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Schultz K, Ha S, Williams AD. Gestational Diabetes and Subsequent Metabolic Dysfunction: An National Health and Nutrition Examination Survey Analysis (2011-2018). Metab Syndr Relat Disord 2024; 22:479-486. [PMID: 38634824 DOI: 10.1089/met.2023.0269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2024] Open
Abstract
Background: Gestational diabetes mellitus (GDM) complicates ∼10% of pregnancies, with the highest rates among Asian women. Evidence suggests that GDM is associated with an increased risk for future chronic health conditions, yet data for Asian women are sparse. We explored the association between prior GDM and metabolic dysfunction with nationally representative data to obtain Asian-specific estimates. Methods: For this cross-sectional study, data were drawn from the National Health and Nutrition Examination Survey for 7195 women with a prior pregnancy. GDM (yes/no) was defined using the question "During pregnancy, were you ever told by a doctor or other health professional that you had diabetes, sugar diabetes, or gestational diabetes?." Current metabolic dysfunction (yes/no) was based on having at least one of four indicators: systolic blood pressure (SBP, ≥130 mmHg), waist circumference (≥88 cm), high-density lipoprotein (HDL) cholesterol (<50 mg/dL), and glycosylated hemoglobin (HbA1c) (≥6.5%). Logistic regression estimated odds ratios (ORs) and 95% confidence intervals (CIs) for the association between prior GDM and metabolic outcomes, overall and by race. Models included sampling weights and demographic and behavioral factors. Results: Overall, women with prior GDM had 46% greater odds of high waist circumference (OR: 1.5; 95% CI: 1.1-2.0) and 200% greater odds (OR: 3.0; 95% CI: 2.1-4.2) of high HbA1c. Prior GDM was not associated with high blood pressure or low HDL cholesterol. In race-specific analyses, prior GDM was associated with increased risk of elevated HbA1c among Asian (OR: 6.6; 95% CI: 2.5-17.2), Mexican American (OR: 3.0; 95% CI: 1.5-5.8), Black (OR: 3.0; 95% CI: 1.7-5.5), and White (OR: 2.6; 95% CI: 1.5-4.6) women. Prior GDM was associated with elevated SBP among Mexican American women and low HDL among Black women. Discussion: Prior GDM is associated with elevated HbA1c among all women, yet is a stronger predictor of elevated HbA1c among Asian women than other women. Race-specific associations between prior GDM and metabolic dysfunction were observed among Mexican American and Black women. Further research is warranted to understand the observed race/ethnic-specific associations.
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Affiliation(s)
- Kelly Schultz
- Public Health Program, Department of Population Health, School of Medicine and Health Sciences, University of North Dakota, Grand Forks, North Dakota, USA
| | - Sandie Ha
- Department of Public Health, School of Social Sciences Humanities and Arts, Health Science Research Institute, University of California Merced, Merced, California, USA
| | - Andrew D Williams
- Public Health Program, Department of Population Health, School of Medicine and Health Sciences, University of North Dakota, Grand Forks, North Dakota, USA
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Li C, Shi H. Inositol supplementation for the prevention and treatment of gestational diabetes mellitus: a meta-analysis of randomized controlled trials. Arch Gynecol Obstet 2024; 309:1959-1969. [PMID: 37308791 DOI: 10.1007/s00404-023-07100-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 06/05/2023] [Indexed: 06/14/2023]
Abstract
BACKGROUND Inositol is a potential new therapeutic agent for gestational diabetes mellitus (GDM), but its effectiveness is still controversial. The aim of the report was to evaluate the effectiveness of inositol to preventing or reducing the severity of GDM. METHODS We searched PubMed, EmBase, Web of science, Cochrane library databases, Clinicaltrials.gov, and International Clinical Trials Registry Platform for randomized controlled trials (RCTs) assessing the effectiveness of inositol supplementation to prevent and treat GDM. This meta-analysis was performed using the random-effects model. RESULTS A total of 7 RCTs (1319 pregnant women at high risk of GDM) were included in the meta-analysis. The meta-analysis found that inositol supplementation resulted in a significantly lower incidence of GDM in the inositol versus the control group (odds ratio [OR] 0.40; 95% confidence interval [CI] 0.24-0.67; P = 0.0005). The inositol group had improved fasting glucose oral glucose tolerance test (FG OGTT; mean difference [MD] = - 3.20; 95% CI - 4.45 to - 1.95; P < 0.00001), 1-h OGTT (MD = - 7.24; 95% CI - 12.23 to - 2.25; P = 0.004), and 2-h OGTT (MD = - 7.15; 95% CI - 12.86 to - 1.44; P = 0.01) results. Inositol also reduced the risk of pregnancy-induced hypertension (OR 0.37; 95% CI 0.18-0.75; P = 0.006) and preterm birth (OR 0.35; 95% CI 0.18-0.69; P = 0.003). A meta-analysis of 4 RCTs including 320 GDM patients showed that the patients' insulin resistance (P < 0.05) and neonatal hypoglycemia risk (OR 0.10, 95% CI 0.01-0.88; P = 0.04) were lower in the inositol than in the control group. CONCLUSIONS Inositol supplementation during pregnancy has the potential to prevent GDM, improve glycemic control, and reduce preterm birth rates.
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Affiliation(s)
- Chaolin Li
- Jinniu District Maternal and Child Health Hospital, Chengdu, 610000, China
| | - Hao Shi
- Department of Pediatrics, Jinniu District Maternal and Child Health Hospital, Chengdu, 610000, China.
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Tranidou A, Magriplis E, Apostolopoulou A, Tsakiridis I, Chroni V, Tsekitsidi E, Kalaitzopoulou I, Pazaras N, Chourdakis M, Dagklis T. Impact of Maternal Micronutrient Intake on Gestational Diabetes Risk: Results from Greece's BORN2020 Prospective Cohort Study. Nutrients 2024; 16:1375. [PMID: 38732620 PMCID: PMC11085310 DOI: 10.3390/nu16091375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2024] [Revised: 04/28/2024] [Accepted: 04/29/2024] [Indexed: 05/13/2024] Open
Abstract
Understanding how maternal micronutrient intake and dietary habits impact gestational diabetes mellitus (GDM) is crucial. Data from 797 pregnant women were prospectively analyzed to assess GDM status with the oral glucose tolerance test (OGTT). Nutritional intake was evaluated using a validated food frequency questionnaire (FFQ) across two periods: Period A, covering 6 months before pregnancy, and Period B, from pregnancy onset to mid-gestation (24 weeks). Micronutrient intakes were compared against the European Food Safety Authority (EFSA) dietary reference values (DRVs) and were used to estimate the mean adequacy ratio (MAR) to assess dietary adequacy. GDM was diagnosed in 14.7% (n = 117) of women with the characteristics of a higher mean maternal age (MA) and pre-pregnancy body mass index (BMI). Out of the 13 vitamins assessed, biotin, folate, niacin, and pantothenic acid were found significantly higher in the GDM group, as did iron, magnesium, manganese, phosphorus, and zinc from the 10 minerals. The results were influenced by the timing of the assessment. Importantly, MAR was higher during pregnancy and was found to increase the risk of GDM by 1% (95%CI: 1, 1.02). A sensitivity analysis revealed that reducing MAR significantly raised the GDM risk by 68% (95%CI: 1.02, 2.79). No association was revealed between adherence to the Mediterranean diet (MD) and GDM risk. These findings highlight areas for further investigation into whether dietary modifications involving these specific micronutrients could effectively influence GDM outcomes.
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Affiliation(s)
- Antigoni Tranidou
- 3rd Department of Obstetrics and Gynecology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece; (A.T.); (I.T.)
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece; (A.A.); (V.C.); (E.T.); (I.K.); (N.P.)
| | - Emmanuella Magriplis
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Iera Odos 75, 118 55 Athens, Greece;
| | - Aikaterini Apostolopoulou
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece; (A.A.); (V.C.); (E.T.); (I.K.); (N.P.)
| | - Ioannis Tsakiridis
- 3rd Department of Obstetrics and Gynecology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece; (A.T.); (I.T.)
| | - Violeta Chroni
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece; (A.A.); (V.C.); (E.T.); (I.K.); (N.P.)
| | - Eirini Tsekitsidi
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece; (A.A.); (V.C.); (E.T.); (I.K.); (N.P.)
| | - Ioustini Kalaitzopoulou
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece; (A.A.); (V.C.); (E.T.); (I.K.); (N.P.)
| | - Nikolaos Pazaras
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece; (A.A.); (V.C.); (E.T.); (I.K.); (N.P.)
| | - Michail Chourdakis
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece; (A.A.); (V.C.); (E.T.); (I.K.); (N.P.)
| | - Themistoklis Dagklis
- 3rd Department of Obstetrics and Gynecology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece; (A.T.); (I.T.)
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Daly BM, Wu Z, Nirantharakumar K, Chepulis L, Rowan JA, Scragg RKR. Increased risk of cardiovascular and renal disease, and diabetes for all women diagnosed with gestational diabetes mellitus in New Zealand-A national retrospective cohort study. J Diabetes 2024; 16:e13535. [PMID: 38599878 PMCID: PMC11006618 DOI: 10.1111/1753-0407.13535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 12/21/2023] [Accepted: 01/08/2024] [Indexed: 04/12/2024] Open
Abstract
BACKGROUND Gestational diabetes mellitus increases the risk of developing type 2 diabetes. The aim of this study is to compare cardiometabolic and renal outcomes for all women in New Zealand with gestational diabetes (2001-2010) with women without diabetes, 10-20 years following delivery. METHODS A retrospective cohort study, utilizing a national dataset providing information for all women who gave birth between 1 January 2001 and 31 December 2010 (n = 604 398). Adolescent girls <15 years, women ≥50 years and women with prepregnancy diabetes were excluded. In total 11 459 women were diagnosed with gestational diabetes and 11 447 were matched (for age and year of delivery) with 57 235 unexposed (control) women. A national hospital dataset was used to compare primary outcomes until 31 May 2021. RESULTS After controlling for ethnicity, women with gestational diabetes were significantly more likely than control women to develop diabetes-adjusted hazard ratio (HR) 20.06 and 95% confidence interval (CI) 18.46-21.79; a first cardiovascular event 2.19 (1.86-2.58); renal disease 6.34 (5.35-7.51) and all-cause mortality 1.55 (1.31-1.83), all p values <.0001. The HR and 95% CI remained similar after controlling for significant covariates: diabetes 18.89 (17.36-20.56), cardiovascular events 1.79 (1.52-2.12), renal disease 5.42 (4.55-6.45), and all-cause mortality 1.44 (1.21-1.70). When time-dependent diabetes was added to the model, significance remained for cardiovascular events 1.33 (1.10-1.61), p = .003 and renal disease 2.33 (1.88-2.88), p < .0001 but not all-cause mortality. CONCLUSIONS Women diagnosed with gestational diabetes have an increased risk of adverse cardiometabolic and renal outcomes. Findings highlight the importance of follow-up screening for diabetes, cardiovascular risk factors, and renal disease.
