Cord-blood lipoproteins, homocysteine, insulin sensitivity/resistance marker profile, and concurrence of dysglycaemia and dyslipaemia in full-term neonates of the Mérida Study

The preventive and therapeutic consumption of meat enriched with carob fruit extract, rich in phenolic compounds, improves colonic antioxidant status in late-stage T2DM rats

Oxidative stress is prevalent in Type 2 Diabetes Mellitus (T2DM) and has been associated with high meat consumption. Carob Fruit Extract (CFE) contains phenolic compounds, making it a suitable functional ingredient. Current study aims to evaluate the effect of CFE-enriched meat (CFE-meat) consumption on the antioxidant status of proximal and distal colon, and its relationship with fecal phenolic compounds in late-stage T2DM rats. Three groups of eight rats were studied: 1) D, fed control-meat; 2) ED, fed CFE-meat since the beginning of the study; 3) DE, fed CFE-meat after confirming T2DM. CFE-meat consumption reduces colonic oxidative stress mainly in the proximal section and helps to ameliorate glutathione metabolism and antioxidant score. Difference between ED and DE groups were associated with colon homeostasis and T2DM progression suggesting greater fermentation but lower absorption in the DE group. CFE appears as a promising tool to improve the antioxidant status observed in late-stage T2DM.

Carob fruit extract-enriched meat, as preventive and curative treatments, improves gut microbiota and colonic barrier integrity in a late-stage T2DM model

Epidemiological and experimental studies have suggested that dietary fiber and proanthocyanidins play an important role on gut microbiota (GM), colonic integrity and body health. Type 2 Diabetes Mellitus (T2DM) is a prevalent disease in which the modifications in the GM and colonic markers stand out. This manuscript hypothesizes the consumption of functional meat enriched in carob fruit extract [CFE; CFE-restructured meat (RM)] ameliorates the dysbiosis and colonic barrier integrity loss in a late-stage T2DM rat model induced by the conjoint action of a high-saturated-fat/high-cholesterol diet (Chol-diet) and a low dose of streptozotocin (STZ) plus a nicotinamide (NAD) injection. Three groups of eight rats were used: (1) D group, a T2DM control group, fed the Chol-diet; (2) ED group, a T2DM preventive strategy group fed the CFE-Chol-diet since the beginning of the study; and (3) DE group, a T2DM curative treatment group, fed the CFE-Chol-diet once the diabetic state was confirmed. The study lasted 8 weeks. Amount and variety of GM, feces short-chain-fatty acids (SCFAs), colonic morphology [crypt depth and density, goblet cells, proliferating cell nuclear antigen (PCNA) and transferase dUTP nick end labelling (TUNEL) indexes] and tight junctions were evaluated. A global colonic index combining 17 markers (GC_index) was calculated. ED rats displayed higher levels of GM richness, SCFAs production, crypt depth, and goblet cells than the D group. DE group showed lower Enterobacteriaceae abundance and greater TUNEL index and occludin expression in the distal colon than D counterpart. GC_index differentiated the colonic health status of the experimental groups in the order (ED > DE > D; P < 0.001) as a 17-51 range-quotation, ED, DE, and D groups displayed the values 43, 32.5, and 27, respectively. Thus, CFE-RM used as a T2DM preventive therapy could induce higher GM richness, more adequate SCFAs production, and better colonic barrier integrity. Furthermore, CFE-RM used with curative purposes induced more modest changes and mainly at the distal colonic mucosa. Further studies are needed to confirm this study's results, to ascertain the benefits of consuming proanthocyanidins-rich fiber during different T2DM stages.

Characterizing the Effects of Diabetes and Obesity on Insulin and Leptin Levels amongst Pregnant Women

OBJECTIVE

In this study, we assess the impact of obesity and diabetes on maternal brain and periphery, as well as fetal exposure to insulin and leptin, and two hormones that play an important role in regulating energy homeostasis.

