiology, Faculty of Pharmacy, Campus Universitario de Cartuja, E-18071 Granada, Spain; (J.M.-F.); (M.L.-F.); (J.D.-C.)
- Institute of Nutrition and Food Technology “José Mataix Verdú”, University of Granada, E-18071 Granada, Spain
| | - Javier Diaz-Castro
- Department of Physiology, Faculty of Pharmacy, Campus Universitario de Cartuja, E-18071 Granada, Spain; (J.M.-F.); (M.L.-F.); (J.D.-C.)
- Institute of Nutrition and Food Technology “José Mataix Verdú”, University of Granada, E-18071 Granada, Spain
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Schütte T, Kedziora SM, Haase N, Herse F, Busjahn A, Birukov A, Alenina N, Müller DN, Bader M, Schupp M, Dechend R, Kräker K, Golic M. Intrauterine Exposure to Diabetic Milieu Does Not Induce Diabetes and Obesity in Male Adulthood in a Novel Rat Model. Hypertension 2020; 77:202-215. [PMID: 33249866 DOI: 10.1161/hypertensionaha.120.16360] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Several studies show an association of maternal diabetes during pregnancy with adverse offspring metabolic health. Other studies, however, suggest that this effect might be biased by obesity, which is independently associated with offspring metabolic disease and often coexistent to maternal diabetes. We performed a prospective study in a rat model to test the hypothesis that the burden of a diabetic pregnancy without obesity deteriorates metabolic health in male offspring. We generated maternal type 2 diabetes before conception that persisted during pregnancy by knockdown of the insulin receptor in small hairpin RNA-expressing transgenic rats. Male WT (wild type) offspring were followed up until adulthood and metabolically challenged by high-fat diet. Blood glucose was measured continuously via a telemetry device. Glucose and insulin tolerance tests were performed, and body composition was analyzed. Weight gain and glucose levels during adolescence and adulthood were similar in male offspring of diabetic and control pregnancies. Body weight and fat mass after high-fat diet, as well as glucose and insulin tolerance tests, were unaltered between male adult offspring of both groups. Glycemic control consisting of up to 49 000 individual glucose measures was comparable between both groups. Intrauterine exposure to maternal hyperglycemia and hyperinsulinemia without obesity had no impact on male offspring metabolic health in our model. We conclude that the intrauterine exposure itself does not represent a mechanism for fetal programming of diabetes and obesity in our model. Other maternal metabolic parameters during pregnancy, such as obesity, might impact long-term offspring metabolic health.
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Affiliation(s)
- Till Schütte
- From the Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Germany (T.S., S.M.K., N.H., F.H., D.N.M., M.B., M.S., R.D., K.K., M.G.).,Institute of Pharmacology, Berlin, Germany (T.S., M.S.).,Berlin Institute of Health, Germany (T.S., S.M.K., N.H., F.H., N.A., D.N.M., M.B., M.S., R.D., K.K., M.G.).,German Center for Cardiovascular Research, Partner Site Berlin, Germany (T.S., S.M.K., N.H., A. Birukov, N.A., D.N.M., M.B., R.D., K.K., M.G.)
| | - Sarah M Kedziora
- From the Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Germany (T.S., S.M.K., N.H., F.H., D.N.M., M.B., M.S., R.D., K.K., M.G.).,Berlin Institute of Health, Germany (T.S., S.M.K., N.H., F.H., N.A., D.N.M., M.B., M.S., R.D., K.K., M.G.).,German Center for Cardiovascular Research, Partner Site Berlin, Germany (T.S., S.M.K., N.H., A. Birukov, N.A., D.N.M., M.B., R.D., K.K., M.G.).,Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany (S.M.K., N.H., F.H., N.A., D.N.M., M.B., R.D., K.K., M.G.).,Experimental and Clinical Research Center-a joint cooperation between the Max-Delbrück-Center for Molecular Medicine and the Charité-Universitätsmedizin Berlin, Germany (S.M.K., N.H., F.H., A. Birukov, D.N.M., R.D., K.K., M.G.)