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Affiliation(s)
- Barbara M. Daly
- Faculty of Medical and Health SciencesUniversity of AucklandAucklandNew Zealand
| | - Zhenqiang Wu
- Department of Geriatric MedicineUniversity of AucklandAucklandNew Zealand
| | - Krishnarajah Nirantharakumar
- Professor in Health Data Science and Public Health, Institute of Applied Health ResearchUniversity of BirminghamBirminghamUK
| | - Lynne Chepulis
- School of HealthUniversity of WaikatoHamiltonWaikatoNew Zealand
| | - Janet A. Rowan
- National Women Health at Auckland City HospitalAucklandNew Zealand
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Christensen MH, Bistrup C, Rubin KH, Nohr EA, Vinter CA, Andersen MS, Möller S, Jensen DM. Kidney Disease in Women With Previous Gestational Diabetes Mellitus: A Nationwide Register-Based Cohort Study. Diabetes Care 2024; 47:401-408. [PMID: 38100751 DOI: 10.2337/dc23-1092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 12/01/2023] [Indexed: 12/17/2023]
Abstract
OBJECTIVE The association between gestational diabetes mellitus (GDM) and incident kidney disease, the mediating effects of diabetes and hypertension, and the impact of severity of metabolic dysfunction during pregnancy on the risk of incident kidney disease were investigated in this study. RESEARCH DESIGN AND METHODS This Danish, nationwide, register-based cohort study included all women giving birth between 1997 and 2018. Outcomes included chronic kidney disease (CKD) and acute kidney disease, based on diagnosis codes. Cox regression analyses explored the association between GDM and kidney disease. A proxy for severity of metabolic dysfunction during pregnancy was based on GDM diagnosis and insulin treatment during GDM in pregnancy and was included in the models as an interaction term. The mediating effects of subsequent diabetes and hypertension prior to kidney disease were quantified using mediation analyses. RESULTS Data from 697,622 women were used. Median follow-up was 11.9 years. GDM was associated with higher risk of CKD (adjusted hazard ratio [aHR] 1.92; 95% CI 1.67-2.21), whereas acute kidney disease was unrelated to GDM. The proportions of indirect effects of diabetes and hypertension on the association between GDM and CKD were 75.7% (95% CI 61.8-89.6) and 30.3% (95% CI 25.2-35.4), respectively, as assessed by mediation analyses. The CKD risk was significantly increased in women with insulin-treated GDM and no subsequent diabetes compared with women without GDM (aHR 2.35; 95% CI 1.39-3.97). CONCLUSIONS The risk of CKD was significantly elevated after GDM irrespective of subsequent development of diabetes and hypertension. Furthermore, women with severe metabolic dysfunction during pregnancy had the highest CKD risk.
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Affiliation(s)
- Maria Hornstrup Christensen
- Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark
- Department of Gynecology and Obstetrics, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Claus Bistrup
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Nephrology, Odense University Hospital, Odense, Denmark
| | - Katrine Hass Rubin
- Research Unit Open Patient data Explorative Network (OPEN), Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- OPEN, Odense University Hospital, Odense, Denmark
| | - Ellen Aagaard Nohr
- Department of Gynecology and Obstetrics, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Christina Anne Vinter
- Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark
- Department of Gynecology and Obstetrics, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Marianne Skovsager Andersen
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Endocrinology, Odense University Hospital, Odense, Denmark
| | - Sören Möller
- Research Unit Open Patient data Explorative Network (OPEN), Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- OPEN, Odense University Hospital, Odense, Denmark
| | - Dorte Moeller Jensen
- Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark
- Department of Gynecology and Obstetrics, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
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6
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Bartáková V, Chalásová K, Pácal L, Ťápalová V, Máchal J, Janků P, Kaňková K. Metabolic Syndrome Prevalence in Women with Gestational Diabetes Mellitus in the Second Trimester of Gravidity. J Clin Med 2024; 13:1260. [PMID: 38592122 PMCID: PMC10932344 DOI: 10.3390/jcm13051260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 02/17/2024] [Accepted: 02/21/2024] [Indexed: 04/10/2024] Open
Abstract
Background: Women with gestational diabetes (GDM) have an increased risk of metabolic syndrome (MS) after delivery. MS could precede gravidity. The aims of this study were (i) to detect the prevalence of MS in women at the time of GDM diagnosis, (ii) to detect the prevalence of MS in the subgroup of GDM patients with any form of impaired glucose tolerance after delivery (PGI), and (iii) to determine whether GDM women with MS have a higher risk of peripartal adverse outcomes. Methods: A cross-sectional observational study comprised n = 455 women with GDM. International Diabetes Federation (IDF) criteria for MS definition were modified to the pregnancy situation. Results: MS was detected in 22.6% of GDM patients in those with PGI 40%. The presence of MS in GDM patients was associated with two peripartal outcomes: higher incidence of pathologic Apgar score and macrosomia (p = 0.01 resp. p = 0.0004, chi-square). Conclusions: The presence of MS in GDM patients is a statistically significant risk factor (p = 0.04 chi-square) for PGI. A strong clinical implication of our findings might be to include MS diagnostics within GDM screening using modified MS criteria in the second trimester of pregnancy.
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Affiliation(s)
- Vendula Bartáková
- Department of Pathophysiology, Faculty of Medicine, Masaryk University, 62500 Brno, Czech Republic (L.P.); (J.M.); (K.K.)
| | - Katarína Chalásová
- Department of Pathophysiology, Faculty of Medicine, Masaryk University, 62500 Brno, Czech Republic (L.P.); (J.M.); (K.K.)
| | - Lukáš Pácal
- Department of Pathophysiology, Faculty of Medicine, Masaryk University, 62500 Brno, Czech Republic (L.P.); (J.M.); (K.K.)
| | - Veronika Ťápalová
- Department of Obstetrics and Gynaecology, University Hospital Brno, 66263 Brno, Czech Republic; (V.Ť.); (P.J.)
| | - Jan Máchal
- Department of Pathophysiology, Faculty of Medicine, Masaryk University, 62500 Brno, Czech Republic (L.P.); (J.M.); (K.K.)
| | - Petr Janků
- Department of Obstetrics and Gynaecology, University Hospital Brno, 66263 Brno, Czech Republic; (V.Ť.); (P.J.)
| | - Kateřina Kaňková
- Department of Pathophysiology, Faculty of Medicine, Masaryk University, 62500 Brno, Czech Republic (L.P.); (J.M.); (K.K.)
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7
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Wambua S, Singh M, Okoth K, Snell KIE, Riley RD, Yau C, Thangaratinam S, Nirantharakumar K, Crowe FL. Association between pregnancy-related complications and development of type 2 diabetes and hypertension in women: an umbrella review. BMC Med 2024; 22:66. [PMID: 38355631 PMCID: PMC10865714 DOI: 10.1186/s12916-024-03284-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 02/02/2024] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND Despite many systematic reviews and meta-analyses examining the associations of pregnancy complications with risk of type 2 diabetes mellitus (T2DM) and hypertension, previous umbrella reviews have only examined a single pregnancy complication. Here we have synthesised evidence from systematic reviews and meta-analyses on the associations of a wide range of pregnancy-related complications with risk of developing T2DM and hypertension. METHODS Medline, Embase and Cochrane Database of Systematic Reviews were searched from inception until 26 September 2022 for systematic reviews and meta-analysis examining the association between pregnancy complications and risk of T2DM and hypertension. Screening of articles, data extraction and quality appraisal (AMSTAR2) were conducted independently by two reviewers using Covidence software. Data were extracted for studies that examined the risk of T2DM and hypertension in pregnant women with the pregnancy complication compared to pregnant women without the pregnancy complication. Summary estimates of each review were presented using tables, forest plots and narrative synthesis and reported following Preferred Reporting Items for Overviews of Reviews (PRIOR) guidelines. RESULTS Ten systematic reviews were included. Two pregnancy complications were identified. Gestational diabetes mellitus (GDM): One review showed GDM was associated with a 10-fold higher risk of T2DM at least 1 year after pregnancy (relative risk (RR) 9.51 (95% confidence interval (CI) 7.14 to 12.67) and although the association differed by ethnicity (white: RR 16.28 (95% CI 15.01 to 17.66), non-white: RR 10.38 (95% CI 4.61 to 23.39), mixed: RR 8.31 (95% CI 5.44 to 12.69)), the between subgroups difference were not statistically significant at 5% significance level. Another review showed GDM was associated with higher mean blood pressure at least 3 months postpartum (mean difference in systolic blood pressure: 2.57 (95% CI 1.74 to 3.40) mmHg and mean difference in diastolic blood pressure: 1.89 (95% CI 1.32 to 2.46) mmHg). Hypertensive disorders of pregnancy (HDP): Three reviews showed women with a history of HDP were 3 to 6 times more likely to develop hypertension at least 6 weeks after pregnancy compared to women without HDP (meta-analysis with largest number of studies: odds ratio (OR) 4.33 (3.51 to 5.33)) and one review reported a higher rate of T2DM after HDP (hazard ratio (HR) 2.24 (1.95 to 2.58)) at least a year after pregnancy. One of the three reviews and five other reviews reported women with a history of preeclampsia were 3 to 7 times more likely to develop hypertension at least 6 weeks postpartum (meta-analysis with the largest number of studies: OR 3.90 (3.16 to 4.82) with one of these reviews reporting the association was greatest in women from Asia (Asia: OR 7.54 (95% CI 2.49 to 22.81), Europe: OR 2.19 (95% CI 0.30 to 16.02), North and South America: OR 3.32 (95% CI 1.26 to 8.74)). CONCLUSIONS GDM and HDP are associated with a greater risk of developing T2DM and hypertension. Common confounders adjusted for across the included studies in the reviews were maternal age, body mass index (BMI), socioeconomic status, smoking status, pre-pregnancy and current BMI, parity, family history of T2DM or cardiovascular disease, ethnicity, and time of delivery. Further research is needed to evaluate the value of embedding these pregnancy complications as part of assessment for future risk of T2DM and chronic hypertension.
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Affiliation(s)
- Steven Wambua
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, UK.
| | - Megha Singh
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, UK
| | - Kelvin Okoth
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, UK
| | - Kym I E Snell
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, UK
| | - Richard D Riley
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, UK
| | - Christopher Yau
- Big Data Institute, University of Oxford, Li Ka Shing Centre for Health Information and Discovery, Old Road Campus, Oxford, OX3 7LF, UK
- Nuffield Department of Women's & Reproductive Health, University of Oxford, Level 3 Women's Centre, John Radcliffe Hospital, Oxford, OX3 9DU, UK
- Health Data Research, London, UK
| | - Shakila Thangaratinam
- WHO Collaborating Centre for Global Women's Health, Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK
- Department of Obstetrics and Gynaecology, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | - Krishnarajah Nirantharakumar
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, UK
| | - Francesca L Crowe
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, UK
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8
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Tranidou A, Tsakiridis I, Apostolopoulou A, Xenidis T, Pazaras N, Mamopoulos A, Athanasiadis A, Chourdakis M, Dagklis T. Prediction of Gestational Diabetes Mellitus in the First Trimester of Pregnancy Based on Maternal Variables and Pregnancy Biomarkers. Nutrients 2023; 16:120. [PMID: 38201950 PMCID: PMC10780503 DOI: 10.3390/nu16010120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Revised: 12/26/2023] [Accepted: 12/27/2023] [Indexed: 01/12/2024] Open
Abstract
Gestational diabetes mellitus (GDM) is a significant health concern with adverse outcomes for both pregnant women and their offspring. Recognizing the need for early intervention, this study aimed to develop an early prediction model for GDM risk assessment during the first trimester. Utilizing a prospective cohort of 4917 pregnant women from the Third Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Greece, the study sought to combine maternal characteristics, obstetric and medical history, and early pregnancy-specific biomarker concentrations into a predictive tool. The primary objective was to create a series of predictive models that could accurately identify women at high risk for developing GDM, thereby facilitating early and targeted interventions. To this end, maternal age, body mass index (BMI), obstetric and medical history, and biomarker concentrations were analyzed and incorporated into five distinct prediction models. The study's findings revealed that the models varied in effectiveness, with the most comprehensive model combining maternal characteristics, obstetric and medical history, and biomarkers showing the highest potential for early GDM prediction. The current research provides a foundation for future studies to refine and expand upon the predictive models, aiming for even earlier and more accurate detection methods.
