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Li H, Liu S, Chen H, Zhou L, Chen B, Wang M, Zhang D, Han TL, Zhang H. Gut dysbiosis contributes to SCFAs reduction-associated adipose tissue macrophage polarization in gestational diabetes mellitus. Life Sci 2024; 350:122744. [PMID: 38810793 DOI: 10.1016/j.lfs.2024.122744] [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: 03/22/2024] [Revised: 05/14/2024] [Accepted: 05/22/2024] [Indexed: 05/31/2024]
Abstract
AIMS The prevalence of gestational diabetes mellitus (GDM) has spurred investigations into various interconnected factors, among which gut dysbiosis is notably prominent. Although gut dysbiosis is strongly associated with GDM, the specific role of the gut microbiome in the pathogenesis of GDM remains unknown. This study aims to explore the pathogenesis of GDM from gut microbiota. MATERIALS AND METHODS In our study, we constructed two GDM mice models: one induced by a high-fat diet (HFD) and the other through fecal microbiota transplantation (FMT) from GDM patients. In vitro, we used a co-culture system of RAW264.7 and 3T3-L1 adipocytes. KEY FINDINGS We induced a GDM-like state in pregnant mice by FMT from GDM patients, which was consistent with the HFD model. A potential mechanism identified involves the diminished abundance of SCFA-producing microbiota, which reduces SCFAs, particularly propionic acid and butyric acid. In vitro, butyric and propionic acids were observed to alleviate LPS-induced TLR4-NF-κB activation, thereby reducing inflammation levels and inhibiting adipose insulin resistance via the PI3K/AKT signaling pathway. This reduction appears to trigger the polarization of adipose tissue macrophages toward M1 and promote insulin resistance in adipose tissue. SIGNIFICANCE Our study fills this knowledge gap by finding that alterations in gut microbiota have an independent impact on hyperglycemia and insulin resistance in the GDM state. In vivo and in vitro, gut dysbiosis is linked to adipose tissue inflammation and insulin resistance via the bacterial product SCFAs in the GDM state, providing new insights into the pathogenesis of GDM.
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Affiliation(s)
- Hongli Li
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China; State Key Laboratory of Maternal and Fetal Medicine of Chongqing, Chongqing Medical University, Chongqing 400016, China; The Chongqing Key Laboratory of Translational Medicine in Major Metabolic Diseases, Chongqing Medical University, Chongqing 400016, China
| | - Siqi Liu
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China; State Key Laboratory of Maternal and Fetal Medicine of Chongqing, Chongqing Medical University, Chongqing 400016, China
| | - Hao Chen
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China; State Key Laboratory of Maternal and Fetal Medicine of Chongqing, Chongqing Medical University, Chongqing 400016, China
| | - Linwei Zhou
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China; State Key Laboratory of Maternal and Fetal Medicine of Chongqing, Chongqing Medical University, Chongqing 400016, China
| | - Bingnan Chen
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Min Wang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Dan Zhang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Ting-Li Han
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China.
| | - Hua Zhang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China; State Key Laboratory of Maternal and Fetal Medicine of Chongqing, Chongqing Medical University, Chongqing 400016, China.
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Ureyen Ozdemir E, Buyuk GN, Erol Koc EM, Ipek G, Gurbuz Ozbebek U, Gurun MA, Hancerliogullari N. Gestational Diabetes and C-Reactive Protein/Albumin Ratio in Pregnancy: A Prospective Study. Yonsei Med J 2024; 65:413-417. [PMID: 38910304 PMCID: PMC11199176 DOI: 10.3349/ymj.2023.0334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 12/20/2023] [Accepted: 01/25/2024] [Indexed: 06/25/2024] Open
Abstract
PURPOSE The C-reactive protein/albumin ratio (CAR) has been reported as a novel inflammatory marker to assess inflammation. The aim of this study was to compare the levels of CAR as a inflammatory marker in gestational diabetes mellitus (GDM) and non GDM patients. MATERIALS AND METHODS Eight hundred ten pregnant women who applied to our hospital for routine antenatal screening were included in this prospective case-control study. The patients were divided into two groups, as positive and negative diagnosis of GDM. CAR between groups was compared as the primary outcome using statistical methods. RESULTS The CAR value was significantly higher in pregnancies with GDM compared to healthy controls [1.07 (0.43-1.89) vs. 0.37 (0.12-0.68), p<0.0001]. The Spearman's correlation analysis revealed that the CAR value had a significant positive correlation with all three steps of 75 gr oral glucose tolerance test (p<0.0001 for each) and neutrophil to lymphocyte ratio value (p=0.011). CONCLUSION Considering that laboratory testing is very simple and inexpensive, CAR is an independent predictor that is clinically easy to use for the development of GDM. This report is the first to show the role of CAR in GDM. However, further studies with larger sample sizes are needed to generalize this comment.
