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Early pregnancy body mass index and gestational weight gain: A mediating or moderating factor for short stature and risk of gestational diabetes mellitus? PLoS One 2022; 17:e0272253. [PMID: 35913963 PMCID: PMC9342715 DOI: 10.1371/journal.pone.0272253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 07/17/2022] [Indexed: 11/19/2022] Open
Abstract
This study examined the association between height and the risk of Gestational Diabetes Mellitus (GDM), and whether this association was mediated or moderated by early pregnancy body mass index (BMI) and gestational weight gain (GWG) that are known independent risk factors for GDM. Data of a retrospective cohort of pregnant women (N = 1,945) were extracted from antenatal clinic cards. The cut-off values of height in relation to risk of GDM were identified using receiver operating characteristic analysis and four categories of height were derived: < 150 cm, 150–155 cm, 156–160 cm, and > 160cm. Mediation analysis was performed using the Preacher and Hayes bootstrapping method while the moderation effect was tested with multiple regression analysis with interaction terms. Although there was no mediation effect of BMI and GWG on the association between height and risk of GDM, both factors moderated this association with a significant association between shorter height and risk of GDM was observed in overweight / obese women (height < 150 cm: AOR = 1.41, 95% CI = 1.03–2.44; height 156–160 cm: AOR = 1.48, 95% CI = 1.03–2.14). Overweight / obese women with height < 150 cm and excessive GWG at the end of the second trimester (AOR = 2.25, 95% CI = 1.45–4.17) had significantly higher risk of GDM than those without these factors. Short stature (< 150 cm) was significantly associated with GDM risk among OW/OB women with excessive gestational weight gain at the end of second trimester. This finding underscores the importance of maintaining a healthy BMI during reproductive age and gaining weight in recommended range during pregnancy.
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Naser I, Shaat M, Taleb M, Najim A. Nutritional assessment of birth outcomes of gestational diabetic mothers in Gaza Strip, Palestine: A retrospective case-control study. INTERNATIONAL JOURNAL OF ACADEMIC MEDICINE 2022. [DOI: 10.4103/ijam.ijam_153_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Arafa A, Dong JY. Maternal height and risk of gestational diabetes: a systematic review and meta-analysis. Acta Diabetol 2019; 56:723-728. [PMID: 31111218 DOI: 10.1007/s00592-019-01368-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 05/13/2019] [Indexed: 12/01/2022]
Abstract
AIMS Identifying women at high risk of developing gestational diabetes mellitus (GDM) is a public health interest. This study aims to investigate the association between maternal height and risk of GDM through meta-analysis. METHODS We retrieved the studies that assessed maternal height in relation to GDM. Pooled risk estimates of the included articles and their 95% confidence intervals (95% CIs) were calculated using a fixed- or random-effects model. Subgroup analyses were conducted according to study design and study location. Quality of studies was determined using the Newcastle-Ottawa Scale. Publication bias was detected using the Egger's and Begg's tests. RESULTS A total of 10 studies including 7 cohort and 3 cross-sectional studies with a total of 126,094 women were included for meta-analysis. Combined, each 5-cm increase in height was associated with about 20% reduction in risk of GDM [pooled odds ratio = 0.80, (95% CI 0.76, 0.85)]. The analysis revealed high heterogeneity between studies which dissolved after subgroup analysis by study design. This significant association did not differ between Asian and non-Asian populations. Egger's and Begg's tests showed little evidence of publication bias. CONCLUSIONS The present meta-analysis supports the conception that short stature is associated with GDM. Further studies of high quality are needed to confirm the findings.
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Affiliation(s)
- Ahmed Arafa
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
- Department of Public Health, Faculty of Medicine, Beni-Suef University, Beni Suef, Egypt
| | - Jia-Yi Dong
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.
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Masalin S, Laine MK, Kautiainen H, Gissler M, Raina M, Pennanen P, Eriksson JG. Impact of maternal height and gestational diabetes mellitus on offspring birthweight. Diabetes Res Clin Pract 2019; 148:110-118. [PMID: 30641170 DOI: 10.1016/j.diabres.2019.01.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 12/12/2018] [Accepted: 01/04/2019] [Indexed: 01/17/2023]
Abstract
AIMS To evaluate the impact of gestational diabetes mellitus (GDM) and maternal height on offspring birthweight. METHODS This is an observational cohort study, encompassing 4 111 Finnish primiparous women from Vantaa city, Finland, with singleton deliveries between 2009 and 2015. Data were obtained from the Finnish Medical Birth Register. The study population was divided into five groups according to maternal height. Cut-offs for height levels were I ≤ 158 cm, II 159-163 cm, III 164-167 cm, IV 168-172 cm, V ≥ 173 cm. The main outcome measure was offspring birthweight, expressed as Z-scores according to sex and gestational age. RESULTS Independently, both maternal height and GDM increased offspring birthweight (p < 0.001 for height and GDM). When studying the interaction, a significant increase in offspring birthweight was noted only in extreme height categories; group I ≤ 158 cm (p = 0.011), group IV 168-172 cm (p = 0.010) and group V ≥ 173 cm (p < 0.001) and the impact was similar in both sexes. Maternal height had no impact on offspring ponderal index (p = 0.20 for trend). CONCLUSIONS In extreme height categories, short and tall primiparous women with GDM are at risk for delivering larger offspring compared to women without GDM of similar height.
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Affiliation(s)
- Senja Masalin
- Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
| | - Merja K Laine
- Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Vantaa Health Center, Vantaa, Finland
| | - Hannu Kautiainen
- Primary Health Care Unit, Kuopio University Hospital, Kuopio, Finland; Folkhälsan Research Center, Helsinki, Finland
| | - Mika Gissler
- National Institute for Health and Welfare, Information Department, Helsinki, Finland; Karolinska Institute, Stockholm, Sweden
| | - Marko Raina
- Vantaa Health Center, Vantaa, Finland; Apotti, Helsinki, Finland
| | | | - Johan G Eriksson
- Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Folkhälsan Research Center, Helsinki, Finland; National Institute for Health and Welfare, Department of Chronic Disease Prevention, Helsinki, Finland; Singapore Institute for Clinical Sciences (SICS), Agency for Science and Technology (A*STAR), Singapore; Obstetrics & Gynecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore
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Mustaniemi S, Vääräsmäki M, Eriksson JG, Gissler M, Laivuori H, Ijäs H, Bloigu A, Kajantie E, Morin-Papunen L. Polycystic ovary syndrome and risk factors for gestational diabetes. Endocr Connect 2018; 7:859-869. [PMID: 29858213 PMCID: PMC6026881 DOI: 10.1530/ec-18-0076] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Accepted: 05/31/2018] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To study the roles of self-reported symptoms and/or prior diagnosis of polycystic ovary syndrome (PCOS) and other potential risk factors for gestational diabetes mellitus (GDM) and to clarify whether the screening of GDM in early pregnancy is beneficial for all women with PCOS. DESIGN The FinnGeDi multicentre case-control study including 1146 women with singleton pregnancies diagnosed with GDM and 1066 non-diabetic pregnant women. There were 174 women with PCOS (symptoms and/or diagnosis self-reported by a questionnaire) and 1767 women without PCOS (data missing for 271). METHODS The study population (N = 1941) was divided into four subgroups: GDM + PCOS (N = 105), GDM + non-PCOS (N = 909), non-GDM + PCOS (N = 69), and controls (N = 858). The participants' characteristics and their parents' medical histories were compared. RESULTS The prevalence of PCOS was 10.4% among GDM women and 7.4% among non-diabetics (odds ratios (OR) 1.44, 95% CI: 1.05-1.97), but PCOS was not an independent risk for GDM after adjustments for participants' age and pre-pregnancy BMI (OR 1.07, 95% CI: 0.74-1.54). In a multivariate logistic regression analysis, the most significant parameters associated with GDM were overweight, obesity, age ≥35 years, participant's mother's history of GDM, either parent's history of type 2 diabetes (T2D) and participant's own preterm birth. CONCLUSIONS The increased risk of GDM in women with PCOS was related to obesity and increased maternal age rather than to PCOS itself, suggesting that routine early screening of GDM in PCOS women without other risk factors should be reconsidered. Instead, family history of GDM/T2D and own preterm birth were independent risk factors for GDM.
