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Wang D, Wang H, Li M, Zhao R. Chemerin levels and its genetic variants are associated with Gestational Diabetes Mellitus: a hospital-based study in a Chinese cohort. Gene 2021; 807:145888. [PMID: 34371096 DOI: 10.1016/j.gene.2021.145888] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 06/29/2021] [Accepted: 08/04/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND Gestational diabetes mellitus (GDM) is a glucose intolerance condition encounters for the first time in a fraction of pregnant women. The role of different host inflammatory molecules in GDM etiology has been deciphered. Chemerin is a chemoattractant protein primarily associated with the pathogenesis of type 2 diabetes, obesity, and metabolic syndrome. However, the association of chemerin and its genetic variants with the predisposition of GDM is not clear, and our present study is aimed to address the issue. MATERIALS AND METHODS A total of 703 Chinese women comprising of GDM (n=303), glucose tolerant pregnant women (n=211), and non-pregnant glucose tolerant controls (n=189) were recruited in the present investigation. GDM was diagnosed according to the World Health Organization recommendation for diagnosis of gestational diabetes during pregnancy. Plasma levels of chemerin were quantified by an Enzyme-linked Immunosorbent Assay (ELISA). Common variants in the chemerin gene (rs4721, rs17173617, rs7806429, and rs17173608) were genotyped by using TaqMan assay. RESULTS Plasma chemerin level was found higher in subjects with GDM as compared to glucose tolerant pregnant and non-pregnant women. Further, a positive correlation between plasma chemerin and HOMA-IR index suggesting an essential role of chemerin in mediating insulin resistance. Variants of rs4721 and rs17173608 polymorphisms were associated with lower levels of plasma chemerin and low HOMA-IR index. Furthermore, mutants of rs4721 and rs17173608 polymorphisms were associated with protection against the development of GDM in the Chinese cohort. CONCLUSIONS Plasma chemerin is elevated in GDM patients. Genetic variation in chemerin gene associated with lower plasma levels of chemerin, HOMA-IR index and protects against the development of GDM in Chinese.
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Affiliation(s)
- Dongsheng Wang
- The department of obstetrics, The Third Hospital of Jinan, Jinan, Shandong 250132, China.
| | - Haiyong Wang
- The department of obstetrics, The Third Hospital of Jinan, Jinan, Shandong 250132, China
| | - Mei Li
- The department of obstetrics, The Third Hospital of Jinan, Jinan, Shandong 250132, China
| | - Ruiyan Zhao
- The department of obstetrics, The Third Hospital of Jinan, Jinan, Shandong 250132, China
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Gázquez A, Rodríguez F, Sánchez-Campillo M, Martínez-Gascón LE, Arnao MB, Saura-Garre P, Albaladejo-Otón MD, Larqué E. Adiponectin agonist treatment in diabetic pregnant rats. J Endocrinol 2021; 251:1-13. [PMID: 34156347 PMCID: PMC8345900 DOI: 10.1530/joe-20-0617] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 06/22/2021] [Indexed: 12/31/2022]
Abstract
Gestational diabetes mellitus (GDM) reduces maternal adiponectin and docosahexaenoic acid (DHA) materno-fetal transfer, which may have negative consequences for the offspring. Our aim was to evaluate the effects of the administration of a novel adiponectin agonist (AdipoRon) to GDM rats on the long-term consequences in glycaemia and fatty acids (FA) profile in the offspring. Pregnant rats were randomized to three groups: GDM rats (GDM, n = 8), GDM rats treated with AdipoRon (GDM + ADI, n = 9), and control rats (n = 10). Diabetes was induced with streptozotocin (50 mg/kg) on day 12 of gestation. GDM+ADI received 50 mg/kg/day AdipoRon from day 14 until delivery. Glycaemia and FA profile were determined in mothers and adult offspring (12 weeks old). AdipoRon tended to reduce fasting glucose in diabetic mothers. Diabetic rats presented the foetus with intrauterine growth restriction and higher adiposity, which tried to be counteracted by AdipoRon. In the adult offspring, both GDM + ADI and control animals showed better glucose recovery after oral glucose overload with respect to GDM. DHA in offspring plasma was significantly reduced in both GDM and GDM + ADI compared to controls (P = 0.043). Nevertheless, n-6/n-3 polyunsaturated FA (PUFA) ratio improved in plasma of GDM + ADI adult offspring (GDM: 14.83 ± 0.85a%; GDM + ADI: 11.49 ± 0.58b%; control: 10.03 ± 1.22b%, P = 0.034). Inflammatory markers and oxidative stress were reduced in the adult offspring of AdipoRon-treated mothers. In conclusion, AdipoRon administration to pregnant diabetic rats improved glycaemia in the mothers and long-term glucose tolerance in the offspring. In addition, it tended to reduce excessive foetal fat accumulation and improved n-6/n-3 PUFA ratio significantly in offspring at the adult state.
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Affiliation(s)
- Antonio Gázquez
- Department of Physiology, CEIR Campus Mare Nostrum, University of Murcia, Biomedical Research Institute of Murcia, Murcia, Spain
| | - Francisca Rodríguez
- Department of Physiology, CEIR Campus Mare Nostrum, University of Murcia, Biomedical Research Institute of Murcia, Murcia, Spain
| | - María Sánchez-Campillo
- Department of Physiology, CEIR Campus Mare Nostrum, University of Murcia, Biomedical Research Institute of Murcia, Murcia, Spain
| | - Lidia E Martínez-Gascón
- Department of Clinical Analysis, Biomedical Research Institute of Murcia, Santa Lucia General University Hospital, Murcia, Spain
| | - Marino B Arnao
- Department of Plant Biology (Plant Physiology), University of Murcia, Murcia, Spain
| | - Pedro Saura-Garre
- Department of Clinical Psychology, University Clinical Hospital Virgen de la Arrixaca, Murcia, Spain
| | - María D Albaladejo-Otón
- Department of Clinical Analysis, Biomedical Research Institute of Murcia, Santa Lucia General University Hospital, Murcia, Spain
| | - Elvira Larqué
- Department of Physiology, CEIR Campus Mare Nostrum, University of Murcia, Biomedical Research Institute of Murcia, Murcia, Spain
- Correspondence should be addressed to E Larque:
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Scazzocchio B, Filardi T, Varì R, Brunelli R, Galoppi P, Morano S, Masella R, Santangelo C. Protocatechuic acid influences immune-metabolic changes in the adipose tissue of pregnant women with gestational diabetes mellitus. Food Funct 2021; 12:7490-7500. [PMID: 34213517 DOI: 10.1039/d1fo00267h] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Gestational diabetes mellitus (GDM) is associated with immune metabolic changes that increase women's risk of developing metabolic disorders later in life. Nutritional intervention is a crucial component in reducing the burden of these pathological features. We examined whether protocatechuic acid (PCA), a major metabolite of anthocyanins abundant in plant food, is able to exert insulin-mimetic activity and modulate inflammation in the visceral adipose tissue (VAT) obtained at delivery, from pregnant women with GDM or normal glucose tolerance (NGT). PCA stimulated glucose uptake in the VAT from both GDM and NGT women. This capability was associated with increased phosphorylation of p38 mitogen-activated protein kinase (p38MAPK), as further demonstrated by the inhibitory effect of SB203580, a p38MAPK inhibitor, on PCA-induced glucose uptake. The GDM-VAT expressed lower adiponectin levels and PCA stimulated adiponectin release in the NGT-VAT and, albeit to a lower extent, in the GDM-VAT. Higher levels of IL6 and TNFα were secreted by the GDM-VAT compared with the NGT one, and PCA had no effects on them. PCA reduced the overexpression of vasoactive intestinal peptide receptor 2 (VPAC2) in the GDM-VAT. Further studies are needed to establish whether and how anthocyanins and food rich in these compounds may contribute to prevent or delay metabolic disorders in women with GDM.
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Affiliation(s)
- Beatrice Scazzocchio
- Center for Gender-Specific Medicine, Gender Specific Prevention and Health Unit, Istituto Superiore di Sanità, Viale Regina Elena, 299, 00161, Rome, Italy.
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Pace NP, Vassallo J. Association Between Neutrophil-Lymphocyte Ratio and Gestational Diabetes-A Systematic Review and Meta-Analysis. J Endocr Soc 2021; 5:bvab051. [PMID: 34095691 PMCID: PMC8169042 DOI: 10.1210/jendso/bvab051] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Indexed: 12/21/2022] Open
Abstract
A growing body of evidence shows that the neutrophil-lymphocyte ratio (NLR) is a surrogate index of systemic inflammation in several chronic diseases. Conflicting associations between NLR and gestational diabetes mellitus (GDM) have been reported in individual studies. This meta-analysis sought to investigate the association between NLR and GDM. The PubMed, EMBASE, and Google Scholar databases were searched to identify relevant articles. The pooled standardized mean difference with 95% CI was calculated using a random-effects model. Subgroup and meta-regression analysis were carried out to control for the effects of GDM diagnostic criteria, ethnicity, body mass index (BMI), and age. Eleven eligible articles were included, containing 1271 participants with GDM and 1504 controls. Pooled outcomes indicated a higher NLR in GDM pregnancies than in normoglycemic controls (SMD = 0.584; 95% CI, 0.339-0.830; P < .001), although extensive heterogeneity between studies was noted. Subgroup analysis revealed that the higher pooled estimate in GDM was not affected by diagnostic criteria, ethnicity, or BMI, although matching for BMI reduced heterogeneity between studies. This meta-analysis supports the higher NLR in GDM described by some individual studies.
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Affiliation(s)
- Nikolai Paul Pace
- Centre for Molecular Medicine and Biobanking, Faculty of Medicine and Surgery, University of Malta, MSD2080 Msida, Malta
| | - Josanne Vassallo
- Centre for Molecular Medicine and Biobanking, Faculty of Medicine and Surgery, University of Malta, MSD2080 Msida, Malta
- Department of Medicine, Faculty of Medicine and Surgery, University of Malta, MSD2080, Msida, Malta
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Tanaka T, Wada T, Uno K, Ogihara S, Ie H, Okekawa A, Ishikawa A, Ito T, Miyazawa Y, Sameshima A, Onogi Y, Tsuneki H, Sasahara M, Nakashima A, Saito S, Sasaoka T. Oestrogen receptor α in T cells controls the T cell immune profile and glucose metabolism in mouse models of gestational diabetes mellitus. Diabetologia 2021; 64:1660-1673. [PMID: 33796910 DOI: 10.1007/s00125-021-05447-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Accepted: 02/08/2021] [Indexed: 12/16/2022]
Abstract
AIMS/HYPOTHESIS The imbalance between maternal insulin resistance and a relative lack of insulin secretion underlies the pathogenesis of gestational diabetes mellitus (GDM). Alterations in T cell subtypes and increased levels of circulating proinflammatory cytokines have been proposed as potential mechanisms underlying the pathophysiology of insulin resistance in GDM. Since oestrogen modulates T cell immunity, we hypothesised that oestrogen plays a homeostatic role in visceral adipose tissue by coordinating T cell immunity through oestrogen receptor α (ERα) in T cells to prevent GDM. METHODS Female CD4-cre ERαfl/fl (KO) mice on a C57BL/6 background with ERα ablation specifically in T cells, and ERαfl/fl (ERα-floxed [FL]) mice were fed 60 kJ% high-fat diet (HFD) for 4 weeks. Female mice mated with male BALB/c mice to achieve allogenic pregnancy and were maintained on an HFD to generate the GDM model. Mice were divided into four experimental groups: non-pregnant FL, non-pregnant KO, pregnant FL (FL-GDM) and pregnant KO (KO-GDM). GTTs and ITTs were performed on day 12.5 or 13.5 and 16.5 after breeding, respectively. On day 18.5 after breeding, mice were killed and T cell subsets in the gonadal white adipose tissue (gWAT) and spleen were analysed using flow cytometry. Histological examination was also conducted and proinflammatory gene expression in gWAT and the liver was evaluated. RESULTS KO mice that mated with BALB/c mice showed normal fertility rates and fetal weights as compared with FL mice. Body and tissue weights were similar between FL and KO mice. When compared with FL-GDM mice, KO-GDM mice showed decreased insulin secretion (serum insulin concentration 15 min after glucose loading: 137.3 ± 18.3 pmol/l and 40.1 ± 36.5 pmol/l, respectively; p < 0.05), impaired glucose tolerance (glucose AUC in GTT: 2308.3 ± 54.0 mmol/l × min and 2620.9 ± 122.1 mmol/l × min, respectively; p < 0.05) and increased numbers of T helper (Th)17 cells in gWAT (0.4 ± 0.0% vs 0.8 ± 0.1%; p < 0.05). However, the contents of Th1 and regulatory T cells (Tregs) in gWAT remained similar between FL-GDM and KO-GDM. Glucose-stimulated insulin secretion was similar between isolated islets derived from FL and KO mice, but was reduced by IL-17A treatment. Moreover, the levels of proinflammatory gene expression, including expression of Emr1 and Tnfa in gWAT, were significantly higher in KO-GDM mice than in FL-GDM mice (5.1-fold and 2.7-fold, respectively; p < 0.01 for both). Furthermore, KO-GDM mice showed increased expression of genes encoding hepatokines, Ahsg and Fgf21 (both were 2.4-fold higher vs FL-GDM mice; p < 0.05 and p = 0.09, respectively), with no changes in inflammatory gene expression (e.g., Tnfa and Ifng) in the liver compared with FL-GDM mice. CONCLUSIONS/INTERPRETATION Deletion of ERα in T cells caused impaired maternal adaptation of insulin secretion, changes in hepatokine profiles, and enhanced chronic inflammation in gWAT alongside an abnormal increase in Th17 cells. These results suggest that the ERα-mediated oestrogen signalling effects in T cells regulate T cell immunity and contribute to glucose homeostasis in pregnancy.
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Affiliation(s)
- Tomoko Tanaka
- Department of Obstetrics and Gynecology, University of Toyama, Toyama, Japan
| | - Tsutomu Wada
- Department of Clinical Pharmacology, University of Toyama, Toyama, Japan.
| | - Kimie Uno
- Department of Clinical Pharmacology, University of Toyama, Toyama, Japan
| | - Saki Ogihara
- Department of Clinical Pharmacology, University of Toyama, Toyama, Japan
| | - Hiromi Ie
- Department of Clinical Pharmacology, University of Toyama, Toyama, Japan
| | - Akira Okekawa
- Department of Clinical Pharmacology, University of Toyama, Toyama, Japan
| | - Akari Ishikawa
- Department of Clinical Pharmacology, University of Toyama, Toyama, Japan
| | - Tetsuo Ito
- Department of Clinical Pharmacology, University of Toyama, Toyama, Japan
| | - Yuichiro Miyazawa
- Department of Clinical Pharmacology, University of Toyama, Toyama, Japan
| | - Azusa Sameshima
- Department of Obstetrics and Gynecology, University of Toyama, Toyama, Japan
| | - Yasuhiro Onogi
- Department of Clinical Pharmacology, University of Toyama, Toyama, Japan
| | - Hiroshi Tsuneki
- Department of Clinical Pharmacology, University of Toyama, Toyama, Japan
| | | | - Akitoshi Nakashima
- Department of Obstetrics and Gynecology, University of Toyama, Toyama, Japan
| | - Shigeru Saito
- Department of Obstetrics and Gynecology, University of Toyama, Toyama, Japan
| | - Toshiyasu Sasaoka
- Department of Clinical Pharmacology, University of Toyama, Toyama, Japan
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Shabir K, Brown JE, Afzal I, Gharanei S, Weickert MO, Barber TM, Kyrou I, Randeva HS. Asprosin, a novel pleiotropic adipokine implicated in fasting and obesity-related cardio-metabolic disease: Comprehensive review of preclinical and clinical evidence. Cytokine Growth Factor Rev 2021; 60:120-132. [PMID: 34108103 DOI: 10.1016/j.cytogfr.2021.05.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 05/09/2021] [Accepted: 05/24/2021] [Indexed: 12/12/2022]
Abstract
White adipose tissue is a dynamic endocrine organ that releases an array of adipokines, which play a key role in regulating metabolic homeostasis and multiple other physiological processes. An altered adipokine secretion profile from adipose tissue depots frequently characterizes obesity and related cardio-metabolic diseases. Asprosin is a recently discovered adipokine that is released in response to fasting. Following secretion, asprosin acts - via an olfactory G-protein coupled receptor and potentially via other unknown receptor(s) - on hepatocytes and agouti-related peptide-expressing neurons in the central nervous system to stimulate glucose secretion and promote appetite, respectively. A growing body of both in vitro and in vivo studies have shown asprosin to exert a number of effects on different metabolic tissues. Indeed, asprosin can attenuate insulin signalling and promote insulin resistance in skeletal muscle by increasing inflammation and endoplasmic reticulum stress. Interestingly, asprosin may also play a protective role in cardiomyocytes that are exposed to hypoxic conditions. Moreover, clinical studies have reported elevated circulating asprosin levels in obesity, type 2 diabetes and other obesity-related cardio-metabolic diseases, with significant associations to clinically relevant parameters. Understanding the spectrum of the effects of this novel adipokine is essential in order to determine its physiologic role and its significance as a potential therapeutic target and/or a biomarker of cardio-metabolic disease. The present review offers a comprehensive overview of the published literature on asprosin, including both clinical and preclinical studies, focusing on its role in metabolism and cardio-metabolic disease.