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Affiliation(s)
- Eda Ureyen Ozdemir
- Department of Obstetrics and Gynecology, Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Gul Nihal Buyuk
- Department of Obstetrics and Gynecology, Ministry of Health Ankara City Hospital, Ankara, Turkey.
| | - Esin Merve Erol Koc
- Department of Obstetrics and Gynecology, Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Goksun Ipek
- Department of Obstetrics and Gynecology, Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Ulku Gurbuz Ozbebek
- Department of Obstetrics and Gynecology, Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Muslume Asli Gurun
- Department of Obstetrics and Gynecology, Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Necati Hancerliogullari
- Department of Obstetrics and Gynecology, Ministry of Health Ankara City Hospital, Ankara, Turkey
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Leca BM, Lagojda L, Kite C, Karteris E, Kassi E, Randeva HS, Kyrou I. Maternal obesity and metabolic (dysfunction) associated fatty liver disease in pregnancy: a comprehensive narrative review. Expert Rev Endocrinol Metab 2024; 19:335-348. [PMID: 38860684 DOI: 10.1080/17446651.2024.2365791] [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: 01/11/2024] [Accepted: 06/05/2024] [Indexed: 06/12/2024]
Abstract
INTRODUCTION Obesity and metabolic-associated fatty liver disease (MAFLD) during pregnancy constitute significant problems for routine antenatal care, with increasing prevalence globally. Similar to obesity, MAFLD is associated with a higher risk for maternal complications (e.g. pre-eclampsia and gestational diabetes) and long-term adverse health outcomes for the offspring. However, MAFLD during pregnancy is often under-recognized, with limited management/treatment options. AREAS COVERED PubMed/MEDLINE, EMBASE, and Scopus were searched based on a search strategy for obesity and/or MAFLD in pregnancy to identify relevant papers up to 2024. This review summarizes the pertinent evidence on the relationship between maternal obesity and MAFLD during pregnancy. Key mechanisms implicated in the underlying pathophysiology linking obesity and MAFLD during pregnancy (e.g. insulin resistance and dysregulated adipokine secretion) are highlighted. Moreover, a diagnostic approach for MAFLD diagnosis during pregnancy and its complications are presented. Finally, promising relevant areas for future research are covered. EXPERT OPINION Research progress regarding maternal obesity, MAFLD, and their impact on maternal and fetal/offspring health is expected to improve the relevant diagnostic methods and lead to novel treatments. Thus, routine practice could apply more personalized management strategies, incorporating individualized algorithms with genetic and/or multi-biomarker profiling to guide prevention, early diagnosis, and treatment.
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Affiliation(s)
- Bianca M Leca
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism (WISDEM), University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Lukasz Lagojda
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism (WISDEM), University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
- Clinical Evidence-Based Information Service (CEBIS), University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
| | - Chris Kite
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism (WISDEM), University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
- School of Health and Society, Faculty of Education, Health and Wellbeing, University of Wolverhampton, Wolverhampton, UK
- Centre for Sport, Exercise and Life Sciences, Research Institute for Health & Wellbeing, Coventry University, Coventry, UK
- Chester Medical School, University of Chester, Shrewsbury, UK
| | - Emmanouil Karteris
- College of Health, Medicine and Life Sciences, Division of Biosciences, Brunel University London, Uxbridge, UK
| | - Eva Kassi
- Department of Biological Chemistry, Medical School, National and Kapodistrian University of Athens, Athens, Greece
- Endocrine Unit, 1st Department of Propaedeutic Internal Medicine, Laiko Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Harpal S Randeva
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism (WISDEM), University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
- Warwick Medical School, University of Warwick, Coventry, UK
- Centre for Sport, Exercise and Life Sciences, Research Institute for Health & Wellbeing, Coventry University, Coventry, UK
- Institute of Cardiometabolic Medicine, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
| | - Ioannis Kyrou
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism (WISDEM), University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
- Warwick Medical School, University of Warwick, Coventry, UK
- Centre for Sport, Exercise and Life Sciences, Research Institute for Health & Wellbeing, Coventry University, Coventry, UK
- Institute of Cardiometabolic Medicine, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
- Aston Medical School, College of Health and Life Sciences, Aston University, Birmingham, UK
- College of Health, Psychology and Social Care, University of Derby, Derby, UK
- Laboratory of Dietetics and Quality of Life, Department of Food Science and Human Nutrition, School of Food and Nutritional Sciences, Agricultural University of Athens, Athens, Greece