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Affiliation(s)
- Antigoni Tranidou
- 3rd Department of Obstetrics and Gynecology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece; (A.T.); (I.T.); (T.X.); (A.M.); (A.A.)
| | - Ioannis Tsakiridis
- 3rd Department of Obstetrics and Gynecology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece; (A.T.); (I.T.); (T.X.); (A.M.); (A.A.)
| | - Aikaterini Apostolopoulou
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (A.A.); (N.P.); (M.C.)
| | - Theodoros Xenidis
- 3rd Department of Obstetrics and Gynecology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece; (A.T.); (I.T.); (T.X.); (A.M.); (A.A.)
| | - Nikolaos Pazaras
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (A.A.); (N.P.); (M.C.)
| | - Apostolos Mamopoulos
- 3rd Department of Obstetrics and Gynecology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece; (A.T.); (I.T.); (T.X.); (A.M.); (A.A.)
| | - Apostolos Athanasiadis
- 3rd Department of Obstetrics and Gynecology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece; (A.T.); (I.T.); (T.X.); (A.M.); (A.A.)
| | - Michail Chourdakis
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (A.A.); (N.P.); (M.C.)
| | - Themistoklis Dagklis
- 3rd Department of Obstetrics and Gynecology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece; (A.T.); (I.T.); (T.X.); (A.M.); (A.A.)
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9
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Zhao L, Chang Q, Cong Z, Zhang Y, Liu Z, Zhao Y. Effects of dietary polyphenols on maternal and fetal outcomes in maternal diabetes. Food Funct 2023; 14:8692-8710. [PMID: 37724008 DOI: 10.1039/d3fo02048g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/20/2023]
Abstract
The incidences of short-term or long-term adverse maternal and fetal outcomes caused by maternal diabetes are increasing. Due to toxicity or side effects, economic pressures, and other problems associated with injections or oral hypoglycemic drugs, many researchers have investigated natural treatment methods. Polyphenols can protect against chronic pathologies by regulating numerous physiological processes and provide many health benefits. Moreover, polyphenols have anti-diabetic properties and can be used to treat diabetic complications. Diets rich in polyphenols are beneficial to pregnant women with diabetes. Here, we review the epidemiological and experimental evidence on the impact of dietary polyphenols on maternal and fetal outcomes in pregnant women with diabetes, and the effects of polyphenols on biological changes and possible mechanisms. Previous data (mainly from in vitro and animal experiments) showed that polyphenols can alleviate gestational diabetes mellitus and diabetic embryopathy by reducing maternal hyperglycemia and insulin resistance, alleviating inflammation and oxidative stress, and regulating related signaling pathways. Although polyphenols have shown many health benefits, further research is needed to better understand the complex interactions between polyphenols and maternal diabetes.
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Affiliation(s)
- Lu Zhao
- Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Shengjing Hospital of China Medical University, Shenyang, China.
| | - Qing Chang
- Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Shengjing Hospital of China Medical University, Shenyang, China.
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Zhangzhao Cong
- Department of Teaching Affairs, China Medical University, Shenyang, China
| | - Yalin Zhang
- Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Shengjing Hospital of China Medical University, Shenyang, China.
| | - Zhuxi Liu
- Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Shengjing Hospital of China Medical University, Shenyang, China.
| | - Yuhong Zhao
- Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Shengjing Hospital of China Medical University, Shenyang, China.
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
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10
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Marschner S, Mukherjee S, Watts M, Min H, Beale AL, O'Brien J, Juneja A, Tremmel JA, Zaman S. Prevention of Cardiovascular Disease in Women With Pregnancy-Related Risk Factors: A Prospective Women's Heart Clinic Study. J Am Heart Assoc 2023; 12:e030015. [PMID: 37642017 PMCID: PMC10547318 DOI: 10.1161/jaha.123.030015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 06/20/2023] [Indexed: 08/31/2023]
Abstract
Background Hypertensive disorders of pregnancy, gestational diabetes, and having a small-for-gestational-age baby are known to substantially increase a woman's risk of cardiovascular disease. Despite this, evidence for models of care that mitigate cardiovascular disease risk in women with these pregnancy-related conditions is lacking. Methods and Results A 6-month prospective cohort study assessed the effectiveness of a multidisciplinary Women's Heart Clinic on blood pressure and lipid control in women aged 30 to 55 years with a past pregnancy diagnosis of hypertensive disorders of pregnancy, gestational diabetes, or a small-for-gestational age baby in Melbourne, Australia. The co-primary end points were (1) blood pressure <140/90 mm Hg or <130/80 mm Hg if diabetes and (2) total cholesterol to high-density lipoprotein cholesterol ratio <4.5. The study recruited 156 women with a mean age of 41.0±4.2 years, 3.9±2.9 years from last delivery, 68.6% White, 20.5% South/East Asian, and 80.5% university-educated. The proportion meeting blood pressure target increased (69.2% to 80.5%, P=0.004), with no significant change in lipid targets (80.6% to 83.7%, P=0.182). Systolic blood pressure (-6.9 mm Hg [95% CI, -9.1 to -4.7], P<0.001), body mass index (-0.6 kg/m2 [95% CI, -0.8 to -0.3], P<0.001), low-density lipoprotein cholesterol (-4.2 mg/dL [95% CI, -8.2 to -0.2], P=0.042), and total cholesterol (-4.6 mg/dL [95% CI, -9.1 to -0.2] P=0.042) reduced. Heart-healthy lifestyle significantly improved with increased fish/olive oil (36.5% to 51.0%, P=0.012), decreased fast food consumption (33.8% to 11.0%, P<0.001), and increased physical activity (84.0% to 92.9%, P=0.025). Conclusions Women at high risk for cardiovascular disease due to past pregnancy-related conditions experienced significant improvements in multiple cardiovascular risk factors after attending a Women's Heart Clinic, potentially improving long-term cardiovascular disease outcomes. Registration URL: https://www.anzctr.org.au; Unique identifier: ACTRN12622000646741.
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Affiliation(s)
- Simone Marschner
- Westmead Applied Research Centre, Faculty of Medicine and HealthThe University of SydneySydneyAustralia
| | - Swati Mukherjee
- Department of CardiologyCabrini HealthMelbourneAustralia
- Department of CardiologyAlfred HospitalMelbourneAustralia
- Faculty of Medicine, Nursing & Health SciencesMonash UniversityMelbourneAustralia
| | - Monique Watts
- Department of CardiologyAlfred HospitalMelbourneAustralia
- Faculty of Medical EducationUniversity of MelbourneMelbourneAustralia
| | - Haeri Min
- Westmead Applied Research Centre, Faculty of Medicine and HealthThe University of SydneySydneyAustralia
| | - Anna L. Beale
- Department of CardiologyAlfred HospitalMelbourneAustralia
| | | | - Aashima Juneja
- Department of MedicineThe Northern HospitalMelbourneAustralia
| | - Jennifer A. Tremmel
- Department of Medicine (Cardiovascular)Stanford University School of MedicineStanfordCA
| | - Sarah Zaman
- Westmead Applied Research Centre, Faculty of Medicine and HealthThe University of SydneySydneyAustralia
- School of Clinical Sciences at Monash HealthMonash UniversityMelbourneAustralia
- Department of CardiologyWestmead HospitalSydneyAustralia
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11
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Marschner S, Pant A, Henry A, Maple‐Brown LJ, Moran L, Cheung NW, Chow CK, Zaman S. Cardiovascular risk management following gestational diabetes and hypertensive disorders of pregnancy: a narrative review. Med J Aust 2023; 218:484-491. [PMID: 37149790 PMCID: PMC10953444 DOI: 10.5694/mja2.51932] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 03/21/2023] [Accepted: 03/24/2023] [Indexed: 05/08/2023]
Affiliation(s)
| | - Anushriya Pant
- Westmead Applied Research CentreUniversity of SydneySydneyNSW
| | - Amanda Henry
- University of New South WalesSydneyNSW
- St George HospitalSydneyNSW
| | - Louise J Maple‐Brown
- Diabetes across the Lifecourse: Northern Australia Partnership, Menzies School of Health ResearchDarwinNT
- Royal Darwin HospitalDarwinNT
| | - Lisa Moran
- Monash Centre for Health Research and ImplementationMonash UniversityMelbourneVIC
- Monash HealthMelbourneVIC
| | - N Wah Cheung
- Westmead Applied Research CentreUniversity of SydneySydneyNSW
- Westmead HospitalSydneyNSW
| | - Clara K Chow
- Westmead Applied Research CentreUniversity of SydneySydneyNSW
- Westmead HospitalSydneyNSW
| | - Sarah Zaman
- Westmead Applied Research CentreUniversity of SydneySydneyNSW
- Westmead HospitalSydneyNSW
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12
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Ray JG, Cohen E, Butler EA, Grandi S, Park A. Indicators of Cardiometabolic Function in Pregnancy and Long-Term Risk of COVID-19: Population-Based Cohort Study. Cureus 2023; 15:e35325. [PMID: 36968929 PMCID: PMC10038685 DOI: 10.7759/cureus.35325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/17/2023] [Indexed: 02/24/2023] Open
Abstract
BACKGROUND Pregnancy increases a woman's susceptibility to severe COVID-19, especially those with metabolic dysfunction. It is unknown if markers of metabolic dysfunction commonly assessed around pregnancy are associated with COVID-19 illness after pregnancy. AIM The aim of this study is to evaluate the indicators of metabolic dysfunction collected in pregnancy and the future risk of severe COVID-19 after pregnancy. METHODS This population-based cohort study was completed in all of Ontario, comprising 417,713 women aged 15-49 years with a hospital birth between April 2007 and March 2018. The main exposure was each 1-kg/m2 higher body mass index (BMI), 1-mmol/L higher glucose concentration at the 50-g glucose challenge test, and one-week earlier gestational week at delivery. The main outcome was severe COVID-19 illness or death, from the start of the pandemic period on March 1, 2020, till December 31, 2021. RESULTS The adjusted hazard ratio (aHR) of COVID-19 illness increased per 1-kg/m2 higher BMI (1.05, 95% CI 1.04-1.06), per 1-mmol/L higher serum glucose concentration (1.16, 95% CI 1.10-1.22), and for each one-week earlier gestational week at delivery (1.12, 95% CI 1.03-1.23). Relative to women with no dichotomized risk factors, the aHR for severe COVID-19 was 1.60 (95% CI 1.28-2.01) with one factor, 3.34 (95% CI 2.51-4.44) with two factors, and 4.52 (95% CI 2.11-9.67) with three factors. CONCLUSIONS The number, and degree, of standard metabolic indicators measured around pregnancy predict the future risk of severe COVID-19 remotely after that pregnancy.
