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Lou Y, He P, Jiang H, Xiang L, Gao X. Analysis of the characteristics of blood lipid metabolism in twin pregnancy. J Investig Med 2023; 71:53-57. [PMID: 36137709 DOI: 10.1136/jim-2022-002412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/22/2022] [Indexed: 01/21/2023]
Abstract
To investigate the characteristics of blood lipid metabolism in twin pregnancy combined with gestational diabetes mellitus (GDM) or pregnancy-induced hypertension (PIH). This study retrospectively analyzed 96 cases of twin pregnancy and 232 cases of full-term singleton pregnancy. General data and blood lipid levels, including triglyceride (TG) and total cholesterol (TC), between twin and singleton pregnancies were compared. Blood lipid levels between GDM (PIH) and non-GDM (non-PIH) groups in twin pregnancy were compared. The TG level for twin pregnancy was higher than that for singleton pregnancy (p<0.05), while there was no significant difference in the TC level between them (p>0.05). The TG level in the GDM group was higher than that in the non-GDM group (p<0.05), while the TC level in the GDM group was not different from that in the non-GDM group (p>0.05). The TG level in the PIH group was higher than that in the non-PIH group (p<0.05), while there was no difference in the TC level between them (p>0.05). Logistic regression analysis showed that age was a risk factor for GDM and PIH in singleton and twin pregnancies. The lipid levels in twin pregnancy increased with the increase of gestational age, and the TG level in twin pregnancy complicated with GDM or PIH was higher than that in twin pregnancy without GDM or PIH, indicating that the blood lipid metabolism was related to the occurrence of GDM and PIH in twin pregnancy to some extent.
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Affiliation(s)
- Yanqin Lou
- Department of Obstetrics, Wuhan No 1 Hospital, Wuhan, Hubei, China
| | - Pei He
- Department of Obstetrics, Wuhan No 1 Hospital, Wuhan, Hubei, China
| | - Huijun Jiang
- Department of Obstetrics, Wuhan No 1 Hospital, Wuhan, Hubei, China
| | - Li Xiang
- Department of Obstetrics, Wuhan No 1 Hospital, Wuhan, Hubei, China
| | - Xuemei Gao
- Department of Obstetrics, Wuhan No 1 Hospital, Wuhan, Hubei, China
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Lin B, Zhang X. Vitamin E Supplement Protects Against Gestational Diabetes Mellitus in Mice Through nuclear factor-erythroid factor 2-related factor 2/heme oxygenase-1 Signaling Pathway. Diabetes Metab Syndr Obes 2023; 16:565-574. [PMID: 36883138 PMCID: PMC9985888 DOI: 10.2147/dmso.s397255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 02/14/2023] [Indexed: 03/05/2023] Open
Abstract
BACKGROUND Gestational diabetes mellitus (GDM) is the most common pregnant disorder worldwide. In this study, we aimed to explore whether vitamin E (VE) treatment alone could protect against GDM in a mouse model. METHODS 6-week-old C57BL/6J female mice were fed on high-fat diet for two weeks and continued with high-fat diet after pregnancy to induce GDM. The pregnant mice were orally administrated with 2.5, 25 or 250 mg/kg VE twice per day during pregnancy together with high-fat diet. Oral glucose tolerance test, insulin amounts, oxidative stress and inflammation were then measured. RESULTS Only 250 mg/kg VE could improve glucose tolerance and insulin level in pregnant mice. VE (250 mg/kg) effectively inhibited GDM-induced hyperlipidemia, and secretion of inflammatory cytokines such as tumor necrosis factor-α and interleukin-6. VE also significantly ameliorated maternal oxidative stress at the late stage of pregnancy, and also improved reproductive outcomes, including increasing the litter size and birth weight in GDM mice. Moreover, VE also activated GDM-reduced nuclear factor-erythroid factor 2-related factor 2 (Nrf2) / heme oxygenase-1 signaling pathway in the maternal liver tissues of GDM mice. CONCLUSION Our data clearly demonstrated that 250 mg/kg VE twice a day during pregnancy could significantly ameliorate the symptoms of GDM by alleviating oxidative stress, inflammation, hyperglycemia, and hyperlipidemia through Nrf2/HO-1 signaling pathway in GDM mice. Thus, additional VE supplement might be beneficial to GDM.