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Dhar P, Sominsky L, O'Hely M, Dawson S, Collier F, Tang MLK, Mansell T, Burgner D, Smith C, Hyde N, Downing K, Hesketh KD, Ponsonby AL, Vuillermin P. Physical activity and circulating inflammatory markers and cytokines during pregnancy: A population-based cohort study. Acta Obstet Gynecol Scand 2024. [PMID: 38924074 DOI: 10.1111/aogs.14870] [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: 10/19/2023] [Revised: 04/03/2024] [Accepted: 04/11/2024] [Indexed: 06/28/2024]
Abstract
INTRODUCTION Physical activity (PA) during pregnancy has numerous benefits, which may be mediated via effects on the immune system. However, supportive evidence is inconsistent and is mainly from studies in high-risk groups. We estimated the effect of PA during pregnancy on systemic inflammatory markers and cytokines in mothers recruited in the Barwon infant study. MATERIAL AND METHODS The Barwon infant study is a prebirth cohort of 1064 mothers recruited in the Barwon Region of Victoria, Australia. Participants reported their previous week's PA at their 28-week antenatal appointment using the International PA Questionnaire. Women were grouped into low, moderate, and high PA categories based on daily duration and weekly frequency of walking, moderate- or vigorous-intensity PA. Women reporting moderate levels of PA, consistent with current recommendations, served as the comparison group. Markers of systemic inflammation, high-sensitivity C-reactive protein (hsCRP), glycoprotein acetyls (GlycA), and 17 cytokines were measured at 28 weeks gestation and log transformed as appropriate. Regression analyses adjusted for maternal smoking, gestational diabetes mellitus, prepregnancy BMI, and household size were performed. RESULTS Compared to women in the moderate group (n = 371, 42%), women reporting low PA (n = 436, 50%) had 10.1% higher hsCRP (95% CI (3.7% to 16.6%), p < 0.01) while women in high PA (n = 76, 9%) had a 14% higher hsCRP (95% CI (3.1% to 24.8%), p = 0.01). Women in the high PA category had higher interleukin (IL)-4 (q = 0.03) and IL-9 (q = 0.03) levels compared to those in moderate category. Each vigorous MET minute/week was associated with lower GlycA (β = -0.004, 95% CI (-0.044 to 0.035); p = 0.03). CONCLUSIONS Low and high PA are each associated with higher hsCRP than moderate PA, suggesting that undertaking the recommended moderate PA during pregnancy decreases systemic inflammation. High PA affects T cell-associated cytokines during pregnancy. Evidence from our study suggests that PA can modulate the immune responses during pregnancy. Studies are now required to assess whether PA during pregnancy impacts maternal and infant clinical outcomes by modifying inflammatory responses.
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Affiliation(s)
- Poshmaal Dhar
- Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine, Deakin University, Geelong, Victoria, Australia
| | - Luba Sominsky
- Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine, Deakin University, Geelong, Victoria, Australia
- Barwon Health, Geelong, Victoria, Australia
| | - Martin O'Hely
- Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine, Deakin University, Geelong, Victoria, Australia
| | - Samantha Dawson
- Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine, Deakin University, Geelong, Victoria, Australia
| | - Fiona Collier
- Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine, Deakin University, Geelong, Victoria, Australia
| | - Mimi L K Tang
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Toby Mansell
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia
| | - David Burgner
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Craig Smith
- Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine, Deakin University, Geelong, Victoria, Australia
| | - Natalie Hyde
- Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine, Deakin University, Geelong, Victoria, Australia
| | - Katherine Downing
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Kylie D Hesketh
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Anne-Louise Ponsonby
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia
- The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria, Australia
| | - Peter Vuillermin
- Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine, Deakin University, Geelong, Victoria, Australia
- Barwon Health, Geelong, Victoria, Australia
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Omidvar-Mehrabadi A, Ebrahimi F, Shahbazi M, Mohammadnia-Afrouzi M. Cytokine and chemokine profiles in women with endometriosis, polycystic ovary syndrome, and unexplained infertility. Cytokine 2024; 178:156588. [PMID: 38555853 DOI: 10.1016/j.cyto.2024.156588] [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: 01/10/2024] [Revised: 03/19/2024] [Accepted: 03/22/2024] [Indexed: 04/02/2024]
Abstract
Numerous factors (including immunological, congenital, hormonal, and morphological disorders) can lead to infertility. In this regard, 3 specific diseases associated with infertility are discussed in this review study (i.e., polycystic ovary syndrome [PCOS], endometriosis [EMS], and unexplained infertility [UI]). PCOS is a common endocrine disorder characterized by chronic low-grade inflammation, and EMS is a benign disease characterized by the presence of ectopic endometrial tissue. UI refers to couples who are unable to conceive for no known reason. Conception and pregnancy are significantly affected by the immune system; in this regard, chemokines and cytokines play important roles in the regulation of immune responses. Patients with PCOS, EMS, and UI have altered cytokine and chemokine profiles, suggesting that dysregulation of these molecules may contribute to infertility in these conditions. Accordingly, the issue of infertility is addressed in this review study, a condition that affects approximately 16% of couples worldwide.