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Affiliation(s)
- Sanna Mustaniemi
- Public Health Promotion UnitNational Institute for Health and Welfare, Helsinki, Finland
- PEDEGO Research UnitMRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Marja Vääräsmäki
- Public Health Promotion UnitNational Institute for Health and Welfare, Helsinki, Finland
- PEDEGO Research UnitMRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Johan G Eriksson
- Department of General Practice and Primary Health CareUniversity of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Folkhälsan Research CentreHelsinki, Finland
| | - Mika Gissler
- Information Services DepartmentNational Institute for Health and Welfare, Helsinki, Finland
- Division of Family MedicineDepartment of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
| | - Hannele Laivuori
- Medical and Clinical GeneticsUniversity of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Department of Obstetrics and GynaecologyTampere University Hospital, Tampere, Finland
- Faculty of Medicine and Life SciencesUniversity of Tampere, Tampere, Finland
- Institute for Molecular Medicine FinlandHelsinki Institute of Life Science, University of Helsinki, Helsinki, Finland
| | - Hilkka Ijäs
- Public Health Promotion UnitNational Institute for Health and Welfare, Helsinki, Finland
- PEDEGO Research UnitMRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Aini Bloigu
- PEDEGO Research UnitMRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Eero Kajantie
- Public Health Promotion UnitNational Institute for Health and Welfare, Helsinki, Finland
- PEDEGO Research UnitMRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Children's HospitalUniversity of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Laure Morin-Papunen
- PEDEGO Research UnitMRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
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Mendoza LC, Harreiter J, Simmons D, Desoye G, Adelantado JM, Juarez F, Chico A, Devlieger R, van Assche A, Galjaard S, Damm P, Mathiesen ER, Jensen DM, Andersen LLT, Tanvig M, Lapolla A, Dalfra MG, Bertolotto A, Mantaj U, Wender-Ozegowska E, Zawiejska A, Hill D, Jelsma JG, Snoek FJ, van Poppel MNM, Worda C, Bancher-Todesca D, Kautzky-Willer A, Dunne FP, Corcoy R. Risk factors for hyperglycemia in pregnancy in the DALI study differ by period of pregnancy and OGTT time point. Eur J Endocrinol 2018; 179:39-49. [PMID: 29739812 DOI: 10.1530/eje-18-0003] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Accepted: 05/08/2018] [Indexed: 01/20/2023]
Abstract
OBJECTIVE Risk factors are widely used to identify women at risk for gestational diabetes mellitus (GDM) without clear distinction by pregnancy period or oral glucose tolerance test (OGTT) time points. We aimed to assess the clinical risk factors for Hyperglycemia in pregnancy (HiP) differentiating by these two aspects. DESIGN AND METHODS Nine hundred seventy-one overweight/obese pregnant women, enrolled in the DALI study for preventing GDM. OGTTs were performed at ≤19 + 6, 24-28 and 35-37 weeks (IADPSG/WHO2013 criteria). Women with GDM or overt diabetes at one time point did not proceed to further OGTTs. Potential independent variables included baseline maternal and current pregnancy characteristics. STATISTICAL ANALYSIS Multivariate logistic regression. RESULTS Clinical characteristics independently associated with GDM/overt diabetes were at ≤19 + 6 weeks, previous abnormal glucose tolerance (odds ratio (OR): 3.11; 95% CI: 1.41-6.85), previous GDM (OR: 2.22; 95% CI: 1.20-4.11), neck circumference (NC) (OR: 1.58; 95% CI: 1.06-2.36 for the upper tertile), resting heart rate (RHR, OR: 1.99; 95% CI: 1.31-3.00 for the upper tertile) and recruitment site; at 24-28 weeks, previous stillbirth (OR: 2.92; 95% CI: 1.18-7.22), RHR (OR: 3.32; 95% CI: 1.70-6.49 for the upper tertile) and recruitment site; at 35-37 weeks, maternal height (OR: 0.41; 95% CI: 0.20-0.87 for upper tertile). Clinical characteristics independently associated with GDM/overt diabetes differed by OGTT time point (e.g. at ≤19 + 6 weeks, NC was associated with abnormal fasting but not postchallenge glucose). CONCLUSION In this population, most clinical characteristics associated with GDM/overt diabetes were non-modifiable and differed by pregnancy period and OGTT time point. The identified risk factors can help define the target population for future intervention trials.
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Affiliation(s)
- Lilian C Mendoza
- Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Jürgen Harreiter
- Division of Endocrinology, Department of Medicine III, Gender Medicine Unit, Medical University of Vienna, Vienna, Austria
| | - David Simmons
- Institute of Metabolic Science, Addenbrookes Hospital, Cambridge, UK
- Macarthur Clinical School, Western Sydney University, Sydney, Australia
| | - Gernot Desoye
- Department of Obstetrics and Gynecology, Medizinische Universitaet Graz, Graz, Austria
| | - J M Adelantado
- Institut de Recerca de l'Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Fabiola Juarez
- Institut de Recerca de l'Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Ana Chico
- Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
- Institut de Recerca de l'Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- CIBER Bioengineering, Biomaterials and Nanotechnology, Instituto de Salud Carlos III, Zaragoza, Spain
| | - Roland Devlieger
- KU Leuven, Department of Development and Regeneration: Pregnancy, Fetus and Neonate, Leuven, Belgium
- Gynaecology and Obstetrics, University Hospitals Leuven, Leuven, Belgium
| | - Andre van Assche
- KU Leuven, Department of Development and Regeneration: Pregnancy, Fetus and Neonate, Leuven, Belgium
- Gynaecology and Obstetrics, University Hospitals Leuven, Leuven, Belgium
| | - Sander Galjaard
- KU Leuven, Department of Development and Regeneration: Pregnancy, Fetus and Neonate, Leuven, Belgium
- Gynaecology and Obstetrics, University Hospitals Leuven, Leuven, Belgium
| | - Peter Damm
- Center for Pregnant Women with Diabetes, Departments of Endocrinology and Obstetrics, Rigshospitalet, Copenhagen, Denmark
- Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Elisabeth R Mathiesen
- Center for Pregnant Women with Diabetes, Departments of Endocrinology and Obstetrics, Rigshospitalet, Copenhagen, Denmark
- Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Dorte M Jensen
- Departments of Endocrinology, Gynaecology and Obstetrics, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, Faculty of Health Science, University of Southern Denmark, Odense, Denmark
| | - Lise Lotte T Andersen
- Departments of Endocrinology, Gynaecology and Obstetrics, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, Faculty of Health Science, University of Southern Denmark, Odense, Denmark
| | - Mette Tanvig
- Departments of Endocrinology, Gynaecology and Obstetrics, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, Faculty of Health Science, University of Southern Denmark, Odense, Denmark
| | | | | | | | - Urszula Mantaj
- Division of Reproduction, Medical Faculty I, Poznan University of Medical Sciences, Poznan, Poland
| | - Ewa Wender-Ozegowska
- Division of Reproduction, Medical Faculty I, Poznan University of Medical Sciences, Poznan, Poland
| | - Agnieszka Zawiejska
- Division of Reproduction, Medical Faculty I, Poznan University of Medical Sciences, Poznan, Poland
| | - David Hill
- Recherche en Santé Lawson SA, St Gallen, Switzerland
| | - Judith G Jelsma
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, VU University Medical Centre, Amsterdam, the Netherlands
| | - Frank J Snoek
- Department of Medical Psychology, VU University Medical Centre and Academic Medical Centre, Amsterdam, the Netherlands
| | - Mireille N M van Poppel
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, VU University Medical Centre, Amsterdam, the Netherlands
- Institute of Sport Science, University of Graz, Graz, Austria
| | - Christof Worda
- Division of Obstetrics and Feto-Maternal Medicine, Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria
| | - Dagmar Bancher-Todesca
- Division of Obstetrics and Feto-Maternal Medicine, Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria
| | - Alexandra Kautzky-Willer
- Division of Endocrinology, Department of Medicine III, Gender Medicine Unit, Medical University of Vienna, Vienna, Austria
- Gender Medicine Institute, Gars am Kamp, Austria
| | | | - Rosa Corcoy
- Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
- Institut de Recerca de l'Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- CIBER Bioengineering, Biomaterials and Nanotechnology, Instituto de Salud Carlos III, Zaragoza, Spain
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Laine M, Kautiainen H, Gissler M, Raina M, Aahos I, Järvinen K, Eriksson J. Short primiparous women are at an increased risk for gestational diabetes mellitus. Public Health 2018; 156:101-108. [DOI: 10.1016/j.puhe.2017.12.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Revised: 12/05/2017] [Accepted: 12/20/2017] [Indexed: 01/05/2023]
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Li H, Song L, Shen L, Liu B, Zheng X, Zhang L, Wang Y, Cao Z, Xu S. Height and Risk of Gestational Diabetes Mellitus: Results from the Healthy Baby Cohort Study. J Diabetes Res 2018; 2018:4679245. [PMID: 30159334 PMCID: PMC6109494 DOI: 10.1155/2018/4679245] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 07/19/2018] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND The aim of this study was to examine the association between height and plasma glucose level, as well as risk of GDM among Chinese women. METHODS A total of 6941 pregnant Chinese women were recruited from the Healthy Baby Cohort study in Hubei Province, China, in 2012-2014. Measured height was categorized into four groups according to the quartile distribution (≤158.0 cm, 158.1-161.0 cm, 161.1-164.0 cm, and >164.0 cm). GDM was defined based on the International Association of the Diabetes in Pregnancy Study Group criteria. Linear regression was used to estimate the association between height and plasma glucose levels. Logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for the association between height and GDM. RESULTS The prevalence of GDM was 14.7% in our study. Height was inversely associated with the 1 h and 2h plasma glucose levels (all P value for trend < 0.05), but not with fasting plasma glucose levels. A significant negative trend was found between height and risk of GDM (P value for trend < 0.05), and each centimeter increase in height was associated with 2% (OR: 0.98; 95% CI: 0.96, 0.99) lower risk of GDM. Women in the highest quartile of height (>164.0 cm) had 23% (OR: 0.77; 95% CI: 0.64, 0.94) lower risk of developing GDM than those in the shortest quartile of height (≤158.0 cm), after adjusting for potential confounders. CONCLUSIONS Our findings suggested that height was negatively associated with risk of GDM among Chinese women. The difference in plasma glucose levels is present in the 1 h and 2 h plasma glucose, but not with fasting plasma glucose.