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Affiliation(s)
- Bozhu Lin
- Gynaecology and Obstetrics Department, Longyan People’s Hospital, Longyan, People’s Republic of China
| | - Xiaorong Zhang
- Neonatal Department, Longyan People’s Hospital, Longyan, People’s Republic of China
- Correspondence: Xiaorong Zhang, Neonatal Department, Longyan People’s Hospital, No. 31, Denggaoxi Road, Xinluo District, Longyan, 364000, People’s Republic of China, Tel +86-13605936060, Email
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Perinatal Outcomes and Related Risk Factors of Single vs Twin Pregnancy Complicated by Gestational Diabetes Mellitus: Meta-Analysis. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:3557890. [PMID: 35832130 PMCID: PMC9273416 DOI: 10.1155/2022/3557890] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 06/17/2022] [Accepted: 06/20/2022] [Indexed: 11/18/2022]
Abstract
Objective Perinatal outcomes and related risk factors of single vs twin pregnancy complicated with gestational diabetes mellitus (GDM) were clarified, providing evidence for developing preventive measures. Methods The Chinese National Knowledge Infrastructure (CNKI), China Biology Medicine (CBM), CQVIP, Wanfang, and PubMed databases were searched for published research on the perinatal outcomes and risk factors of single and twin pregnancy complicated by GDM from 2000 to 2021. The quality of the included literature was evaluated according to the Newcastle-Ottawa Scale (NOS). Meta-analysis of the included literature was conducted using RevMan5.3 software. Results Relative to a single pregnancy group, infertility, gestational weight gain, and family history of diabetes presented statistical significance in the twin pregnancy group (P < 0.05); gestational age at delivery, cesarean section, preterm birth < 37 weeks, and preeclampsia presented statistical significance in the twin pregnancy group (P < 0.05); and neonatal birth weight, small for gestational age (SGA), neonatal asphyxia, neonatal hypoglycemia, neonatal respiratory distress syndrome (NRDS), neonatal hyperbilirubinemia, and neonatal death presented statistical significance in the twin pregnancy group (P < 0.05). Conclusion Infertility, prenatal weight gain, and diabetes in the family are all risk factors for postpartum impaired glucose metabolism in pregnant women with GDM who are carrying twins. The gestational age at delivery, cesarean section, preterm birth < 37 weeks, and preeclampsia of twin pregnant women with diabetes will affect the perinatal status of twin pregnant women. Neonatal birth weight, SGA, neonatal asphyxia, neonatal hypoglycemia, NRDS, neonatal hyperbilirubinemia, neonatal death, etc. should be paid special attention in the perinatal process.
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Ashwal E, Berger H, Hiersch L, Yoon EW, Zaltz A, Shah B, Halperin I, Barrett J, Melamed N. Gestational diabetes and fetal growth in twin compared with singleton pregnancies. Am J Obstet Gynecol 2021; 225:420.e1-420.e13. [PMID: 33872592 DOI: 10.1016/j.ajog.2021.04.225] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 03/11/2021] [Accepted: 04/09/2021] [Indexed: 01/11/2023]
Abstract
BACKGROUND Gestational diabetes mellitus is associated with accelerated fetal growth in singleton pregnancies but may affect twin pregnancies differently because of the slower growth of twin fetuses during the third trimester of pregnancy and their greater predisposition to fetal growth restriction. OBJECTIVE This study aimed to evaluate the association of gestational diabetes mellitus with longitudinal fetal growth in twin pregnancies and to compare this association with that observed in singleton pregnancies. STUDY DESIGN This was a retrospective cohort study of all women with a singleton or twin pregnancy who were followed up at a single tertiary referral center between January 2011 and April 2020. Data on estimated fetal weight and individual fetal biometric indices were extracted from ultrasound examinations of eligible women. Generalized linear models were used to model and compare the change in fetal weight and individual biometric indices as a function of gestational age between women with and without gestational diabetes mellitus in twin pregnancies and between women with and without gestational diabetes mellitus in singleton pregnancies. The primary outcome was estimated fetal weight as a function of gestational age. The secondary outcomes were longitudinal growth of individual fetal biometric indices and the rate of small for gestational age and large for gestational age at birth. RESULTS A total of 26,651 women (94,437 ultrasound examinations) were included in the analysis: 1881 with a twin pregnancy and 24,770 with a singleton pregnancy. The rate of gestational diabetes mellitus in the twin and singleton groups was 9.6% (n=180) and 7.6% (n=1893), respectively. The estimated fetal weight in singleton pregnancies with gestational diabetes mellitus was significantly higher than that in pregnancies without gestational diabetes mellitus (P<.001) starting at approximately 30 weeks of gestation. The differences remained similar after adjusting for maternal age, chronic hypertension, nulliparity, and neonatal sex (P<.001). In twin pregnancies, fetal growth was similar between pregnancies with and without gestational diabetes mellitus (P=.105 and P=.483 for unadjusted and adjusted models, respectively). The findings were similar to the association of gestational diabetes mellitus with the risk of large for gestational fetuses and the growth of each biometric index. When stratified by type of gestational diabetes mellitus treatment, twin pregnancies with gestational diabetes mellitus was associated with accelerated fetal growth only in the subgroup of women with medically treated gestational diabetes mellitus (P<.001), which represented 12% (n=21) of the twin pregnancy group with gestational diabetes mellitus. CONCLUSION In contrast to singleton pregnancies, twin pregnancies with gestational diabetes mellitus is less likely to be associated with accelerated fetal growth. This finding has raised the question of whether the diagnostic criteria for gestational diabetes mellitus and the blood glucose targets in women diagnosed with gestational diabetes mellitus should be individualized for twin pregnancies.