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Affiliation(s)
| | - Fateme Ebrahimi
- Department of Immunology, School of Medicine, Babol University of Medical Sciences, Babol, Iran
| | - Mehdi Shahbazi
- Department of Immunology, School of Medicine, Babol University of Medical Sciences, Babol, Iran.
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Louwen F, Kreis NN, Ritter A, Yuan J. Maternal obesity and placental function: impaired maternal-fetal axis. Arch Gynecol Obstet 2024; 309:2279-2288. [PMID: 38494514 PMCID: PMC11147848 DOI: 10.1007/s00404-024-07462-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 03/04/2024] [Indexed: 03/19/2024]
Abstract
The prevalence of maternal obesity rapidly increases, which represents a major public health concern worldwide. Maternal obesity is characteristic by metabolic dysfunction and chronic inflammation. It is associated with health problems in both mother and offspring. Increasing evidence indicates that the placenta is an axis connecting maternal obesity with poor outcomes in the offspring. In this brief review, we have summarized the current data regarding deregulated placental function in maternal obesity. The data show that maternal obesity induces numerous placental defects, including lipid and glucose metabolism, stress response, inflammation, immune regulation and epigenetics. These placental defects affect each other and result in a stressful intrauterine environment, which transduces and mediates the adverse effects of maternal obesity to the fetus. Further investigations are required to explore the exact molecular alterations in the placenta in maternal obesity, which may pave the way to develop specific interventions for preventing epigenetic and metabolic programming in the fetus.
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Affiliation(s)
- Frank Louwen
- Obstetrics and Prenatal Medicine, Gynecology and Obstetrics, University Hospital Frankfurt, J. W. Goethe-University, Theodor Stern-Kai 7, 60590, Frankfurt, Germany
| | - Nina-Naomi Kreis
- Obstetrics and Prenatal Medicine, Gynecology and Obstetrics, University Hospital Frankfurt, J. W. Goethe-University, Theodor Stern-Kai 7, 60590, Frankfurt, Germany
| | - Andreas Ritter
- Obstetrics and Prenatal Medicine, Gynecology and Obstetrics, University Hospital Frankfurt, J. W. Goethe-University, Theodor Stern-Kai 7, 60590, Frankfurt, Germany
| | - Juping Yuan
- Obstetrics and Prenatal Medicine, Gynecology and Obstetrics, University Hospital Frankfurt, J. W. Goethe-University, Theodor Stern-Kai 7, 60590, Frankfurt, Germany.
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7
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Ji R, Yang H, Chen J, Zhao A, Chen X, Niu Y. The role of hsa_circ_0042260/miR-4782-3p/LAPTM4A axis in gestational diabetes mellitus. APMIS 2024; 132:465-476. [PMID: 38588560 DOI: 10.1111/apm.13407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 03/11/2024] [Indexed: 04/10/2024]
Abstract
Gestational diabetes mellitus (GDM) is a common metabolic condition during pregnancy, posing risks to both mother and fetus. CircRNAs have emerged as important players in various diseases, including GDM. We aimed to investigate the role of newly discovered circRNA, hsa_circ_0042260, in GDM pathogenesis. Using GSE194119 dataset, hsa_circ_0042260 was identified and its expression in plasma, placenta, and HG-stimulated HK-2 cells was examined. Silencing hsa_circ_0042260 in HK-2 cells assessed its impact on cell viability, apoptosis, and inflammation. Bioinformatics analysis revealed downstream targets of hsa_circ_0042260, namely miR-4782-3p and LAPTM4A. The interaction between hsa_circ_0042260, miR-4782-3p, and LAPTM4A was validated through various assays. hsa_circ_0042260 was upregulated in plasma from GDM patients and HG-stimulated HK-2 cells. Silencing hsa_circ_0042260 improved cell viability, suppressed apoptosis and inflammation. Hsa_circ_0042260 interacted with miR-4782-3p, which exhibited low expression in GDM patient plasma and HG-stimulated cells. MiR-4782-3p targeted LAPTM4A, confirmed by additional assays. LAPTM4A expression increased in GDM patient plasma and HG-induced HK-2 cells following hsa_circ_0042260 knockdown or miR-4782-3p overexpression. In rescue assays, inhibition of miR-4782-3p or overexpression of LAPTM4A counteracted the effects of hsa_circ_0042260 downregulation on cell viability, apoptosis, and inflammation. In conclusion, the hsa_circ_0042260/miR-4782-3p/LAPTM4A axis plays a role in regulating GDM progression in HG-stimulated HK-2 cells.