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Affiliation(s)
- Hui Li
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Lulu Song
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Lijun Shen
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Bingqing Liu
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Xiaoxuan Zheng
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Lina Zhang
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Youjie Wang
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Zhongqiang Cao
- Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Shunqing Xu
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
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Li J, Wang P, Zhang C, Leng J, Li N, Wang L, Li W, Liu H, Yu Z, Hu G, Chan JCN, Yang X. Short Body Height and Pre-pregnancy Overweight for Increased Risk of Gestational Diabetes Mellitus: A Population-Based Cohort Study. Front Endocrinol (Lausanne) 2018; 9:349. [PMID: 29997576 PMCID: PMC6028560 DOI: 10.3389/fendo.2018.00349] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 06/11/2018] [Indexed: 12/12/2022] Open
Abstract
Background: Short height is associated with gestational diabetes mellitus (GDM) but the underlying mechanism remains unknown. This study aims to explore whether short height has a synergistic effect with pre-pregnancy overweight/obesity and undue weight gain on the risk of GDM. Methods: We recruited 19,962 singleton pregnant women from their first antenatal care visit in urban Tianjin, China, between October 2010 to August 2012. At 24-28 weeks of gestation, women underwent a 50-g 1-h glucose challenge test (GCT) followed by a 75-g 2-h oral glucose tolerance test (OGTT) if the GCT result was ≥7.8 mmol/L. GDM was defined by the International Association of Diabetes and Pregnancy Study Group's cut-points. Univariable and multivariable logistic regression analyses were performed to obtain odds ratios (ORs) and 95% confidence intervals (CIs). Restricted cubic spline (RCS) analysis nested in the logistic regression analysis was used to identify a cutoff point of height for GDM. Additive interaction was used to test interactions between short height, pregnancy overweight/obesity and undue weight gain. Results: A total of 1,517 (or 7.6%) women developed GDM. The risk of GDM increased rapidly with a decreasing height from 158 cm and downwards. Using height ≥158 cm as the reference group, women with < 158 cm of height were at increased GDM risk (adjusted OR: 1.44, 95%CI: 1.18-1.75). Maternal overweight/obesity at the first antenatal care visit greatly enhanced the OR of short height for GDM (adjusted OR: 3.78, 95%CI: 2.84-5.03) with significant additive interaction (P < 0.05). However, the interaction between short height and undue weight gain was non-significant (P > 0.05). Conclusions: In Chinese pregnant women in urban Tianjin, height < 158 cm had a synergistic effect with pre-pregnancy overweight/obesity on the risk of GDM.
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Affiliation(s)
- Jing Li
- Department of Epidemiology and Biostatistics, School of Public Health & National Demonstration Center for Experimental Preventive Medicine Education, Tianjin Medical University, Tianjin, China
| | - Peng Wang
- Tianjin Women and Children's Health Center, Tianjin, China
| | - Cuiping Zhang
- Tianjin Women and Children's Health Center, Tianjin, China
| | - Junhong Leng
- Tianjin Women and Children's Health Center, Tianjin, China
| | - Nan Li
- Tianjin Women and Children's Health Center, Tianjin, China
| | - Leishen Wang
- Tianjin Women and Children's Health Center, Tianjin, China
| | - Wei Li
- Tianjin Women and Children's Health Center, Tianjin, China
| | - Huikun Liu
- Tianjin Women and Children's Health Center, Tianjin, China
| | - Zhijie Yu
- Population Cancer Research Program and Department of Pediatrics, Dalhousie University, Halifax, NS, Canada
| | - Gang Hu
- Chronic Disease Epidemiology Laboratory, Pennington Biomedical Research Center, Baton Rouge, LA, United States
| | - Juliana C. N. Chan
- Department of Medicine and Therapeutics Hong Kong Institute of Diabetes and Obesity and The Chinese University of Hong Kong-Prince of Wales Hospital-International Diabetes Federation Centre of Education, Hong Kong, Hong Kong
| | - Xilin Yang
- Department of Epidemiology and Biostatistics, School of Public Health & National Demonstration Center for Experimental Preventive Medicine Education, Tianjin Medical University, Tianjin, China
- *Correspondence: Xilin Yang ;
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Wells JCK. The New "Obstetrical Dilemma": Stunting, Obesity and the Risk of Obstructed Labour. Anat Rec (Hoboken) 2017; 300:716-731. [PMID: 28297186 DOI: 10.1002/ar.23540] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Revised: 06/27/2016] [Accepted: 08/30/2016] [Indexed: 01/24/2023]
Abstract
The "obstetrical dilemma" refers to the tight fit between maternal pelvic dimensions and neonatal size at delivery. Most interest traditionally focused on its generic significance for humans, for example our neonatal altriciality and our complex and lengthy birth process. Across contemporary populations, however, the obstetrical dilemma manifests substantial variability, illustrated by differences in the incidence of cephalo-pelvic disproportion, obstructed labour and cesarean section. Beyond accounting for 12% of maternal mortality worldwide, obstructed labour also imposes a huge burden of maternal morbidity, in particular through debilitating birth injuries. This article explores how the double burden of malnutrition and the global obesity epidemic may be reshaping the obstetrical dilemma. First, short maternal stature increases the risk of obstructed labour, while early age at marriage also risks pregnancy before pelvic growth is completed. Second, maternal obesity increases the risk of macrosomic offspring. In some populations, short maternal stature may also promote the risk of gestational diabetes, another risk factor for macrosomic offspring. These nutritional influences are furthermore sensitive to social values relating to issues such as maternal and child nutrition, gender inequality and age at marriage. Secular trends in maternal obesity are substantially greater than those in adult stature, especially in low- and middle-income countries. The association between the dual burden of malnutrition and the obstetrical dilemma is therefore expected to increase, because the obesity epidemic is emerging faster than stunting is being resolved. However, we currently lack objective population-specific data on the association between maternal obesity and birth injuries. Anat Rec, 300:716-731, 2017. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Jonathan C K Wells
- Childhood Nutrition Research Centre, UCL Great Ormond Street Institute of Child Health, London, WC1N 1EH, UK
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Helseth R, Salvesen O, Stafne SN, Mørkved S, Salvesen KA, Carlsen SM. Gestational diabetes mellitus among Nordic Caucasian women: prevalence and risk factors according to WHO and simplified IADPSG criteria. Scandinavian Journal of Clinical and Laboratory Investigation 2014; 74:620-8. [PMID: 24980704 DOI: 10.3109/00365513.2014.928942] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Gestational diabetes mellitus (GDM) is associated with both maternal and offspring adverse effects. The World Health Organization (WHO) has recently adopted novel GDM criteria. The aim of this study was to evaluate the former WHO and a simplified version of the new International Association for Diabetes in Pregnancy Study Group (IADPSG) criteria as to prevalence of and risk factors for GDM in a Nordic Caucasian population. METHODS A 75 g oral glucose tolerance test was performed in 687 women at 18-22 and 32-36 pregnancy weeks. GDM was defined according to the WHO criteria as fasting plasma glucose ≥ 7.0 mmol/L and/or 2-hour plasma glucose ≥ 7.8 mmol/L and by a simplified version of the IADPSG criteria as either fasting glucose ≥ 5.1 mmol/L and/or 2-h plasma glucose ≥ 8.5 mmol/L. One-hour glucose values were not available and were thus not included in the diagnosis of GDM by IADPSG. Prevalence of GDM during pregnancy and risk factors for GDM at 18-22 weeks were studied in retrospect according to each of the two criteria. RESULTS The total prevalence of GDM during pregnancy was 6.1% (42/687) for the WHO criteria and 7.4% (51/687) for the simplified IADPSG criteria. High maternal age and short stature were independently associated with WHO GDM. Maternal age, fasting insulin and no regular exercise at 18-22 pregnancy weeks associated with simplified IADPSG GDM. CONCLUSIONS Simplified IADPSG criteria moderately increase GDM prevalence compared with the WHO criteria. Risk factors for GDM differ with the diagnostic criteria used.