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13
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Tranidou A, Magriplis E, Tsakiridis I, Pazaras N, Apostolopoulou A, Chourdakis M, Dagklis T. Effect of Gestational Weight Gain during the First Half of Pregnancy on the Incidence of GDM, Results from a Pregnant Cohort in Northern Greece. Nutrients 2023; 15:nu15040893. [PMID: 36839252 PMCID: PMC9964795 DOI: 10.3390/nu15040893] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 02/01/2023] [Accepted: 02/07/2023] [Indexed: 02/12/2023] Open
Abstract
The aim of this study was to evaluate the effect of gestational weight gain (GWG) up to 23+6 weeks of gestation on the incidence of Gestational Diabetes Mellitus (GDM). A pregnant cohort of 5948 women in Northern Greece was recruited. Anthropometric features before and during pregnancy were recorded, the GWG by 23+6 weeks was calculated and a Generalized Linear Regression Model (GLM) with subgroup analyses based on weight status were computed. GDM was diagnosed in 5.5% of women. GLM results showed that GDM likelihood increased with maternal age (MA) and pre-pregnancy BMI (aOR: 1.08, 95%CI: [1.06, 1.11] and aOR: 1.09, 95%CI: [1.09, 1.11], respectively). Ιn the normal pre-pregnancy weight group, when the extra weight gain was >8 kgs, the odds of GDM increased (OR: 2.13, 95%CI: [0.98, 4.21], p = 0.03). Women with pre-pregnancy level 2 clinical obesity (OB2 pre) (BMI > 35 and <40 kg/m2) that shifted to OB3 category (BMI ≥ 40 kg/m2) had an increased GDM likelihood (OR: 4.85, 95%CI: [1.50, 15.95]). Women of higher MA may require stricter monitoring for GDM from early pregnancy, while in obese women, recommended GWG may need to be re-evaluated, since refraining from any weight gain may have a preventive effect for GDM.
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Affiliation(s)
- Antigoni Tranidou
- 3rd Department of Obstetrics and Gynaecology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 546 42 Thessaloniki, Greece
| | - Emmanuela Magriplis
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Iera Odos 75, 118 55 Athens, Greece
| | - Ioannis Tsakiridis
- 3rd Department of Obstetrics and Gynaecology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 546 42 Thessaloniki, Greece
| | - Nikolaos Pazaras
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece
| | - Aikaterini Apostolopoulou
- 3rd Department of Obstetrics and Gynaecology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 546 42 Thessaloniki, Greece
| | - Michail Chourdakis
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece
| | - Themistoklis Dagklis
- 3rd Department of Obstetrics and Gynaecology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 546 42 Thessaloniki, Greece
- Correspondence:
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14
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Tranidou A, Dagklis T, Magriplis E, Apostolopoulou A, Tsakiridis I, Chroni V, Tsekitsidi E, Kalaitzopoulou I, Pazaras N, Chourdakis M. Pre-Pregnancy Adherence to Mediterranean Diet and Risk of Gestational Diabetes Mellitus: A Prospective Cohort Study in Greece. Nutrients 2023; 15:nu15040848. [PMID: 36839206 PMCID: PMC9967881 DOI: 10.3390/nu15040848] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 01/30/2023] [Accepted: 02/03/2023] [Indexed: 02/10/2023] Open
Abstract
Gestational Diabetes Mellitus (GDM) is a growing epidemic affecting pregnant women and their offspring. This study aimed to identify the relationship between adherence to a Mediterranean diet (MD) before conception and the risk of GDM in a contemporary Greek pregnant cohort. A prospective cohort of pregnant women was recruited at the routine first trimester visit. Nutritional intake was evaluated using a population specific validated food frequency questionnaire (FFQ). Pre-pregnancy adherence to MD was derived using two different scoring systems, the Mediterranean diet index score (MDS), and a modified version. Adjusted odds ratios (aOR) were computed using multiple logistic regression models for each score derived. Of 743 participating women, 112 (15.1%) developed GDM. The MDS index showed that scoring 5-9 points (high adherence) was associated with a lower GDM incidence (aOR: 0.57 95% CI (0.32, 0.90), p = 0.02), while the modified MDS index showed no significant association for any level of adherence. Pre-pregnancy consumption of "meat and derivatives" and "fatty meat and processed meat" was associated with a higher risk of GDM, with both scoring systems (p = 0.008, p = 0.004, respectively). A higher adherence to a MD pre-pregnancy, especially with less meat consumption, may have a protective effect on the occurrence of GDM.
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Affiliation(s)
- Antigoni Tranidou
- 3rd Department of Obstetrics and Gynecology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece
| | - Themistoklis Dagklis
- 3rd Department of Obstetrics and Gynecology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece
- Correspondence:
| | - Emmanuella Magriplis
- Department of Food Science and Human Nutrition, Agricultural University of Athens, 11855 Athens, Greece
| | - Aikaterini Apostolopoulou
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Ioannis Tsakiridis
- 3rd Department of Obstetrics and Gynecology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece
| | - Violeta Chroni
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Eirini Tsekitsidi
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Ioustini Kalaitzopoulou
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Nikolaos Pazaras
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Michail Chourdakis
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
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15
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Alessi J, Avila GO, de Pádua Borges R, da Rocha Oppermann ML, Telo GH, Schaan BD. Revisiting healthcare accessibility in gestational diabetes during the "pregnancy and infant loss awareness month": are we looking at the bigger picture? Acta Diabetol 2023; 60:323-324. [PMID: 35978139 DOI: 10.1007/s00592-022-01957-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Accepted: 08/04/2022] [Indexed: 01/24/2023]
Affiliation(s)
- Janine Alessi
- Medical Science Program Endocrinology, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400, Porto Alegre, 90035-000, Brazil.
- Postgraduate Program in Medicine and Health Sciences at the Pontifícia Universidade Católica do Rio Grande Do Sul, Porto Alegre, Brazil.
| | - Georgia Oliveira Avila
- School of Medicine, Pontifícia Universidade Católica do Rio Grande Do Sul (PUCRS), Porto Alegre, Brazil
| | - Roberta de Pádua Borges
- Medical Science Program Endocrinology, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400, Porto Alegre, 90035-000, Brazil
| | | | - Gabriela Heiden Telo
- Postgraduate Program in Medicine and Health Sciences at the Pontifícia Universidade Católica do Rio Grande Do Sul, Porto Alegre, Brazil
- School of Medicine, Pontifícia Universidade Católica do Rio Grande Do Sul (PUCRS), Porto Alegre, Brazil
| | - Beatriz D Schaan
- Medical Science Program Endocrinology, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400, Porto Alegre, 90035-000, Brazil
- Endocrinology Division, Hospital de Clinicas de Porto Alegre (HCPA), Porto Alegre, Brazil
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16
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Zhang M, Li Q, Wang KL, Dong Y, Mu YT, Cao YM, Liu J, Li ZH, Cui HL, Liu HY, Hu AQ, Zheng YJ. Lipolysis and gestational diabetes mellitus onset: a case-cohort genome-wide association study in Chinese. J Transl Med 2023; 21:47. [PMID: 36698149 PMCID: PMC9875546 DOI: 10.1186/s12967-023-03902-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 01/17/2023] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Genetic knowledge of gestational diabetes mellitus (GDM) in Chinese women is quite limited. This study aimed to identify the risk factors and mechanism of GDM at the genetic level in a Chinese population. METHODS We conducted a genome-wide association study (GWAS) based on single nucleotide polymorphism (SNP) array genotyping (ASA-CHIA Bead chip, Illumina) and a case-cohort study design. Variants including SNPs, copy number variants (CNVs), and insertions-deletions (InDels) were called from genotyping data. A total of 2232 pregnant women were enrolled in their first/second trimester between February 2018 and December 2020 from Anqing Municipal Hospital in Anhui Province, China. The GWAS included 193 GDM patients and 819 subjects without a diabetes diagnosis, and risk ratios (RRs) and their 95% confidence intervals (CIs) were estimated by a regression-based method conditional on the population structure. The calling and quality control of genotyping data were performed following published guidelines. CNVs were merged into CNV regions (CNVR) to simplify analyses. To interpret the GWAS results, gene mapping and overexpression analyses (ORAs) were further performed to prioritize the candidate genes and related biological mechanisms. RESULTS We identified 14 CNVRs (false discovery rate corrected P values < 0.05) and two suggestively significant SNPs (P value < 0.00001) associated with GDM, and a total of 19 candidate genes were mapped. Ten genes were significantly enriched in gene sets related to lipase (triglyceride lipase and lipoprotein lipase) activity (LIPF, LIPK, LIPN, and LIPJ genes), oxidoreductase activity (TPH1 and TPH2 genes), and cellular components beta-catenin destruction complex (APC and GSK3B genes), Wnt signalosome (APC and GSK3B genes), and lateral element in the Gene Ontology resource (BRCA1 and SYCP2 genes) by two ORA methods (adjusted P values < 0.05). CONCLUSIONS Genes related to lipolysis, redox reaction, and proliferation of islet β-cells are associated with GDM in Chinese women. Energy metabolism, particularly lipolysis, may play an important role in GDM aetiology and pathology, which needs further molecular studies to verify.