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Affiliation(s)
- Rui Ji
- Department of Obstetrics, Xuyi People's Hospital, Huai'an, Jiangsu, China
| | - Hong Yang
- Department of Obstetrics, Xuyi People's Hospital, Huai'an, Jiangsu, China
| | - Jiamei Chen
- Department of Obstetrics, Xuyi People's Hospital, Huai'an, Jiangsu, China
| | - Anna Zhao
- Department of Obstetrics, Xuyi People's Hospital, Huai'an, Jiangsu, China
| | - Xia Chen
- Department of Obstetrics, Xuyi People's Hospital, Huai'an, Jiangsu, China
| | - Yanli Niu
- Department of Obstetrics, Xuyi People's Hospital, Huai'an, Jiangsu, China
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Ghaneialvar H, Mohseni MM, Kenarkoohi A, Kakaee S. Are miR-26a and miR-26b microRNAs potent prognostic markers of gestational diabetes? Health Sci Rep 2024; 7:e2152. [PMID: 38831779 PMCID: PMC11144624 DOI: 10.1002/hsr2.2152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 03/02/2024] [Accepted: 05/08/2024] [Indexed: 06/05/2024] Open
Abstract
Background Gestational diabetes mellitus is a common public health problem, accompanied by complications for the mother and fetus. So, introducing new biomarkers to identify early diabetes is essential. As serum miRNAs are potentially appropriate markers, we investigated miR-26a and miR-26b expression levels in pregnant women with and without gestational diabetes. Method Demographic and clinical characteristics of 40 gestational diabetic patients and 40 healthy controls were assessed. The expression level of miR-26a and miR-26b microRNAs was measured by real-time PCR. Statistical analysis was done with GraphPad Prism software (version 8.4.3). Result The findings of this study showed that the expression level of miR-26a and miR-26b increased in women with gestational diabetes compared with healthy pregnant women, but the increase in expression was only significant for miR-26a (p < 0.05). Conclusion According to the statistical and ROC curves, we suggest miR-26a as a potential biomarker for the early diagnosis of gestational diabetes mellitus.
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Affiliation(s)
- Hori Ghaneialvar
- Biotechnology and Medicinal Plants Research CenterIlam University of Medical SciencesIlamIran
| | | | - Azra Kenarkoohi
- Department of Laboratory Sciences, School of Allied Medical SciencesIlam University of Medical SciencesIlamIran
| | - Saeed Kakaee
- Biotechnology and Medicinal Plants Research CenterIlam University of Medical SciencesIlamIran
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Sen S, Cherkerzian S, Herlihy M, Hacker MR, McElrath TF, Cantonwine DE, Fichorova R, Oken E, Meydani SN. Supplementation with antioxidant micronutrients in pregnant women with obesity: a randomized controlled trial. Int J Obes (Lond) 2024; 48:796-807. [PMID: 38396126 DOI: 10.1038/s41366-024-01472-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 01/03/2024] [Accepted: 01/15/2024] [Indexed: 02/25/2024]
Abstract
BACKGROUND/OBJECTIVE Obesity increases maternal morbidity and adversely affects child health. Maternal inflammation may play a role in adverse outcomes. The objective of this study was to determine whether providing a higher dose of antioxidant micronutrients to pregnant women with obesity would raise concentrations of key antioxidant vitamins and impact inflammation and oxidative stress during pregnancy. SUBJECTS/METHODS This was a double-blind, randomized controlled trial. We recruited pregnant women with a body mass index (BMI) ≥ 30 kg/m2 at their initial prenatal visit ( < 13 weeks gestation) and collected blood and urine samples at baseline, 24-28 weeks, and 32-36 weeks to measure micronutrient concentrations (vitamin C, E, B6 and folate), markers of inflammation (C-reactive protein, interleukin-6, 8, and 1β) and oxidative stress (8-epi-PGF2α and malondialdehyde). We collected maternal and infant health data from enrollment to delivery as secondary outcomes. We enrolled 128 participants (64 in each arm), and 98 (49 in each arm) completed follow-up through delivery. INTERVENTION Both groups received a standard prenatal vitamin containing the recommended daily allowance of micronutrients in pregnancy. In addition, the intervention group received a supplement with 90 mg vitamin C, 30 αTU vitamin E, 18 mg vitamin B6, and 800 μg folic acid, and the control