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Andlib N, Sajad M, Thakur SC. Association of diabetes mellitus with risk of reproductive impairment in females: A comprehensive review. Acta Histochem 2024; 126:152173. [PMID: 39004007 DOI: 10.1016/j.acthis.2024.152173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 05/31/2024] [Accepted: 07/04/2024] [Indexed: 07/16/2024]
Abstract
Reproductive impairment is the most prevalent yet most ignored complication of diabetes mellitus. In diabetes, the problem associated with reproductive health is comprehensive in both males and females. Diabetic females have problems like delayed menarche, irregular menstrual cycle, subfertility, complications in pregnancy and early menopause. This may decrease reproductive age in diabetic females as the menarche is delayed and menopause is early in them. Like diabetic males, diabetic females also have the negative effect of oxidative stress on the reproductive system. This may lead to dysfunction of the ovary. It affects the physiological cycle like the ovary's maturation, embryo development and pregnancy. These complications also affect the offspring, and they may also become diabetic. This review aims to concentrate on the effect of diabetes on the reproductive system of females and the impairment caused by it. We will also discuss in detail the role of the hypothalamus-pituitary ovary axis, diabetes impact on different reproductive phases of females, and the sexual disorders that occur in them.
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Affiliation(s)
- Nida Andlib
- Centre for Interdisciplinary Research in Basic Sciences, Jamia Millia Islamia, New Delhi 110025, India
| | - Mohd Sajad
- Centre for Interdisciplinary Research in Basic Sciences, Jamia Millia Islamia, New Delhi 110025, India
| | - Sonu Chand Thakur
- Centre for Interdisciplinary Research in Basic Sciences, Jamia Millia Islamia, New Delhi 110025, India..
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Ma N, Bai L, Niu Z, Lu Q. Mid-upper arm circumference predicts the risk of gestational diabetes in early pregnancy. BMC Pregnancy Childbirth 2024; 24:462. [PMID: 38965475 PMCID: PMC11225188 DOI: 10.1186/s12884-024-06664-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Accepted: 06/28/2024] [Indexed: 07/06/2024] Open
Abstract
BACKGROUND The present work aimed to assess the value of mid-upper arm circumference (MUAC) at 8 to 12 weeks in predicting the occurrence of gestational diabetes mellitus (GDM). METHODS According to eligibility criteria, 328 women with singleton pregnancies who underwent routine antenatal check-ups at Qinhuangdao Maternal and Child Health Hospital from September 2017 to September 2020 were included. The patients were divided into the gestational diabetes mellitus (GDM) and non-GDM groups according to oral glucose tolerance test (OGTT) data from gestation weeks 24 to 28. Clinical data were compared between the two groups. Logistic regression analysis was performed to determine factors independently predicting GDM. Receiver operating characteristic (ROC) curve analysis was employed to analyze the value of MUAC in predicting the occurrence of GDM. The optimal cut-off points were calculated. RESULTS In logistic regression analysis, pre-pregnancy weight, waist circumference, MUAC, UA, TG, and HDL-C independently predicted the occurrence of GDM (P < 0.05). MUAC retained statistical significance upon adjustment for various confounders (OR = 8.851, 95%CI: 3.907-20.048; P < 0.001). ROC curve analysis revealed good diagnostic potential for MUAC in GDM (AUC = 0.742, 95%CI: 0.684-0.800, P < 0.001), with a cut-off of 28.5 cm, sensitivity and specificity were 61% and 77%, respectively. CONCLUSION Pregnant women with MUAC >28.5 cm are prone to develop GDM during pregnancy, indicating that MUAC as an important predictive factor of GDM in early pregnancy.
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Affiliation(s)
- Ning Ma
- Department of Endocrinology, First Hospital of Qinhuangdao, Hebei, Qinhuangdao, 066000, China
| | - Liwei Bai
- Qinhuangdao Hospital for Maternal and Child Health, Hebei, Qinhuangdao, 066000, China
| | - Ziru Niu
- Department of Endocrinology, First Hospital of Qinhuangdao, Hebei, Qinhuangdao, 066000, China
| | - Qiang Lu
- Department of Endocrinology, First Hospital of Qinhuangdao, Hebei, Qinhuangdao, 066000, China.
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Zhang Y, Liu Y, Shi Y, Bai C, Wang T, Ruan F, Hu C. Upregulation of MMPs in placentas of patients with gestational diabetes mellitus: Involvement of the PI3K/Akt pathway. Heliyon 2024; 10:e32518. [PMID: 39021921 PMCID: PMC11252657 DOI: 10.1016/j.heliyon.2024.e32518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 06/04/2024] [Accepted: 06/05/2024] [Indexed: 07/20/2024] Open
Abstract
In recent years, there has been a notable rise in the incidence of pregnancies complicated by gestational diabetes mellitus (GDM), characterized by glucose intolerance first identified during pregnancy. Analysis of placental tissue has revealed that placentas from women with GDM tend to be larger and heavier compared to control placentas, indicating potential changes in trophoblast proliferation, differentiation, and apoptosis. In this study, transcriptome sequencing was conducted on placentas obtained from both normal pregnancies and pregnancies with GDM to investigate the molecular mechanisms underlying this condition. The original sequencing data were subjected to sequencing analysis, resulting in the identification of 935 upregulated genes and 256 downregulated genes. The KEGG and GO analysis techniques on differential genes uncovered evidence suggesting that the phosphoinositide 3-kinase (PI3K)/Akt signaling pathway may contribute to the pathogenesis of GDM. Subsequent analysis indicated that the expression levels of matrix metalloproteinases (MMP) 11, MMP12, MMP14, and MMP15, which are regulated by the PI3K/Akt pathway, were upregulated in the placentas of patients with GDM when compared to those of individuals with normal placental function. Additionally, our investigation into alternative splicing patterns revealed an increase in exon skipping alternative splicing of CSF3R in the placenta of patients with GDM compared to that in the control group. The CSF3R-PI3K-MMP pathway is speculated to regulate the pathogenesis of GDM.
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Affiliation(s)
- Yanan Zhang
- Department of Obstetrics, Affiliated Hospital of Jining Medical University, Jining, Shandong Province, 272029, PR China
| | - Yufen Liu
- Department of Obstetrics, Affiliated Hospital of Jining Medical University, Jining, Shandong Province, 272029, PR China
| | - Yanyan Shi
- Department of Pediatric Surgery, Affiliated Hospital of Jining Medical University, Jining, Shandong Province, 272029, PR China
| | - Chunyu Bai
- Precision Medicine Laboratory for Chronic Non-communicable Diseases of Shandong Province, Institute of Precision Medicine, Jining Medical University, Jining, Shandong, 272067, PR China
| | - Ting Wang
- Department of Pathology, Affiliated Hospital of Jining Medical University, Jining, Shandong Province, 272029, PR China
| | - Fang Ruan
- Department of Obstetrics, Affiliated Hospital of Jining Medical University, Jining, Shandong Province, 272029, PR China
| | - Chuanbing Hu
- Department of Pediatric Surgery, Affiliated Hospital of Jining Medical University, Jining, Shandong Province, 272029, PR China
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Yang X, Han R, Song Y, Zhang J, Huang H, Zhang J, Wang Y, Gao L. The Mediating Role of Physical Activity Self-Efficacy in Predicting Moderate-Intensity Physical Activity in Pregnant People at High Risk for Gestational Diabetes. J Midwifery Womens Health 2024; 69:403-413. [PMID: 38069454 DOI: 10.1111/jmwh.13589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 10/09/2023] [Indexed: 06/05/2024]
Abstract
INTRODUCTION Gestational diabetes mellitus (GDM) is a common medical complication in pregnancy. Moderate-intensity physical activity during pregnancy can lower the risk of GDM. However, the relationship between moderate-intensity physical activity and correlated factors among pregnant people at high risk for GDM remains unknown. METHODS A cross-sectional study was conducted in China. Two hundred fifty-two participants completed the Pregnancy Physical Activity Questionnaire, Pregnancy Physical Activity Self-Efficacy Scale, Physical Activity Knowledge Questionnaire, Physical Activity Social Support Scale, 7-item Generalized Anxiety Disorder Scale, Edinburgh Postnatal Depression Scale, and a sociodemographic data sheet. Structural equation modeling was used to explore the direct and indirect associations between the study variables. RESULTS A total of 51.6% of the participants did not meet the current physical activity guidelines. Only physical activity self-efficacy was significantly correlated with moderate-intensity physical activity. Physical activity self-efficacy mediated the relationship between moderate-intensity physical activity and knowledge of physical activity, social support for physical activity, and anxiety symptoms. Furthermore, knowledge of physical activity was also associated with improved moderate-intensity physical activity mediated by reduced anxiety symptoms and increased physical activity self-efficacy. CONCLUSION Our study revealed a high prevalence of not meeting current physical activity guidelines among pregnant people at high risk for GDM. Physical activity self-efficacy played an important mediating role in predicting moderate-intensity physical activity. Future studies should focus on enhancing self-efficacy to improve moderate-intensity physical activity for pregnant people at high risk for GDM.
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Affiliation(s)
- Xiao Yang
- School of Nursing, Sun Yat-Sen University, Guangzhou, China
| | - Rongrong Han
- School of Nursing, Sun Yat-Sen University, Guangzhou, China
| | - Yingli Song
- Zhengzhou Maternal and Child Health Hospital, Zhengzhou, China
| | - Ji Zhang
- Zhengzhou Maternal and Child Health Hospital, Zhengzhou, China
| | - Hui Huang
- Zhengzhou Maternal and Child Health Hospital, Zhengzhou, China
| | - Jing Zhang
- Zhengzhou Maternal and Child Health Hospital, Zhengzhou, China
| | - Yan Wang
- Zhengzhou Maternal and Child Health Hospital, Zhengzhou, China
| | - Lingling Gao
- School of Nursing, Sun Yat-Sen University, Guangzhou, China
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Zhang H, Jiang Y, Zhu S, Wei L, Zhou X, Gao P, Zhang J, Chen Y, Du Y, Fang C, Su R, Li J, Wang S, Feng L. MiR-155-5p improves the insulin sensitivity of trophoblasts by targeting CEBPB in gestational diabetes mellitus. Placenta 2024; 148:1-11. [PMID: 38325118 DOI: 10.1016/j.placenta.2024.01.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 12/26/2023] [Accepted: 01/21/2024] [Indexed: 02/09/2024]
Abstract
INTRODUCTION Gestational diabetes mellitus (GDM) is a prevalent pregnancy complication featuring impaired insulin sensitivity. MiR-155-5p is associated with various metabolic diseases. However, its specific role in GDM remains unclear. CCAAT enhancer binding protein beta (CEBPB), a critical role in regulating glucolipid metabolism, has been identified as a potential target of miR-155-5p. This study aims to investigate the impact of miR-155-5p and CEBPB on insulin sensitivity of trophoblasts in GDM. METHODS Placental tissues were obtained from GDM and normal pregnant women; miR-155-5p expression was then evaluated by RT‒qPCR and CEBPB expression by western blot and immunohistochemical staining. To investigate the impact of miR-155-5p on insulin sensitivity and CEBPB expression, HTR-8/SVneo cells were transfected with either miR-155-5p mimic or inhibitor under basal and insulin-stimulated conditions. Cellular glucose uptake consumption was quantified using a glucose assay kit. Furthermore, the targeting relationship between miR-155-5p and CEBPB was validated using a dual luciferase reporter assay. RESULTS Reduced miR-155-5p expression and elevated CEBPB expression were observed in GDM placentas and high glucose treated HTR8/SVneo cells. The overexpression of miR-155-5p significantly enhanced insulin signaling and glucose uptake in trophoblasts. Conversely, inhibiting miR-155-5p induced the opposite effects. Additionally, CEBPB was directly targeted and negatively regulated by miR-155-5p in HTR8/SVneo cells. Silencing CEBPB effectively restored the inhibitory effect of miR-155-5p downregulation on insulin sensitivity in trophoblasts. DISCUSSION These findings suggest that miR-155-5p could enhance insulin sensitivity in trophoblasts by targeting CEBPB, highlighting the potential of miR-155-5p as a therapeutic target for improving the intrauterine hyperglycemic environment in GDM.