STUDY DESIGN

Fasting maternal plasma, fetal cord vein and artery plasma, and maternal cerebrospinal fluid (CSF) were collected in 37 women (12 lean, nondiabetic [prepregnancy body mass index (BMI): 22.9 ± 1.7 kg/m²]; 12 overweight/obese nondiabetic [BMI: 37.8 ± 7.3 kg/m²]; 13 gestational/type 2 diabetes mellitus [BMI: 29.8 ± 7.3 kg/m²]) with uncomplicated singleton pregnancies undergoing elective Cesarean delivery. HbA1C, insulin, glucose, and leptin levels were measured.

RESULTS

Compared with lean mothers, mothers with obesity and diabetes mellitus (DM) had significantly lower CSF-to-plasma ratios of insulin. Moreover, mothers with obesity and DM had significantly lower cord arterial and cord venous to maternal plasma ratios of insulin, but not leptin, compared with lean mothers. There were no differences in CSF and cord blood insulin and leptin levels between obese and DM mothers.

CONCLUSION

Compared with lean individuals, mothers with obesity and DM have relative deficiencies in insulin exposure. The patterns observed in mothers with obesity and diabetes were similar highlighting the importance of the maternal metabolic environment in obesity and suggesting obese patients warrant further clinical focus.

The triglyceride-glucose index, an insulin resistance marker in newborns?

The study aims to assess the utility of the triglyceride-glucose index (TyG) as a marker of insulin resistance (IR) in neonates. TyG and the homeostatic model assessment (HOMA-IR) values were compared in 196 singleton, term normoweight and without distress newborns. A Decision Tree procedure (CHAID) was used to classify cases into groups or predict values of a dependent (Ln HOMA-IR) variable. Three nodes were drawn for TyG: ≤ 6.7, > 6.7-7.8 and > 7.8 (p < 0.0001; F = 20.52). The predictability of those TyG values vs HOMA-IR was statistically significant (p < 0.0001). It was neither affected by gender (p = 0.084), glucose challenge test (p = 0.138) classifications nor by the TyG node* glucose challenge test and TyG node*gender interactions (p = 0.456 and p = 0.209, respectively). Glucose, HOMA-IR, and the triglyceride/HDL cholesterol ratio increased progressively from node 1 to 3 for TyG while QUICKI decreased.

CONCLUSION

In conclusion, TyG appears to be a suitable tool for identifying IR at birth, justifying the further insulin determination in those neonates. TyG ≥ 7.8 is recommended as cut-off point in neonates. The need for a follow-up study to confirm the TyG as early IR marker is desirable.

WHAT IS KNOWN

• HOMA-IR and the triglyceride-glucose index (TyG) show a high correlation. • The TyG has been used as an insulin resistance marker in adults.

WHAT IS NEW

• This is the first study where TyG has been assessed in neonates. • TyG appears to be a suitable and cheap tool for identifying insulin resistance at birth.

Maternal and neonatal FTO rs9939609 polymorphism affect insulin sensitivity markers and lipoprotein profile at birth in appropriate-for-gestational-age term neonates