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Affiliation(s)
- Eran Ashwal
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Tel Aviv Sourasky Medical Center, Lis Maternity Hospital, Tel Aviv University, Tel Aviv, Israel.
| | - Howard Berger
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Saint Michaels Hospital, Toronto, Ontario, Canada
| | - Liran Hiersch
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Tel Aviv Sourasky Medical Center, Lis Maternity Hospital, Tel Aviv University, Tel Aviv, Israel
| | - Eugene W Yoon
- Maternal-Infant Care (MiCare) Research Centre, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Arthur Zaltz
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Baiju Shah
- Department of Medicine and Institute for Health Policy, Evaluative Clinical Sciences, Management and Evaluation, Sunnybrook Research Institute; Division of Endocrinology, Sunnybrook Health Sciences Centre, University of Toronto, Ontario, Canada
| | - Ilana Halperin
- Department of Endocrinology, Sunnybrook Health Sciences Centre, University of Toronto, Ontario, Canada
| | - Jon Barrett
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Nir Melamed
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
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Alonso-Fernández A, Cerdá Moncadas M, Álvarez Ruiz De Larrinaga A, Sánchez Barón A, Codina Marcet M, Rodríguez Rodríguez P, Gil Gómez AV, Giménez Carrero MP, Pía Martínez C, Cubero Marín JP, de la Peña M, Barceló A, Morell-Garcia D, Pierola J, Peña Zarza JA, Durán Cantolla J, Marín Trigo JM, Soriano JB, García-Río F. Impact of Obstructive Sleep Apnea on Gestational Diabetes Mellitus. Arch Bronconeumol 2021; 58:S0300-2896(21)00160-5. [PMID: 34130878 DOI: 10.1016/j.arbres.2021.05.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 04/30/2021] [Accepted: 05/01/2021] [Indexed: 01/11/2023]
Abstract
INTRODUCTION Obstructive sleep apnea (OSA) increases the risk of type 2 diabetes, and hyperinsulinemia. Pregnancy increases the risk of OSA; however, the relationship between OSA and gestational diabetes mellitus (GDM) is unclear. We aimed (1) to evaluate OSA prevalence in GDM patients; (2) to assess the association between OSA and GDM; and (3) to determine the relationships between sleep parameters with insulin resistance (IR). METHODS A total of 177 consecutive women (89 with GDM, 88 controls) in the third trimester of pregnancy underwent a hospital polysomnography. OSA was defined when the apnea-hypopnea index (AHI) was ≥5h-1. RESULTS Patients with GDM had higher pregestational body mass index (BMI) and neck circumference than controls, but no differences in snoring or OSA-symptoms, or AHI (3.2±6.0 vs. 1.9±2.7h-1, p=.069). OSA prevalence was not significantly different in both groups. We did not identify OSA as a GDM risk factor in the crude analysis 1.65 (95%CI: 0.73-3.77; p=.232). Multiple regression showed that total sleep time (TST), TST spent with oxygen saturation<90% (T90), and maximum duration of respiratory events as independent factors related with homeostasis model assessment of IR, while T90 was the only independent determinant of quantitative insulin sensitivity check index. CONCLUSION OSA prevalence during the third trimester of pregnancy was not significantly different in patients with GDM than without GDM, and no associations between OSA and GDM determinants were found. We identified T90 and obstructive respiratory events length positive-related to IR, while TST showed an inverse relationship with IR in pregnant women.