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Affiliation(s)
- Huiting Zhang
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Yi Jiang
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Shenglan Zhu
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Lijie Wei
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Xuan Zhou
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Peng Gao
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Jingyi Zhang
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Yuting Chen
- Department of Obstetrics and Gynecology Ultrasound, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China
| | - Yuanyuan Du
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Chenyun Fang
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Rui Su
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Jiaqi Li
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Nanchang University, Nanchang, 330006, China
| | - Shaoshuai Wang
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Ling Feng
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
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Abindu V, Hope D, Aleni M, Andru M, Ayiasi RM, Afayo V, Oyet C, Kiconco R. Missed Diagnosis of Gestational Diabetes Mellitus Due to Selective Screening: Evidence from a Cross-Sectional Study in the West Nile Sub-Region, Uganda. Diabetes Metab Syndr Obes 2024; 17:1309-1319. [PMID: 38505540 PMCID: PMC10949170 DOI: 10.2147/dmso.s447855] [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: 12/14/2023] [Accepted: 03/05/2024] [Indexed: 03/21/2024] Open
Abstract
Purpose To ascertain the prevalence and risk factors of gestational diabetes mellitus (GDM) in pregnant women receiving antenatal care (ANC) services within the West Nile subregion of Uganda. Patients and Methods An analytical cross-sectional study was conducted on 233 pregnant women who are within 24-28 weeks of gestation and are receiving ANC services in selected hospitals. GDM was diagnosed according to the World Health Organization (WHO) criteria (2013). A questionnaire and anthropometric measurements were used to obtain relevant data. The chi-square test and logistic regression were used to determine the association between GDM and the study variables, including participants' sociodemographic and medical characteristics. Results The prevalence of hyperglycemia first detected in pregnancy among the participants tested was 8%. Overall, 7.45% had GDM and 0.53% had diabetes mellitus in pregnancy. The fasting plasma glucose test alone was positive in 86.7% of the GDM cases. The factors that were significantly associated with GDM included age ≥25 years (p = 0.017, AOR = 3.51) and body mass index (BMI) ≥25 kg/m2 (p = 0.024, AOR = 2.67). Out of the participants diagnosed with GDM, 28.6% did not have a known risk factor. Of the pregnant women with GDM, 57% would have been missed if the selective screening in the national clinical guidelines had been followed. Urinary tract infection (UTI) and Candida were detected in 36.36% and 13.85% of the participants, respectively. Conclusion The study provides new data on the prevalence of GDM in rural settings in the West Nile subregion of Uganda. Of the participants, 7.5% were diagnosed with GDM, of which 57% would have been missed based on the selective screening of the national clinical guidelines. The study findings support the universal screening of GDM in pregnant women.
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Affiliation(s)
- Vincent Abindu
- Department of Nursing and Midwifery - Faculty of Health Sciences, Muni University, Arua, West Nile, Uganda
| | - Derick Hope
- Department of Medical Laboratory Science - Faculty of Health Sciences, Muni University, Arua, West Nile, Uganda
| | - Mary Aleni
- Department of Nursing and Midwifery - Faculty of Health Sciences, Muni University, Arua, West Nile, Uganda
| | - Monicah Andru
- Department of Nursing and Midwifery - Faculty of Health Sciences, Muni University, Arua, West Nile, Uganda
| | - Richard Mangwi Ayiasi
- Department of Public Health - Faculty of Health Sciences, Muni University, Arua, West Nile, Uganda
| | - Victor Afayo
- Department of Obstetrics and Gynaecology, Arua Regional Referral Hospital, Arua, West Nile, Uganda
| | - Caesar Oyet
- Department of Medical Laboratory Science - Faculty of Health Sciences, Clark International University, Kampala, Central, Uganda
| | - Ritah Kiconco
- Department of Clinical Biochemistry - Faculty of Health Sciences, Soroti University, Soroti, Teso, Uganda
- Department of Medical Laboratory Sciences - Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Southwestern, Uganda
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Xie W, Zhang L, Cheng J, Wang Y, Kang H, Gao Y. Physical activity during pregnancy and the risk of gestational diabetes mellitus: a systematic review and dose-response meta-analysis. BMC Public Health 2024; 24:594. [PMID: 38395913 PMCID: PMC10893683 DOI: 10.1186/s12889-024-18131-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 02/16/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Previous research has indicated the inverse association between physical activity (PA) and gestational diabetes mellitus (GDM). However, the dose-response relationship currently remains undetermined. This study aims to explore the dose-response relationship between PA during the first and second trimesters of pregnancy and GDM risk. METHODS Studies on the relationship between PA during pregnancy and GDM risk published before April 25, 2023, were searched for in six databases. According to the inclusion and exclusion criteria, all literature was screened for eligibility. The Newcastle-Ottawa Scale (NOS) was used to assess risk of bias. Publication bias was examined using funnel plots, Begg's and Egger's tests, as well as trim-and-fill analysis. We harmonized exposure estimates of PA during pregnancy to the common unit of the metabolic equivalent of task (MET)-h/week. Restricted cubic splines were used to model the dose-response relationship. The criteria from the World Cancer Research Fund were used to assess the certainty of evidence across outcomes. All analyses were performed using Stata 15.1. RESULTS The results indicated that in contrast with the lowest level of PA, promoting the highest PA level lowers the risk of GDM by 36% (RR = 0.64, 95%CI: 0.53 ~ 0.78). We found a curvilinear dose-response association between PA during the first trimester and incident GDM (Pnonlinearity = 0.012). Compared to inactive pregnant women, for those who achieved the guidelines-suggested minimum level (10 MET-h/week) of PA during the first trimester, the GDM risk was decreased by 13% (RR = 0.87, 95%CI: 0.79 ~ 0.96). A linear relationship was found between PA during the second trimester and the GDM risk (Pnonlinearity = 0.276). The results with a restricted cubic spline model suggested that pregnant women who accumulate 10 MET-h/week have a 1% reduced risk of GDM compared to completely inactive individuals. Twice (20 MET-h/week) or a higher amount of PA (50 MET-h/week) contributed to further reductions in GDM risk. CONCLUSION There is a dose-response relationship between higher levels of PA in both the first and second trimesters and reduced risk of GDM; the relationship is stronger in the first trimester. Increasing PA during pregnancy can prevent the development of GDM. PROSPERO REGISTRATION NUMBER CRD42023420564.
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Affiliation(s)
- Wanting Xie
- Department of Physical Fitness and Health, School of Sport Science, Beijing Sport University, Beijing, 100084, China
| | - Liuwei Zhang
- Department of Physical Fitness and Health, School of Sport Science, Beijing Sport University, Beijing, 100084, China.
- Key Laboratory of Exercise and Physical Fitness, Ministry of Education, Beijing Sport University, Beijing, 100084, China.
| | - Jiaoying Cheng
- Department of Obstetrics and Gynecology, China-Japan Friendship Hospital, Beijing, 100029, China.
| | - Yirui Wang
- Department of Physical Fitness and Health, School of Sport Science, Beijing Sport University, Beijing, 100084, China
| | - Haixin Kang
- Department of Physical Fitness and Health, School of Sport Science, Beijing Sport University, Beijing, 100084, China
| | - Yi Gao
- School of Strength and Conditioning Training, Beijing Sport University, Beijing, 100084, China
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Maleki M, Mousavi P, Abedi P, Rokhafrooz D, Maraghi E. Effect of mobile-assisted education on health promoting lifestyle and blood sugar of women with gestational diabetes: a randomised controlled trial. BMJ Nutr Prev Health 2023; 6:310-317. [PMID: 38618532 PMCID: PMC11009530 DOI: 10.1136/bmjnph-2023-000802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 11/06/2023] [Indexed: 04/16/2024] Open
Abstract
Background The gestational diabetes causes complications for the mother and the baby. Methods It was a randomised controlled trial that was conducted in Public Health Center No 1 in Baghmalek, Khuzestan province, Iran. Seventy-six women with gestational diabetes mellitus (GDM) were recruited and randomly allocated into an intervention (n=38) and a control group (n=38). A mobile app was developed, and the content of the educational programme was designed according to the six dimensions of Health Promotion Lifestyle Profile (HPLP). Participants in the intervention group followed instructions about healthy lifestyle for 4 weeks, whereas the control group received only routine care. A demographic questionnaire, and the HPLP-II were used to gather the data.Health promoting lifestyle and blood sugar of participants were measured after 4 weeks. Results The total score of HPLP was 98.34±13.99 and 92.39±14.56 before the intervention in intervention and control groups, respectively, which was improved significantly in the intervention group compared with the control group after intervention (143.13±23.41 vs 100.39±16.69, p<0.0001). Also, the scores of stress management, responsibility, interpersonal relationship, spiritual growth, nutrition and physical activity were significantly improved in the intervention group. Fasting blood sugar and blood sugar 2 hours after meal significantly reduced in the intervention group compared with the control group (86.05±7.71 mg/dL vs 93.92±5.52 mg/dL) and (113.65±10.96 mg/dL vs 124.97±9.15 mg/dL), (p=0.001), respectively. Conclusions Our results showed that offering educational programmes based on mobile apps can improve healthy lifestyle and blood sugar in women with GDM. Trial registration number IRCT20200817048434N1. Website address https://www.irct.ir/search/result?query=IRCT20200817048434N1.
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Affiliation(s)
- Maryam Maleki
- Departmentof Midwifery, School of Nursing and Midwifery, Diabetes Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran (the Islamic Republic of)
| | - Parvaneh Mousavi
- Instructor of Midwifery, School of Nursing and Midwifery, Diabetes Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Khuzestan, Iran (the Islamic Republic of)
| | - Parvin Abedi
- Midwifery Department, Menopause Andropause Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran (the Islamic Republic of)
| | - Dariush Rokhafrooz
- Medical Education, Nursing Department, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran (the Islamic Republic of)
| | - Elham Maraghi
- Biostatistics Department, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran (the Islamic Republic of)
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Arain H, Patel T, Mureanu N, Efthymiou A, Lombardi G, Tree T, Nicolaides KH, Shangaris P. Regulatory T cells in the peripheral blood of women with gestational diabetes: a systematic review and meta-analysis. Front Immunol 2023; 14:1226617. [PMID: 38111588 PMCID: PMC10726109 DOI: 10.3389/fimmu.2023.1226617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Accepted: 11/08/2023] [Indexed: 12/20/2023] Open
Abstract
Background Gestational diabetes (GDM) affects approximately 14% of pregnancies globally and is associated with short- and long-term complications for both the mother and child. In addition, GDM has been linked to chronic low-grade inflammation with recent research indicating a potential immune dysregulation in pathophysiology and a disparity in regulatory T cells. Objective This systematic review and meta-analysis aimed to determine whether there is an association between GDM and the level of Tregs in the peripheral blood. Methods Literature searches were conducted in PubMed, Embase, and Ovid between the 7th and 14th of February 2022. The inclusion criteria were any original studies published in the English language, measuring differentiated Tregs in women with GDM compared with glucose-tolerant pregnant women. Meta-analysis was performed between comparable Treg markers. Statistical tests were used to quantify heterogeneity: τ 2, χ 2, and I 2. Study quality was assessed using a modified version of the Newcastle-Ottawa scale. Results The search yielded 223 results: eight studies were included in the review and seven in the meta-analysis (GDM = 228, control = 286). Analysis of Tregs across all trimesters showed significantly lower Treg numbers in women with GDM (SMD, -0.76; 95% CI, -1.37, -0.15; I 2 = 90%). This was reflected in the analysis by specific Treg markers (SMD -0.55; 95% CI, -1.04, -0.07; I 2 = 83%; third trimester, five studies). Non-significant differences were found within subgroups (differentiated by CD4+FoxP3+, CD4+CD127-, and CD4+CD127-FoxP3) of both analyses. Conclusion GDM is associated with lower Treg numbers in the peripheral maternal blood. In early pregnancy, there is clinical potential to use Treg levels as a predictive tool for the subsequent development of GDM. There is also a potential therapeutic intervention to prevent the development of GDM by increasing Treg populations. However, the precise mechanism by which Tregs mediate GDM remains unclear. Systematic review registration https://www.crd.york.ac.uk/prospero, identifier CRD42022309796.