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Affiliation(s)
- Ragnhild Helseth
- Department of Internal Medicine, Drammen Hospital , Vestre Viken
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12
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Brite J, Shiroma EJ, Bowers K, Yeung E, Laughon SK, Grewal JG, Zhang C. Height and the risk of gestational diabetes: variations by race/ethnicity. Diabet Med 2014; 31:332-40. [PMID: 24308574 PMCID: PMC4205756 DOI: 10.1111/dme.12355] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2013] [Revised: 08/01/2013] [Accepted: 10/26/2013] [Indexed: 12/25/2022]
Abstract
AIMS Gestational diabetes is a common pregnancy complication affecting races/ethnicities disproportionally. Adult height, an indicator of both genetic and early-life factors, is inconsistently associated with gestational diabetes risk. We examined the association and whether it varies by races in a nationally representative US cohort. METHODS Analyses were conducted among 135 861 pregnancies in the Consortium on Safe Labor, 5567 of which were diagnosed with gestational diabetes based on medical records review. Generalized estimating equations were used to estimate odds ratios (95% confidence intervals) of gestational diabetes, controlling for other risk factors including body weight. Additionally, a meta-analysis of 15 761 pregnancies with gestational diabetes and 205 828 without gestational diabetes was conducted to estimate the pooled mean difference in height between those with gestational diabetes and control subjects. RESULTS Height was inversely associated with gestational diabetes risk across races/ethnicities, with the strongest association among Asians (P for interaction < 0.01). Comparing extreme quartiles (> 168 vs. < 157 cm), adjusted odds ratios (95% confidence intervals) were 0.18 (0.09-0.36) for Asians/Pacific Islanders, 0.33 (0.29-0.38) for non-Hispanic white women, 0.39 (0.31-0.51) for Hispanics and 0.59 (0.47-0.75) for non-Hispanic black women. Meta-analysis found women with gestational diabetes to be significantly shorter than others. CONCLUSIONS Taller women are at lower risk of developing gestational diabetes, with the magnitude of association varying significantly across races/ethnicities.
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Affiliation(s)
- J Brite
- Epidemiology Branch, Division of Epidemiology, Statistics and Prevention Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD; School of Public Health, City University of New York, New York, NY
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13
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Helseth R, Vanky E, Salvesen O, Carlsen SM. Gestational diabetes mellitus among Norwegian women with polycystic ovary syndrome: prevalence and risk factors according to the WHO and the modified IADPSG criteria. Eur J Endocrinol 2013; 169:65-72. [PMID: 23636445 DOI: 10.1530/eje-12-1107] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE The consequences of the recently proposed International Association of Diabetes in Pregnancy Study Group (IADPSG) criteria for gestational diabetes mellitus (GDM) in women with polycystic ovary syndrome (PCOS) are not known. We compared the prevalence rates and risk factors for GDM in PCOS women according to both the WHO and the modified IADPSG criteria. DESIGN Post hoc analyses from a randomized, multicenter study were used. METHODS Fasting and 2-h plasma glucose levels were measured using a 75 g oral glucose tolerance test. GDM was diagnosed according to both the WHO and the modified IADPSG criteria. RESULTS The prevalence rates of GDM according to the WHO and the modified IADPSG criteria were 9.2 and 15.0% at week 12, 18.7 and 18.7% at week 19, and 25.6 and 24.2% at week 32. Shorter stature and increased insulin levels were correlated with WHO-GDM, but not with modified IADPSG-GDM at weeks 12 and 19. Less weight gain in pregnancy predicted GDM according to both sets of criteria. GDM diagnosis was correlated with less maternal weight loss the first year post-partum. CONCLUSIONS No difference was found in the prevalence of GDM between the two sets of criteria used. Less weight gain in pregnancy was associated with GDM, independent of the diagnostic criteria used. Reduced weight loss the first year post-partum in women with GDM raises the question of whether GDM diagnosis per se or the fact that these women lose less weight after pregnancy predicts later diabetes mellitus.
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Affiliation(s)
- R Helseth
- Department of Medicine, Drammen Hospital, Vestre Viken, Norway
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14
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Zhang C, Ning Y. Effect of dietary and lifestyle factors on the risk of gestational diabetes: review of epidemiologic evidence. Am J Clin Nutr 2011; 94:1975S-1979S. [PMID: 21613563 PMCID: PMC3364079 DOI: 10.3945/ajcn.110.001032] [Citation(s) in RCA: 188] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Gestational diabetes mellitus (GDM), defined as glucose intolerance with onset or first recognition in pregnancy, is a common pregnancy complication and a growing health concern. GDM has been related to significant short-term and long-term adverse health outcomes for both mothers and offspring. Importantly, this number is increasing with the increasing burden of obesity among women of reproductive age. Collectively, these data highlight the significance of understanding risk factors, in particular modifiable factors, for GDM and of preventing GDM among high-risk populations. Research in the past decade has identified a few diet and lifestyle factors that are associated with GDM risk. This review provides an overview of emerging diet and lifestyle factors that may contribute to the prevention of GDM. It also discusses major methodologic concerns about the available epidemiologic studies of GDM risk factors.
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Affiliation(s)
- Cuilin Zhang
- Division of Epidemiology, Statistics, and Prevention Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD 21205, USA.
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Wang Y, Chen L, Xiao K, Horswell R, Besse J, Johnson J, Ryan DH, Hu G. Increasing incidence of gestational diabetes mellitus in Louisiana, 1997-2009. J Womens Health (Larchmt) 2011; 21:319-25. [PMID: 22023415 DOI: 10.1089/jwh.2011.2838] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Gestational diabetes mellitus (GDM) is one of the most common pregnancy complications. Although long-term trends are available at the national level, they are less clear for population subgroups, especially those with middle or low income and also at high risk of obesity. METHOD We conducted a retrospective study among women aged 15-50 years with live deliveries between January 1, 1997, and December 31, 2009, at the Louisiana State University Health Care Services Division hospital system. Pregnancies and GDM cases were identified by using ICD-9 code from the Louisiana State University Hospital-Based Longitudinal Study database. The annual incidence of GDM and its standard error (SE) were calculated and stratified by age group and race. RESULTS A total of 2751 GDM incident cases were identified among 62,685 pregnancies between 1997 and 2009. The crude incidence of GDM increased from 4.1% in 1997 to 4.4% in 2009 (increased by 7.3%), and the age-standardized incidence of GDM increased from 5.8% to 7.5% (increased by 29.3%). The incidence of GDM increased with age and reached a peak at 35-39 years of age and then declined in women who were 40-50 years old. Among the three studied races, Asians had significantly higher incidence of GDM than whites and African Americans. CONCLUSIONS The incidence of GDM increased in most years from 1997 to 2009 and reached a peak in 2002 in the women served by Louisiana State University Health Care Services Division hospitals. GDM has become an important public health problem, particularly among women aged 35-39 years.