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Affiliation(s)
- Kiran Shabir
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism (WISDEM), University Hospitals Coventry and Warwickshire NHS Trust, Coventry, CV2 2DX, United Kingdom; Aston Medical School, College of Health and Life Sciences, Aston University, Birmingham, B4 7ET, United Kingdom
| | - James E Brown
- Aston Medical School, College of Health and Life Sciences, Aston University, Birmingham, B4 7ET, United Kingdom; School of Biosciences, College of Health and Life Sciences, Aston University, Birmingham, B4 7ET, United Kingdom
| | - Islam Afzal
- School of Biosciences, College of Health and Life Sciences, Aston University, Birmingham, B4 7ET, United Kingdom
| | - Seley Gharanei
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism (WISDEM), University Hospitals Coventry and Warwickshire NHS Trust, Coventry, CV2 2DX, United Kingdom; Warwick Medical School, University of Warwick, Coventry, CV4 7AL, United Kingdom
| | - Martin O Weickert
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism (WISDEM), University Hospitals Coventry and Warwickshire NHS Trust, Coventry, CV2 2DX, United Kingdom; Warwick Medical School, University of Warwick, Coventry, CV4 7AL, United Kingdom; Centre of Applied Biological & Exercise Sciences, Faculty of Health & Life Sciences, Coventry University, Coventry, CV1 5FB, United Kingdom
| | - Thomas M Barber
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism (WISDEM), University Hospitals Coventry and Warwickshire NHS Trust, Coventry, CV2 2DX, United Kingdom; Warwick Medical School, University of Warwick, Coventry, CV4 7AL, United Kingdom
| | - Ioannis Kyrou
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism (WISDEM), University Hospitals Coventry and Warwickshire NHS Trust, Coventry, CV2 2DX, United Kingdom; Aston Medical School, College of Health and Life Sciences, Aston University, Birmingham, B4 7ET, United Kingdom; Warwick Medical School, University of Warwick, Coventry, CV4 7AL, United Kingdom; Centre for Sport, Exercise and Life Sciences, Research Institute for Health & Wellbeing, Coventry University, CV1 5FB, United Kingdom.
| | - Harpal S Randeva
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism (WISDEM), University Hospitals Coventry and Warwickshire NHS Trust, Coventry, CV2 2DX, United Kingdom; Aston Medical School, College of Health and Life Sciences, Aston University, Birmingham, B4 7ET, United Kingdom; Warwick Medical School, University of Warwick, Coventry, CV4 7AL, United Kingdom.
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Fakhr Y, Brindley DN, Hemmings DG. Physiological and pathological functions of sphingolipids in pregnancy. Cell Signal 2021; 85:110041. [PMID: 33991614 DOI: 10.1016/j.cellsig.2021.110041] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 05/10/2021] [Accepted: 05/11/2021] [Indexed: 01/12/2023]
Abstract
Signaling by the bioactive sphingolipid, sphingosine 1-phosphate (S1P), and its precursors are emerging areas in pregnancy research. S1P and ceramide levels increase towards end of gestation, suggesting a physiological role in parturition. However, high levels of circulating S1P and ceramide are correlated with pregnancy disorders such as preeclampsia, gestational diabetes mellitus and intrauterine growth restriction. Expression of placental and decidual enzymes that metabolize S1P and S1P receptors are also dysregulated during pregnancy complications. In this review, we provide an in-depth examination of the signaling mechanism of S1P and ceramide in various reproductive tissues during gestation. These factors determine implantation and early pregnancy success by modulating corpus luteum function from progesterone production to luteolysis through to apoptosis. We also highlight the role of S1P through receptor signaling in inducing decidualization and angiogenesis in the decidua, as well as regulating extravillous trophoblast migration to anchor the placenta into the uterine wall. Recent advances on the role of the S1P:ceramide rheostat in controlling the fate of villous trophoblasts and the role of S1P as a negative regulator of trophoblast syncytialization to a multinucleated placental barrier are discussed. This review also explores the role of S1P in anti-inflammatory and pro-inflammatory signaling, its role as a vasoconstrictor, and the effects of S1P metabolizing enzymes and receptors in pregnancy.
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Affiliation(s)
- Yuliya Fakhr
- Department of Obstetrics and Gynecology, University of Alberta, Edmonton, AB T6G 2S2, Canada; Women and Children's Health Research Institute, University of Alberta, Edmonton, AB T6G 1C9, Canada
| | - David N Brindley
- Women and Children's Health Research Institute, University of Alberta, Edmonton, AB T6G 1C9, Canada; Signal Transduction Research Group, Department of Biochemistry, University of Alberta, Edmonton, AB T6G 2S2, Canada; Cancer Research Institute of Northern Alberta, University of Alberta, Edmonton, AB T6G 2S2, Canada
| | - Denise G Hemmings
- Department of Obstetrics and Gynecology, University of Alberta, Edmonton, AB T6G 2S2, Canada; Women and Children's Health Research Institute, University of Alberta, Edmonton, AB T6G 1C9, Canada; Li Ka Shing Institute of Virology, University of Alberta, Edmonton, AB T6G 2E1, Canada; Cancer Research Institute of Northern Alberta, University of Alberta, Edmonton, AB T6G 2S2, Canada; Department of Medical Microbiology and Immunology, University of Alberta, Edmonton, AB T6G 2S2, Canada.
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Basu A, Feng D, Planinic P, Ebersole JL, Lyons TJ, Alexander JM. Dietary Blueberry and Soluble Fiber Supplementation Reduces Risk of Gestational Diabetes in Women with Obesity in a Randomized Controlled Trial. J Nutr 2021; 151:1128-1138. [PMID: 33693835 PMCID: PMC8112774 DOI: 10.1093/jn/nxaa435] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 10/09/2020] [Accepted: 12/11/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Gestational diabetes mellitus (GDM) is a growing public health concern and maternal obesity and poor dietary intakes could be implicated. Dietary polyphenols and fiber mitigate the risk of diabetes and its complications, but little is known about their efficacy in preventing GDM. OBJECTIVES We examined the effects of whole blueberry and soluble fiber supplementation on primary outcomes of cardiometabolic profiles in women at high risk of developing GDM. METHODS Women (n = 34; mean ± SD age: 27 ± 5 y; BMI: 35.5 ± 4.0 kg/m2; previous history of GDM ∼56%; Hispanic ∼79%) were recruited in early pregnancy (<20 weeks of gestation) and randomly assigned to 1 of the following 2 groups for 18 wk: intervention (280 g whole blueberries and 12 g soluble fiber per day) and standard prenatal care (control). Both groups received nutrition education and maintained 24-h food recalls throughout the study. Data on anthropometrics, blood pressure, and blood samples for biochemical analyses were collected at baseline (<20 weeks), midpoint (24-28 weeks), and end (32-36 weeks) of gestation. Diagnosis of GDM was based on a 2-step glucose challenge test (GCT). Data were analyzed using a mixed-model ANOVA. RESULTS Maternal weight gain was significantly lower in the dietary intervention than in the control group at the end of the trial (mean ± SD: 6.8 ± 3.2 kg compared with 12.0 ± 4.1 kg, P = 0.001). C-reactive protein was also lower in the intervention than in the control group (baseline: 6.1 ± 4.0 compared with 6.8 ± 7.2 mg/L; midpoint: 6.1 ± 3.7 compared with 7.5 ± 7.3 mg/L; end: 5.5 ± 2.2 compared with 9.5 ± 6.6 mg/L, respectively, P = 0.002). Blood glucose based on GCT was lower in the intervention than in the control (100 ± 33 mg/dL compared with 131 ± 40 mg/dL, P < 0.05). Conventional lipids (total, LDL, and HDL cholesterol and triglycerides) did not differ between groups over time. No differences were noted in infant birth weight. CONCLUSIONS Whole blueberry and soluble fiber supplementation may prevent excess gestational weight gain and improve glycemic control and inflammation in women with obesity.This trial was registered at clinicaltrials.gov as NCT03467503.
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Affiliation(s)
- Arpita Basu
- Department of Kinesiology and Nutrition Sciences, University of Nevada at Las Vegas, Las Vegas, NV, USA
| | - Du Feng
- School of Nursing, University of Nevada at Las Vegas, Las Vegas, NV, USA
| | - Petar Planinic
- Department of Obstetrics & Gynecology, School of Medicine, University of Nevada at Las Vegas, Las Vegas, NV, USA
| | - Jeffrey L Ebersole
- School of Dental Medicine, University of Nevada at Las Vegas, Las Vegas, NV, USA
| | - Timothy J Lyons
- Division of Endocrinology, Medical University of South Carolina, Charleston, SC, USA
| | - James M Alexander
- Department of Obstetrics & Gynecology, School of Medicine, University of Nevada at Las Vegas, Las Vegas, NV, USA
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Mosavat M, Mirsanjari M, Lwaleed BA, Kamarudin M, Omar SZ. Adipocyte-Specific Fatty Acid-Binding Protein (AFABP) and Chemerin in Association with Gestational Diabetes: A Case-Control Study. J Diabetes Res 2021; 2021:5533802. [PMID: 34007846 PMCID: PMC8100411 DOI: 10.1155/2021/5533802] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 04/21/2021] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Adipocytokines participate in regulating the inflammatory response in glucose homeostasis and type 2 diabetes. However, among these peptides, the role of adipocyte-specific fatty-acid-binding protein (AFABP), chemerin, and secreted protein acidic and rich in cysteine (SPARC) in gestational diabetes (GDM) has not been fully investigated. METHOD The maternal fasting level of adipocytokines of 53 subjects with GDM and 43 normal pregnant (NGDM) was measured using multiplex immunoassay at 24-28 weeks, before delivery, immediate postpartum, and 2-6 months postpuerperium. RESULTS Higher levels of AFABP were associated with a 3.7-fold higher risk of GDM. Low chemerin levels were associated with a 3.6-fold higher risk of GDM. Interleukin-10 (IL-10) was inversely associated with the risk of GDM. SPARC had no association with GDM. AFABP was directly correlated to interleukin-6 (r = 0.50), insulin resistance index (r = 0.26), and body mass index (r = 0.28) and inversely correlated to C-reactive protein (r = -0.27). Chemerin levels were directly and strongly correlated with IL-10 (r = 0.41) and interleukin-4 (r = 0.50) and inversely correlated to insulin resistance index (r = -0.23) in GDM but not NGDM. In the longitudinal assessment, there were no significant differences in AFABP and chemerin concentrations of both studied groups. CONCLUSION AFABP and chemerin were associated with a higher risk of GDM. These adipocytokines were related to insulin resistance, body mass index, and inflammation in pregnant women diagnosed with GDM.
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Affiliation(s)
- Maryam Mosavat
- Department of Obstetrics & Gynecology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Mitra Mirsanjari
- Mazandaran University of Medical Sciences, Emam Khomeini Hospital, Fereidonkenar, Mazandaran, Iran
| | | | - Maherah Kamarudin
- Department of Obstetrics & Gynecology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Siti Zawiah Omar
- Department of Obstetrics & Gynecology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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Oztekin O, Cabus U, Enli Y. Decreased serum human leukocyte antigen-G levels are associated with gestational diabetes mellitus. J Obstet Gynaecol Res 2021; 47:2329-2337. [PMID: 33908106 DOI: 10.1111/jog.14811] [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: 10/09/2020] [Revised: 02/21/2021] [Accepted: 04/18/2021] [Indexed: 12/17/2022]
Abstract
AIM This study was designed to determine serum human leukocyte antigen-G (HLA-G) levels and establish whether serum HLA-G level is related with gestational diabetes mellitus (GDM). METHODS Twenty-five GDM patients aged between 24 and 34 years and 24 healthy pregnant women aged between 22 and 33 years were included in this study. Health status of subjects was determined by medical history, physical, and obstetric examinations. Absence of family history for Type 2 diabetes mellitus, absence of diagnosis or clinical evidence of any major disease, and absence of medication use altering glucose metabolism constituted the inclusion criteria. GDM cases who are at their 24-28 weeks of pregnancy and who have not been using any oral hypoglycemic agents were included in GDM group. Control group consisted of healthy pregnant women at their 24-28 weeks of pregnancy. RESULTS Women with GDM had significantly lower levels of serum HLA-G than controls. HLA-G levels were negatively correlated with all parameters of glucose metabolism including insulin (r = - 0.14; p = 0.338), fasting blood glucose (r = - 0.220; p = 0.129), 1-h oral glucose tolerance test (OGTT) blood glucose (r = - 0.18; p = 0.271), 2-h OGTT blood glucose (r = - 0.314; p = 0.172), homeostasis model assessment (r = - 0.226; p = 0.119), HbA1C (r = -0.342; p = 0.108), and WBC (r = -0.149; p = 0.307). There was a negative correlation between HLA-G and BMI (r = -0.341; p = 0.016). CONCLUSION Decreased circulating HLA-G level is found to be associated with insulin resistance and GDM, in this study.
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Affiliation(s)
- Ozer Oztekin
- Department of Obstetrics and Gynecology, School of Medicine, Pamukkale University, Denizli, Turkey
| | - Umit Cabus
- Department of Obstetrics and Gynecology, School of Medicine, Pamukkale University, Denizli, Turkey
| | - Yasar Enli
- Department of Biochemistry, School of Medicine, Pamukkale University, Denizli, Turkey
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Abstract
OBJECTIVE The aim of this study was to evaluate the resistin concentrations in saliva; which is a noninvasive and stress-free diagnostic sample, and to investigate the significance of salivary resistin concentrations in screening GDM. METHODS This cross-sectional case-control study included 41 newly diagnosed GDM patients and 40 healthy pregnant. The participants were consecutively included in the study among eligible pregnant women; who were in the age range from 18 to 40 years of age and at the gestational age between 24 and 28 weeks. The levels of serum and salivary resistin were determined using an enzyme-linked immunosorbent assay method. RESULTS Maternal serum resistin and salivary resistin concentrations were significantly higher in the patients with GDM compared to the individuals in the control group. The data were evaluated by the receiver-operator curve analysis; which revealed that serum and saliva resistin concentrations were moderately successful markers to differentiate subjects with GDM from healthy pregnant women. CONCLUSIONS The results indicate that the determination of saliva resistin levels at the gestational age between 24 to 28 weeks may be used as an alternative, stress-free, and noninvasive technique that may be used in GDM screening.