The influence of maternal fat mass and obesity (FTO) gene polymorphism on neonatal insulin sensitivity/resistance biomarkers and lipoprotein profile has not been tested. The study aimed to assess the association between the FTO rs9939609 polymorphism in mother-neonate couples and neonatal anthropometrical measurements, insulin sensitivity/resistance, and lipid and lipoprotein concentrations at birth. Fifty-three term, appropriate-for-gestational-age, Caucasian newborns together with their respective mothers participated in a cross-sectional study. Sixty-six percent of mothers and neonates carried the A allele (being AA or AT). TT mothers gained less weight during pregnancy, but non-significant maternal gene influence was found for neonatal bodyweight, body mass index, or ponderal index. Neonates from AA + AT mothers showed lower glucose, insulin, and homeostatic model assessment insulin resistance (HOMA-IR) but higher homeostatic model assessment insulin sensitivity (HOMA-IS) and homocysteine than neonates whose mothers were TT. AA + AT neonates had higher insulin and HOMA-IR than TT. The genotype neonatal × maternal association was tested in the following four groups of neonates: TT neonates × TT mothers (nTT × mTT), TT neonates × AA + AT mothers (nTT × mAA + AT), AA + AT neonates × TT mothers (nAA + AT × mTT), and AA + AT neonates × AA + AT mothers (nAA + AT × mAA + AT). Non-significant interactions between neonatal and maternal alleles were found for any parameter tested. However, maternal alleles affected significantly glucose, insulin, HOMA-IR, and homocysteine while neonatal alleles the arylesterase activity. Most significant differences were found between nATT + AA × mTT and nATT + AA × mAA + AT. Glycemia, insulinemia, and HOMA-IR were lower, while the Mediterranean diet adherence (MDA) was higher in the mAA + AT vs. mTT whose children were AA + AT. This dietary fact seems to counterbalance the potential negative effect on glucose homeostasis of the obesogenic A allele in neonates.

Cord Blood Insulin Levels: It's Correlation with Gender, Birth Weight and Placental Weight in Term Newborns

The cause of more insulin resistance in female than males are still unknown. To know the cause from early life, normal values of relevant parameters are required. So, aim of this study was to determine the reference levels of glucose and insulin in cord blood of term newborns and to examine their effects on gender, placental and birth weight of term newborns. In cross sectional study 60 consecutive term newborns were included from constituent hospitals. Placental and birth weights were measured and cord blood was collected for estimation of serum insulin and plasma glucose. Plasma glucose estimation was done by auto analyzer (GOD-POD method) and serum insulin analysis was done using Insulin ELISA Kit. After analysis, mean ± 2SD used for estimating cord blood insulin and glucose levels, which were 10.1 ± 7.8 μIU/mL and 67.8 ± 33.8 mg/dL respectively. Correlation of insulin with both birth weight and placental weight were r = 0.359 and 0.41 respectively; p < 0.001. Interestingly we found higher insulin levels in females as compared to male newborns in spite of having lower birth weight in them. In conclusion this study reported the levels of insulin and glucose in cord blood of term newborns. Incidentally, this is the first study as per our knowledge to report significant correlation between cord blood insulin, glucose with birth weight, placental weight and gender in south India. Female newborns had higher insulin levels than males, despite lesser birth weight can be attributed to intrinsic insulin resistance in them.

Adherence to Mediterranean diet during pregnancy and serum lipid, lipoprotein and homocysteine concentrations at birth

BACKGROUND

Mediterranean diet consumption is associated to low prevalence of major degenerative diseases. Low Mediterranean-diet-adherence (MDA) score has been related to high insulin and homeostatic model assessment-insulin resistance levels at birth. The relationship between maternal MDA and offspring lipoprotein profile at birth has been scarcely reported.

METHODS

Cross-sectional study aimed to study the relationship between pregnancy diet quality and serum lipid, arylesterase and homocysteine values at birth. Cord blood of the offspring of 35 women whose diets were classified as "adequate" or "inadequate" according to their 13-point MDA-score (≥7 or <7, respectively) were studied.

RESULTS

MDA-scores did not significantly change through pregnancy. Low-MDA-score diets presented a higher atherogenic index, contained less fiber and folates, and had a lower (polyunsaturated + monounsaturated)/saturated fatty acids (PUFA + MUFA/SFA) ratio, more cholesterol, and higher SFA/carbohydrates (SFA/CHO) and ω-6/ω-3 PUFA ratios than their respective high-MDA-score counterparts. Mothers at the low MDA-score delivered neonates with high LDL-c (P = 0.049), Apo B (P = 0.040), homocysteine (P = 0.026) and Apo A1/Apo B ratio (P = 0.024).

CONCLUSIONS

Neonates whose mothers consumed low MDA diets presented impaired lipoprotein and increased homocysteine levels at birth. A follow-up study on early cardiovascular disease prevention is needed to understand the importance of present findings later in life.