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Affiliation(s)
- Hania Arain
- Department of Women and Children’s Health, School of Life Course and Population Sciences, Faculty of Life Sciences and Medicine King’s College London, London, United Kingdom
| | - Tina Patel
- Department of Women and Children’s Health, School of Life Course and Population Sciences, Faculty of Life Sciences and Medicine King’s College London, London, United Kingdom
| | - Nicoleta Mureanu
- Department of Women and Children’s Health, School of Life Course and Population Sciences, Faculty of Life Sciences and Medicine King’s College London, London, United Kingdom
- Harris Birthright Research Centre for Fetal Medicine, King’s College Hospital, London, United Kingdom
| | - Athina Efthymiou
- Department of Women and Children’s Health, School of Life Course and Population Sciences, Faculty of Life Sciences and Medicine King’s College London, London, United Kingdom
- Harris Birthright Research Centre for Fetal Medicine, King’s College Hospital, London, United Kingdom
| | - Giovanna Lombardi
- Peter Gorer Department of Immunobiology, School of Immunology & Microbial Sciences, Faculty of Life Sciences & Medicine, King’s College London, London, United Kingdom
| | - Timothy Tree
- Peter Gorer Department of Immunobiology, School of Immunology & Microbial Sciences, Faculty of Life Sciences & Medicine, King’s College London, London, United Kingdom
| | - Kypros H. Nicolaides
- Department of Women and Children’s Health, School of Life Course and Population Sciences, Faculty of Life Sciences and Medicine King’s College London, London, United Kingdom
- Harris Birthright Research Centre for Fetal Medicine, King’s College Hospital, London, United Kingdom
| | - Panicos Shangaris
- Department of Women and Children’s Health, School of Life Course and Population Sciences, Faculty of Life Sciences and Medicine King’s College London, London, United Kingdom
- Harris Birthright Research Centre for Fetal Medicine, King’s College Hospital, London, United Kingdom
- Peter Gorer Department of Immunobiology, School of Immunology & Microbial Sciences, Faculty of Life Sciences & Medicine, King’s College London, London, United Kingdom
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Chaudhary A, Nadeem M, Townsend J, Miller VJ, Hajrasouliha AR. Perinatal events and development of juvenile idiopathic arthritis-associated uveitis. Sci Rep 2023; 13:17576. [PMID: 37845273 PMCID: PMC10579364 DOI: 10.1038/s41598-023-44208-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 10/05/2023] [Indexed: 10/18/2023] Open
Abstract
Uveitis is one of the most common manifestations of juvenile idiopathic arthritis (JIA). Currently, JIA is associated with decreased gut microbiota diversity. Studies confirm that perinatal events can cause aberrant microbial colonization. The objective of this study is to determine if JIA is associated with perinatal events with a secondary focus on these variables to the development of JIA-uveitis. 369 patients with strabismus (n = 200) or JIA (n = 196) were included in the study. Completed surveys (JIA 37; strabismus 18) collected data about birth route, pregnancy and labor complications, JIA medications, and the presence of eye disorders. Analysis indicates that there is no relationship between JIA development and the perinatal events investigated. Similarly, no significance was found between JIA-uveitis and birth route or labor complications. Pregnancy complications, namely gestational diabetes (GD), were statistically higher in the JIA group with uveitis compared to JIA without uveitis. The data from this survey study showed that JIA-uveitis was highly associated with pregnancy complications, particularly with GD. However, no statistically significant association was found between JIA and route of delivery, labor complications, or pregnancy complications. Further studies are needed to understand the ways that GD interrelates with the development of uveitis in JIA patients.
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Affiliation(s)
- Aysha Chaudhary
- Eugene and Marilyn Glick Eye Institute and Department of Ophthalmology, Indiana University School of Medicine, 1160 W Michigan St, Indianapolis, IN, 46202, USA
| | - Manahil Nadeem
- Eugene and Marilyn Glick Eye Institute and Department of Ophthalmology, Indiana University School of Medicine, 1160 W Michigan St, Indianapolis, IN, 46202, USA
| | - Jack Townsend
- Eugene and Marilyn Glick Eye Institute and Department of Ophthalmology, Indiana University School of Medicine, 1160 W Michigan St, Indianapolis, IN, 46202, USA
| | - Victoria J Miller
- Eugene and Marilyn Glick Eye Institute and Department of Ophthalmology, Indiana University School of Medicine, 1160 W Michigan St, Indianapolis, IN, 46202, USA
| | - Amir R Hajrasouliha
- Eugene and Marilyn Glick Eye Institute and Department of Ophthalmology, Indiana University School of Medicine, 1160 W Michigan St, Indianapolis, IN, 46202, USA.
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Takemoto A, Nagai Y, Kawanabe S, Nakagawa T, Matsumoto K, Hasegawa J, Suzuki N, Tanaka Y, Sone M. Patients with gestational diabetes mellitus may be treated in both early and late pregnancy, especially in patients with pre-pregnancy overweight: A cross-sectional study in Japan. Diabetol Int 2023; 14:381-389. [PMID: 37781467 PMCID: PMC10533430 DOI: 10.1007/s13340-023-00646-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 07/04/2023] [Indexed: 10/03/2023]
Abstract
The significance of diagnosing gestational diabetes mellitus (GDM) in early pregnancy is controversial. We used the International Association of Diabetes and Pregnancy Study Group (IADPSG) criteria to investigate whether clinical background and neonatal outcomes differ depending on when GDM is diagnosed in early or late pregnancy. This was a single-center, observational study conducted between November 2012 and March 2020 at St. Marianna University Hospital (Kawasaki, Japan). We compared the background and perinatal outcomes of patients with GDM depending on the time of diagnosis (at < 24 gestational weeks or ≥ 24 weeks). Insulin sensitivity index, homeostasis model assessment of insulin resistance, and β-cell function were calculated from a 75-g oral glucose tolerance test. Stratified analysis was performed by pre-pregnancy BMI in patients with early GDM. As a result, in the 507 patients, 89.9% gave birth at our hospital. The pre-pregnancy BMI was significantly higher in patients with early GDM than in those with late GDM (the median [interquartile range], 22.7 [20.3, 26.3] and 21.5 [19.3, 23.8] kg/m2, respectively; p = 0.001). Perinatal outcomes were not different between the two groups. However, in the subgroup analysis of patients with early GDM, the prevalence of large-for-gestational-age infants was significantly higher in the group with overweight (15.4% vs 2.1%, respectively; p = 0.008). In conclusion, patients with GDM using the IADPSG criteria in early pregnancy may be treated, especially in patients with pre-pregnancy overweight.
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Affiliation(s)
- Ayaka Takemoto
- Division of Metabolism and Endocrinology, Department of Internal Medicine, St. Marianna University School of Medicine, 2-16-1, Sugao, Miyamae-Ku, Kawasaki, Kanagawa 216-8511 Japan
| | - Yoshio Nagai
- Division of Metabolism and Endocrinology, Department of Internal Medicine, St. Marianna University School of Medicine, 2-16-1, Sugao, Miyamae-Ku, Kawasaki, Kanagawa 216-8511 Japan
- Department of Diabetes and Endocrinology, Kanto Rosai Hospital, 1-1, Kizukisumiyoshicho, Nakahara-Ku, Kawasaki, Kanagawa 211-8510 Japan
| | - Shin Kawanabe
- Division of Metabolism and Endocrinology, Department of Internal Medicine, St. Marianna University School of Medicine, 2-16-1, Sugao, Miyamae-Ku, Kawasaki, Kanagawa 216-8511 Japan
| | - Tomoko Nakagawa
- Division of Metabolism and Endocrinology, Department of Internal Medicine, St. Marianna University School of Medicine, 2-16-1, Sugao, Miyamae-Ku, Kawasaki, Kanagawa 216-8511 Japan
| | - Kaho Matsumoto
- St. Marianna University School of Medicine, 2-16-1, Sugao, Miyamae-Ku, Kawasaki, Kanagawa 216-8511 Japan
| | - Jyunichi Hasegawa
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kawasaki, Kanagawa Japan
| | - Nao Suzuki
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kawasaki, Kanagawa Japan
| | - Yasushi Tanaka
- Diabetes Center, Yokohama General Hospital, 2201-5, Kuroganecho, Aoba-Ku, Yokohama, Kanagawa 225-0025 Japan
| | - Masakatsu Sone
- Division of Metabolism and Endocrinology, Department of Internal Medicine, St. Marianna University School of Medicine, 2-16-1, Sugao, Miyamae-Ku, Kawasaki, Kanagawa 216-8511 Japan
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12
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Peterson AK, Zhu Y, Fuller S, Feng J, Alexeeff S, Mitro SD, Kannan K, Robinson M, Padula A, Ferrara A. PFAS concentrations in early and mid-pregnancy and risk of gestational diabetes mellitus in a nested case-control study within the ethnically and racially diverse PETALS cohort. BMC Pregnancy Childbirth 2023; 23:657. [PMID: 37704943 PMCID: PMC10500777 DOI: 10.1186/s12884-023-05953-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 08/24/2023] [Indexed: 09/15/2023] Open
Abstract
BACKGROUND Per- and polyfluoroalkyl substances (PFAS) are persistent synthetic chemicals and are commonly found in everyday items. PFAS have been linked to disrupting glucose homeostasis, however, whether they are associated with gestational diabetes mellitus (GDM) risk remains inconclusive. We examined prospective associations of PFAS concentrations measured twice in pregnancy with GDM risk. METHODS In the PETALS pregnancy cohort, a nested case-control study which included 41 GDM cases and 87 controls was conducted. PFAS analytes were measured in blood serum collected in both early and mid-pregnancy (mean [SD]: 13.9 [2.2] and 20.2 [2.2] gestational weeks, respectively), with cumulative exposure calculated by the area-under-the-curve (AUC) to integrate both the PFAS concentration and the timing of the exposure. Individual adjusted weighted unconditional logistic regression models examined seven PFAS in association with GDM risk. P-values were corrected using the false-discovery-rate (FDR). Mixture models were analyzed with Bayesian kernel machine regression (BKMR). RESULTS PFDA, PFNA and PFOA were individually associated with higher GDM risk per interquartile range (IQR) in early pregnancy (OR [95% CI]: 1.23 [1.09, 1.38]), 1.40 [1.24, 1.58]), and 1.15 [1.04, 1.27], respectively), mid-pregnancy (1.28 [1.15, 1.43], 1.16 [1.05, 1.28], and 1.20 [1.09, 1.33], respectively), and with cumulative exposure (1.23 [1.09, 1.38], 1.21 [1.07, 1.37], and 1.19 [1.09, 1.31], respectively). PFOS in mid-pregnancy and with cumulative exposure was associated with increased GDM risk (1.41 [1.17, 1.71] and 1.33 [1.06, 1.58], respectively). PFUnDA in early pregnancy was associated with lower GDM risk (0.79 [0.64, 0.98]), whereas mid-pregnancy levels were associated with higher risk (1.49 [1.18, 1.89]). PFHxS was associated with decreased GDM risk in early and mid-pregnancy (0.48 [0.38, 0.60] and 0.48 [0.37, 0.63], respectively) and with cumulative exposure (0.49 [0.38,0.63]). PFPeA was not associated with GDM. Similar conclusions were observed in BKMR models; however, overall associations in these models were not statistically significant. CONCLUSIONS Higher risk of GDM was consistently observed in association with PFDA, PFNA, and PFOA exposure in both early and mid-pregnancy. Results should be corroborated in larger population-based cohorts and individuals of reproductive age should potentially avoid known sources of PFAS.