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Affiliation(s)
- Beril Gürlek
- Department of Obstetrics and Gynecology, Faculty of Medicine, Recep Tayyip Erdogan University, Rize, Turkey
| | - Sabri Çolak
- Department of Obstetrics and Gynecology, Faculty of Medicine, Recep Tayyip Erdogan University, Rize, Turkey
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Ding Y, Wei J, Hettinghouse A, Li G, Li X, Einhorn TA, Liu CJ. Progranulin promotes bone fracture healing via TNFR pathways in mice with type 2 diabetes mellitus. Ann N Y Acad Sci 2021; 1490:77-89. [PMID: 33543485 DOI: 10.1111/nyas.14568] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 01/08/2021] [Accepted: 01/15/2021] [Indexed: 12/12/2022]
Abstract
Type 2 diabetes mellitus (T2DM) significantly increases bone fragility and fracture risk. Progranulin (PGRN) promotes bone fracture healing in both physiological and type 1 diabetic conditions. The present study aimed to investigate the role of PGRN in T2DM bone fracture healing. MKR mice (with an FVB/N genetic background) were used as the T2DM model. Drill-hole and Bonnarens and Einhorn models were used to investigate the role of PGRN in T2DM fracture healing in vivo. Primary bone marrow cells were isolated for molecular and signaling studies, and reverse transcription-polymerase chain reaction, immunohistochemical staining, and western blotting were performed to assess PGRN effects in vitro. PGRN mRNA and protein expression were upregulated in the T2DM model. Local administration of recombinant PGRN effectively promoted T2DM bone fracture healing in vivo. Additionally, PGRN could induce anabolic metabolism during endochondral ossification through the TNFR2-Akt and Erk1/2 pathways. Furthermore, PGRN showed anti-inflammatory activity in the T2DM bone regeneration process. These findings suggest that local administration of exogenous PGRN may be an alternative strategy to support bone regeneration in patients with T2DM. Additionally, PGRN might hold therapeutic potential for other TNFR-related metabolic disorders.
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Affiliation(s)
- Yuanjing Ding
- Department of Orthopaedic Surgery, New York University Medical Center, New York, New York.,Department of Orthopaedic Surgery, Jinan Central Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Jianlu Wei
- Department of Orthopaedic Surgery, New York University Medical Center, New York, New York.,Department of Orthopaedic Surgery, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Aubryanna Hettinghouse
- Department of Orthopaedic Surgery, New York University Medical Center, New York, New York
| | - Guangfei Li
- Department of Orthopaedic Surgery, New York University Medical Center, New York, New York
| | - Xin Li
- College of Dentistry, New York University, New York, New York
| | - Thomas A Einhorn
- Department of Orthopaedic Surgery, New York University Medical Center, New York, New York
| | - Chuan-Ju Liu
- Department of Orthopaedic Surgery, New York University Medical Center, New York, New York.,Department of Cell Biology, New York University School of Medicine, New York, New York
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Does C-C Motif Chemokine Ligand 2 (CCL2) Link Obesity to a Pro-Inflammatory State? Int J Mol Sci 2021; 22:ijms22031500. [PMID: 33540898 PMCID: PMC7867366 DOI: 10.3390/ijms22031500] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 01/27/2021] [Accepted: 01/29/2021] [Indexed: 12/14/2022] Open
Abstract
The mechanisms of how obesity contributes to the development of cardio-metabolic diseases are not entirely understood. Obesity is frequently associated with adipose tissue dysfunction, characterized by, e.g., adipocyte hypertrophy, ectopic fat accumulation, immune cell infiltration, and the altered secretion of adipokines. Factors secreted from adipose tissue may induce and/or maintain a local and systemic low-grade activation of the innate immune system. Attraction of macrophages into adipose tissue and altered crosstalk between macrophages, adipocytes, and other cells of adipose tissue are symptoms of metabolic inflammation. Among several secreted factors attracting immune cells to adipose tissue, chemotactic C-C motif chemokine ligand 2 (CCL2) (also described as monocyte chemoattractant protein-1 (MCP-1)) has been shown to play a crucial role in adipose tissue macrophage infiltration. In this review, we aimed to summarize and discuss the current knowledge on CCL2 with a focus on its role in linking obesity to cardio-metabolic diseases.
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Inflammatory and Adipokine Status from Early to Midpregnancy in Arab Women and Its Associations with Gestational Diabetes Mellitus. DISEASE MARKERS 2021; 2021:8862494. [PMID: 33552314 PMCID: PMC7847332 DOI: 10.1155/2021/8862494] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 01/03/2021] [Accepted: 01/13/2021] [Indexed: 12/15/2022]
Abstract
Objective To examine differences in maternal serum levels of adipokines (adiponectin, leptin, and resistin) and inflammatory markers (tumor necrosis factor-alpha (TNF-α) and interlukin-6 (IL-6)) from early to midpregnancy among Arab women with or without gestational diabetes mellitus (GDM), along with their links to GDM risk. Methods This is a multicenter prospective study involving 232 Saudi women attending obstetric care. Both circulating adipokine and markers of inflammation were observed at the first (eight to 12 weeks) and second trimesters (24 to 28 weeks). GDM was screened at 24 to 28 weeks using the International Association of the Diabetes and Pregnancy Study Groups (IADPSG) criteria. Results Age and body mass index- (BMI-) matched circulating TNF-α was significantly higher in women with GDM in comparison to non-GDM women (p = 0.01). Adiponectin and resistin significantly decreased from the first to second trimester in women without GDM (p = 0.002 and 0.026, respectively). Leptin presented a significant rise from the first to second trimester in both groups, with a higher increase in women with GDM (p = 0.013). Multivariate logistic regression analysis revealed that TNF-α was significantly correlated with GDM (p = 0.03). However, significance was lost after adjustments for maternal and lifestyle risk factors (OR 23.58 (0.50 to 1119.98), p = 0.11). Conclusion Inflammatory and adipocytokine profiles are altered in Arab women with GDM, TNF-α in particular. Further studies are needed to establish whether maternal inflammatory and adipocytokine profile influence fetal levels in the same manner.
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Liu X, Zheng T, Xu YJ, Yang MN, Wang WJ, Huang R, Zhang GH, Guo YN, Zhang J, Ouyang F, Li F, Luo ZC. Sex Dimorphic Associations of Gestational Diabetes Mellitus With Cord Plasma Fatty Acid Binding Protein 4 and Estradiol. Front Endocrinol (Lausanne) 2021; 12:740902. [PMID: 34621244 PMCID: PMC8490798 DOI: 10.3389/fendo.2021.740902] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 09/03/2021] [Indexed: 11/13/2022] Open
Abstract
Fatty acid binding protein 4 (FABP4) has been associated with insulin resistance. Gestational diabetes mellitus (GDM) impairs fetal insulin sensitivity. Female newborns are more insulin resistant than male newborns. We sought to evaluate the association between GDM and cord blood FABP4, and explore potential sex dimorphic associations and the roles of sex hormones. This was a nested case-control study in the Shanghai Birth Cohort, including 153 pairs of newborns in GDM vs. euglycemic pregnancies matched by infant sex and gestational age at delivery. Cord plasma FABP4, leptin, total and high-molecular-weight adiponectin, testosterone and estradiol concentrations were measured. Adjusting for maternal and neonatal characteristics, cord plasma FABP4 (Mean ± SD: 27.0 ± 19.6 vs. 18.8 ± 9.6 ng/mL, P=0.045) and estradiol (52.0 ± 28.6 vs. 44.2 ± 26.6, ng/mL, P=0.005) concentrations were higher comparing GDM vs. euglycemic pregnancies in males, but similar in females (all P>0.5). Mediation analyses showed that the positive association between GDM and cord plasma FABP4 in males could be partly mediated by estradiol (P=0.03), but not by testosterone (P=0.72). Cord plasma FABP4 was positively correlated with total adiponectin in females (r=0.17, P=0.053), but the correlation was in the opposite direction in males (r=-0.11, P=0.16) (test for difference in r, P=0.02). Cord plasma FABP4 was not correlated with leptin in both sexes. The study is the first to demonstrate sex-dimorphic associations between GDM and cord plasma FABP4 or estradiol, and between FABP4 and adiponectin in newborns. GDM may affect fetal circulating FABP4 and estradiol levels in males only.
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Affiliation(s)
- Xin Liu
- Ministry of Education-Shanghai Key Laboratory of Children’s Environmental Health, Early Life Health Institute, Department of Developmental and Behavioral Pediatric & Child Primary Care, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Lunenfeld-Tanenbaum Research Institute, Prosserman Centre for Population Health Research, Department of Obstetrics and Gynecology, Mount Sinai Hospital, Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Tao Zheng
- Department of Obstetrics and Gynecology, Xinhua Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China
| | - Ya-Jie Xu
- Ministry of Education-Shanghai Key Laboratory of Children’s Environmental Health, Early Life Health Institute, Department of Developmental and Behavioral Pediatric & Child Primary Care, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Meng-Nan Yang
- Ministry of Education-Shanghai Key Laboratory of Children’s Environmental Health, Early Life Health Institute, Department of Developmental and Behavioral Pediatric & Child Primary Care, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wen-Juan Wang
- Ministry of Education-Shanghai Key Laboratory of Children’s Environmental Health, Early Life Health Institute, Department of Developmental and Behavioral Pediatric & Child Primary Care, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Rong Huang
- Lunenfeld-Tanenbaum Research Institute, Prosserman Centre for Population Health Research, Department of Obstetrics and Gynecology, Mount Sinai Hospital, Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Guang-Hui Zhang
- Department of Clinical Assay Laboratory, Xinhua Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China
| | - Yu-Na Guo
- Department of Obstetrics and Gynecology, International Peace Maternity and Child Health Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China
| | - Jun Zhang
- Ministry of Education-Shanghai Key Laboratory of Children’s Environmental Health, Early Life Health Institute, Department of Developmental and Behavioral Pediatric & Child Primary Care, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Fengxiu Ouyang
- Ministry of Education-Shanghai Key Laboratory of Children’s Environmental Health, Early Life Health Institute, Department of Developmental and Behavioral Pediatric & Child Primary Care, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Fei Li
- Ministry of Education-Shanghai Key Laboratory of Children’s Environmental Health, Early Life Health Institute, Department of Developmental and Behavioral Pediatric & Child Primary Care, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Brain and Behavioral Research Unit, Shanghai Institute of Pediatric Research, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- *Correspondence: Zhong-Cheng Luo, ; Fei Li,
| | - Zhong-Cheng Luo
- Ministry of Education-Shanghai Key Laboratory of Children’s Environmental Health, Early Life Health Institute, Department of Developmental and Behavioral Pediatric & Child Primary Care, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Lunenfeld-Tanenbaum Research Institute, Prosserman Centre for Population Health Research, Department of Obstetrics and Gynecology, Mount Sinai Hospital, Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- *Correspondence: Zhong-Cheng Luo, ; Fei Li,
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Vernini JM, Nicolosi BF, Arantes MA, Costa RA, Magalhães CG, Corrente JE, Lima SAM, Rudge MV, Calderon IM. Metabolic syndrome markers and risk of hyperglycemia in pregnancy: a cross-sectional cohort study. Sci Rep 2020; 10:21042. [PMID: 33273522 PMCID: PMC7713292 DOI: 10.1038/s41598-020-78099-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 10/29/2020] [Indexed: 12/03/2022] Open
Abstract
The aim was to assess the role of Metabolic Syndrome (MetS) diagnostic markers, recommended by three different guidelines, in the prediction of hyperglycemia in pregnancy. This cross-sectional cohort study included 506 non-diabetic women, with a singleton pregnancy, who underwent a diagnostic test for hyperglycemia at 24-28 weeks. Clinical, anthropometric, and laboratory data were obtained. The relationship between MetS markers and the risk of hyperglycemia was evaluated by backward stepwise logistic regression analysis (OR, 95% CI). The limit of statistical significance was 95% (p < 0.05). Triglycerides (TG) ≥ 150 mg/dL, blood pressure (BP) ≥ 130/85 mmHg, fasting glucose (FG) ≥ 100 mg/dL, and waist circumference (WC) > 88 cm were identified as independent risk factors for hyperglycemia in pregnancy. These results might help the selective screening of hyperglycemia in pregnancy.
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Affiliation(s)
- Joice M Vernini
- Graduate Program in Obstetrics, Gynecology and Mastology, Botucatu Medical School, São Paulo State University/Unesp, São Paulo, Brazil
| | - Bianca F Nicolosi
- Graduate Program in Obstetrics, Gynecology and Mastology, Botucatu Medical School, São Paulo State University/Unesp, São Paulo, Brazil
| | - Mariana A Arantes
- Graduate Program in Obstetrics, Gynecology and Mastology, Botucatu Medical School, São Paulo State University/Unesp, São Paulo, Brazil
| | - Roberto A Costa
- Department of Gynecology and Obstetrics, Botucatu Medical School, São Paulo State University/Unesp, Botucatu, SP, Brazil
| | - Claudia G Magalhães
- Department of Gynecology and Obstetrics, Botucatu Medical School, São Paulo State University/Unesp, Botucatu, SP, Brazil
| | - José E Corrente
- Department of Biostatistics, Botucatu Institute of Biosciences, São Paulo State University/Unesp, São Paulo, Brazil
| | - Silvana A M Lima
- Department of Nursing, Botucatu Medical School, São Paulo State University/Unesp, São Paulo, Brazil
| | - Marilza V Rudge
- Graduate Program in Obstetrics, Gynecology and Mastology, Botucatu Medical School, São Paulo State University/Unesp, São Paulo, Brazil
- Department of Gynecology and Obstetrics, Botucatu Medical School, São Paulo State University/Unesp, Botucatu, SP, Brazil
| | - Iracema M Calderon
- Graduate Program in Obstetrics, Gynecology and Mastology, Botucatu Medical School, São Paulo State University/Unesp, São Paulo, Brazil.
- Department of Gynecology and Obstetrics, Botucatu Medical School, São Paulo State University/Unesp, Botucatu, SP, Brazil.
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Parrettini S, Caroli A, Torlone E. Nutrition and Metabolic Adaptations in Physiological and Complicated Pregnancy: Focus on Obesity and Gestational Diabetes. Front Endocrinol (Lausanne) 2020; 11:611929. [PMID: 33424775 PMCID: PMC7793966 DOI: 10.3389/fendo.2020.611929] [Citation(s) in RCA: 97] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 11/02/2020] [Indexed: 12/14/2022] Open
Abstract
Pregnancy offers a window of opportunity to program the future health of both mothers and offspring. During gestation, women experience a series of physical and metabolic modifications and adaptations, which aim to protect the fetus development and are closely related to both pre-gestational nutritional status and gestational weight gain. Moreover, pre-gestational obesity represents a challenge of treatment, and nowadays there are new evidence as regard its management, especially the adequate weight gain. Recent evidence has highlighted the determinant role of nutritional status and maternal diet on both pregnancy outcomes and long-term risk of chronic diseases, through a transgenerational flow, conceptualized by the Development Origin of Health and Diseases (Dohad) theory. In this review we will analyse the physiological and endocrine adaptation in pregnancy, and the metabolic complications, thus the focal points for nutritional and therapeutic strategies that we must early implement, virtually before conception, to safeguard the health of both mother and progeny. We will summarize the current nutritional recommendations and the use of nutraceuticals in pregnancy, with a focus on the management of pregnancy complicated by obesity and hyperglycemia, assessing the most recent evidence about the effects of ante-natal nutrition on the long-term, on either maternal health or metabolic risk of the offspring.