| | - Nadine Haase
- From the Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Germany (T.S., S.M.K., N.H., F.H., D.N.M., M.B., M.S., R.D., K.K., M.G.).,Berlin Institute of Health, Germany (T.S., S.M.K., N.H., F.H., N.A., D.N.M., M.B., M.S., R.D., K.K., M.G.).,German Center for Cardiovascular Research, Partner Site Berlin, Germany (T.S., S.M.K., N.H., A. Birukov, N.A., D.N.M., M.B., R.D., K.K., M.G.).,Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany (S.M.K., N.H., F.H., N.A., D.N.M., M.B., R.D., K.K., M.G.).,Experimental and Clinical Research Center-a joint cooperation between the Max-Delbrück-Center for Molecular Medicine and the Charité-Universitätsmedizin Berlin, Germany (S.M.K., N.H., F.H., A. Birukov, D.N.M., R.D., K.K., M.G.)
| | - Florian Herse
- From the Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Germany (T.S., S.M.K., N.H., F.H., D.N.M., M.B., M.S., R.D., K.K., M.G.).,Berlin Institute of Health, Germany (T.S., S.M.K., N.H., F.H., N.A., D.N.M., M.B., M.S., R.D., K.K., M.G.).,Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany (S.M.K., N.H., F.H., N.A., D.N.M., M.B., R.D., K.K., M.G.).,Experimental and Clinical Research Center-a joint cooperation between the Max-Delbrück-Center for Molecular Medicine and the Charité-Universitätsmedizin Berlin, Germany (S.M.K., N.H., F.H., A. Birukov, D.N.M., R.D., K.K., M.G.)
| | | | - Anna Birukov
- German Center for Cardiovascular Research, Partner Site Berlin, Germany (T.S., S.M.K., N.H., A. Birukov, N.A., D.N.M., M.B., R.D., K.K., M.G.).,Experimental and Clinical Research Center-a joint cooperation between the Max-Delbrück-Center for Molecular Medicine and the Charité-Universitätsmedizin Berlin, Germany (S.M.K., N.H., F.H., A. Birukov, D.N.M., R.D., K.K., M.G.).,Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany (A. Birukov).,German Center for Diabetes Research, München-Neuherberg, Germany (A. Birukov)
| | - Natalia Alenina
- Berlin Institute of Health, Germany (T.S., S.M.K., N.H., F.H., N.A., D.N.M., M.B., M.S., R.D., K.K., M.G.).,German Center for Cardiovascular Research, Partner Site Berlin, Germany (T.S., S.M.K., N.H., A. Birukov, N.A., D.N.M., M.B., R.D., K.K., M.G.).,Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany (S.M.K., N.H., F.H., N.A., D.N.M., M.B., R.D., K.K., M.G.)
| | - Dominik N Müller
- From the Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Germany (T.S., S.M.K., N.H., F.H., D.N.M., M.B., M.S., R.D., K.K., M.G.).,Berlin Institute of Health, Germany (T.S., S.M.K., N.H., F.H., N.A., D.N.M., M.B., M.S., R.D., K.K., M.G.).,German Center for Cardiovascular Research, Partner Site Berlin, Germany (T.S., S.M.K., N.H., A. Birukov, N.A., D.N.M., M.B., R.D., K.K., M.G.).,Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany (S.M.K., N.H., F.H., N.A., D.N.M., M.B., R.D., K.K., M.G.).,Experimental and Clinical Research Center-a joint cooperation between the Max-Delbrück-Center for Molecular Medicine and the Charité-Universitätsmedizin Berlin, Germany (S.M.K., N.H., F.H., A. Birukov, D.N.M., R.D., K.K., M.G.)
| | - Michael Bader
- From the Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Germany (T.S., S.M.K., N.H., F.H., D.N.M., M.B., M.S., R.D., K.K., M.G.).,Berlin Institute of Health, Germany (T.S., S.M.K., N.H., F.H., N.A., D.N.M., M.B., M.S., R.D., K.K., M.G.).,German Center for Cardiovascular Research, Partner Site Berlin, Germany (T.S., S.M.K., N.H., A. Birukov, N.A., D.N.M., M.B., R.D., K.K., M.G.).,Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany (S.M.K., N.H., F.H., N.A., D.N.M., M.B., R.D., K.K., M.G.).,Institute for Biology, University of Lübeck, Germany (M.B.)