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Affiliation(s)
- Alicia K Peterson
- Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA, 94612, USA.
- Center for Upstream Prevention of Adiposity and Diabetes Mellitus (UPSTREAM), Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA, 94612, USA.
| | - Yeyi Zhu
- Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA, 94612, USA
- Center for Upstream Prevention of Adiposity and Diabetes Mellitus (UPSTREAM), Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA, 94612, USA
| | - Sophia Fuller
- Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA, 94612, USA
| | - Juanran Feng
- Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA, 94612, USA
| | - Stacey Alexeeff
- Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA, 94612, USA
| | - Susanna D Mitro
- Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA, 94612, USA
- Center for Upstream Prevention of Adiposity and Diabetes Mellitus (UPSTREAM), Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA, 94612, USA
| | - Kurunthachalam Kannan
- Department of Pediatrics, New York University School of Medicine, 145 East 32 Street, New York, NY, 10016, USA
| | - Morgan Robinson
- Department of Pediatrics, New York University School of Medicine, 145 East 32 Street, New York, NY, 10016, USA
| | - Amy Padula
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, 490 Illinois Street, San Francisco, 94143 CA, USA
| | - Assiamira Ferrara
- Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA, 94612, USA
- Center for Upstream Prevention of Adiposity and Diabetes Mellitus (UPSTREAM), Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA, 94612, USA
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13
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Tao M, Lu G, Zhang S, Li P. Root causes of long-term complications of gestational diabetes mellitus: Metabolic disturbances of the host and gut microbiota. Clin Chim Acta 2023; 548:117490. [PMID: 37453553 DOI: 10.1016/j.cca.2023.117490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 06/27/2023] [Accepted: 07/12/2023] [Indexed: 07/18/2023]
Abstract
BACKGROUND Gestational diabetes mellitus (GDM) poses a risk of short-term and long-term complications for both mother and fetus. However, there is a lack of consensus on the screening approach and pathophysiology of GDM. METHODS Women were screened at 24 to 28 weeks gestation using the one-step screening approach and serum samples were collected for metabolomics based on 1H NMR spectroscopy. A random forest classifier was developed to evaluate its diagnostic efficacy on GDM. RESULTS Serum metabolic fingerprints of women with GDM differed significantly from those with normoglycemic. Of the 59 differential metabolites identified, 25 were well-known risk metabolites associated with type 2 diabetes or cardiovascular diseases, such as branched-chain amino acids and trimethylamine N-oxide. In addition, most of the differential metabolites were microbial metabolites or could be metabolized by gut microbes. The correlation between serum metabolites and maternal 75 g OGTT glucose values supported the establishment of a random forest classifier, which selected 21 metabolites to predict GDM with an AUC of 0.988. CONCLUSIONS Metabolic disturbances in the host and gut microbiota may be a persistent contributor to the risk of developing type 2 diabetes or cardiovascular diseases in GDM. Targeting microbiota is one intervention that needs to be considered.
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Affiliation(s)
- Mingjin Tao
- Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, China
| | - Gaochen Lu
- Department of Microbiota Medicine & Medical Center for Digestive Diseases, the Second Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Sheng Zhang
- Department of Microbiota Medicine & Medical Center for Digestive Diseases, the Second Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Pan Li
- Department of Microbiota Medicine & Medical Center for Digestive Diseases, the Second Affiliated Hospital of Nanjing Medical University, Nanjing, China.
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14
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Preda A, Iliescu DG, Comănescu A, Zorilă GL, Vladu IM, Forțofoiu MC, Țenea-Cojan TS, Preda SD, Diaconu ID, Moța E, Gheorghe IO, Moța M. Gestational Diabetes and Preterm Birth: What Do We Know? Our Experience and Mini-Review of the Literature. J Clin Med 2023; 12:4572. [PMID: 37510687 PMCID: PMC10380752 DOI: 10.3390/jcm12144572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 06/28/2023] [Accepted: 07/06/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND Gestational diabetes mellitus (GDM) is a form of diabetes that develops during pregnancy. The incidence of GDM has been on the rise in tandem with the increasing prevalence of obesity worldwide. We focused on the study of what causes premature births and if there are methods to prevent these events that can result in long-term complications. METHODS This study was a prospective, non-interventional study that lasted for 4 years from December 2018 to December 2022. From the group of women enrolled in the study, we selected and analyzed the characteristics of women who gave birth prematurely. Additionally, we performed a systematic review examining the association between GDM and the frequency of adverse pregnancy outcomes. RESULTS In total, 78% underwent an emergency caesarean and had polyhydramnios. The results indicate that women who had a preterm delivery had a significantly higher maternal age compared to those who had a term delivery (p < 0.001). Conversely, there was no significant difference in preconception BMI between the two groups (p = 0.12). CONCLUSIONS In terms of the understanding of GDM and preterm birth, several gaps in our knowledge remain. The association between GDM and preterm birth is likely multifactorial, involving various maternal factors.
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Affiliation(s)
- Agnesa Preda
- Department of Obstetrics and Gynecology, University Emergency County Hospital Craiova, 200642 Craiova, Romania
| | - Dominic-Gabriel Iliescu
- Department of Obstetrics and Gynecology, University Emergency County Hospital Craiova, 200642 Craiova, Romania
- Department of Obstetrics and Gynecology, University of Medicine and Pharmacy Craiova, 200349 Craiova, Romania
| | - Alexandru Comănescu
- Department of Obstetrics and Gynecology, University Emergency County Hospital Craiova, 200642 Craiova, Romania
- Department of Obstetrics and Gynecology, University of Medicine and Pharmacy Craiova, 200349 Craiova, Romania
| | - George-Lucian Zorilă
- Department of Obstetrics and Gynecology, University Emergency County Hospital Craiova, 200642 Craiova, Romania
- Department of Obstetrics and Gynecology, University of Medicine and Pharmacy Craiova, 200349 Craiova, Romania
| | - Ionela Mihaela Vladu
- Department of Diabetes, Nutrition and Metabolic Diseases, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
- Department of Diabetes, Nutrition and Metabolic Diseases, University Emergency County Hospital Craiova, 200642 Craiova, Romania
| | - Mircea-Cătălin Forțofoiu
- Department of Medical Semiology, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
- Department of Internal Medicine 2, "Philanthropy" Clinical Municipal Hospital of Craiova, 200143 Craiova, Romania
| | - Tiberiu Stefaniță Țenea-Cojan
- Department of General Surgery, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
- Department of General Surgery, C.F. Clinical Hospital, 200374 Craiova, Romania
| | - Silviu-Daniel Preda
- Department of Surgery, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Ileana-Diana Diaconu
- Department of Pediatric Pneumology, "Marius Nasta" National Institute of Pneumophtisiology, 050159 Bucharest, Romania
- Doctoral School, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Eugen Moța
- Doctoral School, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Ioan-Ovidiu Gheorghe
- Doctoral School, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Maria Moța
- Doctoral School, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
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15
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Zang L, Liu X, Xie X, Zhou X, Pan Y, Dai J. Exposure to per- and polyfluoroalkyl substances in early pregnancy, risk of gestational diabetes mellitus, potential pathways, and influencing factors in pregnant women: A nested case-control study. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2023; 326:121504. [PMID: 36965679 DOI: 10.1016/j.envpol.2023.121504] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 02/27/2023] [Accepted: 03/22/2023] [Indexed: 06/18/2023]
Abstract
Although previous studies have reported an association between maternal serum perfluoroalkyl substance (PFAS) exposure and gestational diabetes mellitus (GDM) risk, results have been inconsistent. Few studies have focused on the combined effects of emerging and legacy PFASs on glucose homeostasis while humans are always exposed to multiple PFASs simultaneously. Moreover, the potential pathways by which PFAS exposure induces GDM are unclear. A total of 295 GDM cases and 295 controls were enrolled from a prospective cohort of 2700 pregnant women in Shanghai, China. In total, 16 PFASs were determined in maternal spot serum samples in early pregnancy. We used conditional logistic regression, multiple linear regression, and Bayesian kernel machine regression (BKMR) to examine individual and joint effects of PFAS exposure on GDM risk and oral glucose tolerance test outcomes. The mediating effects of maternal serum biochemical parameters, including thyroid and liver function were further assessed. Maternal perfluorooctanoic acid (PFOA) exposure was associated with an increased risk of GDM (odds ratio (OR) = 1.68; 95% confidence interval (95% CI): 1.10, 2.57), consistent with higher concentrations in GDM cases than controls. Based on mediation analysis, an increase in the free triiodothyronine to free thyroxine ratio partially explained the effect of this association. For continuous glycemic outcomes, positive associations were observed between several PFASs and 1-h and 2-h glucose levels. In BKMR, PFAS mixture exposure showed a positive trend with GDM incidence, although the CIs were wide. These associations were more pronounced among women with normal pre-pregnancy body mass index (BMI). Mixed PFAS congeners may affect glucose homeostasis by increasing 1-h glucose levels, with perfluorononanoic acid found to be a main contributor. Exposure to PFASs was associated with increased risk of GDM and disturbance in glucose homeostasis, especially in normal weight women. The PFAS-associated disruption of maternal thyroid function may alter glucose homeostasis.
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Affiliation(s)
- Lu Zang
- Key Laboratory of Animal Ecology and Conservation Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing, 100101, China; University of Chinese Academy of Sciences, Beijing, 100049, China; State Environmental Protection Key Laboratory of Environmental Health Impact Assessment of Emerging Contaminants, School of Environmental Science and Engineering, Shanghai Jiao Tong University, 800 Dongchuan Road, Shanghai, 200240, China
| | - Xiaorui Liu
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200030, China
| | - Xianjing Xie
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200030, China
| | - Xuming Zhou
- Key Laboratory of Animal Ecology and Conservation Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing, 100101, China
| | - Yitao Pan
- State Environmental Protection Key Laboratory of Environmental Health Impact Assessment of Emerging Contaminants, School of Environmental Science and Engineering, Shanghai Jiao Tong University, 800 Dongchuan Road, Shanghai, 200240, China
| | - Jiayin Dai
- State Environmental Protection Key Laboratory of Environmental Health Impact Assessment of Emerging Contaminants, School of Environmental Science and Engineering, Shanghai Jiao Tong University, 800 Dongchuan Road, Shanghai, 200240, China.
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Liu W, Gao M, Yang S, Sun C, Bi Y, Li Y, Wang J, Yuan X. Effects of omega-3 supplementation on glucose and lipid metabolism in patients with gestational diabetes: A meta-analysis of randomized controlled trials. J Diabetes Complications 2023; 37:108451. [PMID: 36913875 DOI: 10.1016/j.jdiacomp.2023.108451] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 03/01/2023] [Accepted: 03/03/2023] [Indexed: 03/09/2023]
Abstract
AIM We assessed whether omega-3 supplementation could improve glucose and lipid metabolism, insulin resistance, and inflammatory factors in individuals with gestational diabetes mellitus (GDM). METHODS In this meta-study, we used a random-effects or fixed-effects meta-analysis model to analyze the mean differences (MD) and corresponding 95 % confidence intervals (CI) before and after omega-3 and placebo supplementation, thus evaluating the effects of omega-3 on glucose and lipid metabolism, insulin resistance, and inflammatory factors. RESULTS Six randomized controlled trials (331 participants) were included in the meta-analysis. The levels of fasting plasma glucose (FPG) (WMD = -0.25 mmol/L; 95 % CI: -0.38, -0.12), fasting insulin (WMD = -17.13 pmol/L; 95 % CI: -27.95, -6.30), and homeostasis model of assessment-insulin resistance (WMD = -0.51; 95 % CI: -0.89, -0.12) were lower in the omega-3 group compared to their levels in the placebo group. The results of the analysis of lipid metabolism showed that triglycerides (WMD = -0.18 mmol/L; 95 % CI: -0.29, -0.08) and very low-density lipoprotein cholesterol (WMD = -0.1 mmol/L; 95 % CI: -0.16, -0.03) decreased in the omega-3 group, while high-density lipoproteins (WMD = 0.06 mmol/L; 95 % CI: 0.02, 0.10) increased. Compared to the placebo group, inflammatory factor serum C-reactive protein (SMD = -0.68 mmol/L; 95 % CI: -0.96, -0.39) decreased in the omega-3 group. CONCLUSION Omega-3 supplementation can decrease the levels of FPG and inflammatory factors, enhance blood lipid metabolism, and reduce insulin resistance in patients with GDM.