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Affiliation(s)
- Sara Parrettini
- S. Maria della Misericordia Hospital, Division of Endocrinology and Metabolism, Perugia, Italy
- Department of Medicine, University of Perugia, Perugia, Italy
| | - Antonella Caroli
- S. Maria della Misericordia Hospital, Division of Endocrinology and Metabolism, Perugia, Italy
- Department of Medicine, University of Perugia, Perugia, Italy
| | - Elisabetta Torlone
- S. Maria della Misericordia Hospital, Division of Endocrinology and Metabolism, Perugia, Italy
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Guo YY, Li T, Liu H, Tang L, Li YC, Hu HT, Su YF, Lin Y, Wang YY, Li C, Huang HF, Jin L, Liu XM. Circulating levels of Elabela and Apelin in the second and third trimesters of pregnancies with gestational diabetes mellitus. Gynecol Endocrinol 2020; 36:890-894. [PMID: 32208782 DOI: 10.1080/09513590.2020.1739264] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
We design this study to detect levels of Elabela (ELA) and Apelin (APLN) in women with and without gestational diabetes mellitus (GDM) in the second and third trimesters, and to identify whether there is any association between ELA, APLN, and metabolic parameters. Seventy-nine GDM and 80 control subjects in the second trimester and 87 GDM and 88 healthy subjects in the third trimester were included. In the second trimester, lower ELA levels [(14.1 versus 16.9) ng/ml, p = .025] and higher APLN levels [(1021.8 versus 923.5) pg/ml, p = .046] were observed in GDM patients compared to controls. ELA levels were positively correlated with fasting plasma glucose (FPG) (r = 0.423, p < .001) in the control group, and APLN levels were negatively correlated with triglycerides (TG) (r = -0.251, p = .025) in the control group and total cholesterol (TC) (r = -0.227, p = .044) in the GDM group. ELA appeared to be related to glucose metabolism and APLN is involved in lipid metabolism during pregnancy. The expression of ELA is significantly downregulated from the second trimester to the third trimester.
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Affiliation(s)
- Yan-Yan Guo
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China
- Shanghai Municipal Key Clinical Specialty, Shanghai, China
- Institute of Embryo-Fetal Original Adult Disease, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Tong Li
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China
- Shanghai Municipal Key Clinical Specialty, Shanghai, China
- Institute of Embryo-Fetal Original Adult Disease, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Han Liu
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China
- Shanghai Municipal Key Clinical Specialty, Shanghai, China
- Institute of Embryo-Fetal Original Adult Disease, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Lin Tang
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China
- Shanghai Municipal Key Clinical Specialty, Shanghai, China
- Institute of Embryo-Fetal Original Adult Disease, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yu-Chen Li
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China
- Shanghai Municipal Key Clinical Specialty, Shanghai, China
- Institute of Embryo-Fetal Original Adult Disease, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Hong-Tao Hu
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Department of Gynecology and Obstetrics, the First Affiliated Hospital of Nanjing Medical University/Jiangsu Province hospital, Nanjing, China
| | - Yun-Fei Su
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China
- Shanghai Municipal Key Clinical Specialty, Shanghai, China
- Institute of Embryo-Fetal Original Adult Disease, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yu Lin
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China
- Shanghai Municipal Key Clinical Specialty, Shanghai, China
- Institute of Embryo-Fetal Original Adult Disease, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yin-Yu Wang
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China
- Shanghai Municipal Key Clinical Specialty, Shanghai, China
- Institute of Embryo-Fetal Original Adult Disease, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Cheng Li
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China
- Shanghai Municipal Key Clinical Specialty, Shanghai, China
- Institute of Embryo-Fetal Original Adult Disease, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - He-Feng Huang
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China
- Shanghai Municipal Key Clinical Specialty, Shanghai, China
- Institute of Embryo-Fetal Original Adult Disease, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Li Jin
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China
- Shanghai Municipal Key Clinical Specialty, Shanghai, China
- Institute of Embryo-Fetal Original Adult Disease, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Xin-Mei Liu
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China
- Shanghai Municipal Key Clinical Specialty, Shanghai, China
- Institute of Embryo-Fetal Original Adult Disease, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
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Sun J, Zhang D, Xu J, Chen C, Deng D, Pan F, Dong L, Li S, Ye S. Circulating FABP4, nesfatin-1, and osteocalcin concentrations in women with gestational diabetes mellitus: a meta-analysis. Lipids Health Dis 2020; 19:199. [PMID: 32861247 PMCID: PMC7456504 DOI: 10.1186/s12944-020-01365-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 08/10/2020] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE Recent studies have investigated the circulating adipocyte fatty acid binding protein (FABP4), nesfatin-1, and osteocalcin (OC) concentrations in women diagnosed with gestational diabetes mellitus (GDM), but the findings prove to be conflicting. The objective of this research was to systematically assess the relationship of circulating levels of above adipokines with GDM. METHODS Pubmed, Embase, Web of Science, Cochrane library, OVID, and Scopus were performed to locate articles published up to January 31, 2020. Pooled standard mean differences (SMDs) with 95% confidence intervals (CIs), and 95% predictive intervals (PIs) were calculated by random-effects models to compare levels of adipokines between GDM cases and control groups. Cumulative and single-arm meta-analyses were also performed. RESULTS Thirty-one studies comprising 4590 participants were included. No significant differences were found between GDM women and healthy controls in circulating nesfatin-1 levels (4.56 vs. 5.02 ng/mL; SMD = - 0.11, 95% CI -0.61-0.38, 95% PI -1.63-1.41). Nevertheless, circulating FABP4 and OC levels observed in GDM women outnumbered normal controls (FABP4, 23.68 vs. 16.04 ng/mL; SMD = 2.99, 95% CI 2.28-3.69, 95% PI 0.28-5.71; OC, 52.34 vs. 51.04 ng/mL; SMD = 0.68, 95% CI 0.31-1.05, 95% PI -0.48-1.84). The cumulative meta-analysis showed that the SMDs of circulating FABP4 and OC levels had stabilized between the two groups. CONCLUSIONS Elevated circulating FABP4 and OC levels were observed in GDM women, but nesfatin-1 levels did not change, the PI of OC crossed the no-effect threshold. The results suggested that FABP4 is more suitable as a biomarker of GDM compared to OC in a future study, which is useful in identifying pregnant women who are likely to develop GDM and providing prompt management strategies.
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Affiliation(s)
- Jianran Sun
- Division of Life Science and Medicine, Department of Endocrinology, The First Affiliated Hospital of USTC (Anhui Provincial Hospital), University of Science and Technology of China, 17 Lujiang Road, Hefei, 230001, China
| | - Dai Zhang
- Division of Life Science and Medicine, Department of Endocrinology, The First Affiliated Hospital of USTC (Anhui Provincial Hospital), University of Science and Technology of China, 17 Lujiang Road, Hefei, 230001, China
| | - Jiang Xu
- Division of Life Science and Medicine, Department of Endocrinology, The First Affiliated Hospital of USTC (Anhui Provincial Hospital), University of Science and Technology of China, 17 Lujiang Road, Hefei, 230001, China
| | - Chao Chen
- Division of Life Science and Medicine, Department of Endocrinology, The First Affiliated Hospital of USTC (Anhui Provincial Hospital), University of Science and Technology of China, 17 Lujiang Road, Hefei, 230001, China
| | - Datong Deng
- Department of Endocrinology, The First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Hefei, 230022, Anhui, China
| | - Faming Pan
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81Meishan Road, Hefei, 230032, Anhui, China
| | - Lin Dong
- Division of Life Science and Medicine, Department of Endocrinology, The First Affiliated Hospital of USTC (Anhui Provincial Hospital), University of Science and Technology of China, 17 Lujiang Road, Hefei, 230001, China
| | - Sumei Li
- Division of Life Science and Medicine, Department of Endocrinology, The First Affiliated Hospital of USTC (Anhui Provincial Hospital), University of Science and Technology of China, 17 Lujiang Road, Hefei, 230001, China
| | - Shandong Ye
- Division of Life Science and Medicine, Department of Endocrinology, The First Affiliated Hospital of USTC (Anhui Provincial Hospital), University of Science and Technology of China, 17 Lujiang Road, Hefei, 230001, China.
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Shi D, Wang GH, Feng W. Nutritional assessments in pregnancy and the risk of postpartum depression in Chinese women: A case-control study. Medicine (Baltimore) 2020; 99:e21647. [PMID: 32872028 PMCID: PMC7437826 DOI: 10.1097/md.0000000000021647] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 06/06/2020] [Accepted: 07/09/2020] [Indexed: 01/21/2023] Open
Abstract
Prevalence of postpartum depression (PD) in Chinese women is rising and its associated factors are not well known. In this study we aim to explore the associations between nutritional factors in pregnancy and the risk of PD in Chinese women.A case-control study was performed in our hospital during January 2016 to June 2019. A food frequency questionnaire was designed to collect food consumption before the childbirth preceding month. Nutrition related biochemical indicators including fasting blood-glucose (GLU), total cholesterol (TC), triglyceride (TG), low density lipoprotein (LDL), high density lipoprotein (HDL), and uric acid in the third trimester of pregnancy were detected. Logistic regression model was applied to compute odds ratio (OR) and its corresponding 95% confidence interval (CI).There were 565 participants in this study, which comprised 182 individuals with PD and 383 individuals without. Patients with PD had higher odds of increased GLU (OR=2.62, 95%CI = 1.67-4.11), TC (OR = 1.73 95%CI = 1.22-2.46), TG (OR = 2.43, 95%CI = 1.55-3.81), and LDL (OR = 3.41, 95%CI = 2.09-5.57), but decreased HDL (OR = 3.41, 95%CI = 2.09-5.57) during pregnancy. With respect to uric acid, there was lack of no statistical association (OR = 2.23, 95%CI = 0.82-6.26). Food frequency questionnaire indicated a higher meat intake, but a lower vegetable, fruit, fish, and poultry intake in patients with PD during pregnancy.Increased GLU, TC, TG, and LDL, but decreased HDL in later stages of pregnancy might be associated with PD.
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C1q/TNF-Related Protein-3 (CTRP-3) and Pigment Epithelium-Derived Factor (PEDF) Concentrations in Patients with Gestational Diabetes Mellitus: A Case-Control Study. J Clin Med 2020; 9:jcm9082587. [PMID: 32785102 PMCID: PMC7465884 DOI: 10.3390/jcm9082587] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 07/17/2020] [Accepted: 07/30/2020] [Indexed: 02/06/2023] Open
Abstract
Background: Gestational diabetes mellitus (GDM) is the most common metabolic disorder in pregnant women, defined as any degree of glucose intolerance with onset or first detected during pregnancy. Explanation of its pathogenesis is extremely important due to the possibility of preventing serious maternal and fetal complications. The aim of the study was to evaluate the concentrations of two molecules: C1q/tumor necrosis factor-related protein-3 (CTRP-3) and pigment epithelium-derived factor (PEDF) which may possibly participate in GDM development. To our knowledge, this is the first study in pregnant women with GDM evaluating CTRP-3 level. Methods: Serum CTRP-3 and PEDF concentration and clinical characteristics were detected in 172 pregnant women. These women were divided into two groups: normal glucose tolerance group (NGT, n = 54) and gestational diabetes mellitus group (GDM, n = 118). This second group was further divided into two subgroups depending on the treatment used: GDM 1—diet only (n = 75) and GDM 2—insulin treatment (n = 43). Results: Our study did not reveal any statistically significant difference between the concentration of PEDF in the control and GDM group. In our study there was a significantly higher concentration of CTRP-3 evaluated in the peripheral blood serum in patients with gestational diabetes (GDM) compared to those in the control group (8.84 vs. 4.79 ng/mL). Significantly higher values of CTRP-3 were observed in both the diet-treated subgroup and the group with insulin therapy when compared to control group (8.40 and 10.96, respectively vs. 4.79 ng/mL). Conclusion: PEDF concentration does not change in GDM, whereas an increased level of CTRP-3 may point to the key role of this adipokine in the development of GDM.
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Francis EC, Li M, Hinkle SN, Cao Y, Chen J, Wu J, Zhu Y, Cao H, Kemper K, Rennert L, Williams J, Tsai MY, Chen L, Zhang C. Adipokines in early and mid-pregnancy and subsequent risk of gestational diabetes: a longitudinal study in a multiracial cohort. BMJ Open Diabetes Res Care 2020; 8:8/1/e001333. [PMID: 32747382 PMCID: PMC7398109 DOI: 10.1136/bmjdrc-2020-001333] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 05/07/2020] [Accepted: 05/18/2020] [Indexed: 12/31/2022] Open
Abstract
INTRODUCTION Several adipokines are implicated in the pathophysiology of gestational diabetes mellitus (GDM), however, longitudinal data in early pregnancy on many adipokines are lacking. We prospectively investigated the association of a panel of adipokines in early and mid-pregnancy with GDM risk. RESEARCH DESIGN AND METHODS Within the National Institute of Child Health and Human Development (NICHD) Fetal Growth Studies-Singletons cohort (n=2802), a panel of 10 adipokines (plasma fatty acid binding protein-4 (FABP4), chemerin, interleukin-6 (IL-6), leptin, soluble leptin receptor (sOB-R), adiponectin, omentin-1, vaspin, and retinol binding protein-4) were measured at gestational weeks (GWs) 10-14, 15-26, 23-31, and 33-39 among 107 GDM cases (ascertained on average at GW 27) and 214 non-GDM controls. Conditional logistic regression was used to estimate ORs of each adipokine and GDM, controlling for known GDM risk factors including pre-pregnancy body mass index. RESULTS Throughout pregnancy changes in chemerin, sOB-R, adiponectin, and high-molecular-weight adiponectin (HMW-adiponectin) concentrations from 10-14 to 15-26 GWs were significantly different among GDM cases compared with non-GDM controls. In early and mid-pregnancy, FABP4, chemerin, IL-6 and leptin were positively associated with increased GDM risk. For instance, at 10-14 GWs, the OR comparing the highest versus lowest quartile (ORQ4-Q1) of FABP4 was 3.79 (95% CI 1.63 to 8.85). In contrast, in both early and mid-pregnancy adiponectin (eg, ORQ4-Q1 0.14 (0.05, 0.34) during 10-14 GWs) and sOB-R (ORQ4-Q1 0.23 (0.11, 0.50) during 10-14 GWs) were inversely related to GDM risk. At 10-14 GWs a model that included conventional GDM risk factors and FABP4, chemerin, sOB-R, and HMW-adiponectin improved the estimated prediction (area under the curve) from 0.71 (95% CI 0.66 to 0.77) to 0.77 (95% CI 0.72 to 0.82). CONCLUSIONS A panel of understudied adipokines including FABP4, chemerin, and sOB-R may be implicated in the pathogenesis of GDM with significant associations detected approximately 10-18 weeks before typical GDM screening.