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Affiliation(s)
- Alberto Alonso-Fernández
- Department of Pneumology, Hospital Universitario Son Espases, Palma de Mallorca, Spain; Institut d'Investigació Sanitària Illes Balears (IdISBa), Palma de Mallorca, Spain; Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.
| | | | | | | | - Mercedes Codina Marcet
- Department of Endocrinology and metabolism, Hospital Universitario Son Espases, Palma de Mallorca, Spain
| | | | | | | | | | | | - Mónica de la Peña
- Department of Pneumology, Hospital Universitario Son Espases, Palma de Mallorca, Spain; Institut d'Investigació Sanitària Illes Balears (IdISBa), Palma de Mallorca, Spain; Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Antonia Barceló
- Institut d'Investigació Sanitària Illes Balears (IdISBa), Palma de Mallorca, Spain; Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Department of Clinical Analysis, Hospital Universitario Son Espases, Palma de Mallorca, Spain
| | - Daniel Morell-Garcia
- Institut d'Investigació Sanitària Illes Balears (IdISBa), Palma de Mallorca, Spain; Department of Clinical Analysis, Hospital Universitario Son Espases, Palma de Mallorca, Spain
| | - Javier Pierola
- Institut d'Investigació Sanitària Illes Balears (IdISBa), Palma de Mallorca, Spain; Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - José Antonio Peña Zarza
- Institut d'Investigació Sanitària Illes Balears (IdISBa), Palma de Mallorca, Spain; Department of Pediatrics, Hospital Universitario Son Espases, Palma de Mallorca, Spain
| | - Joaquín Durán Cantolla
- Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Sleep Unit, Hospital Universitario de Araba, Vitoria, Spain; Instituto de Investigación BIOARABA, Vitoria, Spain
| | - José María Marín Trigo
- Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Department of Pneumology, Hospital Universitario Miguel Servet, Zaragoza, Spain; Instituto de Investigación Sanitaria de Aragón, Zaragoza, Spain
| | - Joan B Soriano
- Hospital Universitario de la Princesa-Universidad Autónoma de Madrid, Madrid, Spain
| | - Francisco García-Río
- Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Department of Pneumology, Hospital Universitario La Paz, IdiPAZ, Madrid, Spain
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Hozyasz KK, Żółkowska J, Chyż K. Comparison of phenylalanine tolerance in singleton and twin pregnancies in patients with phenylketonuria. J Int Med Res 2021; 48:300060520934623. [PMID: 32962492 PMCID: PMC7520934 DOI: 10.1177/0300060520934623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Objectives Empirical determination of phenylalanine (Phe) tolerance in patients with
phenylketonuria (PKU) relies on frequent assessment of blood Phe
concentrations in relation to Phe intake from detailed meal records. This
study aimed to determine Phe tolerance in twin pregnancies. Methods The reviewed cases included three women with PKU who each had a singleton and
twin pregnancy (i.e., they were pregnant twice). All patients were under
regular supervision to maintain Phe concentrations in a steady state and
determine safe Phe intake. Restriction of Phe in the patient’s diet was
determined depending on the amount of Phe intake, which allowed for stable
blood Phe concentrations within the target range. Results In all three patients with PKU, the ratio of Phe tolerance during the course
of the twin and singleton pregnancies was <1 for most of the pregnancy.
The ratio of the increase in Phe tolerance between 29 and 34 weeks of
gestation and that between 15 and 28 weeks of gestation was 0.66 and 1.17,
0.51 and 0.14, and 0.76 and 1.42 in the twin and singleton pairs of
pregnancies, respectively. Conclusions Our study shows that Phe tolerance in a twin pregnancy is not greater than
that in a singleton pregnancy.