| | - Michael Schupp
- From the Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Germany (T.S., S.M.K., N.H., F.H., D.N.M., M.B., M.S., R.D., K.K., M.G.).,Institute of Pharmacology, Berlin, Germany (T.S., M.S.).,Berlin Institute of Health, Germany (T.S., S.M.K., N.H., F.H., N.A., D.N.M., M.B., M.S., R.D., K.K., M.G.)
| | - Ralf Dechend
- From the Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Germany (T.S., S.M.K., N.H., F.H., D.N.M., M.B., M.S., R.D., K.K., M.G.).,Berlin Institute of Health, Germany (T.S., S.M.K., N.H., F.H., N.A., D.N.M., M.B., M.S., R.D., K.K., M.G.).,German Center for Cardiovascular Research, Partner Site Berlin, Germany (T.S., S.M.K., N.H., A. Birukov, N.A., D.N.M., M.B., R.D., K.K., M.G.).,Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany (S.M.K., N.H., F.H., N.A., D.N.M., M.B., R.D., K.K., M.G.).,Experimental and Clinical Research Center-a joint cooperation between the Max-Delbrück-Center for Molecular Medicine and the Charité-Universitätsmedizin Berlin, Germany (S.M.K., N.H., F.H., A. Birukov, D.N.M., R.D., K.K., M.G.).,HELIOS Klinikum, Department of Cardiology and Nephrology, Berlin, Germany (R.D.)
| | - Kristin Kräker
- From the Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Germany (T.S., S.M.K., N.H., F.H., D.N.M., M.B., M.S., R.D., K.K., M.G.).,Berlin Institute of Health, Germany (T.S., S.M.K., N.H., F.H., N.A., D.N.M., M.B., M.S., R.D., K.K., M.G.).,German Center for Cardiovascular Research, Partner Site Berlin, Germany (T.S., S.M.K., N.H., A. Birukov, N.A., D.N.M., M.B., R.D., K.K., M.G.).,Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany (S.M.K., N.H., F.H., N.A., D.N.M., M.B., R.D., K.K., M.G.).,Experimental and Clinical Research Center-a joint cooperation between the Max-Delbrück-Center for Molecular Medicine and the Charité-Universitätsmedizin Berlin, Germany (S.M.K., N.H., F.H., A. Birukov, D.N.M., R.D., K.K., M.G.)
| | - Michaela Golic
- From the Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Germany (T.S., S.M.K., N.H., F.H., D.N.M., M.B., M.S., R.D., K.K., M.G.).,Berlin Institute of Health, Germany (T.S., S.M.K., N.H., F.H., N.A., D.N.M., M.B., M.S., R.D., K.K., M.G.).,German Center for Cardiovascular Research, Partner Site Berlin, Germany (T.S., S.M.K., N.H., A. Birukov, N.A., D.N.M., M.B., R.D., K.K., M.G.).,Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany (S.M.K., N.H., F.H., N.A., D.N.M., M.B., R.D., K.K., M.G.).,Experimental and Clinical Research Center-a joint cooperation between the Max-Delbrück-Center for Molecular Medicine and the Charité-Universitätsmedizin Berlin, Germany (S.M.K., N.H., F.H., A. Birukov, D.N.M., R.D., K.K., M.G.)