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Affiliation(s)
- Yujie Wang
- Pennington Biomedical Research Center, Baton Rouge, Louisiana 70808, USA
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Detsch JCM, Almeida ACRD, Bortolini LGC, Nascimento DJ, Oliveira Junior FC, Réa RR. Marcadores para o diagnóstico e tratamento de 924 gestações com diabetes melito gestacional. ACTA ACUST UNITED AC 2011; 55:389-98. [DOI: 10.1590/s0004-27302011000600005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2010] [Accepted: 06/21/2011] [Indexed: 11/22/2022]
Abstract
OBJETIVOS: Avaliar o perfil epidemiológico e a evolução de mulheres com diabetes melito gestacional (DMG), determinando fatores de risco para maior vigilância. SUJEITOS E MÉTODOS: Foram estudadas 924 gestações de 916 pacientes, de 6 de novembro de 2001 a 21 de setembro de 2009. RESULTADOS: Foram encontrados fatores de risco para DMG em 95,1% dos casos. A prevalência de diabetes materno, paterno e em outros familiares foi de 24,3%, 9,4% e 24,7%, respectivamente. Os fatores preditivos para uso de insulina foram: glicemia de jejum (GJ) no rastreamento ≥ 85, GJ no Teste Oral de Tolerância à Glicose (TOTG) ≥ 95, glicemia 2h após 75 g de glicose ≥ 200 mg/dL, DMG prévio, obesidade, HbA1c > 6% e história familiar de DM em parente de primeiro grau associada à obesidade ou DMG prévio, esta última a associação mais relevante (p < 0,05). CONCLUSÕES: Os fatores de risco analisados se mostraram altamente sensíveis para a detecção de DMG, e a disposição da história familiar reforça sua relação com o DM2. Recomenda-se maior vigilância a gestantes com fatores preditivos para necessidade de insulina.
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Abstract
Gestational diabetes mellitus is defined as glucose intolerance that begins or is first recognized during pregnancy. Its prevalence, generally situated between 2-6%, may reach 10-20% in high-risk populations, with an increasing trend across most racial/ethnic groups studied. Among traditional risk factors, previous gestational diabetes, advanced maternal age and obesity have the highest impact on gestational diabetes risk. Racial/ethnic origin and family history of type 2 diabetes have a significant but moderate impact (except for type 2 diabetes in siblings). Several non traditional factors have been recently characterized, either physiological (low birthweight and short maternal height) or pathological (polycystic ovaries). The multiplicity of risk factors and their interactions results in a low reliability of risk prediction on an individual basis.
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Affiliation(s)
- F Galtier
- HRU Montpellier, Centre d'investigation clinique et Département des Maladies Endocriniennes,, 34295 Montpellier cedex 05, France.
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Marino M, Masella R, Bulzomi P, Campesi I, Malorni W, Franconi F. Nutrition and human health from a sex-gender perspective. Mol Aspects Med 2011; 32:1-70. [PMID: 21356234 DOI: 10.1016/j.mam.2011.02.001] [Citation(s) in RCA: 84] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2010] [Revised: 01/25/2011] [Accepted: 02/18/2011] [Indexed: 02/07/2023]
Abstract
Nutrition exerts a life-long impact on human health, and the interaction between nutrition and health has been known for centuries. The recent literature has suggested that nutrition could differently influence the health of male and female individuals. Until the last decade of the 20th century, research on women has been neglected, and the results obtained in men have been directly translated to women in both the medicine and nutrition fields. Consequently, most modern guidelines are based on studies predominantly conducted on men. However, there are many sex-gender differences that are the result of multifactorial inputs, including gene repertoires, sex steroid hormones, and environmental factors (e.g., food components). The effects of these different inputs in male and female physiology will be different in different periods of ontogenetic development as well as during pregnancy and the ovarian cycle in females, which are also age dependent. As a result, different strategies have evolved to maintain male and female body homeostasis, which, in turn, implies that there are important differences in the bioavailability, metabolism, distribution, and elimination of foods and beverages in males and females. This article will review some of these differences underlying the impact of food components on the risk of developing diseases from a sex-gender perspective.
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Affiliation(s)
- Maria Marino
- Department of Biology, University Roma Tre, Viale Guglielmo Marconi 446, I-00146 Roma, Italy
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Weitzman S, Wang CH, Pankow JS, Schmidt MI, Brancati FL. Are measures of height and leg length related to incident diabetes mellitus? The ARIC (Atherosclerosis Risk in Communities) study. Acta Diabetol 2010; 47:237-42. [PMID: 19774332 DOI: 10.1007/s00592-009-0145-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2008] [Accepted: 06/03/2009] [Indexed: 10/20/2022]
Abstract
This study was designed to estimate the risk of developing diabetes in relation to adult height components, namely leg length and leg length/height ratio. Data on 12,800 individuals without diabetes were obtained at the baseline examination from the ARIC cohort. Cox proportional hazard models were used to estimate hazard rate ratios of diabetes for each 5-cm difference in leg length and 1 SD difference in the leg length/height ratio. During a mean follow-up period of 7.6 years, the age-adjusted incidence per 1,000 person years of follow-up was 25.8, 24.2, 10.4, and 16.2 in African American (AA) women, AA men, white women, and white men, respectively. The hazard ratio for diabetes (95% CI) per 5-cm difference in leg length was 0.85 (0.75-0.95) in white men, 0.79 (0.69-0.90) in white women, 0.90 (0.75-1.07) in AA women, and 0.99 (0.77-1.27) in AA men, after adjusting for age, parental history of diabetes, parental socioeconomic status, and weight at age 25. The hazard ratio for diabetes per 1 SD difference in leg length/height ratio followed the same trend. Leg length is inversely and independently related to an increased risk of diabetes in middle-age white men and women but not in African-Americans. This sex-race heterogeneity suggests that nutritional and environmental factors in childhood may modify this risk through different pathways.
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Affiliation(s)
- Shimon Weitzman
- Department of Epidemiology and Health Services Evaluation, Ben-Gurion University of the Negev, Beersheba, Israel.
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Coolen JC, Verhaeghe J. Physiology and clinical value of glycosuria after a glucose challenge during pregnancy. Eur J Obstet Gynecol Reprod Biol 2010; 150:132-6. [DOI: 10.1016/j.ejogrb.2010.02.032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2009] [Revised: 01/28/2010] [Accepted: 02/10/2010] [Indexed: 01/27/2023]
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Faerch K, Borch-Johnsen K, Vaag A, Jørgensen T, Witte DR. Sex differences in glucose levels: a consequence of physiology or methodological convenience? The Inter99 study. Diabetologia 2010; 53:858-65. [PMID: 20182862 DOI: 10.1007/s00125-010-1673-4] [Citation(s) in RCA: 81] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2009] [Accepted: 01/06/2010] [Indexed: 01/30/2023]
Abstract
AIMS/HYPOTHESIS We aimed to examine whether sex differences in fasting plasma glucose (FPG), 2 h post-OGTT plasma glucose (2hPG) and HbA(1c) could be explained by differences in body size and/or body composition between men and women in a general non-diabetic Danish population. Moreover, we aimed to study to what degree the newly suggested high-risk HbA(1c) criteria overlapped with the current OGTT-based criteria of glucose intolerance. METHODS We used cross-sectional data from 6,006 non-diabetic men and women. HbA(1c) and FPG levels were measured and a 75 g OGTT was performed in all individuals. Height, weight and waist and hip circumferences were measured and BMI was calculated. Data were analysed in age-adjusted linear regression models. RESULTS Men had higher FPG and HbA(1c) levels than women, and women had higher 2hPG levels than men. Sex differences in 2hPG levels were explained by differences in height and FPG levels, but sex differences in FPG or HbA(1c) levels were not explained by anthropometric measures. Among individuals with HbA(1c) in the high-risk range (6.0-6.5%), 73% had normal glucose tolerance. CONCLUSIONS/INTERPRETATION Sex differences in 2hPG levels after an OGTT may to some extent be a consequence of giving the same amount of glucose to individuals with different body size. In contrast, sex differences in FPG and HbA(1c) levels are likely to have a true physiological basis. In clinical practice, the HbA(1c) assay may be more convenient than the OGTT, but it is important to note that different populations are identified by the two methods.