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Affiliation(s)
- Miao Zhang
- grid.8547.e0000 0001 0125 2443Department of Epidemiology, School of Public Health, Fudan University, Shanghai, 200032 China ,grid.8547.e0000 0001 0125 2443Key Laboratory for Health Technology Assessment, National Commission of Health and Family Planning, Fudan University, Shanghai, 200032 China ,grid.8547.e0000 0001 0125 2443Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai, 200032 China
| | - Qing Li
- Department of Obstetrics and Gynecology, Anqing Municipal Hospital, Anqing, 246003 China
| | - Kai-Lin Wang
- grid.8547.e0000 0001 0125 2443Department of Epidemiology, School of Public Health, Fudan University, Shanghai, 200032 China ,grid.8547.e0000 0001 0125 2443Key Laboratory for Health Technology Assessment, National Commission of Health and Family Planning, Fudan University, Shanghai, 200032 China ,grid.8547.e0000 0001 0125 2443Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai, 200032 China
| | - Yao Dong
- grid.8547.e0000 0001 0125 2443Department of Epidemiology, School of Public Health, Fudan University, Shanghai, 200032 China ,grid.8547.e0000 0001 0125 2443Key Laboratory for Health Technology Assessment, National Commission of Health and Family Planning, Fudan University, Shanghai, 200032 China ,grid.8547.e0000 0001 0125 2443Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai, 200032 China
| | - Yu-Tong Mu
- grid.8547.e0000 0001 0125 2443Department of Epidemiology, School of Public Health, Fudan University, Shanghai, 200032 China ,grid.8547.e0000 0001 0125 2443Key Laboratory for Health Technology Assessment, National Commission of Health and Family Planning, Fudan University, Shanghai, 200032 China ,grid.8547.e0000 0001 0125 2443Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai, 200032 China
| | - Yan-Min Cao
- grid.8547.e0000 0001 0125 2443Department of Epidemiology, School of Public Health, Fudan University, Shanghai, 200032 China ,grid.8547.e0000 0001 0125 2443Key Laboratory for Health Technology Assessment, National Commission of Health and Family Planning, Fudan University, Shanghai, 200032 China ,grid.8547.e0000 0001 0125 2443Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai, 200032 China
| | - Jin Liu
- grid.8547.e0000 0001 0125 2443Department of Epidemiology, School of Public Health, Fudan University, Shanghai, 200032 China ,grid.8547.e0000 0001 0125 2443Key Laboratory for Health Technology Assessment, National Commission of Health and Family Planning, Fudan University, Shanghai, 200032 China ,grid.8547.e0000 0001 0125 2443Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai, 200032 China
| | - Zi-Heng Li
- grid.8547.e0000 0001 0125 2443Department of Epidemiology, School of Public Health, Fudan University, Shanghai, 200032 China ,grid.8547.e0000 0001 0125 2443Key Laboratory for Health Technology Assessment, National Commission of Health and Family Planning, Fudan University, Shanghai, 200032 China ,grid.8547.e0000 0001 0125 2443Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai, 200032 China
| | - Hui-Lu Cui
- grid.8547.e0000 0001 0125 2443Department of Epidemiology, School of Public Health, Fudan University, Shanghai, 200032 China ,grid.8547.e0000 0001 0125 2443Key Laboratory for Health Technology Assessment, National Commission of Health and Family Planning, Fudan University, Shanghai, 200032 China ,grid.8547.e0000 0001 0125 2443Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai, 200032 China
| | - Hai-Yan Liu
- Department of Clinical Laboratory, Anqing Municipal Hospital, Anqing, 246003 China
| | - An-Qun Hu
- Department of Clinical Laboratory, Anqing Municipal Hospital, Anqing, 246003 China
| | - Ying-Jie Zheng
- grid.8547.e0000 0001 0125 2443Department of Epidemiology, School of Public Health, Fudan University, Shanghai, 200032 China ,grid.8547.e0000 0001 0125 2443Key Laboratory for Health Technology Assessment, National Commission of Health and Family Planning, Fudan University, Shanghai, 200032 China ,grid.8547.e0000 0001 0125 2443Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai, 200032 China
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17
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Luo P, Fan Y, Xiong Y, Zhang C, Yang Z, Sun F, Mei B. Metabolic Characteristics of Gestational Diabetes Mellitus and the Effects on Pregnancy Outcomes. Diabetes Metab Syndr Obes 2023; 16:15-29. [PMID: 36760593 PMCID: PMC9843504 DOI: 10.2147/dmso.s390999] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 11/30/2022] [Indexed: 01/18/2023] Open
Abstract
OBJECTIVE To describe the metabolic characteristics of gestational diabetes mellitus (GDM) and assess their effects on perinatal outcomes. METHODS A two-center nested case‒control study was designed, including 192 pregnant women with GDM and 191 pregnant women with normal glucose tolerance (NGT). Serum glucose and insulin concentrations based upon the 75 g oral glucose tolerance test (OGTT) were measured. Several indices were calculated to describe the metabolic characteristics of the subjects. The relationship between glucose metabolism parameters and pregnancy outcomes was evaluated using stepwise linear regression and binary logistic regression. RESULTS Compared with the NGT group, the GDM group showed significantly higher fasting and postprandial glucose parameters but significantly lower fasting and postprandial insulin responses. Meanwhile, the GDM group had significantly lower HOMA-β, DI and ISIMatsuda but comparable HOMA-IR. The IFG subgroup showed significantly lower FINS/FPG only, while the IGT and IFSG subgroups showed deficiency in both fasting and postprandial insulin response. The IFSG subgroup had the highest glucose parameters and the lowest insulin parameters, as well as significantly lower ISIMatsuda and HOMA-β than the NGT group. FPG had a significant effect on infants' birth weight, and 1hPG and FINS/FPG had a significant effect on delivery gestational age. AUC-INS, IGI60 and DI were related to premature delivery risk after adjusting for confounders. The IFG subgroup of GDM was 2.319 times more likely to be subject to cesarean section than the NGT group. FPG, FINS/FPG, AUC-GLU, AUC-INS/AUC-GLU and HOMA-β were related to macrosomia risk. CONCLUSION Beta cell dysfunction rather than insulin resistance determines the occurrence of GDM in the central Chinese population. Women with predominant insulin secretion defects had a similar risk of adverse perinatal outcomes to women with NGT. Our study provided a basis for the selection of glucose metabolism monitoring indicators useful for the prevention of adverse perinatal outcomes.
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Affiliation(s)
- Ping Luo
- Department of Laboratory Medicine, Jingzhou Hospital Affiliated to Yangtze University, Jingzhou, People’s Republic of China
| | - Ying Fan
- Gongan County Maternal and Child Health Care Hospital, Jingzhou, People’s Republic of China
| | - Yusha Xiong
- Gongan County Maternal and Child Health Care Hospital, Jingzhou, People’s Republic of China
| | - Chunlin Zhang
- Department of Laboratory Medicine, Jingzhou Hospital Affiliated to Yangtze University, Jingzhou, People’s Republic of China
| | - Zhiping Yang
- Department of Laboratory Medicine, Jingzhou Hospital Affiliated to Yangtze University, Jingzhou, People’s Republic of China
| | - Fenglan Sun
- Department of Laboratory Medicine, Jingzhou Hospital Affiliated to Yangtze University, Jingzhou, People’s Republic of China
| | - Bing Mei
- Department of Laboratory Medicine, Jingzhou Hospital Affiliated to Yangtze University, Jingzhou, People’s Republic of China
- Correspondence: Bing Mei, Department of Laboratory Medicine, Jingzhou Hospital Affiliated to Yangtze University, Jingzhou, People’s Republic of China, Email
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Giouleka S, Tsakiridis I, Koutsouki G, Kostakis N, Mamopoulos A, Kalogiannidis I, Athanasiadis A, Dagklis T. Obesity in Pregnancy: A Comprehensive Review of Influential Guidelines. Obstet Gynecol Surv 2023; 78:50-68. [PMID: 36607201 DOI: 10.1097/ogx.0000000000001091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Importance Obesity is one of the most common clinical entities complicating pregnancies and is associated with short- and long-term consequences for both the mother and the offspring. Objective The aim of this study were to review and compare the most recently published influential guidelines on the management of maternal obesity in the preconceptional, antenatal, intrapartum, and postpartum period. Evidence Acquisition A descriptive review of guidelines from the American College of Obstetricians and Gynecologists, the International Federation of Gynecology and Obstetrics, the Society of Obstetricians and Gynecologists of Canada, the Royal College of Obstetricians and Gynecologists, and the Royal Australian and New Zealand College of Obstetricians and Gynecologists on obesity in pregnancy was carried out. Results There is an overall agreement among the reviewed guidelines regarding the importance of prepregnancy weight loss with behavioral modification, optimization of gestational weight gain, and screening for comorbidities in improving pregnancy outcomes of obese women. Women with previous bariatric surgery should be screened for nutritional deficiencies and have a closer antenatal surveillance, according to all guidelines. In addition, folic acid supplementation is recommended for 1 to 3 months before conception and during the first trimester, but several discrepancies were identified with regard to other vitamins, iodine, calcium, and iron supplementation. All medical societies recommend early screening for gestational diabetes mellitus and early anesthetic assessment in obese women and suggest the use of aspirin for the prevention of preeclampsia when additional risk factors are present, although the optimal dosage is controversial. The International Federation of Gynecology and Obstetrics, Society of Obstetricians and Gynecologists of Canada, Royal College of Obstetricians and Gynecologists, and Royal Australian and New Zealand College of Obstetricians and Gynecologists point out that specific equipment and adequate resources must be readily available in all health care facilities managing obese pregnant women. Moreover, thromboprophylaxis and prophylactic antibiotics are indicated in case of cesarean delivery, and intrapartum fetal monitoring is justified during active labor in obese patients. However, there are no consistent protocols regarding the fetal surveillance, the monitoring of multiple gestations, the timing and mode of delivery, and the postpartum follow-up, although weight loss and breastfeeding are unanimously supported. Conclusions Obesity in pregnancy is a significant contributor to maternal and perinatal morbidity with a constantly rising global prevalence among reproductive-aged women. Thus, the development of uniform international protocols for the effective management of obese women is of paramount importance to safely guide clinical practice and subsequently improve pregnancy outcomes.
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Affiliation(s)
| | | | | | | | | | | | | | - Themistoklis Dagklis
- Assistant Professor, Third Department of Obstetrics and Gynaecology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
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19
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Dugas C, Laberee L, Perron J, St-Arnaud G, Richard V, Perreault V, Leblanc N, Marc I, Di Marzo V, Doyen A, Veilleux A, Robitaille J. Gestational Diabetes Mellitus, Human Milk Composition, and Infant Growth. Breastfeed Med 2023; 18:14-22. [PMID: 36409543 DOI: 10.1089/bfm.2022.0085] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background: Gestational diabetes mellitus (GDM) is known to affect human milk composition. Aims of this study were to compare macronutrient and energy content of human milk of women with (GDM+) and without GDM (GDM-), to assess the association between maternal health and human milk macronutrient and energy content and association between human milk macronutrient and energy content and infant growth. Study Design and Methods: Two months after delivery, hindmilk samples were collected. Triglyceride (TG), lactose, and protein content of human milk were measured. An oral glucose tolerance test was performed. Infant weight and length at birth and 2 months were collected. Weight-for-age (WAZ) and weight-for-length z-scores were calculated. Results: Twenty-four GDM+ and 29 GDM- women were included. Protein, lactose, and energy content of human milk were similar between groups. TG concentration was higher in GDM+ than in GDM- women (6.3 ± 2.0 versus 5.3 ± 1.2, p = 0.04). This difference was no longer significant after adjustment for maternal age and infant sex (p = 0.23). Maternal age was associated with TG (r = 0.28, p = 0.04) and lactose (r = -0.30, p = 0.03), while fasting glucose was associated with proteins (r = 0.30, p = 0.03) and tended to be associated with TG (r = 0.27, p = 0.05) and energy (r = 0.24, p = 0.08). TG levels in human milk were associated with weight (β: 0.26, 95% confidence interval [CI]: 0.02 to 0.50) and WAZ (β: 0.40, 95% CI: 0.05 to 0.75) at 2 months among children unexposed (GDM-) to GDM, but not among children exposed (GDM+) Conclusions: In conclusion, GDM status, maternal age, and fasting glucose level were associated with human milk composition. Finally, TG in human milk was associated with infant growth among GDM- children but not among GDM+ children. ClinicalTrials.gov NCT02872402.