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Affiliation(s)
- Weixia Liu
- Department of Endocrinology and Metabolism, First Hospital of Jilin University, 1 Xinmin Street, Changchun 130021, Jilin, China
| | - Menghan Gao
- Department of Endocrinology and Metabolism, First Hospital of Jilin University, 1 Xinmin Street, Changchun 130021, Jilin, China
| | - Shuo Yang
- Department of Clinical Nutrition, First Hospital of Jilin University, 1 Xinmin Street, Changchun 130021, Jilin, China
| | - Chenglin Sun
- Department of Endocrinology and Metabolism, First Hospital of Jilin University, 1 Xinmin Street, Changchun 130021, Jilin, China; Department of Clinical Nutrition, First Hospital of Jilin University, 1 Xinmin Street, Changchun 130021, Jilin, China
| | - Yaru Bi
- Department of Endocrinology and Metabolism, First Hospital of Jilin University, 1 Xinmin Street, Changchun 130021, Jilin, China
| | - Yuting Li
- Department of Endocrinology and Metabolism, First Hospital of Jilin University, 1 Xinmin Street, Changchun 130021, Jilin, China
| | - Jiping Wang
- Department of Clinical Nutrition, First Hospital of Jilin University, 1 Xinmin Street, Changchun 130021, Jilin, China.
| | - Xiaojie Yuan
- Department of Clinical Nutrition, First Hospital of Jilin University, 1 Xinmin Street, Changchun 130021, Jilin, China.
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17
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Hooks SK, Abiodun-Ojo O, Noah AI, Hill AV, Perez-Patron MJ, Menon R, Taylor BD. Evaluating the Impact of Fetal Sex on Gestational Diabetes Mellitus Following Interaction with Maternal Characteristics. Reprod Sci 2023; 30:1359-1365. [PMID: 36241953 DOI: 10.1007/s43032-022-01106-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 10/07/2022] [Indexed: 11/30/2022]
Abstract
Fetal-sex-specific changes to placental immunity and metabolism occur in response to obesity. Few studies have determined if fetal sex interacts with maternal characteristics to alter risk of gestational diabetes mellitus (GDM). Among 43,727 singleton pregnancies, we examined the association between male fetal sex and GDM using log-binomial logistic regression to calculate relative risks (RR) and 95% confidence intervals (CI). Interactions were examined between fetal sex and maternal characteristics on the risk of GDM by calculating relative excess risk due to interaction. After adjusting for body mass index, race/ethnicity, maternal age, education, and gravidity, male fetal sex was not associated with GDM (RRadj. 0.95, 95% CI 0.93, 1.04). We found a positive interaction between male fetal sex and obesity (p = 0.04). Nonobese women with male fetuses were less likely to develop GDM, but in the presence of obesity, an opposite trend was observed. There was a positive interaction between male fetal sex and GDM on the risk of preterm delivery < 37-weeks gestation (p = 0.0006). In response to underlying maternal obesity, fetal sex may modify the risk of GDM. In addition, male fetal sex may increase the occurrence of preterm birth among women with GDM.
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Affiliation(s)
- Sarah Kaitlyn Hooks
- Department of Preventive Medicine and Population Health, University of Texas Medical Branch-Galveston, Galveston, TX, USA
| | - Olayinka Abiodun-Ojo
- Department of Internal Medicine, Piedmont Athens Regional Medical Center, Athens, GA, USA
| | - Akaninyene I Noah
- Division of Basic Science and Translational Research, Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, TX, USA
| | - Ashley V Hill
- Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Maria J Perez-Patron
- Department of Epidemiology and Biostatistics, School of Public Health, Texas A&M University, College Station, TX, USA
| | - Ramkumar Menon
- Division of Basic Science and Translational Research, Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, TX, USA
| | - Brandie DePaoli Taylor
- Department of Preventive Medicine and Population Health, University of Texas Medical Branch-Galveston, Galveston, TX, USA.
- Division of Basic Science and Translational Research, Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, TX, USA.
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18
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Pregnancy thiamine and riboflavin intake and the risk of gestational diabetes mellitus: A prospective cohort study. Am J Clin Nutr 2023; 117:426-435. [PMID: 36811572 DOI: 10.1016/j.ajcnut.2022.11.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Revised: 11/14/2022] [Accepted: 11/18/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Thiamine and riboflavin deficiencies exist to varying degrees worldwide, especially in developing countries. Evidence regarding the association between thiamine and riboflavin intake and gestational diabetes mellitus (GDM) is scarce. OBJECTIVES We aimed to evaluate the association of thiamine and riboflavin intake during pregnancy, including dietary source and supplementation, with GDM risk in a prospective cohort study. METHODS We included 3036 pregnant women (923 in the first trimester and 2113 in the second trimester) from the Tongji Birth Cohort. A validated semi-quantitative food frequency questionnaire and a lifestyle questionnaire were used to assess thiamine and riboflavin intake from dietary source and supplementation, respectively. GDM was diagnosed using the 75 g 2-h oral glucose tolerance test at 24-28 weeks of gestation. A modified Poisson regression or logistic regression model was used to evaluate the association between thiamine and riboflavin intake and GDM risk. RESULTS Dietary intake of thiamine and riboflavin was at low levels during pregnancy. In the fully adjusted model, compared with participants in quartile 1 (Q1), those who had more total thiamine and riboflavin intake had a lower risk of GDM during the first trimester [thiamine: Q2: RR: 0.58 (95% CI: 0.34, 0.98); Q3: RR: 0.45 (95% CI: 0.24, 0.84); Q4: RR: 0.35 (95% CI: 0.17, 0.72), P for trend = 0.002; riboflavin: Q2: RR: 0.63 (95% CI: 0.37, 1.09); Q3: RR: 0.45 (95% CI: 0.24, 0.87); Q4: RR: 0.39 (95% CI: 0.19, 0.79), P for trend = 0.006]. This association was also observed during the second trimester. Similar results were observed for the association between thiamine and riboflavin supplement use but not dietary intake and GDM risk. CONCLUSIONS Higher intake of thiamine and riboflavin during pregnancy is associated with a lower incidence of GDM. This trial was registered at http://www.chictr.org.cn as ChiCTR1800016908.
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Adam S, McIntyre HD, Tsoi KY, Kapur A, Ma RC, Dias S, Okong P, Hod M, Poon LC, Smith GN, Bergman L, Algurjia E, O'Brien P, Medina VP, Maxwell CV, Regan L, Rosser ML, Jacobsson B, Hanson MA, O'Reilly SL, McAuliffe FM. Pregnancy as an opportunity to prevent type 2 diabetes mellitus: FIGO Best Practice Advice. Int J Gynaecol Obstet 2023; 160 Suppl 1:56-67. [PMID: 36635082 PMCID: PMC10107137 DOI: 10.1002/ijgo.14537] [Citation(s) in RCA: 21] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Gestational diabetes (GDM) impacts approximately 17 million pregnancies worldwide. Women with a history of GDM have an 8-10-fold higher risk of developing type 2 diabetes and a 2-fold higher risk of developing cardiovascular disease (CVD) compared with women without prior GDM. Although it is possible to prevent and/or delay progression of GDM to type 2 diabetes, this is not widely undertaken. Considering the increasing global rates of type 2 diabetes and CVD in women, it is essential to utilize pregnancy as an opportunity to identify women at risk and initiate preventive intervention. This article reviews existing clinical guidelines for postpartum identification and management of women with previous GDM and identifies key recommendations for the prevention and/or delayed progression to type 2 diabetes for global clinical practice.
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Affiliation(s)
- Sumaiya Adam
- Department of Obstetrics and Gynecology, School of Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.,Diabetes Research Centre, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Harold David McIntyre
- Mater Health, University of Queensland, Mater Health Campus, South Brisbane, Queensland, Australia
| | - Kit Ying Tsoi
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China
| | | | - Ronald C Ma
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China.,Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong, China
| | - Stephanie Dias
- Biomedical Research and Innovation Platform (BRIP), South African Medical Research Council, Cape Town, South Africa
| | - Pius Okong
- Department of Obstetrics and Gynecology, St Francis Hospital Nsambya, Kampala City, Uganda
| | - Moshe Hod
- Helen Schneider Hospital for Women, Rabin Medical Center, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Liona C Poon
- Department of Obstetrics and Gynecology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
| | - Graeme N Smith
- Department of Obstetrics and Gynecology, Kingston Health Sciences Centre, Queen's University, Kingston, Ontario, Canada
| | - Lina Bergman
- Department of Obstetrics and Gynecology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Obstetrics and Gynecology, Stellenbosch University, Cape Town, South Africa.,Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Esraa Algurjia
- The World Association of Trainees in Obstetrics and Gynecology (WATOG), Paris, France.,Elwya Maternity Hospital, Baghdad, Iraq
| | - Patrick O'Brien
- Institute for Women's Health, University College London, London, UK
| | - Virna P Medina
- Department of Obstetrics and Gynecology, Faculty of Health, Universidad del Valle, Clínica Imbanaco Quirón Salud, Universidad Libre, Cali, Colombia
| | - Cynthia V Maxwell
- Maternal Fetal Medicine, Sinai Health and Women's College Hospital University of Toronto, Ontario, Canada
| | | | - Mary L Rosser
- Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York, New York, USA
| | - Bo Jacobsson
- Department of Obstetrics and Gynecology, Sahlgrenska University Hospital/Ostra, Gothenburg, Sweden.,Department of Genetics and Bioinformatics, Domain of Health Data and Digitalisation, Institute of Public Health, Oslo, Norway
| | - Mark A Hanson
- Institute of Developmental Sciences, University Hospital Southampton, Southampton, UK.,NIHR Southampton Biomedical Research Centre, University of Southampton, Southampton, UK
| | - Sharleen L O'Reilly
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland.,School of Agriculture and Food Science, University College Dublin, Dublin, Ireland
| | - Fionnuala M McAuliffe
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland
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MOTS-c, the Most Recent Mitochondrial Derived Peptide in Human Aging and Age-Related Diseases. Int J Mol Sci 2022; 23:ijms231911991. [PMID: 36233287 PMCID: PMC9570330 DOI: 10.3390/ijms231911991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Revised: 10/02/2022] [Accepted: 10/05/2022] [Indexed: 11/24/2022] Open
Abstract
MOTS-c, a 16 amino acid mitochondrial derived peptide, is encoded from the 12S rRNA region of the mitochondrial genome. Under stress conditions, MOTS-c translocates to the nucleus where it regulates a wide range of genes in response to metabolic dysfunction. It is colocalized to mitochondria in various tissues and is found in plasma, but the levels decline with age. Since MOTS-c has important cellular functions as well as a possible hormonal role, it has been shown to have beneficial effects on age-related diseases including Diabetes, Cardiovascular diseases, Osteoporosis, postmenopausal obesity and Alzheimer. Aging is characterized by gradual loss of (mitochondrial) metabolic balance, decreased muscle homeostasis and eventual diminished physical capability, which potentially can be reversed with MOTS-c treatment. This review examines the latest findings on biological effects of MOTS-c as a nuclear regulatory peptide and focuses on the role of MOTS-c in aging and age-related disorders, including mechanisms of action and therapeutic potential.