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Affiliation(s)
- K Faerch
- Steno Diabetes Center, Niels Steensens Vej 2, DK-2820, Gentofte, Denmark.
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Chu SY, Abe K, Hall LR, Kim SY, Njoroge T, Qin C. Gestational diabetes mellitus: all Asians are not alike. Prev Med 2009; 49:265-8. [PMID: 19596364 DOI: 10.1016/j.ypmed.2009.07.001] [Citation(s) in RCA: 87] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2009] [Revised: 06/26/2009] [Accepted: 07/02/2009] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To estimate the prevalence of gestational diabetes mellitus (GDM) prevalence estimates for subgroups of US Asian and Pacific Islander (API) women by using data from 2005 and 2006 birth certificates. METHODS Using 2005-2006 natality files from states that implemented the revised 2003 US birth certificate, which differentiates between GDM and preexisting diabetes (2005: 12 states; 2006: 19 states), we calculated age-adjusted GDM prevalence estimates for API mothers who delivered singleton infants. RESULTS Among 3,108,877 births, US APIs had a substantially higher age-adjusted prevalence of GDM (6.3%) than whites (3.8%), blacks (3.5%), or Hispanics (3.6%). Among API subgroups, age-adjusted GDM prevalence varied significantly, from 3.7% among women of Japanese descent to 8.6% among women of Asian Indian descent. Foreign-born APIs had significantly higher GDM rates than US-born APIs except among women of Japanese and Korean ancestry. CONCLUSION Overall, US API women have the highest risk for GDM among all US racial/ethnic groups. However, APIs are a heterogeneous group by genetic background, culture, and diet and other lifestyle behaviors. Our findings imply that, whenever possible, API subgroups should be evaluated separately in health research.
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Affiliation(s)
- Susan Y Chu
- Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, Georgia 30341, USA.
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Dode MASDO, Santos IDSD. Fatores de risco para diabetes mellitus gestacional na coorte de nascimentos de Pelotas, Rio Grande do Sul, Brasil, 2004. CAD SAUDE PUBLICA 2009; 25:1141-52. [DOI: 10.1590/s0102-311x2009000500021] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2008] [Accepted: 11/26/2008] [Indexed: 01/04/2023] Open
Abstract
Consensos de diversos países referem idade, obesidade e história familiar de diabetes mellitus como fatores de risco para diabetes mellitus gestacional. Outros fatores permanecem controversos. O objetivo deste estudo foi investigar fatores associados ao diabetes mellitus gestacional entre mães dos recém-nascidos da coorte de nascimentos de Pelotas, Rio Grande do Sul, Brasil, em 2004. Foram entrevistadas 4.243 puérperas no hospital, havendo 0,5% de recusas. O diagnóstico de diabetes mellitus gestacional foi auto-referido. A prevalência de diabetes mellitus gestacional foi 2,95% (IC95%: 2,53-3,64). Análise bruta realizada por meio de testes qui-quadrado mostrou associação direta com aumento da idade, escolaridade, nível econômico e índice de massa corporal (IMC) e inversa com altura materna. Cor não branca, história familiar de diabetes mellitus, tabagismo no primeiro e segundo trimestres e atividade física antes da gestação e no primeiro trimestre mostraram-se associados. A análise ajustada hierarquizada realizada através de regressão logística mostrou associação com maior idade, cor não branca, maior escolaridade, história familiar de diabetes mellitus e maior IMC. A altura ficou no limiar da significância. Tabagismo no primeiro e segundo trimestres foi protetor.
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Short stature and obesity: positive association in adults but inverse association in children and adolescents. Br J Nutr 2009; 102:453-61. [DOI: 10.1017/s0007114508190304] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Shorter than average adults are at a higher risk for obesity and are also more susceptible to diabetes and CVD, independent of BMI. In contrast, taller children have a higher risk of obesity. We hypothesised that short stature is related to adverse body composition and that the association between stature and obesity differs between generations. In a cross-sectional German database of 213 804 adults and 12 411 children and adolescents, the prevalence of overweight and obesity was compared between percentiles of height. The association between stature and percentage of fat mass (%FM), lean BMI (LBMI; kg/m2) or waist:hip ratio (in children only) was analysed within BMI groups. In adults, the prevalence of BMI >30 kg/m2 gradually increased with decreasing percentile of height whereas in children and adolescents, a positive association between height and weight status was observed. Short-stature women and girls had a 0·8–3·2 % lower %FM than tall subjects (P < 0·05), whereas no trend for %FM was observed in males. When compared with tall subjects, LBMI was 0·2–0·6 kg/m2 lower in short-stature men, as well as obese women (P < 0·05). There was a non-significant trend for a lower LBMI and a higher waist:hip ratio in shorter children. In conclusion, short stature is associated with an increased risk of obesity in adults. Cardiometabolic risk in short stature is not explained by an adverse body composition.
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Dode MASDO, Santos ISD. Non classical risk factors for gestational diabetes mellitus: a systematic review of the literature. CAD SAUDE PUBLICA 2009; 25 Suppl 3:S341-59. [DOI: 10.1590/s0102-311x2009001500002] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2009] [Accepted: 08/19/2009] [Indexed: 12/16/2022] Open
Abstract
Age, obesity and family history of diabetes are well known risk factors for gestational diabetes mellitus. Others are more controversial. The objective of this review is to find evidence in the literature that justifies the inclusion of these other conditions among risk factors. The MEDLINE, Cochrane, LILACS and Pan American Health Organization databases were searched, covering articles dating from between 1992 and 2006. Keywords were used in combination (AND) with gestational diabetes mellitus separately and with each one of the risk factors studied. The methodological quality of the studies included was assessed, resulting in the selection of 41 papers. Most studies investigating maternal history of low birth weight, low stature, and low level of physical activity have found positive associations with gestational diabetes mellitus. Low socioeconomic levels, smoking during pregnancy, high parity, belonging to minority groups, and excessive weight gain during pregnancy presented conflicting results. Publication bias cannot be ruled out. Standardization of techniques, cutoff points for screening and diagnosis, as well as studies involving larger sample sizes would allow future meta-analyses.
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Janghorbani M, Amini M. Effects of gender and height on the oral glucose tolerance test: the isfahan diabetes prevention study. Rev Diabet Stud 2008; 5:163-70. [PMID: 19099088 PMCID: PMC2613268 DOI: 10.1900/rds.2008.5.163] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2008] [Revised: 11/11/2008] [Accepted: 11/28/2008] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Impaired fasting glucose (IFG) is more prevalent in men, whereas impaired glucose tolerance (IGT) is more prevalent in women. AIM To determine whether gender difference in the prevalence of glucose intolerance is related to height. METHODS A cross-sectional study of 2,368 first-degree relatives (FDR) of patients with type 2 diabetes was conducted between years 2003 to 2005. All participants (614 men and 1754 women) were in the age range 30-60 years, and were FDR of consecutive patients from outpatient clinics at Isfahan Endocrine and Metabolism Research Centre, Iran. All subjects underwent a standard 75 g 2-h oral glucose tolerance test (OGTT). Weight, height, waist and hip circumference, and glycated haemoglobin were also measured. RESULTS IGT was more common amongst women (OR 0.66; 95% CI 0.51, 0.87),whereas diabetes (OR 1.31; 95% CI 0.96, 1.78), and IFG (OR 1.41; 95% CI 1.10, 1.80) was more common amongst men. Women had a lower mean fasting plasma glucose (FPG) (p < 0.001), but showed higher 2hPG, and FPG-2hPG increase (p < 0.001). The gender difference in mean 2hPG and FPG-2hPG increase, was not evident after adjustment for height. Negative correlation to height was observed in 2hPG and FPG-2hPG increase, both in men and women (p < 0.001), but height showed little association with FPG. CONCLUSIONS Women had higher mean 2hPG and FPG-2hPG increase, but showed a lower FPG level than men. The inverse association between height and 2hPG and FPG-2hPG increase may be explained by gender difference.