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97
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Hromadnikova I, Kotlabova K, Krofta L, Sirc J. Association Analysis in Children Born from Normal and Complicated Pregnancies-Cardiovascular Disease Associated microRNAs and the Incidence of Prehypertension/Hypertension, Overweight/Obesity, Valve Problems and Heart Defects. Int J Mol Sci 2020; 21:ijms21218413. [PMID: 33182505 PMCID: PMC7672623 DOI: 10.3390/ijms21218413] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 11/04/2020] [Accepted: 11/09/2020] [Indexed: 12/14/2022] Open
Abstract
The goal was to assess how a history of any kind of pregnancy-related complication altered expression profile of microRNAs played a role in the pathogenesis of diabetes, cardiovascular and cerebrovascular diseases in the peripheral blood leukocytes of children at the age of 3–11 years. The prior exposure to gestational hypertension, preeclampsia, fetal growth restriction, gestational diabetes mellitus, preterm prelabor rupture of membranes or spontaneous preterm birth causes that a significant proportion of children (57.42% to 90.0% specifically) had a substantially altered microRNA expression profile, which might be the origin of a lifelong cardiovascular risk. A total of 23 out of 29 tested microRNAs were upregulated in children born from such complicated gestation. The occurrence of overweight, obesity, valve problems and heart defects even intensified upregulation of microRNAs already present in children exposed to such pregnancy complications. The occurrence of overweight/obesity (miR-92a-3p, and miR-210-3p) and valve problems or heart defects (miR-342-3p) induced microRNA upregulation in children affected with pregnancy complications. Overall, 42.86% overweight/obese children and 27.36% children with valve problems or heart defects had even higher microRNA levels than children with normal clinical findings after complicated pregnancies. In addition, the microRNA expression profile was also able to differentiate between children descending from normal gestation in relation to the occurrence of overweight and obesity. Screening on the base of the combination of 19 microRNAs identified 70.0% overweight/obese children at 90.0% specificity. In general, children after complicated pregnancies, just as children after normal pregnancies, with abnormal findings are at a higher risk of the onset of cardiovascular complications, and their dispensarization, with the aim to implement primary prevention strategies, would be beneficial.
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Affiliation(s)
- Ilona Hromadnikova
- Department of Molecular Biology and Cell Pathology, Third Faculty of Medicine, Charles University, 100 00 Prague, Czech Republic;
- Correspondence: ; Tel.: +420-296511336
| | - Katerina Kotlabova
- Department of Molecular Biology and Cell Pathology, Third Faculty of Medicine, Charles University, 100 00 Prague, Czech Republic;
| | - Ladislav Krofta
- Institute for the Care of the Mother and Child, Third Faculty of Medicine, Charles University, 147 00 Prague, Czech Republic; (L.K.); (J.S.)
| | - Jan Sirc
- Institute for the Care of the Mother and Child, Third Faculty of Medicine, Charles University, 147 00 Prague, Czech Republic; (L.K.); (J.S.)
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98
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Bandres-Meriz J, Dieberger AM, Hoch D, Pöchlauer C, Bachbauer M, Glasner A, Niedrist T, van Poppel MNM, Desoye G. Maternal Obesity Affects the Glucose-Insulin Axis During the First Trimester of Human Pregnancy. Front Endocrinol (Lausanne) 2020; 11:566673. [PMID: 33154737 PMCID: PMC7586307 DOI: 10.3389/fendo.2020.566673] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 08/31/2020] [Indexed: 12/21/2022] Open
Abstract
Background and objective: The maternal glucose-insulin axis is central for metabolic adaptations required for a healthy pregnancy. Metabolic changes in obese mothers in early pregnancy have been scantly described. Here we characterized the glucose-insulin axis in the first trimester of human pregnancy and assessed the effect of maternal obesity and fat mass. Methods: In this cross-sectional study, maternal blood samples (N = 323) were collected during voluntary pregnancy termination (gestational age 4+0-11+6 weeks) after overnight fasting. Smokers (N = 198) were identified by self-report and serum cotinine levels (ELISA). Maternal BMI (kg/m2) and serum leptin (ELISA) were used as proxy measures of obesity and maternal fat mass, respectively. BMI was categorized into under-/normal weight (BMI < 25.0 kg/m2), overweight (BMI 25.0-29.9 kg/m2) and obese (BMI ≥ 30.0 kg/m2), and leptin in tertiles (1st tertile: leptin < 6.80 ng/ml, 2nd tertile: leptin 6.80-12.89 ng/ml, 3rd tertile: leptin > 12.89 ng/ml). ISHOMA insulin sensitivity index was calculated from glucose and C-peptide (ELISA) serum concentrations. Analyses of covariance including multiple confounders were performed to test for differences in glucose, C-peptide and ISHOMA between gestational age periods, BMI and leptin groups. C-peptide and ISHOMA were log-transformed before analyses. Results: At weeks 7-9, fasting glucose and C-peptide levels were lower (P < 0.01 and P < 0.001, respectively) and insulin sensitivity higher (P < 0.001) than at weeks 4-6. Glucose levels were not significantly different between BMI or leptin categories. In contrast, C-peptide increased by 19% (P < 0.01) between the normal weight and the overweight group and by 39% (P < 0.001) between the overweight and obese group. In the leptin groups, C-peptide increased by 25% (P < 0.001) between the 1st and 2nd leptin tertile and by 15% (P < 0.05) between the 2nd and 3rd leptin tertile. ISHOMA decreased with higher BMI and fat mass. ISHOMA decreased by 18% (P < 0.01) between the normal weight and the overweight group and by 30% (P < 0.01) between the overweight and the obese group. In the leptin groups, ISHOMA decreased by 22% (P < 0.001) between the 1st and 2nd leptin tertile and by 14% (P < 0.05) between the 2nd and 3rd leptin tertile. Conclusions: At the group level, fasting glucose, C-peptide and insulin sensitivity dynamically change in the first trimester of human pregnancy. Maternal obesity is associated with higher C-peptide and lower insulin sensitivity at all periods in the first trimester of human pregnancy, while glucose is unaltered. These findings have implications for the timing of early gestational diabetes mellitus risk screening.