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21
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Qu Q, Rong R, Yu J. Effect of magnesium supplementation on pregnancy outcome in gestational diabetes mellitus patients: A meta-analysis of randomized controlled trials. Food Sci Nutr 2022; 10:3193-3202. [PMID: 36249983 PMCID: PMC9548361 DOI: 10.1002/fsn3.2561] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 08/14/2021] [Accepted: 08/22/2021] [Indexed: 11/14/2022] Open
Abstract
Conflicting evidence exists regarding the effectiveness of magnesium supplementation during pregnancy in gestational diabetes mellitus (GDM) patients. This meta-analysis examines the effect of magnesium on glycemic indices and metabolic status in GDM. We searched databases for randomized controlled trials (RCTs) conducted, and after applying inclusion and exclusion criteria, a total of four RCTs were considered eligible for the analysis. Outcome parameters included markers for glycemic control and metabolic status. A total of four RCTs with 198 participants (control = 99; magnesium supplemented = 99) were selected for the analysis. Magnesium supplementation resulted in a significant reduction in markers of glycemic control-fasting plasma glucose (standard mean difference ( μ ^ ) = -0.83; 95% CI: [-1.13, -0.54]; p-value <.0001), and insulin levels ( μ ^ = -0.95; 95% CI: [-1.38, -0.52]; p-value <.0001). Also, Mg intake resulted in altered oxidative stress markers TAC ( μ ^ = 1.09; 95% CI: [0.10, 2.07]; p-value = .03) of the pregnant women. No significant effect on GSH and CRP levels was observed. This study provides evidence of the positive effects of magnesium intervention on insulin sensitivity and oxidative stress in GDM patients.
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Affiliation(s)
- Qiuchan Qu
- Department of Reproductive Health, Maternal and Child Health HospitalAffiliated to Nantong UniversityNantongChina
| | - Rong Rong
- Department of Reproductive Health, Maternal and Child Health HospitalAffiliated to Nantong UniversityNantongChina
| | - Jinhua Yu
- Department of Reproductive Health, Maternal and Child Health HospitalAffiliated to Nantong UniversityNantongChina
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22
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Zhong H, Zhang J, Xia J, Zhu Y, Chen C, Shan C, Cui X. Influence of gestational diabetes mellitus on lipid signatures in breast milk and association with fetal physical development. Front Nutr 2022; 9:924301. [PMID: 36034909 PMCID: PMC9402091 DOI: 10.3389/fnut.2022.924301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 07/22/2022] [Indexed: 12/03/2022] Open
Abstract
Gestational diabetes mellitus (GDM) commonly leads to adverse pregnancy outcomes and long-term metabolic complications in offspring. Breastfeeding has been shown to rewrite the fetal “metabolic programming” resulting from maternal diabetes and finally lead to a lower risk of future metabolic disease. Lipids in breast milk act like hormones to promote infant growth and development, but there is minimal information invested thus far in constitution changes of lipids in breast milk, especially in the context of GDM. In the present study, we performed a lipidomics analysis to compare the lipid composition in breast milk collected from women with or without GDM. We further revealed the correlations of dysregulated lipids in breast milk with maternal glucose and infant physical development. A total of 833 lipid species from 15 classes were identified, 60 of which were found to be significantly altered in response to the high glucose, suggesting a remarkable lipid profiling change in breast milk induced by GDM. Our results showed significant associations between dysregulated lipids (e.g., neutral lipids, phospholipids, sphingolipids) and maternal glucose. Furthermore, correction analysis demonstrated that GDM related lipids were also associated with indicators of infant physical development, including body weight, length, and head circumference. These findings may help to understand the protective effects of breastfeeding especially during GDM pregnancy.
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Affiliation(s)
- Hong Zhong
- School of Nursing, Nanjing Medical University, Nanjing, China.,Nanjing Maternal and Child Health Institute, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China
| | - Jiahua Zhang
- School of Nursing, Nanjing Medical University, Nanjing, China.,Nanjing Maternal and Child Health Institute, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China
| | - Jiaai Xia
- Department of Obstetrics and Gynecology, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China
| | - Yuting Zhu
- Department of Obstetrics and Gynecology, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China
| | - Chen Chen
- Nanjing Maternal and Child Health Institute, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China
| | - Chunjian Shan
- School of Nursing, Nanjing Medical University, Nanjing, China.,Department of Obstetrics and Gynecology, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China
| | - Xianwei Cui
- Nanjing Maternal and Child Health Institute, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China
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23
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Umbilical cord blood metabolomics: association with intrauterine hyperglycemia. Pediatr Res 2022; 91:1530-1535. [PMID: 33980991 DOI: 10.1038/s41390-021-01516-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 03/11/2021] [Accepted: 03/20/2021] [Indexed: 11/08/2022]
Abstract
BACKGROUND Intrauterine hyperglycemia can harm a fetus's growth and development, and this can be seen in the umbilical cord blood metabolism disorder. However, the metabolites and metabolic mechanisms involved in the condition remain unknown. METHODS Targeted metabolomics using liquid chromatography and MetaboAnalyst were conducted in this study to explore differences in metabolites and metabolic pathways between individuals with hyperglycemia or well-controlled gestational diabetes mellitus (GDM) and healthy controls. RESULTS Univariate analysis found that the hyperglycemic and healthy control groups differed in 30 metabolites, while the well-controlled GDM and the healthy control groups differed only in three metabolites-ursodeoxycholic acid, docosahexaenoic acid, and 8,11,14-eicosatrienoic acid. Most of these metabolic variations were negatively associated with neonatal weights. Further research showed that the variations in the metabolites were primarily associated with the metabolic pathways of linoleic acid (LA) and alpha-linolenic acid (ALA). CONCLUSION Gestational hyperglycemia and well-controlled GDM, which may play a major role by inhibiting the LA and ALA metabolic pathways, have detrimental effects on cord blood metabolism. IMPACT The main point of this paper is that intrauterine hyperglycemia has a negative effect on cord blood metabolism mainly through the linoleic acid and alpha-linolenic acid metabolic pathways. This is a study to report a new association between well-controlled GDM and cord blood metabolism. This study provides a possible explanation for the association between intrauterine hyperglycemia and neonatal adverse birth outcomes.
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Abstract
PURPOSE OF REVIEW To review recent evidence linking maternal body mass index and gestational diabetes mellitus (GDM) with offspring health outcomes. RECENT FINDINGS It is now established that the rising prevalences of maternal obesity and GDM are both making substantial contributions to the growing burden of childhood obesity and associated disorders. Strengthening evidence also links maternal obesity with increased offspring risks of cardiovascular disease, nonalcoholic fatty liver disease, lower respiratory tract infections during infancy, wheezing illnesses, asthma and attention deficit hyperactivity disorder during childhood, and with higher risks of psychiatric disorders and colorectal cancer in adulthood. GDM has been associated with increased offspring risks of cardiovascular disease, childhood wheeze/asthma (but not allergic sensitization), and with high refractive error, attention deficit hyperactivity and psychiatric disorders from childhood onwards. SUMMARY The long-term consequences of maternal obesity and GDM for the offspring in childhood and later adult life present major challenges for public health across the life course and for future generations. Tackling these challenges requires a systems-based approach to support achieving a healthy weight in young people prior to conception, alongside new insights into population based preventive measures against gestational diabetes.
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Affiliation(s)
- Kathryn V Dalrymple
- Medical Research Council Lifecourse Epidemiology Centre, University of Southampton, Southampton
- Department of Women and Children's Health, School of Life Course and Population Sciences, King's College London, London
| | - Sarah El-Heis
- Medical Research Council Lifecourse Epidemiology Centre, University of Southampton, Southampton
| | - Keith M Godfrey
- Medical Research Council Lifecourse Epidemiology Centre, University of Southampton, Southampton
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
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25
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McLennan NM, Hazlehurst J, Thangaratinam S, Reynolds RM. ENDOCRINOLOGY IN PREGNANCY: Targeting metabolic health promotion to optimise maternal and offspring health. Eur J Endocrinol 2022; 186:R113-R126. [PMID: 35380983 PMCID: PMC9066590 DOI: 10.1530/eje-21-1046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 04/05/2022] [Indexed: 11/16/2022]
Abstract
There is an increase in maternal metabolic burden due to the rise in pregnancies complicated by obesity, gestational diabetes, type 2 diabetes and polycystic ovary syndrome. Metabolic dysfunction during pregnancy is associated with increased risks of long-term morbidity and mortality for women and their offspring. Lifestyle interventions in pregnancy in women at risk of metabolic dysfunction have demonstrated short-term improvements such as reduced gestational weight gain and lowered risk of gestational diabetes. It is not known whether these interventions lead to sustained improvements in the metabolic health of the mother and baby. Pharmacological interventions have also shown benefits for the mother and baby in pregnancy, including improvements in glycaemic control, reduction in gestational weight gain and reduction in large for gestational age infants; however, there remains uncertainty over long-term outcomes for mother and child. Existing studies on interventions targeting metabolic health are limited to selected populations in the preconception and postpartum periods and lack follow-up beyond delivery of the intervention. The COVID-19 pandemic has refocused our attention on the effects of maternal metabolic ill-health that play a role in contributing to premature morbidity and mortality. There is an urgent need for strategies to accurately identify the growing number of women and offspring at risk of long-term adverse metabolic health. Strategies which focus on early identification and risk stratification using individualised risk scores in the pre and inter-conception periods must take priority if we are to target and improve the metabolic health of women and their offspring who are at highest risk.
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Affiliation(s)
- Niamh-Maire McLennan
- MRC Centre for Reproductive Health, University of Edinburgh, Queen’s Medical Research Institute, Edinburgh, UK
| | - Jonathan Hazlehurst
- Department of Diabetes and Endocrinology, University Hospital Birmingham Foundation Trust, Birmingham, UK
| | - Shakila Thangaratinam
- WHO Collaborating Centre for Women’s Health, Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK
- Birmingham Women’s and Children’s NHS Trust, Birmingham, UK
| | - Rebecca M Reynolds
- BHF/University Centre for Cardiovascular Science, University of Edinburgh, Queen’s Medical Research Institute, Edinburgh, UK
- Correspondence should be addressed to R M Reynolds;
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Zheng Y, Hou W, Xiao J, Huang H, Quan W, Chen Y. Application Value of Predictive Model Based on Maternal Coagulation Function and Glycolipid Metabolism Indicators in Early Diagnosis of Gestational Diabetes Mellitus. Front Public Health 2022; 10:850191. [PMID: 35387184 PMCID: PMC8978602 DOI: 10.3389/fpubh.2022.850191] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 02/21/2022] [Indexed: 11/30/2022] Open
Abstract
Objective To investigate whether first-trimester fasting plasma glucose (FPG), blood coagulation function and lipid metabolism could predict gestational diabetes mellitus (GDM) risk. Methods From October 2020 to May 2021, a total of 584 pregnant women who took prenatal care in Shanghai Jiaotong University Affiliated Sixth People's Hospital were chosen as the observation subjects. The clinical information and serum samples of all pregnant women were collected at 10–13 weeks of gestation and the blood coagulation function, fasting blood glucose and lipid profiles of the pregnant women were detected. A 75 g oral glucose tolerance test was performed up to 24–28 weeks of gestation. One hundred forty-two pregnant women with GDM and 442 pregnant women without GDM were detected. Data were expressed by x ± s or median (interquartile range) and were analyzed using student's t-test, Wilcoxon rank sum test and Logistic regression analysis. The area under the curve (AUC) was calculated by receiver operating characteristic curve (ROC) to analyze the predictive values. Results Compared with non-GDM group, age, pre-pregnancy BMI, FPG, FIB, D-Dimer, FDP, FPG, TC, TG, LDL-C, sdLDL-C, APOB and APOE in GDM group were significantly higher than those in non-GDM group, while PT, INR, APTT and TT were significantly lower than those in non-GDM group. Univariate logistic regression analysis was used to explore the risk factors of GDM. Gestational age, pre-pregnancy BMI, FPG, PT, INR, APTT, FIB, TT, D-Dimer, TC, TG, LDL-C, sdLDL-C, APOB and APOE were all independent predictors of GDM. Multivariatelogistic regression showed that pre-pregnancy BMI, FPG, APTT, TT, TG, LDL-C, sdLDL-C and APOB were risk factors for GDM. The AUC of the established GDM risk prediction model was 0.892 (0.858–0.927), and the sensitivity and specificity were 80.71 and 86.85%, respectively; which were greater than that of pre-pregnancy BMI, FPG, APTT, TT,TG, LDL-C, sdLDL-C, APOB alone, and the difffference was statistically signifificant (P < 0.05). Conclusions FPG, APTT, TT, TG, LDL-C, sdLDL-C, APOB and pre-pregnancy BMI in early pregnancy has important clinical value for the prediction of GDM, We combined these laboratory indicators and established a GDM risk prediction model, which is conducive to the early identification, intervention and treatment of GDM, so as to reduce the morbidity of maternal and infant complications.