group received a placebo. RESULTS The intervention group had higher vit B6 (log transformed (ln), β 24-28 weeks: 0.76 nmol/L (95% CI: 0.40, 1.12); β 32-36 weeks: 0.52 nmol/L (95% CI: 0.17, 0.88)) than the control group. Vitamins C, E, erythrocyte RBC folate concentrations did not differ by randomization group. The intervention did not impact biomarkers of inflammation or oxidative stress. There were no differences in maternal or neonatal clinical outcomes by randomization group. CONCLUSIONS Higher concentrations of antioxidant vitamins during pregnancy increased specific micronutrients and did not impact maternal inflammation and oxidative stress, which may be related to dosing or type of supplementation provided. CLINICAL TRIAL REGISTRATION Clinical Trial Identification Number: NCT02802566; URL of the Registration Site: www. CLINICALTRIALS gov .
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Affiliation(s)
- Sarbattama Sen
- Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Boston, MA, USA.
- JM USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA.
- Harvard Medical School, Boston, MA, USA.
| | - Sara Cherkerzian
- Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Mary Herlihy
- Harvard Medical School, Boston, MA, USA
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Michele R Hacker
- Harvard Medical School, Boston, MA, USA
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Thomas F McElrath
- Harvard Medical School, Boston, MA, USA
- Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women's Hospital, Boston, MA, USA
| | - David E Cantonwine
- Harvard Medical School, Boston, MA, USA
- Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women's Hospital, Boston, MA, USA
| | - Raina Fichorova
- Harvard Medical School, Boston, MA, USA
- Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women's Hospital, Boston, MA, USA
| | - Emily Oken
- Harvard Medical School, Boston, MA, USA
- Department of Population Medicine, Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Simin N Meydani
- JM USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA
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Xue L, Chen R, Liu Y, Niu P, Zhou J, Liu J, Zhang J, Chen H. Association of maternal blood high-mobility group box 1 levels and adverse pregnancy outcomes: A systematic review and meta-analysis. Reprod Biol 2024; 24:100859. [PMID: 38492434 DOI: 10.1016/j.repbio.2024.100859] [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: 11/22/2023] [Revised: 01/16/2024] [Accepted: 01/24/2024] [Indexed: 03/18/2024]
Abstract
Conflicting findings have emerged regarding the levels of high mobility group box 1 (HMGB1) in individuals experiencing adverse pregnancy outcomes. Here we conducted a meta-analysis to assess the association between maternal blood HMGB1 levels and adverse pregnancy outcomes. Utilizing databases such as PubMed, Cochrane Central Register of Controlled Trials, Web of Science, Embase and China National Knowledge Infrastructure (CNKI), a systematic literature search was conducted in January 2024. Eligible literature was screened according to inclusion and exclusion criteria. Quality assessment was evaluated using the Newcastle-Ottawa Scale (NOS). The extracted data were analyzed using Review Manager 5.4 and STATA 12.0 software. 21 observational studies with a total of 2471 participants were included in this meta-analysis. Significantly higher peripheral blood levels of HMGB1 were associated with preeclampsia (PE) (SMD=1.34; 95% CI: 0.72-1.95; P < 0.0001) and gestational diabetes mellitus (GDM) (SMD=1.20; 95% CI: 0.31-2.09; P = 0.009). Additionally, HMGB1 levels in peripheral blood were significantly elevated in patients with unexplained recurrent spontaneous abortion (URSA) than those in pregnancy controls (SMD=4.22; 95% CI: 1.64-6.80; P = 0.001) or non-pregnancy controls (SMD=3.87; 95% CI: 1.81-5.92; P = 0.0002). Interestingly, higher blood HMGB1 levels were observed in women with preterm birth (PTB), however, the results did not reach a statistical difference (SMD=0.54; 95% CI: -0.36-1.44; P = 0.24). In conclusion, overexpressed maternal blood HMGB1 levels were associated with adverse pregnancy outcomes, including PE, GDM and URSA. Further studies should be conducted to validate the efficacy of HMGB1 as a biomarker for assessing the risk of adverse pregnancy outcomes.