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Affiliation(s)
- Kamil Konrad Hozyasz
- Institute of Health Sciences, State School of Higher Education, Biała Podlaska, Poland
| | | | - Katarzyna Chyż
- PKU Polyclinic, Institute of Mother and Child, Warsaw, Poland
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Al-Rifai RH, Abdo NM, Paulo MS, Saha S, Ahmed LA. Prevalence of Gestational Diabetes Mellitus in the Middle East and North Africa, 2000-2019: A Systematic Review, Meta-Analysis, and Meta-Regression. Front Endocrinol (Lausanne) 2021; 12:668447. [PMID: 34512543 PMCID: PMC8427302 DOI: 10.3389/fendo.2021.668447] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 07/30/2021] [Indexed: 12/16/2022] Open
Abstract
UNLABELLED Women in the Middle East and North Africa (MENA) region are burdened with several risk factors related to gestational diabetes mellitus (GDM) including overweight and high parity. We systematically reviewed the literature and quantified the weighted prevalence of GDM in MENA at the regional, subregional, and national levels. Studies published from 2000 to 2019 reporting the prevalence of GDM in the MENA region were retrieved and were assessed for their eligibility. Overall and subgroup pooled prevalence of GDM was quantified by random-effects meta-analysis. Sources of heterogeneity were investigated by meta-regression. The risk of bias (RoB) was assessed by the National Heart, Lung, and Blood Institute's tool. One hundred and two research articles with 279,202 tested pregnant women for GDM from 16 MENA countries were included. Most of the research reports sourced from Iran (36.3%) and Saudi Arabia (21.6%), with an overall low RoB. In the 16 countries, the pooled prevalence of GDM was 13.0% (95% confidence interval [CI], 11.5-14.6%, I2 , 99.3%). Nationally, GDM was highest in Qatar (20.7%, 95% CI, 15.2-26.7% I2 , 99.0%), whereas subregionally, GDM was highest in Gulf Cooperation Council (GCC) countries (14.7%, 95% CI, 13.0-16.5%, I2 , 99.0%). The prevalence of GDM was high in pregnant women aged ≥30 years (21.9%, 95% CI, 18.5-25.5%, I2 , 97.1%), in their third trimester (20.0%, 95% CI, 13.1-27.9%, I2 , 98.8%), and who were obese (17.2%, 95% CI, 12.8-22.0%, I2 , 93.8%). The prevalence of GDM was 10.6% (95% CI, 8.1-13.4%, I2 , 98.9%) in studies conducted before 2009, whereas it was 14.0% (95% CI, 12.1-16.0%, I2 , 99.3%) in studies conducted in or after 2010. Pregnant women in the MENA region are burdened with a substantial prevalence of GDM, particularly in GCC and North African countries. Findings have implications for maternal health in the MENA region and call for advocacy to unify GDM diagnostic criteria. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42018100629.
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Affiliation(s)
- Rami H. Al-Rifai
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
- *Correspondence: Rami H. Al-Rifai,
| | - Noor Motea Abdo
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Marília Silva Paulo
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Sumanta Saha
- Department of Community Medicine, R. G. Kar Medical College, Kolkata, India
| | - Luai A. Ahmed
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
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Zheng J, Xu J, Zhang Y, Zhou N. Effects of insulin combined with metformin on serum cystatin C, homocysteine and maternal and neonatal outcomes in pregnant women with gestational diabetes mellitus. Exp Ther Med 2019; 19:467-472. [PMID: 31853319 PMCID: PMC6909788 DOI: 10.3892/etm.2019.8224] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 09/02/2019] [Indexed: 12/30/2022] Open
Abstract
Effects of insulin combined with metformin on serum cystatin C (Cys C), homocysteine (Hcy) and maternal and neonatal outcomes in pregnant women with gestational diabetes mellitus (GDM) were investigated. In total, 80 cases of pregnant women diagnosed with GDM in the Department of Obstetrics and Gynecology of Liaocheng Third People's Hospital from July 2015 to July 2017 were selected and divided into a study group (42 cases) and a control group (38 cases). The study group was treated with insulin combined with metformin, and the control group was treated with insulin. Fasting blood glucose (FBG) and postprandial blood glucose after 2 h (2hPG) of the two groups were compared before and after treatment. Levels of serum Cys C, Hcy, urinary protein (UmAlb), postpartum maternal outcomes and adverse reactions during pregnancy were compared in the two groups before and after treatment. After treatment, the level of FBG and 2hPG in the control group was higher than that in the treatment group (P<0.05). After treatment, the level of serum Cys C and Hcy in both groups were lower than that before the treatment, and the level in the study group was lower than that in the control group (P<0.05). The total incidence of neonatal adverse outcomes and the number of adverse pregnancies in GDM patients in the study group were significantly lower than those in the control group (P<0.05). There were no significant differences in adverse reactions during pregnancy between the two groups (P>0.05). In conclusion, insulin combined with metformin is more effective than insulin alone in reducing serum Cys C and Hcy levels, with significant effect on the improvement of maternal and neonatal outcomes.