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Affiliation(s)
- Mohsen Janghorbani
- School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Massoud Amini
- Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Sicree RA, Zimmet PZ, Dunstan DW, Cameron AJ, Welborn TA, Shaw JE. Differences in height explain gender differences in the response to the oral glucose tolerance test- the AusDiab study. Diabet Med 2008; 25:296-302. [PMID: 18307457 DOI: 10.1111/j.1464-5491.2007.02362.x] [Citation(s) in RCA: 95] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
AIM To determine the extent of gender-related differences in the prevalence of glucose intolerance for the Australian population and whether body size may explain such differences. METHODS Cross-sectional data were collected from a national cohort of 11 247 Australians aged > or = 25 years. Glucose tolerance status was assessed according to both fasting plasma glucose (FPG) and 2-h plasma glucose (2hPG) levels following a 75-g oral glucose tolerance test (OGTT). Anthropometric and glycated haemoglobin measurements were also made. RESULTS Undiagnosed diabetes and non-diabetic glucose abnormalities were more prevalent among men than women when based only on the FPG results (diabetes: men 2.2%, women 1.6%, P = 0.02; impaired fasting glycaemia: men 12.3%, women 6.6%, P < 0.001). In contrast 16.0% of women and 13.0% of men had a 2hPG abnormality (either diabetes or impaired glucose tolerance, P = 0.14). Women had a mean FPG 0.3 mmol/l lower than men (P < 0.001), but 2hPG 0.3 mmol/l higher (P = 0.002) and FPG-2hPG increment 0.5 mmol/l greater (P < 0.001). The gender difference in mean 2hPG and FPG-2hPG increment disappeared following adjustment for height. For both genders, those in the shortest height quartile had 2hPG levels 0.5 mmol/l higher than the tallest quartile, but height showed almost no relationship with the FPG. CONCLUSIONS Men and women had different glycaemic profiles; women had higher mean 2hPG levels, despite lower fasting levels. It appeared that the higher 2hPG levels for women related to lesser height and may be a consequence of using a fixed glucose load in the OGTT, irrespective of body size.
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Affiliation(s)
- R A Sicree
- International Diabetes Institute, Melbourne, Victoria, Australia.
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Ma RM, Lao TT, Ma CL, Liao SJ, Lu YF, Du MY, Xiao H, Zhang L, Yang MH, Xiao X. Relationship between leg length and gestational diabetes mellitus in Chinese pregnant women. Diabetes Care 2007; 30:2960-1. [PMID: 17666468 DOI: 10.2337/dc07-0763] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Run Mei Ma
- Department of Obstetrics and Gynecology, 1st Affiliated Hospital of Kunming Medical College, P.O. Box 650032, 295 Xichang Rd., Kunming, Yunnan Province, PR China.
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Litou H, Anastasiou E, Thalassinou L, Sarika HL, Philippou G, Alevizaki M. Increased prevalence of VNTR III of the insulin gene in women with gestational diabetes mellitus (GDM). Diabetes Res Clin Pract 2007; 76:223-8. [PMID: 17011062 DOI: 10.1016/j.diabres.2006.08.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2006] [Revised: 06/18/2006] [Accepted: 08/29/2006] [Indexed: 12/18/2022]
Abstract
OBJECTIVE The VNTR polymorphism in the promoter region of the insulin gene (INS-VNTR) affects transcription rate and has been associated with insulin resistance and DM2. Gestational diabetes mellitus (GDM) is a multifactorial disorder, where both impaired insulin secretion and action may be involved. The aim of the study was to examine the distribution of the INS-VNTRs in women with GDM and to investigate possible associations with features of beta cell function and glycaemic control in this population. METHODS One hundred and sixty-one women with GDM and 111 normal pregnant women (n) were genotyped for INS-VNTR during the 24th-32nd pregnancy week. Glucose and insulin levels were determined during the diagnostic OGTT. The majority of the previous GDM women were also examined at 3-6 months post-partum. RESULTS VNTR class III/III genotype was significantly more frequent in the GDM group 8.7% versus 2.7%, p=0.02 giving an OR of 3.97 (1.1-14.29). An increased frequency of the VNTR class III allele was found in those GDM women who required insulin for treatment compared to those controlled with diet alone (12.4% versus 4%, p<0.001). Basal insulin levels tended to be lower in GDM women homozygous for the class III allele without reaching statistical significance (p=0.09). CONCLUSIONS The INS-VNTR class III is more frequent in women who develop GDM, and may be associated with decreased ability of the beta cell to meet the increased insulin requirements as reflected by the need for insulin supplementation for adequate glycaemic control.
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Affiliation(s)
- Hariklia Litou
- Endocrine Unit, Evgenideion Hospital, Department of Clinical Therapeutics, Alexandra University Hospital, 115 28 Athens, Greece
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Asao K, Kao WHL, Baptiste-Roberts K, Bandeen-Roche K, Erlinger TP, Brancati FL. Short stature and the risk of adiposity, insulin resistance, and type 2 diabetes in middle age: the Third National Health and Nutrition Examination Survey (NHANES III), 1988-1994. Diabetes Care 2006; 29:1632-7. [PMID: 16801590 DOI: 10.2337/dc05-1997] [Citation(s) in RCA: 110] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To investigate the association between stature-related measurements (height, leg length, and leg length-to-height ratio) and adiposity, insulin resistance, and glucose intolerance. RESEARCH DESIGN AND METHODS We conducted a cross-sectional analysis of a nationally representative sample of 7,424 adults aged 40-74 years, from the Third National Health and Nutrition Examination Survey (1988-1994). The main outcome measures were percent body fat, homeostasis model assessment of insulin resistance (HOMA-IR), and glucose intolerance based on the World Health Organization's 1985 criteria for an oral glucose tolerance test. RESULTS Shorter height and leg length, and lower leg length-to-height ratio, were associated with higher percent body fat, especially in women. Lower leg length-to-height ratio was associated with greater insulin resistance estimated by HOMA-IR. In multinomial regression models adjusting for potential confounders, including percent body fat, the relative prevalence of type 2 diabetes per 1-SD lower values in height, leg length, and leg length-to-height ratio were 1.10 (95% CI 0.94-0.29), 1.17 (0.98-1.39), and 1.19 (1.02-1.39), respectively. CONCLUSIONS Our study supports the hypothesis that adult markers of prepubertal growth, especially leg length-to-height ratio, are associated with adiposity, insulin resistance, and type 2 diabetes in the general U.S. population.
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Affiliation(s)
- Keiko Asao
- Department of Epidemiology, Johns Hopkins University, Baltimore, MD 21205, USA
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Adipokine profile and C-reactive protein in pregnancy: effects of glucose challenge response versus body mass index. ACTA ACUST UNITED AC 2006; 12:330-4. [PMID: 15979544 DOI: 10.1016/j.jsgi.2005.02.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2004] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To test the hypothesis that gravidas who have an abnormal response to glucose loading have dysfunctional adipose tissue cells that produce more insulin resistance-inducing and proinflammatory adipokines but less insulin-sensitizing adipokines. METHODS We performed a nested case-control study within a larger sample of gravidas who had a glucose challenge test (GCT) at 24-29 weeks; we compared 73 cases with an abnormal GCT (>8.3 mM) and 146 controls with a strictly normal GCT (<7.2 mM) matched for body mass index (BMI) and height (mean difference between cases and controls: 0.1 kg/m(2) and 1 cm, respectively). We measured plasma insulin, adipokines (leptin, adiponectin, resistin, tumor necrosis factor [TNF]-alpha, interleukin [IL]-6), soluble leptin receptor (sOb-R), the main leptin-binding protein, and C-reactive protein (CRP). RESULTS The cases showed a 48% increase in insulin concentrations and a 27% increase in TNF-alpha concentrations compared to the controls (both P < .0001), but leptin, sOb-R, IL-6, and adiponectin, as well as CRP, concentrations were comparable between cases and controls. In the whole group (n = 219), BMI was correlated with insulin, leptin, IL-6, and CRP, and inversely with sOb-R and adiponectin concentrations (all P < .0003). CONCLUSIONS Plasma leptin, sOb-R, IL-6, and adiponectin, as well as CRP, are strongly related to BMI in gravidas at 24-29 weeks gestational age but not to the glucose loading response. However, TNF-alpha is higher in women with an abnormal GCT. Further studies should disclose the source of increased TNF-alpha in these women, and to assess whether TNF-alpha is causally related to glucose intolerance during pregnancy.