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Affiliation(s)
- Camille Dugas
- Centre de recherche Nutrition, Santé et Société (NUTRISS), Institute of Nutrition and Functional Foods (INAF), Université Laval, Quebec City, Canada.,School of Nutrition, Université Laval, Quebec City, Canada
| | | | - Julie Perron
- Centre de recherche Nutrition, Santé et Société (NUTRISS), Institute of Nutrition and Functional Foods (INAF), Université Laval, Quebec City, Canada
| | - Gabrielle St-Arnaud
- Centre de recherche Nutrition, Santé et Société (NUTRISS), Institute of Nutrition and Functional Foods (INAF), Université Laval, Quebec City, Canada.,School of Nutrition, Université Laval, Quebec City, Canada
| | - Véronique Richard
- Centre de recherche Nutrition, Santé et Société (NUTRISS), Institute of Nutrition and Functional Foods (INAF), Université Laval, Quebec City, Canada
| | | | - Nadine Leblanc
- School of Nutrition, Université Laval, Quebec City, Canada.,Canada Excellence Research Chair on the Microbiome-Endocannabinoidome Axis in Metabolic Health, Université Laval, Quebec City, Canada
| | - Isabelle Marc
- Department of Pediatrics, Université Laval, Centre de recherche du CHU de Quebec, Quebec, Canada
| | - Vincenzo Di Marzo
- Centre de recherche Nutrition, Santé et Société (NUTRISS), Institute of Nutrition and Functional Foods (INAF), Université Laval, Quebec City, Canada.,Canada Excellence Research Chair on the Microbiome-Endocannabinoidome Axis in Metabolic Health, Université Laval, Quebec City, Canada.,Heart and Lung Research Institute of Université Laval, Quebec City, Canada
| | - Alain Doyen
- Centre de recherche Nutrition, Santé et Société (NUTRISS), Institute of Nutrition and Functional Foods (INAF), Université Laval, Quebec City, Canada.,Department of Food Sciences, Université Laval, Quebec City, Canada
| | - Alain Veilleux
- Centre de recherche Nutrition, Santé et Société (NUTRISS), Institute of Nutrition and Functional Foods (INAF), Université Laval, Quebec City, Canada.,School of Nutrition, Université Laval, Quebec City, Canada.,Canada Excellence Research Chair on the Microbiome-Endocannabinoidome Axis in Metabolic Health, Université Laval, Quebec City, Canada
| | - Julie Robitaille
- Centre de recherche Nutrition, Santé et Société (NUTRISS), Institute of Nutrition and Functional Foods (INAF), Université Laval, Quebec City, Canada.,School of Nutrition, Université Laval, Quebec City, Canada
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20
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Hasbullah FY, Mohd Yusof BN, Abdul Ghani R, Mat Daud Z‘A, Appannah G, Abas F, Shyam S. Maternal and Dietary Factors Are Associated with Metabolic Syndrome in Women with a Previous History of Gestational Diabetes Mellitus. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16797. [PMID: 36554678 PMCID: PMC9779785 DOI: 10.3390/ijerph192416797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 12/06/2022] [Accepted: 12/11/2022] [Indexed: 06/17/2023]
Abstract
While it is known that women with a previous history of gestational diabetes mellitus (post-GDM) have a higher risk of metabolic syndrome (MetS), evidence of lifestyle practices from low- and middle-income countries (LMICs) is still scarce. This study aimed to determine the factors associated with MetS in women post-GDM. This cross-sectional study involved 157 women post-GDM (mean age 34.8 ± 5.6 years) sampled from Selangor, Malaysia. We collected data on sociodemographic characteristics and obstetric history. Food intake was assessed using a food frequency questionnaire, and dietary patterns were derived from principal component analysis. MetS was diagnosed according to the 2009 Harmonized criteria. The prevalence of MetS in this study was 22.3%. Western dietary pattern consumption was correlated with MetS, body mass index (BMI), waist circumference, and triglyceride levels. Independent factors associated with MetS were lower education level (odds ratio, OR 4.017, p = 0.007), pre-pregnancy BMI (OR 1.192, p = 0.002), and Caesarean delivery (OR 3.798, p = 0.009). The study identified the maternal and dietary factors associated with MetS in women post-GDM in Malaysia. Community-based interventions that include dietary modification are warranted to prevent MetS and its complications, thus helping to reduce the overall disease burden.
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Affiliation(s)
- Farah Yasmin Hasbullah
- Department of Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Selangor, Malaysia
| | - Barakatun-Nisak Mohd Yusof
- Department of Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Selangor, Malaysia
- Diabetes Research Unit, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Selangor, Malaysia
- Institute for Social Science Studies, Putra Infoport, Universiti Putra Malaysia, Serdang 43400, Selangor, Malaysia
| | - Rohana Abdul Ghani
- Department of Internal Medicine, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh 47000, Selangor, Malaysia
| | - Zulfitri ‘Azuan Mat Daud
- Department of Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Selangor, Malaysia
| | - Geeta Appannah
- Department of Nutrition, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Selangor, Malaysia
| | - Faridah Abas
- Department of Food Science, Faculty of Food Science and Technology, Universiti Putra Malaysia, Serdang 43400, Selangor, Malaysia
| | - Sangeetha Shyam
- Unitat de Nutrició Humana, Departament de Bioquímica i Biotecnologia, Universitat Rovira i Virgili, 43201 Reus, Spain
- Institut d’Investigació Sanitària Pere Virgili (IISPV), Hospital Universitari Sant Joan de Reus, 43204 Reus, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Centre for Translational Research, IMU Institute for Research and Development (IRDI), International Medical University (IMU), Kuala Lumpur 57000, Malaysia
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21
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Effects of Probiotic Supplementation during Pregnancy on the Future Maternal Risk of Metabolic Syndrome. Int J Mol Sci 2022; 23:ijms23158253. [PMID: 35897822 PMCID: PMC9330652 DOI: 10.3390/ijms23158253] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 07/21/2022] [Accepted: 07/23/2022] [Indexed: 12/12/2022] Open
Abstract
Probiotics are live microorganisms that induce health benefits in the host. Taking probiotics is generally safe and well tolerated by pregnant women and their children. Consumption of probiotics can result in both prophylactic and therapeutic effects. In healthy adult humans, the gut microbiome is stable at the level of the dominant taxa: Bacteroidetes, Firmicutes and Actinobacteria, and has a higher presence of Verrucomicrobia. During pregnancy, an increase in the number of Proteobacteria and Actinobacteria phyla and a decrease in the beneficial species Roseburia intestinalis and Faecalibacterium prausnitzii are observed. Pregnancy is a "window" to the mother's future health. The aim of this paper is to review studies assessing the potentially beneficial effects of probiotics in preventing the development of diseases that appear during pregnancy, which are currently considered as risk factors for the development of metabolic syndrome, and consequently, reducing the risk of developing maternal metabolic syndrome in the future. The use of probiotics in gestational diabetes mellitus, preeclampsia and excessive gestational weight gain is reviewed. Probiotics are a relatively new intervention that can prevent the development of these disorders during pregnancy, and thus, would reduce the risk of metabolic syndrome resulting from these disorders in the mother's future.
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22
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Mao Y, Hu W, Xia B, Liu L, Han X, Liu Q. Association Between Gestational Diabetes Mellitus and the Risks of Type-Specific Cardiovascular Diseases. Front Public Health 2022; 10:940335. [PMID: 35865249 PMCID: PMC9294140 DOI: 10.3389/fpubh.2022.940335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 06/13/2022] [Indexed: 12/02/2022] Open
Abstract
Objective Gestational diabetes mellitus (GDM) has been linked to subsequent overall cardiovascular diseases. However, evidence on the associations of GDM with type-specific cardiovascular diseases is lacking, and findings on the potential impact of type 2 diabetes on the associations are not consistent. This study aimed to explore the associations between GDM and the risks of type-specific cardiovascular diseases. Methods Data were from 12,025 women (≥20 years) who had delivered at least one live birth in the National Health and Nutrition Examination Survey, 2007–2018. GDM history and type-specific cardiovascular diseases including coronary heart disease (CHD), heart failure and stroke were defined by self-report. We also combined our results with those from previously related publications on the associations between GDM and risks of type-specific cardiovascular diseases with a random-effect model. Results Compared with women without GDM, the multivariable-adjusted odds ratios (95% confidence intervals) were 1.82 (1.21–2.72) for CHD, 1.43 (0.80–2.53) for heart failure, and 1.19 (0.76–1.86) for stroke among women with a history of GDM. Type 2 diabetes was associated with 43.90, 67.44, and 63.16% of the excess odds of CHD, heart failure and stroke associated with GDM, respectively. Combining results from this study with those from previously related studies yielded odds ratios (95% confidence intervals) of 1.81 (1.60–2.05) for CHD (12 studies, 7,615,322 participants, I2= 72.6%), 1.66 (1.25–2.21) for heart failure (5 studies, 4,491,665 participants, I2= 88.6%), and 1.25 (1.07–1.46) for cerebrovascular disease (9 studies, 6,090,848 participants, I2= 77.8%). Conclusions GDM showed stronger associations with coronary heart diseases and heart failure than cerebrovascular disease, and the excess risks are attributable, in part, to type 2 diabetes.
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Affiliation(s)
- Yuanyuan Mao
- Department of Obstetrics and Gynecology, Suzhou Medical College of Soochow University, Suzhou, China
- Department of Obstetrics and Gynecology, The First People's Hospital of Kunshan Affiliated With Jiangsu University, Suzhou, China
| | - Wenbin Hu
- Department of Chronic and Noncommunicable Disease Control and Preventions, The Kunshan Center for Disease Control and Prevention, Suzhou, China
| | - Bin Xia
- Department of Obstetrics and Gynecology, Suzhou Medical College of Soochow University, Suzhou, China
- Department of Obstetrics and Gynecology, The First People's Hospital of Kunshan Affiliated With Jiangsu University, Suzhou, China
| | - Li Liu
- Department of Obstetrics and Gynecology, The First People's Hospital of Kunshan Affiliated With Jiangsu University, Suzhou, China
| | - Xia Han
- Department of Administration, Maternal and Child Health Institution, Kunshan, China
| | - Qin Liu
- Department of Obstetrics and Gynecology, The First People's Hospital of Kunshan Affiliated With Jiangsu University, Suzhou, China
- *Correspondence: Qin Liu
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23
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Mao Y, Hu W, Xia B, Liu L, Liu Q. Association Between History of Gestational Diabetes Mellitus and the Risk of Arthritis in Women. Front Public Health 2022; 10:878845. [PMID: 35692328 PMCID: PMC9184514 DOI: 10.3389/fpubh.2022.878845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 04/28/2022] [Indexed: 11/23/2022] Open
Abstract
Objective The association between gestational diabetes mellitus (GDM) and the risk of arthritis has not been reported. GDM increases the risk of long-term complications including diabetes and metabolic syndrome that are positively associated with the risk of arthritis. This study aimed to explore the association between GDM and the risk of arthritis. Methods Women (age ≥ 20 years) who had delivered at least one live birth were included from the 2007 to 2018 National Health and Nutrition Examination Survey cohort (N = 11,997). Patients who had a history of GDM and arthritis were identified by in-home interview. Subgroup analyses were conducted by arthritis types and status of obesity, current diabetes, metabolic syndrome, smoking, alcohol drinking, and physical activity. Results GDM was associated with increased odds of arthritis [multivariable-adjusted odds ratio (95% confidence interval): 1.31 (1.06–1.62)], and the result was similar in sensitivity analysis with further adjustment for metabolic syndrome [1.30 (1.05–1.60)]. In subgroup analyses, GDM was associated with increased odds of osteoarthritis [1.47 (1.05–2.06)], while no association was observed with rheumatoid arthritis [1.04 (0.69–1.57)] and other types [1.26 (0.94–1.68)]. GDM was associated with increased odds of arthritis in women without metabolic syndrome [1.34 (1.00–1.78)] and diabetes [1.35 (1.03–1.76)], in obese individuals [1.64 (1.24–2.16)], current/former smokers [1.43 (1.05–1.95)], and current drinkers [1.76 (1.00–3.14)], and in individuals engaging in higher levels of physical activity [1.53 (1.06–2.20)]. Conclusions GDM was associated with increased odds of arthritis, and the association was independent of type 2 diabetes and metabolic syndrome.