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Affiliation(s)
- Liping Xue
- Department of Pharmacy, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian, China; School of Pharmacy, Fujian Medical University, Fuzhou, Fujian, China
| | - Ruolin Chen
- College of Letter and Science, University of California Davis, CA, USA
| | - Ying Liu
- Department of Pharmacy, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian, China
| | - Peiguang Niu
- Department of Pharmacy, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian, China
| | - Jintuo Zhou
- Department of Pharmacy, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian, China
| | - Jinhua Liu
- Department of Pharmacy, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian, China; School of Pharmacy, Fujian Medical University, Fuzhou, Fujian, China
| | - Jinhua Zhang
- Department of Pharmacy, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian, China; School of Pharmacy, Fujian Medical University, Fuzhou, Fujian, China.
| | - Huajiao Chen
- Department of Pharmacy, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian, China; School of Pharmacy, Fujian Medical University, Fuzhou, Fujian, China.
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11
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Nelson BN, Friedman JE. Developmental Programming of the Fetal Immune System by Maternal Western-Style Diet: Mechanisms and Implications for Disease Pathways in the Offspring. Int J Mol Sci 2024; 25:5951. [PMID: 38892139 PMCID: PMC11172957 DOI: 10.3390/ijms25115951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Revised: 05/24/2024] [Accepted: 05/27/2024] [Indexed: 06/21/2024] Open
Abstract
Maternal obesity and over/undernutrition can have a long-lasting impact on offspring health during critical periods in the first 1000 days of life. Children born to mothers with obesity have reduced immune responses to stimuli which increase susceptibility to infections. Recently, maternal western-style diets (WSDs), high in fat and simple sugars, have been associated with skewing neonatal immune cell development, and recent evidence suggests that dysregulation of innate immunity in early life has long-term consequences on metabolic diseases and behavioral disorders in later life. Several factors contribute to abnormal innate immune tolerance or trained immunity, including changes in gut microbiota, metabolites, and epigenetic modifications. Critical knowledge gaps remain regarding the mechanisms whereby these factors impact fetal and postnatal immune cell development, especially in precursor stem cells in bone marrow and fetal liver. Components of the maternal microbiota that are transferred from mothers consuming a WSD to their offspring are understudied and identifying cause and effect on neonatal innate and adaptive immune development needs to be refined. Tools including single-cell RNA-sequencing, epigenetic analysis, and spatial location of specific immune cells in liver and bone marrow are critical for understanding immune system programming. Considering the vital role immune function plays in offspring health, it will be important to understand how maternal diets can control developmental programming of innate and adaptive immunity.
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Affiliation(s)
- Benjamin N. Nelson
- Harold Hamm Diabetes Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA;
| | - Jacob E. Friedman
- Harold Hamm Diabetes Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA;
- Department of Physiology and Biochemistry, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
- Department of Pediatrics, Section of Diabetes and Endocrinology, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
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12
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Li J, Wang M, Ma S, Jin Z, Yin H, Yang S. Association of gastrointestinal microbiome and obesity with gestational diabetes mellitus-an updated globally based review of the high-quality literatures. Nutr Diabetes 2024; 14:31. [PMID: 38773069 PMCID: PMC11109140 DOI: 10.1038/s41387-024-00291-5] [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: 01/07/2024] [Revised: 04/27/2024] [Accepted: 05/03/2024] [Indexed: 05/23/2024] Open
Abstract
OBJECTIVES The purpose of this review is to investigate the relationship between gastrointestinal microbiome, obesity, and gestational diabetes mellitus (GDM) in an objective manner. METHODS We conducted a thorough and comprehensive search of the English language literatures published in PubMed, Web of Science, and the Cochrane Library from the establishment of the library until 12 December 2023. Our search strategy included both keywords and free words searches, and we strictly applied inclusion and exclusion criteria. Meta-analyses and systematic reviews were prepared. RESULTS Six high-quality literature sources were identified for meta-analysis. However, after detailed study and analysis, a certain degree of heterogeneity was found, and the credibility of the combined analysis results was limited. Therefore, descriptive analyses were conducted. The dysbiosis of intestinal microbiome, specifically the ratio of Firmicutes/Bacteroides, is a significant factor in the development of metabolic diseases such as obesity and gestational diabetes. Patients with intestinal dysbiosis and obesity are at a higher risk of developing GDM. CONCLUSIONS During pregnancy, gastrointestinal microbiome disorders and obesity may contribute to the development of GDM, with all three factors influencing each other. This finding could aid in the diagnosis and management of patients with GDM through further research on their gastrointestinal microbiome.