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Affiliation(s)
- Ying Zheng
- Department of Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Weiwei Hou
- Department of Laboratory Medicine, Shanghai Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Jing Xiao
- Department of Obstetrics and Gynecology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Hongling Huang
- Department of Obstetrics and Gynecology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Wenqiang Quan
- Department of Laboratory Medicine, Shanghai Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Yu Chen
- Department of Obstetrics and Gynecology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
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Vaigauskaitė B, Baušytė R, Valatkaitė E, Skliutė G, Kazėnaitė E, Ramašauskaitė D, Navakauskienė R. Prognostic Gene Predictors of Gestational Diabetes in Endometrium and Follicular Fluid of Women after Infertility. Medicina (B Aires) 2022; 58:medicina58040498. [PMID: 35454338 PMCID: PMC9025034 DOI: 10.3390/medicina58040498] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 03/22/2022] [Accepted: 03/25/2022] [Indexed: 11/16/2022] Open
Abstract
Background and objectives. Gestational diabetes mellitus is an increasingly diagnosed metabolic disorder during pregnancy with unknown pathological pathways. Taking into account the growing numbers of women who are conceiving after assisted reproductive technologies, they comprise an engaging target group for gestational diabetes mellitus etiopathogenesis research. In terms of metabolism and genetics, as the evidence shows, both unexplained infertility and gestational diabetes mellitus pose challenges for their interpretation due to the complex bodily processes. Materials and Methods. Our study examined the expression of genes (IGF2, GRB10, CRTC2, HMGA2, ESR1, DLK1, SLC6A15, GPT2, PLAGL1) associated with glucose metabolism in unexplained infertility patients who conceived after in vitro fertilization procedure, were diagnosed with GDM and their findings were compared with control population. Results. There were no significant differences in gene expression of endometrium stromal cells between healthy pregnant women and women with gestational diabetes, although the significant downregulation of CRTC2 was observed in the follicular fluid of women with gestational diabetes mellitus. Moreover, expression of HMGA2 and ESR1 was significantly reduced in FF cells when compared to endometrial cells. Conclusions. These findings may indicate about the importance of follicular fluid as an indicator for gestational diabetes and should be explored more by further research.
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Affiliation(s)
- Brigita Vaigauskaitė
- Department of Molecular Cell Biology, Institute of Biochemistry, Life Sciences Center, Vilnius University, Saulėtekio Av. 7, LT-10257 Vilnius, Lithuania; (R.B.); (E.V.); (G.S.); (R.N.)
- Centre of Obstetrics and Gynaecology of the Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Santariškių St, LT-08661 Vilnius, Lithuania;
- Correspondence:
| | - Raminta Baušytė
- Department of Molecular Cell Biology, Institute of Biochemistry, Life Sciences Center, Vilnius University, Saulėtekio Av. 7, LT-10257 Vilnius, Lithuania; (R.B.); (E.V.); (G.S.); (R.N.)
- Centre of Obstetrics and Gynaecology of the Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Santariškių St, LT-08661 Vilnius, Lithuania;
| | - Elvina Valatkaitė
- Department of Molecular Cell Biology, Institute of Biochemistry, Life Sciences Center, Vilnius University, Saulėtekio Av. 7, LT-10257 Vilnius, Lithuania; (R.B.); (E.V.); (G.S.); (R.N.)
| | - Giedrė Skliutė
- Department of Molecular Cell Biology, Institute of Biochemistry, Life Sciences Center, Vilnius University, Saulėtekio Av. 7, LT-10257 Vilnius, Lithuania; (R.B.); (E.V.); (G.S.); (R.N.)
| | - Edita Kazėnaitė
- Faculty of Medicine, Vilnius University Hospital Santaros Klinikos, Vilnius University, Santariškių St, LT-08661 Vilnius, Lithuania;
| | - Diana Ramašauskaitė
- Centre of Obstetrics and Gynaecology of the Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Santariškių St, LT-08661 Vilnius, Lithuania;
| | - Rūta Navakauskienė
- Department of Molecular Cell Biology, Institute of Biochemistry, Life Sciences Center, Vilnius University, Saulėtekio Av. 7, LT-10257 Vilnius, Lithuania; (R.B.); (E.V.); (G.S.); (R.N.)
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Nataly F, Hadas GH, Ohad G, Letizia S, Michal K. Is there a difference in placental pathology in pregnancies complicated with gestational diabetes A2 versus gestational diabetes A1, versus one abnormal value, on 100 gr glucose tolerance test? Placenta 2022; 120:60-64. [DOI: 10.1016/j.placenta.2022.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 01/04/2022] [Accepted: 02/15/2022] [Indexed: 11/30/2022]
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29
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Yin Y, Pan Y, He J, Zhong H, Wu Y, Ji C, Liu L, Cui X. The mitochondrial-derived peptide MOTS-c relieves hyperglycemia and insulin resistance in gestational diabetes mellitus. Pharmacol Res 2022; 175:105987. [PMID: 34798268 DOI: 10.1016/j.phrs.2021.105987] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 11/08/2021] [Accepted: 11/11/2021] [Indexed: 01/29/2023]
Abstract
The most common complication during pregnancy, gestational diabetes mellitus (GDM), can cause adverse pregnancy outcomes and result in the mother and infant having a higher risk of developing type 2 diabetes after pregnancy. However, existing therapies for GDM remain scant, with the most common being lifestyle intervention and appropriate insulin treatment. MOTS-c, a mitochondrial-derived peptide, can target skeletal muscle and enhance glucose metabolism. Here, we demonstrate that MOTS-c can be an effective treatment for GDM. A GDM mouse model was established by short term high-fat diet combined with low-dose streptozotocin (STZ) treatment while MOTS-c was administrated daily during pregnancy. GDM symptoms such as blood glucose and insulin levels, glucose and insulin tolerance, as well as reproductive outcomes were investigated. MOTS-c significantly alleviated hyperglycemia, improved insulin sensitivity and glucose tolerance, and reduced birth weight and the death of offspring induced by GDM. Similar to a previous study, MOTS-c also could activate insulin sensitivity in the skeletal muscle of GDM mice and elevate glucose uptake in vitro. In addition, we found that MOTS-c protects pancreatic β-cell from STZ-mediated injury. Taken together, our findings demonstrate that MOTS-c could be a promising strategy for the treatment of GDM.
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Affiliation(s)
- Yadong Yin
- Department of Obstetrics and Gynecology, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing 210004, China; Nanjing Maternal and Child Health Institute, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing 210004, China
| | - Yihui Pan
- Department of Obstetrics and Gynecology, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing 210004, China
| | - Jin He
- Nanjing Maternal and Child Health Institute, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing 210004, China
| | - Hong Zhong
- Nanjing Maternal and Child Health Institute, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing 210004, China
| | - Yangyang Wu
- Nanjing Maternal and Child Health Institute, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing 210004, China
| | - Chenbo Ji
- Department of Obstetrics and Gynecology, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing 210004, China; Nanjing Maternal and Child Health Institute, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing 210004, China
| | - Lan Liu
- Department of Obstetrics and Gynecology, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing 210004, China; Nanjing Maternal and Child Health Institute, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing 210004, China.
| | - Xianwei Cui
- Department of Obstetrics and Gynecology, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing 210004, China; Nanjing Maternal and Child Health Institute, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing 210004, China.
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Tian ML, Du LY, Ma GJ, Zhang T, Ma XY, Zhang YK, Tang ZJ. Secular increase in the prevalence of gestational diabetes and its associated adverse pregnancy outcomes from 2014 to 2021 in Hebei province, China. Front Endocrinol (Lausanne) 2022; 13:1039051. [PMID: 36407306 PMCID: PMC9669063 DOI: 10.3389/fendo.2022.1039051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 10/10/2022] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE We aimed to investigate the secular prevalence of gestational diabetes mellitus (GDM) and evaluate its adverse pregnancy outcomes among pregnant women in Hebei province, China. METHODS We analyzed the data from the monitoring information management system for pregnant women in 22 hospitals of Hebei province, China. In this study, 366,212 individuals with singleton live births from 2014 to 2021 were included, of whom 25,995 were diagnosed with gestational diabetes. We described the incidence of common complications and further analyzed the clinical characteristics in GDM patients and the relationship between GDM and adverse pregnancy outcomes. RESULTS The top 3 pregnancy complications in Hebei province are anemia, gestational hypertension, and GDM. The average incidence of GDM was 7.10% (25,995/366,212). The incidence rate of GDM significantly increased from 2014 to 2021 (χ2 trend = 7,140.663, P < 0.001). The top 3 regions with GDM incidence were Baoding (16.60%), Shijiazhuang (8.00%), and Tangshan (3.80%). The incidence of GDM in urban pregnant women (10.6%) is higher than that in rural areas (3.7%).The difference between the GDM and Non-GDM groups was statistically significant in terms of maternal age, gravidity, parity, education level, and incidence of pregnancy complications (gestational hypertension, heart diseases, and anemia) (P < 0.05). GDM individuals were at significantly increased risk of most assessed adverse pregnancy outcomes, including premature delivery, Cesarean delivery, uterine inertia, neonatal intensive care unit (NICU) admission, Apgar (activity-pulse-grimace-appearance-respiration) score at 1 min, and macrosomia (P < 0.05). The multivariate logistic regression analysis showed that GDM was an independent risk factor in terms of premature birth, Cesarean delivery, uterine inertia, placental abruption, NICU admission, and macrosomia. CONCLUSION The risk of adverse pregnancy outcome in pregnant women with GDM is significantly increased. In order to reduce the occurrence of adverse pregnancy outcomes, effective interventions are needed.