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Abstract
OBJECTIVE To assess the relationship between leg length and glucose tolerance in pregnancy. RESEARCH DESIGN AND METHODS The leg length and leg-to-height percentage were prospectively determined on 161 glucose-tolerant women during pregnancy and 61 women with gestational diabetes mellitus (GDM). RESULTS Women with GDM were a mean of 2.8 cm shorter than women who were glucose tolerant, due entirely to their leg lengths being a mean of 3.2 cm shorter. With respect to the 2-h result on the glucose tolerance test (GTT), there were negative correlations for height (r = -0.161, P = 0.017), leg length (r = -0.266, P < 0.0005), and the leg-to-height percentage (r = -0.294, P < 0.0005). The correlation between the leg-to-height percentage and the 2-h result on the GTT remained significant after adjustment for age (r = -0.252, P < 0.0005) and for age and BMI (r = -0.224, P = 0.001). CONCLUSIONS Women with GDM are shorter than glucose-tolerant women and have a lower leg-to-height percentage. Consideration of short stature as a risk factor for GDM is not valid without taking into account the leg-to-height percentage.
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Affiliation(s)
- Robert G Moses
- Diabetes Service, Illawarra Area Health Service, Wollongong, New South Wales, Australia.
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Willows ND, Gray-Donald K. High birth weight does not guarantee protection from type 2 diabetes. Am J Clin Nutr 2003. [DOI: 10.1093/ajcn/77.6.1528a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Yang X, Hsu-Hage B, Zhang H, Yu L, Dong L, Li J, Shao P, Zhang C. Gestational diabetes mellitus in women of single gravidity in Tianjin City, China. Diabetes Care 2002; 25:847-51. [PMID: 11978679 DOI: 10.2337/diacare.25.5.847] [Citation(s) in RCA: 93] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE The aim of this study was to investigate the prevalence of gestational diabetes mellitus (GDM) and risk factors for the development of GDM in pregnant women in Tianjin, China, where the prevalence of GDM is still unknown. STUDY DESIGN AND METHODS A total of 9,471 pregnant women living in the six urban districts of Tianjin, China, took part in the initial screening between December 1998 and December 1999. The screening test consisted of a 50-g 1-h glucose test. Women with a reading > or =7.8 mmol/l at the initial screening were invited to undergo a 75-g 2-h oral glucose tolerance test (OGTT). GDM was confirmed using the World Health Organization's diagnostic criteria. RESULTS At the initial screening test, 888 women had a glucose reading of > or =7.8 mmol/l. A total of 701 (79%) women took a subsequent OGTT. Of these, 174 women were confirmed to have GDM (154 with impaired glucose tolerance [IGT] and 20 with diabetes). The prevalence of GDM was 2.31% (2.03% for IGT and 0.28% for diabetes), adjusting for serum glucose levels at the initial screening test. Independent predictors for GDM were maternal age, stature, prepregnancy BMI, weight gain in pregnancy before screening, diabetes in first-degree relatives, and habitual cigarette smoking during pregnancy. Women who smoked or had a short stature are more likely to develop GDM than their counterparts. CONCLUSIONS The prevalence of GDM in pregnant women in the city of Tianjin, China, was 2.31%. Short stature and smoking in pregnancy were additional risk factors for GDM.
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Affiliation(s)
- Xilin Yang
- Department of Rural Health, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Shepparton, Australia
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Abstract
Recent findings have sparked intense interest in birth weight as a predictor of type 2 diabetes mellitus. In some populations, there is an inverse association between birth size and disease; however, in the Pima Indians, a population with very high rates of gestational diabetes, high birth weight and low birth weight are associated with diabetes. This results in a U-shaped curve with higher diabetes rates in both tails of the distribution. Similarly, there are reports of an inverse association between stature and prevalence of gestational diabetes, but, in California Latina women with gestational diabetes, there is a positive association between stature and glucose concentration. Could these disparate findings also represent the two ends of a U-shaped curve? The disparities are likely due to differences in the environment, both in utero and postnatally, that different groups experience.
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Affiliation(s)
- D J Pettitt
- Sansum Medical Research Institute, 2219 Bath Street, Santa Barbara, CA 93105, USA.
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Abstract
The prevalence of type 2 diabetes is rising rapidly in all non-industrialised populations. By 2025, three-quarters of the world's 300 million adults with diabetes will be in non-industrialised countries, and almost a third in India and China alone. There is strong evidence that this epidemic has been triggered by social and economic development and urbanisation, which are associated with general improvements in nutrition and longevity, but also with obesity, reduced physical exercise and other diabetogenic factors. There is evidence too that fetal growth retardation and growth failure in infancy, both still widespread in non-industrialised populations, increase susceptibility to diabetes. An additional factor may be intergenerational effects of gestational diabetes occurring in mothers who grew poorly in early life and become obese as adults. Prevention of type 2 diabetes will require measures to promote exercise and reduce obesity in adults and children, alongside programmes to achieve healthy fetal and infant growth.
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Affiliation(s)
- C H Fall
- MRC Environmental Epidemiology Unit, University of Southampton, UK
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Kousta E, Lawrence NJ, Penny A, Millauer BA, Robinson S, Johnston DG, McCarthy MI. Women with a history of gestational diabetes of European and South Asian origin are shorter than women with normal glucose tolerance in pregnancy. Diabet Med 2000; 17:792-7. [PMID: 11131104 DOI: 10.1046/j.1464-5491.2000.00393.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
AIMS It has been reported that short individuals are more likely to have abnormalities of glucose homeostasis. The aim of this study was to examine the relationship between adult height and gestational diabetes mellitus (GDM), taking into account possible artefactual or confounding explanations. METHODS Three hundred and forty-six women with previous GDM (169 European, 102 South Asian, 75 Afro-Caribbean) and 470 control women with no previous history of GDM (282 European, 94 South Asian and 94 Afro-Caribbean) were studied. Post-partum glucose status and height were measured. RESULTS European and South Asian women with previous GDM were shorter than control women from the same ethnic groups (European: (mean +/- SD) 162.9 +/- 6.1 vs. 165.3 +/- 6.8 cm, P < 0.0001; South Asian: 155.2 +/- 5.4 vs. 158.2 +/- 6.3 cm, P = 0.003, adjusted for age). A similar, but non-significant trend was observed among Afro-Caribbean women (162.2 +/- 6.2 vs. 163.7 +/- 6.1 cm, P = 0.1). Similar, significant height differences were observed in Europeans and South Asians when analysis was restricted to those GDM women who had received insulin during pregnancy. There was no association between height and glucose tolerance postpartum within the GDM group. CONCLUSIONS European and South Asian women with previous GDM are shorter than control women from the same ethnic groups. The data demonstrate that this is unlikely to be an artefact resulting from the use of an fixed 75 g load in women of differing sizes, and suggest that there are likely to be common pathophysiological mechanisms underlying GDM and the determination of final adult height.
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Affiliation(s)
- E Kousta
- Section of Endocrinology and Metabolic Medicine, Imperial College School of Medicine, St Mary's Hospital, London, UK
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Nenov VD, Taal MW, Sakharova OV, Brenner BM. Multi-hit nature of chronic renal disease. Curr Opin Nephrol Hypertens 2000; 9:85-97. [PMID: 10757212 DOI: 10.1097/00041552-200003000-00001] [Citation(s) in RCA: 98] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- V D Nenov
- Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts 02115, USA
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Abstract
Interest in diabetes mellitus research has escalated in Greece during the last decade. This may be attributed to the realization that diabetes is becoming a major problem for the Greek population, the effect of the St Vincent Declaration in passing specific government legislation, and the founding of the National Hellenic Center for the Prevention and Treatment of Diabetes and its Complications. Research areas include epidemiology, etiopathogenesis, glucose metabolism, complications, prevention and treatment of the disease.
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Affiliation(s)
- C S Bartsocas
- Department of Pediatrics, Faculty of Nursing, University of Athens at P & A Kyriakou Children's Hospital, Athens, Greece.
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