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Affiliation(s)
- Yuanyuan Mao
- Suzhou Medical College of Soochow University, Suzhou, China
- Department of Obstetrics and Gynecology, The First People's Hospital of Kunshan Affiliated With Jiangsu University, Suzhou, China
| | - Wenbin Hu
- Department of Chronic and Noncommunicable Disease Control and Preventions, The Kunshan Center for Disease Control and Prevention, Suzhou, China
| | - Bin Xia
- Suzhou Medical College of Soochow University, Suzhou, China
- Department of Obstetrics and Gynecology, The First People's Hospital of Kunshan Affiliated With Jiangsu University, Suzhou, China
| | - Li Liu
- Department of Obstetrics and Gynecology, The First People's Hospital of Kunshan Affiliated With Jiangsu University, Suzhou, China
| | - Qin Liu
- Department of Obstetrics and Gynecology, The First People's Hospital of Kunshan Affiliated With Jiangsu University, Suzhou, China
- *Correspondence: Qin Liu
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24
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Can B, Tutuncu Y, Can B, Keskin H, Bekpinar S, Dinccag N. Inflammatory markers are associated with the progression of gestational diabetes to metabolic syndrome. J OBSTET GYNAECOL 2022; 42:1857-1861. [PMID: 35468011 DOI: 10.1080/01443615.2022.2048363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The progression of gestational diabetes mellitus (GDM) to metabolic syndrome (MetS) is associated with systemic inflammation. The aim of this study was to compare the levels of inflammatory markers in former GDM patients with and without MetS. Medical records were screened retrospectively for patients who were diagnosed with GDM 10 (±2) years ago. Former GDM patients were invited to the hospital for an assessment of their current health status. Of 52 women with former GDM, 27 (52%) had MetS. C-reactive protein (CRP), interleukin-6 and plasminogen activator inhibitor-1 (PAI-1) levels were significantly higher in the MetS group while adiponectin was significantly lower (p < .001, p = .037, p = .002 and p = .013, respectively). There was no significant difference in plasma levels of visfatin and tumour necrosis factor-α. Interleukin-6, CRP, PAI-1 and adiponectin may be used as biomarkers to detect MetS in the pre-clinical phase. With timely diagnosis, early interventions can be implemented. IMPACT STATEMENTWhat is already known on this subject? The progression of 'gestational diabetes mellitus' to 'metabolic syndrome' is associated with systemic inflammation. Up to half of cases with former gestational diabetes mellitus (GDM) eventually progress to metabolic syndrome (MetS).What do the results of this study add? Interleukin-6, C-reactive protein, plasminogen activator inhibitor-1 and adiponectin may be used as biomarkers to detect MetS in the pre-clinical phase.What are the implications of these findings from clinical practice and/or further research? The progression of GDM to MetS is associated with systemic inflammation. Potential therapies should therefore target this inflammatory state. Interleukin-6, C-reactive protein, plasminogen activator inhibitor-1 and adiponectin may be used as biomarkers to detect MetS in the pre-clinical phase. With timely diagnosis, early interventions and lifestyle changes can be implemented to prevent morbidity and mortality associated with full-blown MetS.
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Affiliation(s)
- Bulent Can
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Yildiz Tutuncu
- Department of Immunology, Koc University, Istanbul, Turkey
| | - Busra Can
- Department of Internal Medicine, Division of Geriatrics, School of Medicine, Marmara University, Istanbul, Turkey
| | - Havva Keskin
- Department of Internal Medicine, Goztepe Training and Research Hospital, Istanbul Medeniyet University, Istanbul, Turkey
| | - Seldag Bekpinar
- Department of Biochemistry, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Nevin Dinccag
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Faculty of Medicine, Istanbul University, Istanbul, Turkey
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North S, Crofts C, Zinn C. Health professionals' views and experiences around the dietary and lifestyle management of gestational diabetes in New Zealand. Nutr Diet 2022; 79:255-264. [PMID: 35128768 DOI: 10.1111/1747-0080.12719] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 12/05/2021] [Accepted: 12/08/2021] [Indexed: 12/11/2022]
Abstract
AIM This study aimed to investigate New Zealand health professionals' views and experiences around the dietary and lifestyle management of gestational diabetes. METHODS Semi-structured interviews were conducted remotely with health professionals; sessions were recorded and transcribed. Core themes were extracted using inductive thematic analysis using a framework method. RESULTS Twenty-seven health professionals were interviewed (13 diabetes dietitians, 8 specialist diabetes midwives, 2 community midwives, 1 antenatal clinic midwife, 1 obstetrician and 2 endocrinologists). Themes were organised into three central domains: (a) Social and cultural barriers, (b) Service provision and (c) Nutrition advice. Enabling themes included professional collaboration, innovation and creating trusting and supportive environments. Key barriers identified included accessibility, cultural barriers, overwhelmed service, fragmentation and conflicting information and nutrition resource gaps. CONCLUSIONS Findings highlight foremost a deficit in primary antenatal nutrition advice that may play a significant role in the fragmentation identified. Investment in community-inclusive services providing antenatal nutrition and diabetes education appears critical to overcome barriers associated with misinformation and poor outcomes. Pathways to include nutrition education from various primary care health providers should be investigated to ease the burden from specialist gestational diabetes clinicians and allow effective delegation of dietetic resources. Revision of current nutrition guidelines for the management of gestational diabetes in New Zealand is needed to facilitate consistent messaging and standards of care.
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Affiliation(s)
- Sylvia North
- Human Potential Centre, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Catherine Crofts
- School of Interprofessional Health, Auckland University of Technology, Auckland, New Zealand
| | - Caryn Zinn
- Human Potential Centre, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand
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Haschka SJ, Gar C, Sacco V, Banning F, Ferrari U, Freibothe I, Kern-Matschilles S, Potzel AL, Rauch B, Fueessl LU, Meisel M, Benz I, Then C, Seissler J, Lechner A. Pre-diabetes, diabetes and fluctuations of glucose tolerance after gestational diabetes mellitus: 5-year follow-up of a contemporary, prospective study in Germany. BMJ Open Diabetes Res Care 2022; 10:10/2/e002621. [PMID: 35241429 PMCID: PMC8895937 DOI: 10.1136/bmjdrc-2021-002621] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 01/29/2022] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION Ten years ago, Germany started offering screening for gestational diabetes mellitus (GDM) to all pregnant women. This approach revealed more but also, on average, less severe cases of GDM than the risk-based screening practiced previously. We now examined the incidence of pre-diabetes and diabetes following a GDM diagnosis in the era of universal screening in Germany and compared our results with studies in the previous period. Additionally, we examined the year-to-year fluctuations of glucose tolerance after a pregnancy complicated by GDM. RESEARCH DESIGN AND METHODS We report 5-year follow-up data from 202 women in the prospective, monocenter, postpartum study PPSDiab. Consecutive recruitment took place in Munich, Germany between 2011 and 2016. In the study, we conducted yearly examinations that included anthropometrics, laboratory chemistry and oral glucose tolerance testing. RESULTS During the first 5 years post partum, 111 (55%) and 12 (6%) of the women developed pre-diabetes and type 2 diabetes, respectively, while 2 (1%) developed type 1 diabetes. Impaired fasting glucose (IFG) was the most common first manifestation of disturbed glucose tolerance, followed by impaired glucose tolerance (IGT), the combination of IFG and IGT, and diabetes. Glucose tolerance did not deteriorate steadily in most women but fluctuated from year to year. CONCLUSIONS In our analysis, the incidence of diabetes, both type 1 and type 2, after GDM diagnosed in universal screening was substantially lower than in studies from the previous period of risk-based screening. Nevertheless, the high incidence of pre-diabetes we observed after GDM still confirms the importance of this diagnosis as a risk marker. Additionally, we documented frequent fluctuations of glucose tolerance from 1 year to the next. Therefore, a single postpartum glucose tolerance test, as currently practiced in routine care, may be insufficient for reliable risk stratification after GDM.
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Affiliation(s)
- Stefanie J Haschka
- Diabetes Research Group, LMU Klinikum; Medizinische Klinik und Poliklinik IV, Munich, Germany
- Clinical Cooperation Group Type 2 Diabetes, Helmholtz Zentrum München; German Research Center for Environmental Health, Neuherberg, Germany
- German Center for Diabetes Research, Neuherberg, Germany
| | - Christina Gar
- Diabetes Research Group, LMU Klinikum; Medizinische Klinik und Poliklinik IV, Munich, Germany
- Clinical Cooperation Group Type 2 Diabetes, Helmholtz Zentrum München; German Research Center for Environmental Health, Neuherberg, Germany
- German Center for Diabetes Research, Neuherberg, Germany
| | - Vanessa Sacco
- Diabetes Research Group, LMU Klinikum; Medizinische Klinik und Poliklinik IV, Munich, Germany
- Clinical Cooperation Group Type 2 Diabetes, Helmholtz Zentrum München; German Research Center for Environmental Health, Neuherberg, Germany
- German Center for Diabetes Research, Neuherberg, Germany
| | - Friederike Banning
- Diabetes Research Group, LMU Klinikum; Medizinische Klinik und Poliklinik IV, Munich, Germany
- Clinical Cooperation Group Type 2 Diabetes, Helmholtz Zentrum München; German Research Center for Environmental Health, Neuherberg, Germany
- German Center for Diabetes Research, Neuherberg, Germany
| | - Uta Ferrari
- Diabetes Research Group, LMU Klinikum; Medizinische Klinik und Poliklinik IV, Munich, Germany
- Clinical Cooperation Group Type 2 Diabetes, Helmholtz Zentrum München; German Research Center for Environmental Health, Neuherberg, Germany
- German Center for Diabetes Research, Neuherberg, Germany
| | - Ines Freibothe
- Diabetes Research Group, LMU Klinikum; Medizinische Klinik und Poliklinik IV, Munich, Germany
- Clinical Cooperation Group Type 2 Diabetes, Helmholtz Zentrum München; German Research Center for Environmental Health, Neuherberg, Germany
- German Center for Diabetes Research, Neuherberg, Germany
| | - Stefanie Kern-Matschilles
- Diabetes Research Group, LMU Klinikum; Medizinische Klinik und Poliklinik IV, Munich, Germany
- Clinical Cooperation Group Type 2 Diabetes, Helmholtz Zentrum München; German Research Center for Environmental Health, Neuherberg, Germany
- German Center for Diabetes Research, Neuherberg, Germany
| | - Anne L Potzel
- Diabetes Research Group, LMU Klinikum; Medizinische Klinik und Poliklinik IV, Munich, Germany
- Clinical Cooperation Group Type 2 Diabetes, Helmholtz Zentrum München; German Research Center for Environmental Health, Neuherberg, Germany
- German Center for Diabetes Research, Neuherberg, Germany
| | - Barbara Rauch
- Diabetes Research Group, LMU Klinikum; Medizinische Klinik und Poliklinik IV, Munich, Germany
- Clinical Cooperation Group Type 2 Diabetes, Helmholtz Zentrum München; German Research Center for Environmental Health, Neuherberg, Germany
- German Center for Diabetes Research, Neuherberg, Germany
| | - Louise U Fueessl
- Diabetes Research Group, LMU Klinikum; Medizinische Klinik und Poliklinik IV, Munich, Germany
- Clinical Cooperation Group Type 2 Diabetes, Helmholtz Zentrum München; German Research Center for Environmental Health, Neuherberg, Germany
- German Center for Diabetes Research, Neuherberg, Germany
| | - Mandy Meisel
- Diabetes Research Group, LMU Klinikum; Medizinische Klinik und Poliklinik IV, Munich, Germany
- Clinical Cooperation Group Type 2 Diabetes, Helmholtz Zentrum München; German Research Center for Environmental Health, Neuherberg, Germany
- German Center for Diabetes Research, Neuherberg, Germany
| | - Irina Benz
- Diabetes Research Group, LMU Klinikum; Medizinische Klinik und Poliklinik IV, Munich, Germany
- Clinical Cooperation Group Type 2 Diabetes, Helmholtz Zentrum München; German Research Center for Environmental Health, Neuherberg, Germany
- German Center for Diabetes Research, Neuherberg, Germany
| | - Cornelia Then
- Diabetes Research Group, LMU Klinikum; Medizinische Klinik und Poliklinik IV, Munich, Germany
- Clinical Cooperation Group Type 2 Diabetes, Helmholtz Zentrum München; German Research Center for Environmental Health, Neuherberg, Germany
- German Center for Diabetes Research, Neuherberg, Germany
| | - Jochen Seissler
- Diabetes Research Group, LMU Klinikum; Medizinische Klinik und Poliklinik IV, Munich, Germany
- Clinical Cooperation Group Type 2 Diabetes, Helmholtz Zentrum München; German Research Center for Environmental Health, Neuherberg, Germany
- German Center for Diabetes Research, Neuherberg, Germany
| | - Andreas Lechner
- Diabetes Research Group, LMU Klinikum; Medizinische Klinik und Poliklinik IV, Munich, Germany
- Clinical Cooperation Group Type 2 Diabetes, Helmholtz Zentrum München; German Research Center for Environmental Health, Neuherberg, Germany
- German Center for Diabetes Research, Neuherberg, Germany
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27
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Mao Y, Hu W, Liu L, Liu Q. Association Between Gestational Diabetes Mellitus and Future Risk of Kidney Stones. Front Public Health 2022; 10:843383. [PMID: 35237556 PMCID: PMC8882577 DOI: 10.3389/fpubh.2022.843383] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Accepted: 01/21/2022] [Indexed: 11/18/2022] Open
Abstract
Objective The association between history of gestational diabetes mellitus (GDM) and risk of kidney stones has not been reported. GDM increases the risk of long-term complications including diabetes, hypertension and metabolic syndrome, which are risk factors of kidney stones. This study aimed to explore the association between previous GDM and odds of kidney stones. Methods Women (age ≥ 20 years) who had delivered at least one live birth were included from the 2007–2018 National Health and Nutrition Examination Survey cohort (N = 12,003). Patients with kidney stones and history of GDM were identified by in-home interview for all participants. Subgroup analyses were conducted by age, race/ethnicity, postpartum duration and status of hypertension, obesity, current diabetes and metabolic syndrome. Results Previous GDM was positively associated with odds of kidney stones [multivariate-adjusted odds ratio (95% confidence interval): 1.41 (1.13–1.77)], and the association was stronger with odds of passing 2 or more times of kidney stones [1.72 (1.31–2.26)]. In subgroup analyses, the association between previous GDM and odds of kidney stones was significant in women within 15 years of a pregnancy complicated by GDM [1.54 (1.12–2.11)], in obese participants [1.56 (1.18–2.06)], in women without hypertension [1.49 (1.07–2.08)], current diabetes [1.38 (1.02–1.87)] and metabolic syndrome [1.56 (1.10–2.19)], in women of Non-Hispanic White [1.59 (1.15–2.18)] and in women aged more than 50 year [1.45 (1.02–2.07)]. Conclusions Previous GDM was positively associated with odds of kidney stones, and the association was independent of type 2 diabetes, hypertension and metabolic syndrome.