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Affiliation(s)
- Ellen C Francis
- Colorado School of Public Health, University of Colorado Denver - Anschutz Medical Campus, Aurora, Colorado, USA
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland, USA
| | - Mengying Li
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland, USA
| | - Stefanie N Hinkle
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland, USA
| | - Yaqi Cao
- Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Jinbo Chen
- Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Jing Wu
- Glotech, Rockville, Maryland, USA
| | - Yeyi Zhu
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA
| | - Haiming Cao
- Cardiovascular Branch, National Heart Lung and Blood Institute, Bethesda, Maryland, USA
| | - Karen Kemper
- Department of Public Health Sciences, Clemson University College of Behavioral, Social and Health Sciences, Clemson, South Carolina, USA
| | - Lior Rennert
- Department of Public Health Sciences, Clemson University College of Behavioral, Social and Health Sciences, Clemson, South Carolina, USA
| | - Joel Williams
- Department of Public Health Sciences, Clemson University College of Behavioral, Social and Health Sciences, Clemson, South Carolina, USA
| | - Michael Y Tsai
- Laboratory Medicine and Pathology, University of Minnesota System, Minneapolis, Minnesota, USA
| | - Liwei Chen
- Epidemiology, University of California Los Angeles Jonathan and Karin Fielding School of Public Health, Los Angeles, California, USA
| | - Cuilin Zhang
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland, USA
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Jensen ME, Barrett HL, Peek MJ, Gibson PG, Murphy VE. Maternal asthma and gestational diabetes mellitus: Exploration of potential associations. Obstet Med 2020; 14:12-18. [PMID: 33995566 DOI: 10.1177/1753495x20926799] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 02/14/2020] [Accepted: 04/20/2020] [Indexed: 11/17/2022] Open
Abstract
Asthma and gestational diabetes mellitus are prevalent during pregnancy and associated with adverse perinatal outcomes. The risk of gestational diabetes mellitus is increased with asthma, and more severe asthma; yet, the underlying mechanisms are unknown. This review examines existing literature to explore possible links. Asthma and gestational diabetes mellitus are associated with obesity, excess gestational weight gain, altered adipokine levels and low vitamin D levels; yet, it's unclear if these underpin the gestational diabetes mellitus-asthma association. Active antenatal asthma management reportedly mitigates asthma-associated gestational diabetes mellitus risk. However, mechanistic studies are lacking. Existing research suggests asthma management during pregnancy influences gestational diabetes mellitus risk; this may have important implications for future antenatal strategies to improve maternal-fetal outcomes by addressing both conditions. Addressing shared risk factors, as part of antenatal care, may also improve outcomes. Finally, mechanistic studies, to establish the underlying pathophysiology linking asthma and gestational diabetes mellitus, could uncover new treatment approaches to optimise maternal and child health outcomes.
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Affiliation(s)
- M E Jensen
- Priority Research Centre Grow Up Well, School of Medicine & Public Health, Faculty of Health, University of Newcastle, NSW, Australia
| | - H L Barrett
- Queensland Diabetes and Endocrine Centre, Mater Health Services, South Brisbane, QLD, Australia.,Mater Research Institute, The University of Queensland, St Lucia, QLD, Australia
| | - M J Peek
- Australian National University Medical School, The Australian National University, ACT, Australia.,Department of Obstetrics and Gynaecology, Centenary Hospital for Women and Children, ACT, Australia
| | - P G Gibson
- Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute, University of Newcastle, NSW, Australia.,Department of Respiratory and Sleep Medicine, John Hunter Hospital, NSW, Australia
| | - V E Murphy
- Priority Research Centre Grow Up Well, School of Medicine & Public Health, Faculty of Health, University of Newcastle, NSW, Australia
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74
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Zhang C, Li Y, Wang J, Liu C, Chen Y. Association between levels of aquaporin 3 in the placenta and adiponectin in the umbilical cord blood with gestational diabetes mellitus and pregnancy outcome. Mol Med Rep 2020; 22:1498-1506. [PMID: 32627013 PMCID: PMC7339817 DOI: 10.3892/mmr.2020.11225] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 04/28/2020] [Indexed: 12/20/2022] Open
Abstract
Pregnant women with gestational diabetes mellitus (GDM) may have adverse pregnancy outcomes, even if their blood glucose level is well-controlled. Aquaporin 3 (AQP3) and adiponectin (APN) serve important roles in fetal growth and development. However, the associations of AQP3 and APN with GDM and pregnancy outcome are not known. Therefore, the present study was performed to evaluate the expression of AQP3 in the placenta and APN in the umbilical artery blood, and the association of the two factors with GDM and pregnancy outcome. The patient cohort was divided into two groups: Pregnant women with GDM; and pregnant women with normal glucose tolerance (NGT). The expression levels of AQP3 in the placenta and APN in the umbilical artery blood were detected. Logistic regression was used to analyze the associations of AQP3 and APN with GDM and pregnancy outcome. The expression levels of AQP3 and AQP3 mRNA in the placenta of the GDM group were decreased compared with that of the NGT group, and the difference was statistically significant (P<0.05). The expression of APN in the umbilical artery blood of the GDM group was also decreased compared with that of the NGT group, and the difference was also statistically significant (P<0.05). Multivariate logistic regression analyses indicated that the AQP3 and APN levels were negatively correlated not only with the risk of developing GDM [AQP3 odds ratio (OR)=5.00 (P<0.01); APN OR=2.98 (P=0.01)], but also with abnormal pregnancy outcome [(AQP3 OR=4.64 (P<0.01); APN OR=5.41 (P<0.01)]. The levels of AQP3 in the placenta and APN in the umbilical cord blood were associated with GDM, and the risk of GDM was increased in pregnant women with decreased AQP3 and APN levels. The AQP3 and APN levels also had an effect on pregnancy outcome. The risk of abnormal pregnancy outcomes, including cesarean section, macrosomia, fetal distress and neonatal asphyxia, was increased in pregnant women with decreased AQP3 and APN levels.
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Affiliation(s)
- Chunqi Zhang
- Department of Obstetrics and Gynecology, North China University of Science and Technology Affiliated Hospital, Tangshan, Hebei 063000, P.R. China
| | - Yanxia Li
- Department of Obstetrics and Gynecology, North China University of Science and Technology Affiliated Hospital, Tangshan, Hebei 063000, P.R. China
| | - Jia Wang
- Department of Obstetrics and Gynecology, North China University of Science and Technology Affiliated Hospital, Tangshan, Hebei 063000, P.R. China
| | - Chunmei Liu
- Department of Obstetrics and Gynecology, North China University of Science and Technology Affiliated Hospital, Tangshan, Hebei 063000, P.R. China
| | - Yan Chen
- Department of Obstetrics and Gynecology, North China University of Science and Technology Affiliated Hospital, Tangshan, Hebei 063000, P.R. China
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Role of adipose tissue in regulating fetal growth in gestational diabetes mellitus. Placenta 2020; 102:39-48. [PMID: 33218577 DOI: 10.1016/j.placenta.2020.05.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 05/14/2020] [Accepted: 05/17/2020] [Indexed: 02/06/2023]
Abstract
Gestational diabetes mellitus (GDM) is a global health issue with significant short and long-term complications for both mother and baby. There is a strong need to identify an effective therapeutic that can prevent the development of GDM. A better understanding of the pathophysiology of GDM and the relationship between the adipose tissue, the placenta and fetal growth is required. The placenta regulates fetal growth by modulating nutrient transfer of glucose, amino acids and fatty acids. Various factors secreted by the adipose tissue, such as adipokines, adipocytokines and more recently identified extracellular vesicles, can influence inflammation and interact with placental nutrient transport. In this review, the role of the placental nutrient transporters and the adipose-derived factors that can influence their function will be discussed. A better understanding of these factors and their relationship may make a potential target for therapeutic interventions to prevent the development of GDM and its consequences.
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Grupe K, Asuaje Pfeifer M, Dannehl F, Liebmann M, Rustenbeck I, Schürmann A, Scherneck S. Metabolic changes during pregnancy in glucose-intolerant NZO mice: A polygenic model with prediabetic metabolism. Physiol Rep 2020; 8:e14417. [PMID: 32374082 PMCID: PMC7201426 DOI: 10.14814/phy2.14417] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 03/18/2020] [Accepted: 03/18/2020] [Indexed: 12/25/2022] Open
Abstract
Gestational diabetes mellitus (GDM) is a complex metabolic disease involving genetic and environmental factors. Recent studies have underlined its heterogeneity, so it is reasonable to divide patients into subpopulations depending on whether an insulin secretion or sensitivity defect is predominant. Since testing for GDM is usually performed in the second trimester, misinterpretation of prediabetes as gestational diabetes may occur. As with type 2 diabetes (T2DM), rodent models are needed for both GDM and prediabetes, but few do exist. Here, we compared the metabolic changes in pregnant normal NMRI mice with those in New Zealand obese (NZO) mice. Male animals of this strain are an established model of T2DM, whereas female mice of this strain are protected from hyperglycemia and β-cell death. We demonstrate that female NZO mice exhibited impaired glucose tolerance, preconceptional hyperinsulinemia, and hyperglucagonemia without any signs of manifest diabetes. The NZO model showed, compared with the NMRI control strain, a reduced proliferative response of the Langerhans islets during pregnancy (3.7 ± 0.4 vs. 7.2 ± 0.8% Ki-67-positive nuclei, p = .004). However, oral glucose tolerance tests revealed improved stimulation of insulin secretion in both strains. But this adaption was not sufficient to prevent impaired glucose tolerance in NZO mice compared with the NMRI control (p = .0002). Interestingly, glucose-stimulated insulin secretion was blunted in isolated primary NZO islets in perifusion experiments. In summary, the NZO mouse reflects important characteristics of human GDM and prediabetes in pregnancy and serves as a model for subpopulations with early alterations in glucose metabolism and primary insulin secretion defect.
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Affiliation(s)
- Katharina Grupe
- Institute of Pharmacology, Toxicology and Clinical PharmacyTechnische Universität BraunschweigBraunschweigGermany
| | - Melissa Asuaje Pfeifer
- Institute of Pharmacology, Toxicology and Clinical PharmacyTechnische Universität BraunschweigBraunschweigGermany
| | - Franziska Dannehl
- Institute of Pharmacology, Toxicology and Clinical PharmacyTechnische Universität BraunschweigBraunschweigGermany
| | - Moritz Liebmann
- Institute of Pharmacology, Toxicology and Clinical PharmacyTechnische Universität BraunschweigBraunschweigGermany
| | - Ingo Rustenbeck
- Institute of Pharmacology, Toxicology and Clinical PharmacyTechnische Universität BraunschweigBraunschweigGermany
| | - Annette Schürmann
- Department of Experimental DiabetologyGerman Institute of Human Nutrition Potsdam‐RehbrückeNuthetalGermany
- German Institute for Diabetes Research (DZD)NeuherbergGermany
| | - Stephan Scherneck
- Institute of Pharmacology, Toxicology and Clinical PharmacyTechnische Universität BraunschweigBraunschweigGermany
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Adipocytokines are not associated with gestational diabetes mellitus but with pregnancy status. Cytokine 2020; 131:155088. [PMID: 32283441 DOI: 10.1016/j.cyto.2020.155088] [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] [Received: 01/13/2020] [Revised: 03/12/2020] [Accepted: 04/01/2020] [Indexed: 02/08/2023]
Abstract
AIMS Adipose tissue-secreted proteins, i.e. adipocytokines, have been identified as potential mediators linking fat mass and adipose tissue dysfunction with impaired glucose homeostasis, alterations in the inflammatory status, and risk of diabetes. The aim of this study was to determine whether seven circulating adipocytokines are associated with gestational diabetes mellitus (GDM) or are altered by metabolic and weight changes during pregnancy itself. METHODS A panel of seven adipocytokines (i.e. adiponectin, adipocyte fatty acid-binding protein, chemerin, leptin, Pro-Enkephalin, progranulin, and Pro-Neurotensin) was quantified in serum in a cross-sectional cohort of 222 women with the following three groups matched for age and body mass index: (i) 74 pregnant women with GDM; (ii) 74 pregnant women without GDM; and (iii) 74 non-pregnant and healthy women. A stepwise statistical approach was used by performing pairwise comparisons, principal component analysis (PCA), and partial least square discriminant analysis (PLS-DA). RESULTS Five out of seven adipocytokines were dysregulated between pregnant and non-pregnant women, i.e. adiponectin, chemerin, leptin, Pro-Enkephalin, and progranulin. None of the adipocytokines significantly differed between GDM and non-GDM status during pregnancy. The same five adipocytokines clustered in a principal component representing pregnancy-induced effects. Fasting insulin was the most relevant parameter in the discrimination of GDM as compared to pregnant women without GDM, whereas chemerin and adiponectin were most relevant factors to discriminate pregnancy status. CONCLUSIONS Pregnancy status but not presence of GDM can be distinguished by the seven investigated adipocytokines in discrimination analyses.
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Zhou X, Wei LJ, Li JQ, Zhang JY, Zhu SL, Zhang HT, Jia J, Yu J, Wang SS, Feng L. The Activation of Peroxisome Proliferator-activated Receptor γ Enhances Insulin Signaling Pathways Via Up-regulating Chemerin Expression in High Glucose Treated HTR-8/SVneo Cells. MATERNAL-FETAL MEDICINE 2020. [DOI: 10.1097/fm9.0000000000000044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Miao Z, Wu H, Ren L, Bu N, Jiang L, Yang H, Zhang J, Guo X. Long-Term Postpartum Outcomes of Insulin Resistance and β-cell Function in Women with Previous Gestational Diabetes Mellitus. Int J Endocrinol 2020; 2020:7417356. [PMID: 32184821 PMCID: PMC7061142 DOI: 10.1155/2020/7417356] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 12/11/2019] [Accepted: 12/26/2019] [Indexed: 12/17/2022] Open
Abstract
AIMS The objective of the present study was to explore the long-term postpartum glucose metabolism in women with previous GDM, and study the mechanism of hyperglycemia from gestation to postpartum by investigating the postpartum insulin resistance and insulin secretion. METHODS A total of 321 females with previous GDM were followed up once during 1- to 6-years postpartum. Characteristics during pregnancy, perinatal period, and postpartum were compared between postpartum NGT and hyperglycemic women. HOMA-IR and HOMA-β were used to assess insulin resistance and insulin secretion levels with different glucose statuses. RESULTS The prevalence of postpartum hyperglycemia had a fluctuant increase from 25.9% at 1 year, to 53.7% at 5 year. 75 g OGTT 2 hPG during pregnancy was an independent predictor of postpartum hyperglycemia with an OR of 2.15 (95% CI 1.245, 3.722) (P=0.006). After ROC analysis, the best equilibrium between sensitivity (70.3%) and specificity (60.4%) for 2 hPG was 9.03 mmol/L. HOMA-IR was increased in postpartum normal glucose tolerance (NGT), prediabetes, and T2DM (1.64 vs. 2.14 vs. 4.27, P=0.006). After ROC analysis, the best equilibrium between sensitivity (70.3%) and specificity (60.4%) for 2 hPG was 9.03 mmol/L. HOMA-IR was increased in postpartum normal glucose tolerance (NGT), prediabetes, and T2DM (1.64 vs. 2.14 vs. 4.27, β were used to assess insulin resistance and insulin secretion levels with different glucose statuses. P=0.006). After ROC analysis, the best equilibrium between sensitivity (70.3%) and specificity (60.4%) for 2 hPG was 9.03 mmol/L. HOMA-IR was increased in postpartum normal glucose tolerance (NGT), prediabetes, and T2DM (1.64 vs. 2.14 vs. 4.27, β were used to assess insulin resistance and insulin secretion levels with different glucose statuses. CONCLUSIONS 75 g OGTT 2h PG during pregnancy higher than 9.03 mmol/L is regarded as an independent risk factor of postpartum hyperglycemia. Insulin resistance with insufficient insulin secretion compensation is still common phenomenon during long-term postpartum. Women with heavier insulin resistance in the postpartum period are more likely develop prediabetes, while decreased β-cell function contributes more to T2DM development.β were used to assess insulin resistance and insulin secretion levels with different glucose statuses.