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Affiliation(s)
- Julia Bandres-Meriz
- Department of Obstetrics and Gynecology, Medical University of Graz, Graz, Austria
| | - Anna M. Dieberger
- Department of Obstetrics and Gynecology, Medical University of Graz, Graz, Austria
| | - Denise Hoch
- Department of Obstetrics and Gynecology, Medical University of Graz, Graz, Austria
| | - Caroline Pöchlauer
- Department of Obstetrics and Gynecology, Medical University of Graz, Graz, Austria
| | - Martina Bachbauer
- Department of Obstetrics and Gynecology, Medical University of Graz, Graz, Austria
| | | | - Tobias Niedrist
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | | | - Gernot Desoye
- Department of Obstetrics and Gynecology, Medical University of Graz, Graz, Austria
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99
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Preston CC, Larsen TD, Eclov JA, Louwagie EJ, Gandy TCT, Faustino RS, Baack ML. Maternal High Fat Diet and Diabetes Disrupts Transcriptomic Pathways That Regulate Cardiac Metabolism and Cell Fate in Newborn Rat Hearts. Front Endocrinol (Lausanne) 2020; 11:570846. [PMID: 33042024 PMCID: PMC7527411 DOI: 10.3389/fendo.2020.570846] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 08/18/2020] [Indexed: 12/14/2022] Open
Abstract
Background: Children born to diabetic or obese mothers have a higher risk of heart disease at birth and later in life. Using chromatin immunoprecipitation sequencing, we previously demonstrated that late-gestation diabetes, maternal high fat (HF) diet, and the combination causes distinct fuel-mediated epigenetic reprogramming of rat cardiac tissue during fetal cardiogenesis. The objective of the present study was to investigate the overall transcriptional signature of newborn offspring exposed to maternal diabetes and maternal H diet. Methods: Microarray gene expression profiling of hearts from diabetes exposed, HF diet exposed, and combination exposed newborn rats was compared to controls. Functional annotation, pathway and network analysis of differentially expressed genes were performed in combination exposed and control newborn rat hearts. Further downstream metabolic assessments included measurement of total and phosphorylated AKT2 and GSK3β, as well as quantification of glycolytic capacity by extracellular flux analysis and glycogen staining. Results: Transcriptional analysis identified significant fuel-mediated changes in offspring cardiac gene expression. Specifically, functional pathways analysis identified two key signaling cascades that were functionally prioritized in combination exposed offspring hearts: (1) downregulation of fibroblast growth factor (FGF) activated PI3K/AKT pathway and (2) upregulation of peroxisome proliferator-activated receptor gamma coactivator alpha (PGC1α) mitochondrial biogenesis signaling. Functional metabolic and histochemical assays supported these transcriptome changes, corroborating diabetes- and diet-induced cardiac transcriptome remodeling and cardiac metabolism in offspring. Conclusion: This study provides the first data accounting for the compounding effects of maternal hyperglycemia and hyperlipidemia on the developmental cardiac transcriptome, and elucidates nuanced and novel features of maternal diabetes and diet on regulation of heart health.