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Affiliation(s)
- Jizeng Zheng
- Department of Obstetrics and Gynecology, Liaocheng Third People's Hospital, Liaocheng, Shandong 252000, P.R. China
| | - Juan Xu
- Department of Obstetrics, Tengzhou Central People's Hospital, Tengzhou, Shandong 277500, P.R. China
| | - Yin Zhang
- Department of Obstetrics and Gynecology, Liaocheng Third People's Hospital, Liaocheng, Shandong 252000, P.R. China
| | - Nan Zhou
- Department of Health Care, Jinan Central Hospital, Jinan, Shandong 250013, P.R. China
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Piao C, Wang X, Peng S, Guo X, Zhao H, He L, Zeng Y, Zhang F, Zhu K, Wang Y. IL-34 causes inflammation and beta cell apoptosis and dysfunction in gestational diabetes mellitus. Endocr Connect 2019; 8:1503-1512. [PMID: 31648183 PMCID: PMC6865862 DOI: 10.1530/ec-19-0436] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Accepted: 10/24/2019] [Indexed: 12/05/2022]
Abstract
OBJECTIVE Gestational diabetes mellitus (GDM) is characterized by glucose intolerance during gestation. It is associated with a series of maternal and foetal complications. Interleukin (IL)-34 is a recently discovered pro-inflammatory cytokine that functions as a ligand for colony-stimulating factor-1 receptor (CSF-1R). The contribution of IL-34 in the development of multiple chronic inflammatory diseases and autoimmune diseases has been recently discovered. The aim of this study was to evaluate whether IL-34 participates in the pathogenesis of GDM. METHOD A total of 120 women were enrolled in this study, which included 60 GDM patients and age- and sex-matched healthy pregnant women. The expression of IL-34 in serum, cord blood and placental tissues was analysed by ELISA and Western blot assays. The association between IL-34 levels and clinical features was also studied. We additionally evaluated the effect of recombinant mouse IL-34 (rmIL-34) on apoptosis and pancreatic β cell function. RESULTS We found that IL-34 expression is highly increased in serum, cord blood and placental tissues in patients with GDM. In addition, there was a positive association between serum IL-34 and insulin resistance and glucose concentrations. Our data also revealed that IL-34 contributes to the apoptosis of pancreatic β cells in GDM caused by CSF-1R. Furthermore, functional studies found that IL-34 inhibited pancreatic β cell function and cell viability, while CSF-1R inhibitor blocked this effect. CONCLUSION IL-34 plays a crucial role in the development of GDM by targeting CSF-1R, insulin production and β cell function.
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Affiliation(s)
- Chenghao Piao
- Department of Radiology, The Second Affiliated Hospital of Shenyang Medical College, Shenyang City, Liaoning Province, People’s Republic of China
| | - Xiaojie Wang
- Department of Human Anatomy, Shenyang Medical College, Shenyang City, Liaoning Province, People’s Republic of China
| | - Shiqiao Peng
- Department of Endocrinology and Metabolism, Institute of Endocrinology, Liaoning Provincial Key Laboratory of Endocrine Diseases, The First Affiliated Hospital of China Medical University, Shenyang City, Liaoning Province, People’s Republic of China
| | - Xinyu Guo
- Department of Obstetrics, The Second Affiliated Hospital of Shenyang Medical College, Shenyang City, Liaoning Province, People’s Republic of China
| | - Hui Zhao
- Department of Laboratory Medicine, The Second Affiliated Hospital of Shenyang Medical College, Shenyang City, Liaoning Province, People’s Republic of China
| | - Li He
- Department of Gastroenterology, The Second Affiliated Hospital of Shenyang Medical College, Shenyang City, Liaoning Province, People’s Republic of China
| | - Yan Zeng
- Department of Obstetrics, The Second Affiliated Hospital of Shenyang Medical College, Shenyang City, Liaoning Province, People’s Republic of China
| | - Fan Zhang
- Department of Endocrinology and Metabolism, Institute of Endocrinology, Liaoning Provincial Key Laboratory of Endocrine Diseases, The First Affiliated Hospital of China Medical University, Shenyang City, Liaoning Province, People’s Republic of China
| | - Kewen Zhu
- Department of Human Anatomy, Shenyang Medical College, Shenyang City, Liaoning Province, People’s Republic of China
| | - Yiwei Wang
- Department of Human Anatomy, Shenyang Medical College, Shenyang City, Liaoning Province, People’s Republic of China
- Correspondence should be addressed to Y Wang:
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