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Affiliation(s)
- Zhirong Miao
- Department of Endocrinology and Metabolism, Peking University First Hospital, Beijing 100034, China
| | - Honghua Wu
- Department of Endocrinology and Metabolism, Peking University First Hospital, Beijing 100034, China
| | - Liu Ren
- Department of Endocrinology and Metabolism, Peking University First Hospital, Beijing 100034, China
| | - Nan Bu
- Department of Endocrinology and Metabolism, Peking University First Hospital, Beijing 100034, China
| | - Lili Jiang
- Department of Endocrinology and Metabolism, Peking University First Hospital, Beijing 100034, China
| | - Huixia Yang
- Department of Gynecology and Obstetrics, Peking University First Hospital, Beijing 100034, China
| | - Junqing Zhang
- Department of Endocrinology and Metabolism, Peking University First Hospital, Beijing 100034, China
| | - Xiaohui Guo
- Department of Endocrinology and Metabolism, Peking University First Hospital, Beijing 100034, China
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Sun J, Ren J, Zuo C, Deng D, Pan F, Chen R, Zhu J, Chen C, Ye S. Circulating apelin, chemerin and omentin levels in patients with gestational diabetes mellitus: a systematic review and meta-analysis. Lipids Health Dis 2020; 19:26. [PMID: 32087711 PMCID: PMC7035755 DOI: 10.1186/s12944-020-01209-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2019] [Accepted: 02/18/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The available data on the significance of circulating apelin, chemerin and omentin in women with gestational diabetes mellitus (GDM) are inconsistent. This analysis includes a systematic review of the evidence associating the serum concentrations of these adipokines with GDM. METHODS Publications through December 2019 were retrieved from PubMed, Embase, the Cochrane Library, and Web of Science. Subgroup analysis and meta-regression were conducted to evaluate sources of heterogeneity. RESULTS Analysis of 20 studies, including 1493 GDM patients and 1488 normal pregnant women did not find significant differences in circulating apelin and chemerin levels (apelin standardized mean difference [SMD] = 0.43, 95% confidence interval (CI): - 0.40 to 1.26, P = 0.31; chemerin SMD = 0.77, 95% CI - 0.07 to 1.61, P = 0.07). Circulating omentin was significantly lower in women with GDM than in healthy controls (SMD = - 0.72, 95% CI - 1.26 to - 0.19, P = 0.007). Publication bias was not found; sensitivity analysis confirmed the robustness of the pooled results. CONCLUSIONS Circulating omentin was decreased in GDM patients, but apelin and chemerin levels were not changed. The results suggest that omentin has potential as a novel biomarker for the prediction and early diagnosis of GDM.
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Affiliation(s)
- Jianran Sun
- Division of Life Science and Medicine, Department of Endocrinology, The First Affiliated Hospital of USTC (Anhui Provincial Hospital), University of Science and Technology of China, 17 Lujiang Road, Hefei, 230001, China
| | - Jiale Ren
- Department of Rheumatology and Immunology, Arthritis Research Institute, The First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Hefei, 230022, Anhui, China
| | - Chunlin Zuo
- Department of Endocrinology, Institute of Endocrinology and Metabolism, The First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Hefei, 230022, Anhui, China
| | - Datong Deng
- Department of Endocrinology, Institute of Endocrinology and Metabolism, The First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Hefei, 230022, Anhui, China
| | - Faming Pan
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81Meishan Road, Hefei, 230032, Anhui, China
| | - Ruoping Chen
- Division of Life Science and Medicine, Department of Endocrinology, The First Affiliated Hospital of USTC (Anhui Provincial Hospital), University of Science and Technology of China, 17 Lujiang Road, Hefei, 230001, China
| | - Jie Zhu
- Division of Life Science and Medicine, Department of Endocrinology, The First Affiliated Hospital of USTC (Anhui Provincial Hospital), University of Science and Technology of China, 17 Lujiang Road, Hefei, 230001, China
| | - Chao Chen
- Division of Life Science and Medicine, Department of Endocrinology, The First Affiliated Hospital of USTC (Anhui Provincial Hospital), University of Science and Technology of China, 17 Lujiang Road, Hefei, 230001, China
| | - Shandong Ye
- Division of Life Science and Medicine, Department of Endocrinology, The First Affiliated Hospital of USTC (Anhui Provincial Hospital), University of Science and Technology of China, 17 Lujiang Road, Hefei, 230001, China.
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Homayouni A, Bagheri N, Mohammad-Alizadeh-Charandabi S, Kashani N, Mobaraki-Asl N, Mirghafurvand M, Asgharian H, Ansari F, Pourjafar H. Prevention of Gestational Diabetes Mellitus (GDM) and Probiotics: Mechanism of Action: A Review. Curr Diabetes Rev 2020; 16:538-545. [PMID: 31544699 DOI: 10.2174/1573399815666190712193828] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2019] [Revised: 05/05/2019] [Accepted: 06/20/2019] [Indexed: 12/16/2022]
Abstract
BACKGROUND Gestational Diabetes Mellitus (GDM) is a health problem that is increasing around the world. INTRODUCTION Prevention of GDM, rather than treatment, could have several benefits in terms of both health and economic cost. Even a slight reduction in maternal glucose in non-diabetic women, particularly in women at high risk for GDM, may have significant benefits for pregnancy results and the future health of off-springs. Probiotics are a relatively new intervention, which are assessed by mothers' metabolism, and can reduce blood sugar levels, prevent gestational diabetes and reduce the maternal and fetal complications resulting from it. The aim of this study was to review the studies on the prevention of gestational diabetes and assess the potential beneficial effects of probiotics on gestational diabetes and their possible mechanism of action. METHODS Articles compiled through clinical trials indexed in PubMed, Science Direct, Cochran, and Medlib between 2000 and 2017, with the keywords probiotics, prevention, and gestational diabetes mellitus were selected. RESULTS Considering the potential of probiotics in the modulation of gut microbiota, naturalization increases intestinal permeability, regulation of pro-inflammatory mediators' secretion and thereby controlling local and systemic inflammation results in decreasing intestinal permeability, enhancing the immune system. It likely has the ability to prevent or control diabetes during pregnancy although confirmatory studies are still needed. CONCLUSION Experimental and clinical evidence support the supposition that the modulation of the gut microbiota via probiotic microorganisms could be effective in the prevention of gestational diabetes mellitus.
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Affiliation(s)
- Aziz Homayouni
- Department of Food Science and Technology, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Nahal Bagheri
- Chemistry and Electrical Engineering, Sharif University of Technology, Tehran, Iran
| | | | - Neda Kashani
- Department of Midwifery, Faculty of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran
| | | | - Mojgan Mirghafurvand
- Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hanieh Asgharian
- Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Fereshteh Ansari
- Research Center for Evidence-Based Medicine, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
- Iranian EBM Centre: A Joanna Briggs Institute Affiliated Group, Tabriz, Iran
- Razi Vaccine and Serum Research Institute, Agricultural Research, Education and Extension Organization (AREEO), Tehran, Iran
| | - Hadi Pourjafar
- Department of Food Sciences and Nutrition, Maragheh University of Medical Sciences, Maragheh, Iran
- Alborz University of Medical Sciences, Dietary Supplements and Probiotic Research Center, Karaj, Iran
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Pan X, Kaminga AC, Wen SW, Acheampong K, Liu A. Omentin-1 in diabetes mellitus: A systematic review and meta-analysis. PLoS One 2019; 14:e0226292. [PMID: 31821362 PMCID: PMC6903756 DOI: 10.1371/journal.pone.0226292] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Accepted: 11/22/2019] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE Previous studies found inconsistent results on the relationship between diabetes mellitus and concentrations of omentin-1. This study performed a systematic review and meta-analysis to summarize previous findings on this relationship. METHODS Studies related to this outcome were obtained using a systematic search in the electronic databases of Cochrane Library, PubMed, Embase, SCOPUS, Google Scholar, gray literature and Web of Science in September 2019. The random effects model was used to measure the strength of the association between diabetes mellitus and concentrations of omentin-1, using standardized mean difference. RESULTS Forty-two eligible studies were included in the final meta-analysis. There was no significant difference in omentin-1 concentration between patients with type 1 diabetes mellitus and the controls. On the other hand, lower concentration levels of omentin-1 were observed in patients with gestational diabetes mellitus (standardized mean difference:-0.44, 95% confidence interval:-0.76; -0.12, p = 0.007), or type 2 diabetes mellitus (standardized mean difference: -1.74, 95% confidence interval: -2.31; -1.16, p< 0.001) than in the controls. CONCLUSION Decreased omentin-1 concentrations may be an important indicator for gestational diabetes mellitus and type 2 diabetes mellitus. More studies are needed to validate this hypothesis and evaluate the role of omentin-1 concentrations in type 1 diabetes mellitus.
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Affiliation(s)
- Xiongfeng Pan
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Atipatsa C. Kaminga
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
- Department of Mathematics and Statistics, Mzuzu University, Mzuzu, Malawi
| | - Shi Wu Wen
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
- Department of Obstetrics and Gynaecology and Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada
| | - Kwabena Acheampong
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
- Department of Public, School of Postgraduate Studies, Adventist University of Africa, Nairobi, Kenya
| | - Aizhong Liu
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
- * E-mail:
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Assaf-Balut C, García de la Torre N, Calle-Pascual AL, Calle-Pascual AL, Torre NGDL, Durán A, Jiménez I, Rubio MÁ, Herraíz MÁ, Izquierdo N, Pérez N, Garcia AS, Dominguez GC, Torrejón MJ, Cuadrado MÁ, Assaf-Balut C, Del Valle L, Bordiú E, Valerio J, Barabash A, Orta MS, Parayuelo MVSD, Muñoz LF, Calzada F. Detection, treatment and prevention programs for gestational diabetes mellitus: The St Carlos experience. ACTA ACUST UNITED AC 2019; 67:342-350. [PMID: 31519528 DOI: 10.1016/j.endinu.2019.06.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Revised: 06/18/2019] [Accepted: 06/26/2019] [Indexed: 01/15/2023]
Abstract
Gestational diabetes mellitus (GDM) increases the risk of adverse events in pregnancy and jeopardizes long-term health of the mother and offspring. There is currently no consensus as to what screening strategies improve the efficiency of GDM diagnosis. Which criteria should be used? Is the one-step or two-step procedure better? There is no agreement as to what the best dietary approach in the treatment of GDM is. In addition, different nutritional interventions have been studied in the prevention of GDM. The Mediterranean diet seems to be effective in preventing GDM and other maternofoetal outcomes. We review herein our experience using the one-step criteria for GDM screening; the treatment and prevention strategies used; and the overall impact of nutrition on maternofoetal health.
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Affiliation(s)
- Carla Assaf-Balut
- Endocrinology and Nutrition Department. Hospital Clínico San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain; Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain
| | - Nuria García de la Torre
- Endocrinology and Nutrition Department. Hospital Clínico San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain; Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain
| | - Alfonso L Calle-Pascual
- Endocrinology and Nutrition Department. Hospital Clínico San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain; Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain; Departamento de Medicina II, Facultad de Medicina, Universidad Complutense de Madrid, Spain.
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Estienne A, Bongrani A, Reverchon M, Ramé C, Ducluzeau PH, Froment P, Dupont J. Involvement of Novel Adipokines, Chemerin, Visfatin, Resistin and Apelin in Reproductive Functions in Normal and Pathological Conditions in Humans and Animal Models. Int J Mol Sci 2019; 20:ijms20184431. [PMID: 31505789 PMCID: PMC6769682 DOI: 10.3390/ijms20184431] [Citation(s) in RCA: 102] [Impact Index Per Article: 20.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 09/06/2019] [Accepted: 09/06/2019] [Indexed: 12/23/2022] Open
Abstract
It is well known that adipokines are endocrine factors that are mainly secreted by white adipose tissue. Their central role in energy metabolism is currently accepted. More recently, their involvement in fertility regulation and the development of some reproductive disorders has been suggested. Data concerning the role of leptin and adiponectin, the two most studied adipokines, in the control of the reproductive axis are consistent. In recent years, interest has grown about some novel adipokines, chemerin, visfatin, resistin and apelin, which have been found to be strongly associated with obesity and insulin-resistance. Here, we will review their expression and role in male and female reproduction in humans and animal models. According to accumulating evidence, they could regulate the secretion of GnRH (Gonadotropin-Releasing Hormone), gonadotropins and steroids. Furthermore, their expression and that of their receptors (if known), has been demonstrated in the human and animal hypothalamo-pituitary-gonadal axis. Like leptin and adiponectin, these novel adipokines could thus represent metabolic sensors that are able to regulate reproductive functions according to energy balance changes. Therefore, after investigating their role in normal fertility, we will also discuss their possible involvement in some reproductive troubles known to be associated with features of metabolic syndrome, such as polycystic ovary syndrome, gestational diabetes mellitus, preeclampsia and intra-uterine growth retardation in women, and sperm abnormalities and testicular pathologies in men.
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Affiliation(s)
- Anthony Estienne
- INRA UMR 85 Physiologie de la Reproduction et des Comportements, F-37380 Nouzilly, France
- CNRS UMR 7247 Physiologie de la Reproduction et des Comportements, F-37380 Nouzilly, France
- Université François Rabelais de Tours F-37041 Tours, France
- IFCE, F-37380 Nouzilly, France
| | - Alice Bongrani
- INRA UMR 85 Physiologie de la Reproduction et des Comportements, F-37380 Nouzilly, France
- CNRS UMR 7247 Physiologie de la Reproduction et des Comportements, F-37380 Nouzilly, France
- Université François Rabelais de Tours F-37041 Tours, France
- IFCE, F-37380 Nouzilly, France
| | - Maxime Reverchon
- SYSAAF-Syndicat des Sélectionneurs Avicoles et Aquacoles Français, Centre INRA Val de Loire, F-37380 Nouzilly, France
| | - Christelle Ramé
- INRA UMR 85 Physiologie de la Reproduction et des Comportements, F-37380 Nouzilly, France
- CNRS UMR 7247 Physiologie de la Reproduction et des Comportements, F-37380 Nouzilly, France
- Université François Rabelais de Tours F-37041 Tours, France
- IFCE, F-37380 Nouzilly, France
| | - Pierre-Henri Ducluzeau
- INRA UMR 85 Physiologie de la Reproduction et des Comportements, F-37380 Nouzilly, France
- CNRS UMR 7247 Physiologie de la Reproduction et des Comportements, F-37380 Nouzilly, France
- Université François Rabelais de Tours F-37041 Tours, France
- IFCE, F-37380 Nouzilly, France
- Internal Medicine Department, Unit of Endocrinology, CHRU Tours, F-37044 Tours, France
| | - Pascal Froment
- INRA UMR 85 Physiologie de la Reproduction et des Comportements, F-37380 Nouzilly, France
- CNRS UMR 7247 Physiologie de la Reproduction et des Comportements, F-37380 Nouzilly, France
- Université François Rabelais de Tours F-37041 Tours, France
- IFCE, F-37380 Nouzilly, France
| | - Joëlle Dupont
- INRA UMR 85 Physiologie de la Reproduction et des Comportements, F-37380 Nouzilly, France.
- CNRS UMR 7247 Physiologie de la Reproduction et des Comportements, F-37380 Nouzilly, France.
- Université François Rabelais de Tours F-37041 Tours, France.
- IFCE, F-37380 Nouzilly, France.
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Siddiqui S, Waghdhare S, Jha S, Dubey S. Role of immunological markers in gestational diabetes mellitus-a brief review. Diabetes Metab Syndr 2019; 13:2983-2985. [PMID: 30076086 DOI: 10.1016/j.dsx.2018.07.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Accepted: 07/29/2018] [Indexed: 12/30/2022]
Abstract
Gestational Diabetes Mellitus (GDM) is a condition which develops due to insulin resistance. There are a number of immunological markers (IL-6, TNF-α, IL-10, etc), which play significant role during normal pregnancy and their irregular levels could likely cause some level of insulin resistance. There are studies which have compared the levels of different immunological mediators in GDM affected females and their healthy controls, but their findings are little controversial. Some of the studies have reported increased levels of IL-6, TNF-α, adiponectin, leptin, in females affected with GDM, while others do not confirm this. We have tried to summarize, in this short review, the findings of research studies being conducted globally, which have reported the association of insulin resistance, GDM and immunological markers. Our review suggests that there is a need for high quality data on the immunological parameters associated with GDM, especially from India.