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Affiliation(s)
- Claudia C. Preston
- Genetics and Genomics Group, Sanford Research, Sioux Falls, SD, United States
| | - Tricia D. Larsen
- Environmental Influences on Health and Disease Group, Sanford Research, Sioux Falls, SD, United States
| | - Julie A. Eclov
- Environmental Influences on Health and Disease Group, Sanford Research, Sioux Falls, SD, United States
| | - Eli J. Louwagie
- Environmental Influences on Health and Disease Group, Sanford Research, Sioux Falls, SD, United States
| | - Tyler C. T. Gandy
- Environmental Influences on Health and Disease Group, Sanford Research, Sioux Falls, SD, United States
| | - Randolph S. Faustino
- Genetics and Genomics Group, Sanford Research, Sioux Falls, SD, United States
- Department of Pediatrics, Sanford School of Medicine of the University of South Dakota, Sioux Falls, SD, United States
| | - Michelle L. Baack
- Environmental Influences on Health and Disease Group, Sanford Research, Sioux Falls, SD, United States
- Department of Pediatrics, Sanford School of Medicine of the University of South Dakota, Sioux Falls, SD, United States
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100
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Zhuang W, Lv J, Liang Q, Chen W, Zhang S, Sun X. Adverse effects of gestational diabetes-related risk factors on pregnancy outcomes and intervention measures. Exp Ther Med 2020; 20:3361-3367. [PMID: 32855709 DOI: 10.3892/etm.2020.9050] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 05/28/2020] [Indexed: 12/26/2022] Open
Abstract
This study was designed to investigate the risk factors of gestational diabetes mellitus (GDM), analyze its adverse effects on pregnancy outcomes and propose corresponding interventions. From January 2017 to December 2018, 378 GDM patients (GDM group) awaiting delivery in Weifang People's hospital were selected. At the same time, 200 pregnant women with normal blood glucose (NGT) were randomly selected as the control group. According to general and clinical data, the univariate and multivariate logistic regression analyses were used to screen the risk factors for GDM. The pregnancy outcomes of the two groups were calculated and corresponding intervention measures were proposed to provide a basis for the comprehensive prevention and treatment of gestational diabetes. Multivariate logistic regression analysis showed that age, pre-pregnancy body mass index (BMI), family history of diabetes, 2 h postprandial blood glucose (2hPBG), and glycated hemoglobin (HbA1c) were independent risk factors for GDM (P<0.05). The incidence of dystocia and cesarean section, abnormal amniotic fluid, premature rupture of membranes, and pathological pregnancy in the GDM group were significantly higher than those in the normal control group (P<0.01). The probability of fetal distress, macrosomia, small for date infants, and preterm infants in the GDM group was significantly higher than those in the normal control group (P<0.01). The 2hPBG and HbA1c in the GDM group after the intervention were significantly lower than those before intervention (P<0.05). The age of pregnant women and family history of diabetes play important roles in the presence and progression of GDM. Therefore, pregnant women should pay close attention to the relevant risk factors that trigger GDM, in the screening and prevention of GDM during pregnancy, reduce and prevent the presence of GDM to ensure the safety of mothers and infants.
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Affiliation(s)
- Wenzhen Zhuang
- Medical Record Management Section, Weifang People's Hospital, Weifang, Shandong 261041, P.R. China
| | - Jia Lv
- Department of Obstetrics and Gynecology, Qingdao Hospital of Traditional Chinese Medicine, Qingdao Hiser Hospital, Qingdao, Shandong 266033, P.R. China
| | - Qing Liang
- Department of Obstetrics and Gynecology, Jiyang People's Hospital, Jinan, Shandong 251400, P.R. China
| | - Wenping Chen
- Department of Cardiothoracic Surgery, The People's Hospital of Zhangqiu Area, Jinan, Shandong 250200, P.R. China
| | - Shuangjun Zhang
- Department of Radiology, The People's Hospital of Zhangqiu Area, Jinan, Shandong 250200, P.R. China
| | - Xicai Sun
- Department of Health Management, Weifang People's Hospital, Weifang, Shandong 261041, P.R. China
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