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Affiliation(s)
- Yuanyuan Mao
- Medical College of Soochow University, Suzhou, China
- Department of Obstetrics and Gynecology, The First People's Hospital of Kunshan Affiliated With Jiangsu University, Suzhou, China
| | - Wenbin Hu
- Department of Chronic and Noncommunicable Disease Control and Preventions, The Kunshan Center for Disease Control and Prevention, Suzhou, China
| | - Li Liu
- Department of Obstetrics and Gynecology, The First People's Hospital of Kunshan Affiliated With Jiangsu University, Suzhou, China
| | - Qin Liu
- Department of Obstetrics and Gynecology, The First People's Hospital of Kunshan Affiliated With Jiangsu University, Suzhou, China
- *Correspondence: Qin Liu
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28
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Tano S, Kotani T, Ushida T, Yoshihara M, Imai K, Nakano-Kobayashi T, Moriyama Y, Iitani Y, Kinoshita F, Yoshida S, Yamashita M, Kishigami Y, Oguchi H, Kajiyama H. Annual Body Mass Index Gain and Risk of Gestational Diabetes Mellitus in a Subsequent Pregnancy. Front Endocrinol (Lausanne) 2022; 13:815390. [PMID: 35399932 PMCID: PMC8990746 DOI: 10.3389/fendo.2022.815390] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 02/16/2022] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION Weight change during the interpregnancy is related to gestational diabetes mellitus (GDM) in the subsequent pregnancy. In interpregnancy care/counseling, the timeframe for goal setting is important, while the timing of the next conception is unpredictable and preventing age-related body weight gain is difficult. This study aimed to investigate the association between annual weight gain during the interpregnancy, which provide clearer timeframe, and GDM in subsequent pregnancies. METHODS This multicenter retrospective study was conducted by collecting data on two pregnancies of the same women in 2009-2019. The association between annual BMI gain and GDM during the subsequent pregnancy was examined. RESULTS This study included 1,640 pregnant women. A history of GDM [adjusted odds ratio (aOR), 26.22; 95% confidence interval (CI), 14.93-46.07] and annual BMI gain (aOR, 1.48; 95% CI, 1.22-1.81) were related to GDM during the subsequent pregnancy. In the women with a pre-pregnant BMI of <25.0 kg/m2 and without GDM during the index pregnancy, an annual BMI gain of ≥0.6 kg/m2/year during the interpregnancy were associated with GDM in subsequent pregnancies; however, in the other subgroups, it was not associated with GDM in subsequent pregnancies. CONCLUSIONS For women with a pre-pregnant BMI of <25.0 kg/m2 and without GDM during the index pregnancy, maintaining an annual BMI gain of <0.6 kg/m2/year may prevent GDM during the subsequent pregnancy.
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Affiliation(s)
- Sho Tano
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Department of Obstetrics, Perinatal Medical Center, TOYOTA Memorial Hospital, Toyota, Japan
| | - Tomomi Kotani
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Division of Perinatology, Center for Maternal-Neonatal Care, Nagoya University Hospital, Nagoya, Japan
- *Correspondence: Tomomi Kotani,
| | - Takafumi Ushida
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Masato Yoshihara
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kenji Imai
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Tomoko Nakano-Kobayashi
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yoshinori Moriyama
- Department of Obstetrics and Gynecology, Fujita Health University School of Medicine, Toyoake, Japan
| | - Yukako Iitani
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Fumie Kinoshita
- Data Science Division, Data Coordinating Center, Department of Advanced Medicine, Nagoya University Hospital, Nagoya, Japan
| | | | | | - Yasuyuki Kishigami
- Department of Obstetrics, Perinatal Medical Center, TOYOTA Memorial Hospital, Toyota, Japan
| | - Hidenori Oguchi
- Department of Obstetrics, Perinatal Medical Center, TOYOTA Memorial Hospital, Toyota, Japan
| | - Hiroaki Kajiyama
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan
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29
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Jacobsen KH, Aalders J, Sølling K, Andersen MS, Snogdal LS, Christensen MH, Vinter CA, Højlund K, Jensen DM. Long-Term Metabolic Outcomes after Gestational Diabetes Mellitus (GDM): Results from the Odense GDM Follow-Up Study (OGFUS). J Diabetes Res 2022; 2022:4900209. [PMID: 35789592 PMCID: PMC9250439 DOI: 10.1155/2022/4900209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 03/28/2022] [Accepted: 05/10/2022] [Indexed: 11/17/2022] Open
Abstract
AIMS To compare metabolic profiles and the long-term risk of metabolic dysfunction between women with previous gestational diabetes mellitus (pGDM) and women without pGDM (non-GDM) matched on age, prepregnancy body mass index (BMI), and parity. METHODS In total, 128 women with pGDM (median follow-up: 7.8 years) and 70 non-GDM controls (median follow-up: 10.0 years) completed a 2 h oral glucose tolerance test (OGTT) with assessment of glucose, C-peptide, insulin, and other metabolic measures. Additionally, anthropometrics, fat mass, and blood pressure were assessed and indices of insulin sensitivity and beta cell function were calculated. RESULTS The prevalence of type 2 diabetes mellitus (T2DM) was significantly higher in the pGDM group compared to the non-GDM group (26% vs. 0%). For women with pGDM, the prevalence of prediabetes (38%) and the metabolic syndrome (MetS) (59%) were approximately 3-fold higher than in non-GDM women (p's < 0.001). Both insulin sensitivity and beta cell function were significantly reduced in pGDM women compared to non-GDM women. CONCLUSION Despite similar BMI, women with pGDM had a substantially higher risk of developing T2DM, prediabetes, and the MetS compared to controls. Both beta cell dysfunction and reduced insulin sensitivity seem to contribute to this increased risk.
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Affiliation(s)
| | - Jori Aalders
- Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Psychology, University of Southern Denmark, Odense, Denmark
| | - Katrine Sølling
- Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark
| | - Marianne Skovsager Andersen
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Endocrinology, Odense University Hospital, Odense, Denmark
| | | | - Maria Hornstrup Christensen
- Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Gynecology and Obstetrics, Odense University Hospital, Odense, Denmark
| | - Christina Anne Vinter
- Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark
- Department of Endocrinology, Odense University Hospital, Odense, Denmark
- Department of Gynecology and Obstetrics, Odense University Hospital, Odense, Denmark
| | - Kurt Højlund
- Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark
- Department of Endocrinology, Odense University Hospital, Odense, Denmark
| | - Dorte Møller Jensen
- Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark
- Department of Endocrinology, Odense University Hospital, Odense, Denmark
- Department of Gynecology and Obstetrics, Odense University Hospital, Odense, Denmark
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30
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Moon JH, Jang HC. Gestational Diabetes Mellitus: Diagnostic Approaches and Maternal-Offspring Complications. Diabetes Metab J 2022; 46:3-14. [PMID: 35135076 PMCID: PMC8831816 DOI: 10.4093/dmj.2021.0335] [Citation(s) in RCA: 73] [Impact Index Per Article: 36.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 12/29/2021] [Indexed: 11/09/2022] Open
Abstract
Gestational diabetes mellitus (GDM) is the most common complication during pregnancy and is defined as any degree of glucose intolerance with onset or first recognition during pregnancy. GDM is associated with adverse pregnancy outcomes and long-term offspring and maternal complications. For GDM screening and diagnosis, a two-step approach (1-hour 50 g glucose challenge test followed by 3-hour 100 g oral glucose tolerance test) has been widely used. After the Hyperglycemia and Adverse Pregnancy Outcome study implemented a 75 g oral glucose tolerance test in all pregnant women, a one-step approach was recommended as an option for the diagnosis of GDM after 2010. The one-step approach has more than doubled the incidence of GDM, but its clinical benefit in reducing adverse pregnancy outcomes remains controversial. Long-term complications of mothers with GDM include type 2 diabetes mellitus and cardiovascular disease, and complications of their offspring include childhood obesity and glucose intolerance. The diagnostic criteria of GDM should properly classify women at risk for adverse pregnancy outcomes and long-term complications. The present review summarizes the strengths and weaknesses of the one-step and two-step approaches for the diagnosis of GDM based on recent randomized controlled trials and observational studies. We also describe the long-term maternal and offspring complications of GDM.
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Affiliation(s)
- Joon Ho Moon
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Hak Chul Jang
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
- Corresponding author: Hak Chul Jang https://orcid.org/0000-0002-4188-6536 Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82 Gumi-ro 173beon-gil, Bundang-gu, Seongnam 13620, Korea E-mail:
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