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Affiliation(s)
- Samreen Siddiqui
- Institute of Endocrinology, Diabetes & Metabolism, Max Healthcare Inst. Ltd., Saket, New Delhi, 110017, India; Amity Institute of Virology & Immunology, Amity University, Sector-125, Noida, Uttar Pradesh, 201313, India.
| | - Swati Waghdhare
- Institute of Endocrinology, Diabetes & Metabolism, Max Healthcare Inst. Ltd., Saket, New Delhi, 110017, India
| | - Sujeet Jha
- Institute of Endocrinology, Diabetes & Metabolism, Max Healthcare Inst. Ltd., Saket, New Delhi, 110017, India
| | - Shweta Dubey
- Amity Institute of Virology & Immunology, Amity University, Sector-125, Noida, Uttar Pradesh, 201313, India
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Pace NP, Bonello A, Roshan MH, Vassallo J. Circulating visfatin levels in the second and third trimester of pregnancies with gestational diabetes: a systematic review. MINERVA GINECOLOGICA 2019; 71:329-343. [PMID: 31274262 DOI: 10.23736/s0026-4784.18.04293-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
INTRODUCTION There are multiple published conflicting associations of the adipocytokine visfatin with gestational diabetes. In this study, we attempted to investigate this relationship via a systematic review of the published literature. EVIDENCE ACQUISITION Literature retrieval using PubMed, Google Scholar, Scopus and Hydi databases followed by article selection and data extraction were conducted. Relevant studies published up to June 2018 were included. In total, 29 cohorts that were published in 27 articles were analyzed. Three studies carried out in early pregnancy were excluded. A total of 2365 individuals, with 1069 gestational diabetes (GDM) cases and 1296 controls from studies describing visfatin in the second or third trimester of gestation were included. EVIDENCE SYNTHESIS The difference in visfatin levels between women with GDM and the controls in the second and third trimester was measured by weighted mean difference (WMD) and 95% confidence intervals (CI). Heterogeneity was inspected by using both subgroup and meta-regression analysis. Analysis was restricted to studies describing singleton pregnancies. The quality of included studies was assessed by the Newcastle-Ottawa Scale. CONCLUSIONS No significant difference in circulating visfatin levels in GDM during the second trimester of pregnancy (WMD -0.30 ng/mL, 95% CI: -2.06, 1.45, SE=0.895, P=0.733) was detected. Meta-analysis of the studies in the third trimester revealed a significant negative effect, that was however driven by only one study. This finding limits the meaningful interpretation of the pooled analysis. Significant heterogeneity was identified between studies, and meta-regression analysis showed that homeostatic model assessment for insulin resistance contributes significantly to heterogeneity. In conclusion, our findings suggest that peripheral blood visfatin concentration cannot be robustly associated with gestational diabetes status in the second and third trimesters of pregnancy.
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Affiliation(s)
- Nikolai P Pace
- Centre for Molecular Medicine and Biobanking, University of Malta, Msida, Malta -
| | - Antonia Bonello
- Centre for Molecular Medicine and Biobanking, University of Malta, Msida, Malta
| | - Mohsin H Roshan
- Centre for Molecular Medicine and Biobanking, University of Malta, Msida, Malta
| | - Josanne Vassallo
- Department of Medicine, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
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Nahavandi S, Price S, Sumithran P, Ekinci EI. Exploration of the shared pathophysiological mechanisms of gestational diabetes and large for gestational age offspring. World J Diabetes 2019; 10:333-340. [PMID: 31231456 PMCID: PMC6571486 DOI: 10.4239/wjd.v10.i6.333] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Revised: 05/13/2019] [Accepted: 05/23/2019] [Indexed: 02/05/2023] Open
Abstract
Gestational diabetes mellitus (GDM) and large for gestational age (LGA) offspring are two common pregnancy complications. Connections also exist between the two conditions, including mutual maternal risk factors for the conditions and an increased prevalence of LGA offspring amongst pregnancies affected by GDM. Thus, it is important to elucidate potential shared underlying mechanisms of both LGA and GDM. One potential mechanistic link relates to macronutrient metabolism. Indeed, derangement of carbohydrate and lipid metabolism is present in GDM, and maternal biomarkers of glucose and lipid control are associated with LGA neonates in such pregnancies. The aim of this paper is therefore to reflect on the existing nutritional guidelines for GDM in light of our understanding of the pathophysiological mechanisms of GDM and LGA offspring. Lifestyle modification is first line treatment for GDM, and while there is some promise that nutritional interventions may favourably impact outcomes, there is a lack of definitive evidence that changing the macronutrient composition of the diet reduces the incidence of either GDM or LGA offspring. The quality of the available evidence is a major issue, and rigorous trials are needed to inform evidence-based treatment guidelines.
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Affiliation(s)
- Sofia Nahavandi
- The Royal Children’s Hospital Melbourne, Parkville, VIC 3052, Australia
| | - Sarah Price
- Department of Endocrinology, Austin Health, Repatriation Campus Heidelberg West, Melbourne, VIC 3081, Australia
- Department of Medicine, Austin Health and the University of Melbourne (Austin Campus), Parkville, Melbourne, VIC 3084, Australia
| | - Priya Sumithran
- Department of Endocrinology, Austin Health, Repatriation Campus Heidelberg West, Melbourne, VIC 3081, Australia
- Department of Medicine, Austin Health and the University of Melbourne (Austin Campus), Parkville, Melbourne, VIC 3084, Australia
| | - Elif Ilhan Ekinci
- Department of Endocrinology, Austin Health, Repatriation Campus Heidelberg West, Melbourne, VIC 3081, Australia
- Department of Medicine, Austin Health and the University of Melbourne (Austin Campus), Parkville, Melbourne, VIC 3084, Australia
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Gestational diabetes and postnatal depressive symptoms: A prospective cohort study in Western China. Women Birth 2019; 32:e427-e431. [DOI: 10.1016/j.wombi.2018.08.171] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 08/25/2018] [Accepted: 08/26/2018] [Indexed: 01/01/2023]
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89
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Dong B, Sun J, Zhi M, Han M, Lin H, Yu H, Li L. Effect of gestational weight gain on insulin resistance mediated by serum adipokine concentrations in advanced maternal age. Arch Med Sci 2019; 17:1575-1582. [PMID: 34900036 PMCID: PMC8641507 DOI: 10.5114/aoms.2019.85144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Accepted: 12/23/2018] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION With the implementation of the universal two-child policy, the number of pregnant women of advanced maternal age (AMA) will increase steadily. We aimed to investigate whether the effect of gestational weight gain on insulin resistance (IR) before delivery was mediated by serum adipokine concentrations in AMA. MATERIAL AND METHODS This cross-sectional study included 80 pregnant women of AMA recruited consecutively before delivery from the Department of Obstetrics and Gynecology between August 2016 and July 2017. At delivery, maternal weight during the third trimester was recorded and serum adipokines were measured. IR was calculated using the homeostasis model assessment 2 (HOMA2) method. RESULTS Weight gain (WG) during the third trimester was positively associated with serum leptin concentrations (r = 0.34, p = 0.0018) and HOMA-IR indices (r = 0.25, p = 0.025), but not related with serum concentration of adiponectin (r = 0.12, p = 0.28). WG during the third trimester and serum concentration of leptin were independently associated with the level of HOMA-IR by multivariate analysis. Subsequently, according to mediation analysis, the association between WG during the third trimester and HOMA-IR mediated by serum leptin concentrations was statistically significant (z = 1.588, p < 0.05). CONCLUSIONS Taken together, our findings suggest that the relationship between WG during the third trimester and IR was mediated by serum leptin concentrations in AMA, but not serum adiponectin concentrations.
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Affiliation(s)
- Beibei Dong
- Department of Endocrinology, ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China
- Pancreatic Research Institute, Southeast University, Nanjing, China
| | - Jinfang Sun
- Key Laboratory of Environmental Medicine Engineering of Ministry of Education, School of Public Health, Southeast University, Nanjing, China
| | - Mengmeng Zhi
- Department of Endocrinology, ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China
- Pancreatic Research Institute, Southeast University, Nanjing, China
| | - Manman Han
- Department of Endocrinology, ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China
- Pancreatic Research Institute, Southeast University, Nanjing, China
| | - Hao Lin
- Pancreatic Research Institute, Southeast University, Nanjing, China
- Department of Clinical Science and Research, ZhongDa Hospital, Southeast University, Nanjing, China
| | - Hong Yu
- Department of Obstetrics and Gynecology, ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Ling Li
- Department of Endocrinology, ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China
- Pancreatic Research Institute, Southeast University, Nanjing, China
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Manoharan B, Bobby Z, Dorairajan G, Vinayagam V, Packirisamy RM. Adipokine levels and their association with insulin resistance and fetal outcomes among the newborns of Indian gestational diabetic mothers. Saudi Med J 2019; 40:353-359. [PMID: 30957128 PMCID: PMC6506657 DOI: 10.15537/smj.2019.4.24058] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 03/03/2019] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES To investigate the cord blood levels of adipokine and to assess their association with the fetal insulin resistance and fetal outcomes in newborns of gestational diabetic women (GDM). Methods: This cross-sectional study was performed in 40 GDM women and 40 healthy pregnant women (HPW) in the Department of Obstetrics and Gynecology at Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER) hospital in Puducherry, India, during the period from May 2016 to December 2017. Cord blood samples were collected at delivery from GDM and HPW groups. Cord plasma biochemical parameters such as insulin, C-peptide, adiponectin, leptin, resistin, and visfatin concentrations were measured. Leptin/adiponectin ratio (L/A), homeostasis model assessment of insulin resistance (HOMA2-IR), insulin sensitivity (HOMA2-%S) and beta cell function (HOMA2-%B) were calculated. The pregnancy outcomes such as birth weight (BW), Ponderal index and Apgar scores of the baby were measured. Results: The BW and Ponderal index of the baby were found to be significantly higher in GDM newborns compared to HPW newborns. Cord plasma insulin, C-peptide, HOMA2 -IR, visfatin, leptin, and L/A ratio were significantly higher whereas adiponectin level was lower in GDM compared to HPW. A significant positive correlation was observed between L/A ratio and fetal HOMA2-IR. Conclusion: Altered adipokine levels with increased L/A ratio was observed among the new-borns of Indian gestational diabetic mothers. There was an association between increased L/A ratio, insulin resistance and increased Ponderal index among the new-borns.
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Affiliation(s)
- Balachandiran Manoharan
- Department of Biochemistry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India. E-mail.
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91
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Elabela and Apelin actions in healthy and pathological pregnancies. Cytokine Growth Factor Rev 2019; 46:45-53. [PMID: 30910349 DOI: 10.1016/j.cytogfr.2019.03.003] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 03/12/2019] [Indexed: 12/18/2022]
Abstract
Pregnancy is a dynamic and precisely organized process during which one or more baby develops. Embryonic development relies on the formation of the placenta, allowing nutrient and oxygen exchange between the mother and the fetus. Dysfunction of placental formation lead to pregnancy disorders such as preeclampsia (PE) with serious deleterious consequences for fetal and maternal health. Identifying factors involved in fetoplacental homeostasis could inform better diagnostic and therapeutic strategies for these pathological pregnancies. Here, we summarize actions of elabela, apelin and their common receptor APJ in the fetoplacental unit. Studies indicate that elabela is crucial for embryo cardiovascular system formation and early placental development, while apelin acts in mid/late gestation to modulate fetal angiogenesis and energy homeostasis. Most of these findings, drawn from animal models, indicate a key role of elabela/apelin-APJ system in the fetoplacental unit. This review also provides an overview of clinical studies investigating elabela/apelin-APJ system in pathological complicated pregnancies such as PE and gestational diabetes mellitus (GDM). While elabela-deficient mice display all the features of PE, current clinical studies show no difference in circulating elabela levels between PE and control patients which does not support a role in PE development. Conversely, apelin levels are increased during PE, but the use of apelin as an early PE marker remains to be fully investigated.
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92
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Trojnar M, Patro-Małysza J, Kimber-Trojnar Ż, Leszczyńska-Gorzelak B, Mosiewicz J. Associations between Fatty Acid-Binding Protein 4⁻A Proinflammatory Adipokine and Insulin Resistance, Gestational and Type 2 Diabetes Mellitus. Cells 2019; 8:cells8030227. [PMID: 30857223 PMCID: PMC6468522 DOI: 10.3390/cells8030227] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 03/03/2019] [Accepted: 03/03/2019] [Indexed: 12/12/2022] Open
Abstract
There is ample scientific evidence to suggest a link between the fatty acid-binding protein 4 (FABP4) and insulin resistance, gestational (GDM), and type 2 (T2DM) diabetes mellitus. This novel proinflammatory adipokine is engaged in the regulation of lipid metabolism at the cellular level. The molecule takes part in lipid oxidation, the regulation of transcription as well as the synthesis of membranes. An involvement of FABP4 in the pathogenesis of obesity and insulin resistance seems to be mediated via FABP4-dependent peroxisome proliferator-activated receptor γ (PPARγ) inhibition. A considerable number of studies have shown that plasma concentrations of FABP4 is increased in obesity and T2DM, and that circulating FABP4 levels are correlated with certain clinical parameters, such as body mass index, insulin resistance, and dyslipidemia. Since plasma-circulating FABP4 has the potential to modulate the function of several types of cells, it appears to be of extreme interest to try to develop potential therapeutic strategies targeting the pathogenesis of metabolic diseases in this respect. In this manuscript, representing a detailed review of the literature on FABP4 and the abovementioned metabolic disorders, various mechanisms of the interaction of FABP4 with insulin signaling pathways are thoroughly discussed. Clinical aspects of insulin resistance in diabetic patients, including women diagnosed with GDM, are analyzed as well.
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Affiliation(s)
- Marcin Trojnar
- Chair and Department of Internal Medicine, Medical University of Lublin, 20-081 Lublin, Poland.
| | - Jolanta Patro-Małysza
- Chair and Department of Obstetrics and Perinatology, Medical University of Lublin, 20-090 Lublin, Poland.
| | - Żaneta Kimber-Trojnar
- Chair and Department of Obstetrics and Perinatology, Medical University of Lublin, 20-090 Lublin, Poland.
| | | | - Jerzy Mosiewicz
- Chair and Department of Internal Medicine, Medical University of Lublin, 20-081 Lublin, Poland.
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93
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Ma Y, Ye W, Tang Y. Gestational diabetes mellitus increases the baseline level of procalcitonin in maternal blood but not in umbilical cord blood in late pregnancy: A retrospective case-controlled study. Medicine (Baltimore) 2019; 98:e14914. [PMID: 30882713 PMCID: PMC6426544 DOI: 10.1097/md.0000000000014914] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
To study the effects of gestational diabetes mellitus (GDM) on the level of procalcitonin (PCT) in maternal blood and umbilical cord blood in late-pregnant women.We retrospectively analyzed 37 pregnant women in late pregnancy who had GDM and compared with those of 97 age-matched normal glucose-tolerant (NGT) pregnant women. The PCT level was converted to a value with normal distribution (LG-PCT) by taking the logarithm of each value to the base 10 (log10).The body mass index (BMI) before delivery, family history of diabetes mellitus (DM), and postpartum blood loss within 24 hours were markedly higher in GDM group than in NGT group, while the gestational age was smaller in GDM group than in NGT group. The maternal blood LG-PCT was significantly higher in GDM group than in NGT group, while the umbilical cord blood LG-PCT was not significantly different between the 2 groups. Multivariate analysis showed that family history of DM, gestational age, and maternal blood LG-PCT were independent risk factors of GDM after adjusting for BMI and postpartum blood loss within 24 hours.GDM increases the baseline level of maternal blood PCT but has little effect on umbilical cord blood PCT.