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Affiliation(s)
- Mei-Ling Tian
- Department of Obstetrics and Gynecology, Hebei General Hospital, Shijiazhuang, China
- *Correspondence: Mei-Ling Tian,
| | - Li-Yan Du
- Department of Information Management, Hebei Center for Women and Children’s Health, Shijiazhuang, China
| | - Guo-Juan Ma
- Department of Obstetrics and Gynecology, Hebei General Hospital, Shijiazhuang, China
| | - Ting Zhang
- Department of Reproductive Medicine, Hebei Reproductive Health Hospital, Shijiazhuang, China
| | - Xu-Yuan Ma
- Department of Obstetrics and Gynecology, Hebei General Hospital, Shijiazhuang, China
| | - Ying-Kui Zhang
- Department of Information Management, Hebei Center for Women and Children’s Health, Shijiazhuang, China
| | - Zeng-Jun Tang
- Department of Obstetrics and Gynecology, Hebei General Hospital, Shijiazhuang, China
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Wei Y, Peng J, Li H, Wei M, Peng H, Wang K, Yu Y, He Q. Association Between Maternal Fasting Plasma Glucose Value and Fetal Weight Among Singletons of Mothers with Gestational Diabetes Mellitus. Diabetes Metab Syndr Obes 2022; 15:3799-3807. [PMID: 36530589 PMCID: PMC9749413 DOI: 10.2147/dmso.s391253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 11/29/2022] [Indexed: 12/13/2022] Open
Abstract
PURPOSE Infants with macrosomia are more likely to be born to mothers with gestational diabetes mellitus (GDM). This study aimed to investigate the associations between maternal blood glucose levels and fetal weight, placental weight, and risk of macrosomia in mothers with GDM. PATIENTS AND METHODS This retrospective study included 3211 singletons of mothers with GDM at the Shanghai First Maternity and Infant Hospital between January 2017 and December 2019. All women underwent an oral glucose tolerance test (OGTT) during the 24-28 weeks gestation period. Data on fetal and placental parameters were collected at delivery. Multiple linear regression models were used to evaluate the associations of maternal blood glucose levels with fetal weight and placental weight, while multiple logistic regression model was used to estimate the association between maternal blood glucose levels and the risk of macrosomia. RESULTS The prevalence of GDM in our study was 7%. Fasting plasma glucose (FPG) was positively correlated with fetal weight (r2=0.0329, P<0.001), and macrosomia risk (odds ratio [OR], 2.42; 95% confidence interval [CI], 1.93-3.04; P<0.001). After adjusting for gestational age, the result remained significant (OR, 2.67; 95% CI, 2.11-3.38; P<0.001). In contrast, there was no significant relationship between 1-h plasma glucose (1hPG) or 2-h plasma glucose (2hPG) and fetal weight (P=0.18, P=0.46). Additionally, 1hPG or 2hPG was not strongly associated with macrosomia risk (OR, 0.95; 95% CI, 0.85-1.05; P=0.32 vs OR, 0.94; 95% CI, 0.85-1.05; P=0.28). Maternal blood glucose levels did not affect placental weight. The associations were similar in women carrying male and female fetuses. CONCLUSION Maternal fasting plasma glucose levels were strongly associated with increased birth weight and macrosomia risk. Our findings suggest that fasting plasma glucose may predict birth weight.
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Affiliation(s)
- Yingying Wei
- Clinical and Translational Research Center, Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, People’s Republic of China
| | - Jiahuan Peng
- Department of Biostatistics, School of Public Health, Fudan University, Shanghai, People’s Republic of China
| | - Han Li
- Clinical and Translational Research Center, Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, People’s Republic of China
| | - Mengtian Wei
- Clinical and Translational Research Center, Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, People’s Republic of China
| | - Hao Peng
- Clinical and Translational Research Center, Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, People’s Republic of China
| | - Kai Wang
- Clinical and Translational Research Center, Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, People’s Republic of China
| | - Yongfu Yu
- Department of Biostatistics, School of Public Health, Fudan University, Shanghai, People’s Republic of China
| | - Qizhi He
- Department of Pathology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, People’s Republic of China
- Correspondence: Qizhi He, Department of Pathology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, No. 2699, West Gaoke Road, Pudong District, Shanghai, 201204, People’s Republic of China, Fax +86-2120261141, Email
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Hanks AJ, Hume C, Lim S, Grieger JA. The Perspectives of Diabetes Educators and Dietitians on Diet and Lifestyle Management for Gestational Diabetes Mellitus: A Qualitative Study. J Diabetes Res 2022; 2022:3542375. [PMID: 35782628 PMCID: PMC9242803 DOI: 10.1155/2022/3542375] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 05/13/2022] [Accepted: 06/13/2022] [Indexed: 12/31/2022] Open
Abstract
This study explores the knowledge and practice of diabetes educators and dietitians on diet and lifestyle management in women with gestational diabetes mellitus (GDM). Diabetes educators and dietitians were recruited from three maternity hospitals in Adelaide (Australia), through snowball and purposive sampling. Thirteen semistructured interviews were conducted, audio recorded, transcribed verbatim, and analysed for codes and themes. Four themes emerged: guidelines and resources, dietary intervention, management delivery, and communication. Diabetes educators and dietitians demonstrated consistent knowledge of nutritional management for GDM and uniform delivery methods. However, a lack of culturally diverse resources was highlighted, along with a lack of continuity of care across the multidisciplinary team. Barriers towards uptake of dietary intervention were reflected by diabetes educators and dietitians as women showing signs of guilt and stress and disengaging from the service. Further exploration on the knowledge and practice of diabetes educators and dietitians for GDM to best inform implementation strategies for knowledge translation of nutritional management is needed. The indication of language and cultural barriers and resources highlight an ongoing key priority area to support the care of women of ethnic minorities.
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Affiliation(s)
- Amber J. Hanks
- School of Public Health, University of Adelaide, Adelaide 5000, Australia
- Adelaide Medical School, University of Adelaide, Adelaide, SA 5005, Australia
| | - Clare Hume
- School of Public Health, University of Adelaide, Adelaide 5000, Australia
- Adelaide Medical School, University of Adelaide, Adelaide, SA 5005, Australia
| | - Siew Lim
- Monash Centre for Health Research and Implementation, Monash University, Clayton 3168, Australia
| | - Jessica A. Grieger
- Adelaide Medical School, University of Adelaide, Adelaide, SA 5005, Australia
- Robinson Research Institute, University of Adelaide, Adelaide, SA 5005, Australia
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Sun X, Sun H, Li P. Association of circulating inflammatory cells and platelets with gestational diabetes and pregnancy outcomes. Clin Chim Acta 2021; 523:87-96. [PMID: 34508686 DOI: 10.1016/j.cca.2021.09.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 09/05/2021] [Accepted: 09/07/2021] [Indexed: 11/16/2022]
Abstract
Gestational diabetes mellitus (GDM) is the most common cause of hyperglycemia during pregnancy, and its prevalence has increased over the past decades. GDM is directly related to the recent obstetric outcomes and long-term maternal and child health, which can be greatly improved by early identification and diagnosis of GDM. However, the prediction of the disease has always been a difficult problem due to the lack of simple and practical serological markers. Despite the controversy, recent studies have identified that circulating inflammatory cells and platelets, routinely included in the obstetric blood tests, are related to the development of GDM and adverse pregnancy outcomes. In this review, we summarized the studies in this field based on the recent literature. The inflammatory cell components we included were the total number of white blood cells, neutrophils, lymphocytes, monocytes and platelets, which were routinely examined in the blood tests in pregnancy. The aim of this review is not only to enrich our understanding of the pathogenesis of GDM but also to provide evidence for the value of these novel and practical serological markers in early identification of GDM and the prevention and its adverse outcomes.
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Affiliation(s)
- Xiaoshi Sun
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, People's Republic of China
| | - He Sun
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, People's Republic of China
| | - Ping Li
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, People's Republic of China.
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Olmos-Ortiz A, Flores-Espinosa P, Díaz L, Velázquez P, Ramírez-Isarraraz C, Zaga-Clavellina V. Immunoendocrine Dysregulation during Gestational Diabetes Mellitus: The Central Role of the Placenta. Int J Mol Sci 2021; 22:8087. [PMID: 34360849 PMCID: PMC8348825 DOI: 10.3390/ijms22158087] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 07/15/2021] [Accepted: 07/26/2021] [Indexed: 02/07/2023] Open
Abstract
Gestational Diabetes Mellitus (GDM) is a transitory metabolic condition caused by dysregulation triggered by intolerance to carbohydrates, dysfunction of beta-pancreatic and endothelial cells, and insulin resistance during pregnancy. However, this disease includes not only changes related to metabolic distress but also placental immunoendocrine adaptations, resulting in harmful effects to the mother and fetus. In this review, we focus on the placenta as an immuno-endocrine organ that can recognize and respond to the hyperglycemic environment. It synthesizes diverse chemicals that play a role in inflammation, innate defense, endocrine response, oxidative stress, and angiogenesis, all associated with different perinatal outcomes.
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Affiliation(s)
- Andrea Olmos-Ortiz
- Departamento de Inmunobioquímica, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes (INPer), Ciudad de México 11000, Mexico; (A.O.-O.); (P.F.-E.)
| | - Pilar Flores-Espinosa
- Departamento de Inmunobioquímica, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes (INPer), Ciudad de México 11000, Mexico; (A.O.-O.); (P.F.-E.)
| | - Lorenza Díaz
- Departamento de Biología de la Reproducción, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México 14080, Mexico;
| | - Pilar Velázquez
- Departamento de Ginecología y Obstetricia, Hospital Ángeles México, Ciudad de México 11800, Mexico;
| | - Carlos Ramírez-Isarraraz
- Clínica de Urología Ginecológica, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes (INPer), Ciudad de México 11000, Mexico;
| | - Verónica Zaga-Clavellina
- Departamento de Fisiología y Desarrollo Celular, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes (INPer), Ciudad de México 11000, Mexico
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Panaitescu AM, Ciobanu AM, Popa M, Duta I, Gica N, Peltecu G, Veduta A. Screening for Gestational Diabetes during the COVID-19 Pandemic-Current Recommendations and Their Consequences. ACTA ACUST UNITED AC 2021; 57:medicina57040381. [PMID: 33920937 PMCID: PMC8071285 DOI: 10.3390/medicina57040381] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 04/07/2021] [Accepted: 04/13/2021] [Indexed: 01/11/2023]
Abstract
Gestational diabetes mellitus (GDM) is recognized as one of the most common medical complications of pregnancy that can lead to significant short-term and long-term risks for the mother and the fetus if not detected early and treated appropriately. Current evidence suggests that, with the use of appropriate screening programs for GDM, those women diagnosed and treated have reduced perinatal morbidity. It has been implied that, when screening for GDM, there should be uniformity in the testing used and in further management. This paper summarizes and compares current screening strategies proposed by international bodies and discusses application in the context of the COVID-19 pandemic.
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Affiliation(s)
- Anca Maria Panaitescu
- Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania; (A.M.C.); (N.G.); (G.P.)
- Filantropia Clinical Hospital, 11171 Bucharest, Romania; (M.P.); (A.V.)
- Correspondence: ; Tel.: +40-2318-8930
| | - Anca Marina Ciobanu
- Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania; (A.M.C.); (N.G.); (G.P.)
- Filantropia Clinical Hospital, 11171 Bucharest, Romania; (M.P.); (A.V.)
| | - Maria Popa
- Filantropia Clinical Hospital, 11171 Bucharest, Romania; (M.P.); (A.V.)
| | - Irina Duta
- Endocrinology and Diabetes, Southend University Hospital, Essex SS0 0RYUK, UK;
| | - Nicolae Gica
- Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania; (A.M.C.); (N.G.); (G.P.)
- Filantropia Clinical Hospital, 11171 Bucharest, Romania; (M.P.); (A.V.)
| | - Gheorghe Peltecu
- Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania; (A.M.C.); (N.G.); (G.P.)
- Filantropia Clinical Hospital, 11171 Bucharest, Romania; (M.P.); (A.V.)
| | - Alina Veduta
- Filantropia Clinical Hospital, 11171 Bucharest, Romania; (M.P.); (A.V.)
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36
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Hui L. The intimate connection between maternal health and fetal development. Prenat Diagn 2020; 40:1045-1046. [PMID: 32602191 DOI: 10.1002/pd.5775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Accepted: 06/20/2020] [Indexed: 11/07/2022]
Affiliation(s)
- Lisa Hui
- Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, Victoria, Australia.,Reproductive Epidemiology group, Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Department of Perinatal Medicine, Mercy Hospital for Women, Heidelberg, Victoria, Australia.,Department of Obstetrics and Gynaecology, Northern Health, Epping, Victoria, Australia
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