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94
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Calan M, Arkan T, Kume T, Bayraktar F. The relationship between urotensin II and insulin resistance in women with gestational diabetes mellitus. Hormones (Athens) 2019; 18:91-97. [PMID: 30471011 DOI: 10.1007/s42000-018-0084-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 11/15/2018] [Indexed: 02/07/2023]
Abstract
AIM Urotensin II (UII), a pluripotent vasoactive peptide, plays a crucial role in development of insulin resistance. Gestational diabetes mellitus (GDM) is a metabolic disorder associated with insulin resistance. The aims of the current study were to compare UII levels in women with or without GDM and to investigate the relationship between UII and insulin resistance in women with GDM. METHODS A total of 84 women were recruited in this case-control study (42 women with GDM and 42 age- and body mass index (BMI)-matched pregnant women without GDM as controls). GDM was diagnosed by a 2-h 75-g oral glucose tolerance test over a period of 24-28 gestational weeks. Circulating UII levels were assessed via the ELISA method. The metabolic parameters of the recruited women were also determined. RESULTS The circulating levels of UII in women with GDM were higher than in controls (11.56 ± 4.13 vs. 7.62 ± 3.45 ng/ml, P < 0.001). UII showed a positive correlation with insulin resistance marker (HOMA-IR), fasting blood glucose, and BMI. Moreover, according to the results of multiple linear regression analyses, UII was independently related to HOMA-IR. Additionally, the binary logistic analysis revealed that the women with the highest tertile of UII levels showed increased risk for GDM by comparison with those women with the lowest tertile of UII levels. CONCLUSION Elevated UII levels are associated with insulin resistance in women with GDM.
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Affiliation(s)
- Mehmet Calan
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Izmir Bozyaka Training and Research Hospital, Bozyaka, 35170, Izmir, Turkey.
| | - Tugba Arkan
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Dokuz Eylul University Medical School, Inciralti, 35340, Izmir, Turkey
| | - Tuncay Kume
- Department of Biochemistry and Clinical Biochemistry, Dokuz Eylul University Medical School, Inciralti, 35340, Izmir, Turkey
| | - Fırat Bayraktar
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Dokuz Eylul University Medical School, Inciralti, 35340, Izmir, Turkey
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95
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Patro-Małysza J, Trojnar M, Kimber-Trojnar Ż, Mierzyński R, Bartosiewicz J, Oleszczuk J, Leszczyńska-Gorzelak B. FABP4 in Gestational Diabetes-Association between Mothers and Offspring. J Clin Med 2019; 8:jcm8030285. [PMID: 30818771 PMCID: PMC6462903 DOI: 10.3390/jcm8030285] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2018] [Revised: 02/18/2019] [Accepted: 02/22/2019] [Indexed: 12/16/2022] Open
Abstract
Fetuses exposed to gestational diabetes mellitus (GDM) have a higher risk of abnormal glucose homeostasis in later life. The molecular mechanisms of this phenomenon are still not fully understood. Fatty acid binding protein 4 (FABP4) appears to be one of the most probable candidates involved in the pathophysiology of GDM. The main aim of the study was to investigate whether umbilical cord serum FABP4 concentrations are altered in term neonates born to GDM mothers. Two groups of subjects were selected—28 healthy controls and 26 patients with GDM. FABP4, leptin, and ghrelin concentrations in the umbilical cord serum, maternal serum, and maternal urine were determined via an enzyme-linked immunosorbent assay. The umbilical cord serum FABP4 levels were higher in the GDM offspring and were directly associated with the maternal serum FABP4 and leptin levels, as well as the prepregnancy body mass index (BMI) and the BMI at and after delivery; however, they correlated negatively with birth weight and lipid parameters. In the multiple linear regression models, the umbilical cord serum FABP4 concentrations depended positively on the maternal serum FABP4 and negatively on the umbilical cord serum ghrelin levels and the high-density lipoprotein cholesterol. There are many maternal variables that can affect the level of FABP4 in the umbilical cord serum, thus, their evaluation requires further investigation.
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Affiliation(s)
- Jolanta Patro-Małysza
- Department of Obstetrics and Perinatology, Medical University of Lublin, 20-090 Lublin, Poland.
| | - Marcin Trojnar
- Department of Internal Medicine, Medical University of Lublin, 20-081 Lublin, Poland.
| | - Żaneta Kimber-Trojnar
- Department of Obstetrics and Perinatology, Medical University of Lublin, 20-090 Lublin, Poland.
| | - Radzisław Mierzyński
- Department of Obstetrics and Perinatology, Medical University of Lublin, 20-090 Lublin, Poland.
| | - Jacek Bartosiewicz
- Department of Obstetrics and Perinatology, Medical University of Lublin, 20-090 Lublin, Poland.
| | - Jan Oleszczuk
- Department of Obstetrics and Perinatology, Medical University of Lublin, 20-090 Lublin, Poland.
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96
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Hyperglycaemia cause vascular inflammation through advanced glycation end products/early growth response-1 axis in gestational diabetes mellitus. Mol Cell Biochem 2019; 456:179-190. [DOI: 10.1007/s11010-019-03503-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Accepted: 02/01/2019] [Indexed: 12/27/2022]
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97
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Kawanabe S, Nagai Y, Nakamura Y, Nishine A, Nakagawa T, Tanaka Y. Association of the muscle/fat mass ratio with insulin resistance in gestational diabetes mellitus. Endocr J 2019; 66:75-80. [PMID: 30393250 DOI: 10.1507/endocrj.ej18-0252] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
This study assessed the association of muscle mass with insulin resistance, evaluated from the insulin sensitivity index (ISI), in Japanese patients with gestational diabetes mellitus (GDM). Consecutive patients with GDM (n = 96) admitted to St. Marianna University Hospital between October 2015 and March 2018 for initial education and glycemic control were enrolled in a prospective observational study. Insulin resistance was evaluated by measuring the ISI and body composition was assessed by bioelectrical impedance analysis. The subjects were aged 34.4 ± 4.8 years (mean ± SD) and their body mass index (BMI) before pregnancy was 22.3 ± 4.0 kg/m2. Fifty-three patients (55.2%) had a history of diabetes in first-degree relatives. The ISI was 7.2 ± 3.3, appendicular skeletal muscle mass (ASM) was 17.0 ± 2.1 kg, and fat mass (FM) was 18.8 ± 8.2 kg. The ASM/FM ratio was 1.02 ± 0.34. There was a positive correlation between FM and ASM (r = 0.734, p < 0.001). To adjust for confounders when evaluating the association of ASM with ISI, multivariate analysis was conducted using age, family history of diabetes, and BMI as variables. In this analysis, the ASM/FM ratio showed a significant positive correlation with ISI (β = 0.303, p = 0.020). These findings suggest that inadequate ASM/FM ratio is important for the development of insulin resistance in Japanese patients with GDM. Excessive emphasis on dieting rather than health might increase the risk of GDM by reducing the muscle mass below the level that maintains normal glucose metabolism.
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Affiliation(s)
- Shin Kawanabe
- Division of Metabolism and Endocrinology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki 216-8511, Japan
| | - Yoshio Nagai
- Division of Metabolism and Endocrinology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki 216-8511, Japan
| | - Yuta Nakamura
- Division of Metabolism and Endocrinology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki 216-8511, Japan
| | - Ami Nishine
- Division of Metabolism and Endocrinology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki 216-8511, Japan
| | - Tomoko Nakagawa
- Division of Metabolism and Endocrinology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki 216-8511, Japan
| | - Yasushi Tanaka
- Division of Metabolism and Endocrinology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki 216-8511, Japan
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98
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Mierzyński R, Poniedziałek-Czajkowska E, Dłuski D, Patro-Małysza J, Kimber-Trojnar Ż, Majsterek M, Leszczyńska-Gorzelak B. Nesfatin-1 and Vaspin as Potential Novel Biomarkers for the Prediction and Early Diagnosis of Gestational Diabetes Mellitus. Int J Mol Sci 2019; 20:E159. [PMID: 30621139 PMCID: PMC6337752 DOI: 10.3390/ijms20010159] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Revised: 12/08/2018] [Accepted: 12/28/2018] [Indexed: 12/17/2022] Open
Abstract
Gestational diabetes mellitus (GDM) is considered to be one of the most frequent medical complication observed among pregnant women. The role of adipokines in the pathogenesis of GDM remains strictly unknown. Different adipokines have been studied throughout gestation, and they have been proposed as biomarkers of GDM and other pregnancy-related complications; however, there is no biomarker reported for GDM screening at present. The aim of this study was to evaluate serum nesfatin-1 and vaspin levels in GDM and non-GDM women, to characterize the correlation between these adipokines, and to assess the potential role of circulating adipokines in the prediction of risk of gestational diabetes mellitus. Serum concentrations of nesfatin-1 and vaspin were measured in 153 women with GDM, and in 84 patients with uncomplicated pregnancy by enzyme-linked immunosorbent assay (ELISA) kits, according to the manufacturer's instructions. Circulating levels of nesfatin-1 and vaspin were significantly lower in the GDM group than in the control group. Nesfatin-1 levels were negatively correlated with vaspin levels. The results of this study point out the possible role of nesfatin-1 and vaspin as potential novel biomarkers for the prediction and early diagnosis of GDM. Further studies are necessary to evaluate the influence of nesfatin-1 and vaspin on glucose metabolism in the early stages of GDM.
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Affiliation(s)
- Radzisław Mierzyński
- Chair and Department of Obstetrics and Perinatology, Medical University of Lublin, Poland, ul. Jaczewskiego 8, 20-954 Lublin, Poland.
| | - Elżbieta Poniedziałek-Czajkowska
- Chair and Department of Obstetrics and Perinatology, Medical University of Lublin, Poland, ul. Jaczewskiego 8, 20-954 Lublin, Poland.
| | - Dominik Dłuski
- Chair and Department of Obstetrics and Perinatology, Medical University of Lublin, Poland, ul. Jaczewskiego 8, 20-954 Lublin, Poland.
| | - Jolanta Patro-Małysza
- Chair and Department of Obstetrics and Perinatology, Medical University of Lublin, Poland, ul. Jaczewskiego 8, 20-954 Lublin, Poland.
| | - Żaneta Kimber-Trojnar
- Chair and Department of Obstetrics and Perinatology, Medical University of Lublin, Poland, ul. Jaczewskiego 8, 20-954 Lublin, Poland.
| | - Maciej Majsterek
- Chair and Department of Obstetrics and Perinatology, Medical University of Lublin, Poland, ul. Jaczewskiego 8, 20-954 Lublin, Poland.
| | - Bożena Leszczyńska-Gorzelak
- Chair and Department of Obstetrics and Perinatology, Medical University of Lublin, Poland, ul. Jaczewskiego 8, 20-954 Lublin, Poland.
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99
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Tönjes A, Kralisch S, Hoffmann A, Schleinitz D, Kratzsch J, Blüher M, Stumvoll M, Kovacs P, Fasshauer M, Ebert T. Circulating Pro-Neurotensin in gestational diabetes mellitus. Nutr Metab Cardiovasc Dis 2019; 29:23-29. [PMID: 30527352 DOI: 10.1016/j.numecd.2018.09.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 09/21/2018] [Accepted: 09/24/2018] [Indexed: 11/24/2022]
Abstract
BACKGROUND AND AIMS Pro-Neurotensin (NT), a stable surrogate parameter of NT, has recently been introduced as a peptide predicting the development of obesity, diabetes mellitus, cardiovascular diseases, and cardiovascular mortality. However, regulation of Pro-NT in gestational diabetes mellitus (GDM) remains uninvestigated. METHODS AND RESULTS Pro-NT was quantified in 74 women with GDM, 74 healthy, gestational age-matched, pregnant controls, as well as in a second cohort comprising of 74 healthy, non-pregnant control women, using a chemiluminometric sandwich immunoassay. Pro-NT was correlated to measures of obesity, hypertension, glucose and lipid metabolism, renal function, and inflammation. Mean ± standard deviation of circulating Pro-NT levels were not significantly different in women with GDM (100.2 ± 75.7 pmol/l) as compared to healthy, pregnant controls (103.2 ± 37.4 pmol/l) and healthy, non-pregnant female controls (105.9 ± 38.9 pmol/l) (p = 0.661). Homeostasis model assessment of insulin resistance (HOMA-IR) and creatinine positively correlated with serum Pro-NT in multivariate regression analysis. In contrast, free fatty acids (FFA) were inversely correlated with circulating Pro-NT. Results sustained adjustment for pregnancy status. CONCLUSIONS Circulating Pro-NT is not independently associated with GDM, but is with HOMA-IR, creatinine, and FFA even after adjustment for pregnancy status.
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Affiliation(s)
- A Tönjes
- University of Leipzig, Department of Endocrinology and Nephrology, 04103, Leipzig, Germany
| | - S Kralisch
- University of Leipzig, Department of Endocrinology and Nephrology, 04103, Leipzig, Germany; Leipzig University Medical Center, IFB AdiposityDiseases, 04103, Leipzig, Germany
| | - A Hoffmann
- University of Leipzig, Department of Endocrinology and Nephrology, 04103, Leipzig, Germany
| | - D Schleinitz
- Leipzig University Medical Center, IFB AdiposityDiseases, 04103, Leipzig, Germany
| | - J Kratzsch
- University of Leipzig, Institute of Laboratory Medicine, 04103, Leipzig, Germany
| | - M Blüher
- University of Leipzig, Department of Endocrinology and Nephrology, 04103, Leipzig, Germany
| | - M Stumvoll
- University of Leipzig, Department of Endocrinology and Nephrology, 04103, Leipzig, Germany
| | - P Kovacs
- Leipzig University Medical Center, IFB AdiposityDiseases, 04103, Leipzig, Germany
| | - M Fasshauer
- University of Leipzig, Department of Endocrinology and Nephrology, 04103, Leipzig, Germany; Leipzig University Medical Center, IFB AdiposityDiseases, 04103, Leipzig, Germany; Justus-Liebig-University, Institute of Nutritional Science, 35390, Giessen, Germany
| | - T Ebert
- University of Leipzig, Department of Endocrinology and Nephrology, 04103, Leipzig, Germany; Leipzig University Medical Center, IFB AdiposityDiseases, 04103, Leipzig, Germany.
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100
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The Role of Inflammation in the Development of GDM and the Use of Markers of Inflammation in GDM Screening. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2019; 1134:217-242. [PMID: 30919340 DOI: 10.1007/978-3-030-12668-1_12] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Gestational diabetes mellitus is a hyperglycaemic state first recognised in pregnancy. GDM affects both mother and child. Women with GDM and their new-borns are at risk of developing type 2 diabetes in the future. The screening and diagnostic criteria for GDM are inconsistent and thus novel biomarkers of GDM are required to strengthen the screening and diagnostic processes in GDM. Chronic low-grade inflammation is linked to the majority of the well-established risk factors of GDM such as old age, obesity and PCOS. This review provides an overview of the present knowledge on the pathology of GDM, the screening criteria applied, the role of inflammation in the development of GDM and the use of markers of inflammation namely cytokines, oxidative stress markers, lipids, amino acids and iron markers in screening and diagnosis of GDM.
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