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Affiliation(s)
- Jiahui Li
- Department of Gynecology and Obstetrics, The Second Hospital of Jilin University, Changchun, 130000, Jilin, China
| | - Min Wang
- Department of Gynecology and Obstetrics, The Second Hospital of Jilin University, Changchun, 130000, Jilin, China
| | - Shuai Ma
- Department of Gynecology and Obstetrics, The Second Hospital of Jilin University, Changchun, 130000, Jilin, China
| | - Zhong Jin
- Department of Gynecology and Obstetrics, The Second Hospital of Jilin University, Changchun, 130000, Jilin, China
| | - Haonan Yin
- Department of Gynecology and Obstetrics, The Second Hospital of Jilin University, Changchun, 130000, Jilin, China
| | - Shuli Yang
- Department of Gynecology and Obstetrics, The Second Hospital of Jilin University, Changchun, 130000, Jilin, China.
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13
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Musumeci A, McElwain CJ, Manna S, McCarthy F, McCarthy C. Exposure to gestational diabetes mellitus increases subclinical inflammation mediated in part by obesity. Clin Exp Immunol 2024; 216:280-292. [PMID: 38334487 PMCID: PMC11097910 DOI: 10.1093/cei/uxae010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 12/18/2023] [Accepted: 02/07/2024] [Indexed: 02/10/2024] Open
Abstract
Gestational diabetes mellitus (GDM) is a frequent and serious complication of pregnancy, often associated with obesity. Metabolic dysfunction and metainflammation are evident in both obesity and GDM. In this cross-sectional study, we aimed at defining the direct contribution of the immune system in GDM, across the main metabolic tissues, specifically focussing on elucidating the roles of obesity and GDM to the clinical outcome. Using immunoassays and multicolour flow cytometry, cytokine profiles and immune cell frequencies were measured in maternal circulation and central metabolic tissues [placenta and visceral adipose tissue (VAT)] in GDM-diagnosed (n = 28) and normal glucose tolerant (n = 32) women undergoing caesarean section. Participants were sub-grouped as non-obese [body mass index (BMI) < 30 kg/m2] or obese (BMI ≥ 30 kg/m2). Unsupervised data analysis was performed on the flow cytometry data set to identify functional alterations. GDM obese participants had significantly elevated circulating IL-6 and IL-17A levels. GDM non-obese participants had elevated circulating IL-12p70, elevated placental IL-17A, and VAT IFN-γ production. Unsupervised clustering of immune populations across the three biological sites simultaneously, identified different NK- and T-cell phenotypes that were altered in NGT obese and GDM non-obese participants, while a classical tissue monocyte cluster was increased in GDM obese participants. In this study, there was significant evidence of subclinical inflammation, and significant alterations in clusters of NK cells, T cells, and tissue monocyte populations in GDM. While increased adiposity assimilates with increased inflammation in the non-pregnant state, this overt relationship may not be as evident during pregnancy and warrants further examination in future longitudinal studies.
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Affiliation(s)
- Andrea Musumeci
- Department of Pharmacology and Therapeutics, Western Gateway Building, University College Cork, Cork, Ireland
| | - Colm John McElwain
- Department of Pharmacology and Therapeutics, Western Gateway Building, University College Cork, Cork, Ireland
| | - Samprikta Manna
- Department of Obstetrics and Gynaecology, Cork University Maternity Hospital, Cork, Ireland
| | - Fergus McCarthy
- Department of Obstetrics and Gynaecology, Cork University Maternity Hospital, Cork, Ireland
| | - Cathal McCarthy
- Department of Pharmacology and Therapeutics, Western Gateway Building, University College Cork, Cork, Ireland
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14
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Violette CJ, Aberle LS, Anderson ZS, Komatsu EJ, Song BB, Mandelbaum RS, Matsuzaki S, Ouzounian JG, Matsuo K. Pregnancy with endometriosis: Assessment of national-level trends, characteristics, and maternal morbidity at delivery. Eur J Obstet Gynecol Reprod Biol 2024; 299:1-11. [PMID: 38815411 DOI: 10.1016/j.ejogrb.2024.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 05/01/2024] [Accepted: 05/11/2024] [Indexed: 06/01/2024]
Abstract
OBJECTIVE To examine pregnancy characteristics and maternal morbidity at delivery among pregnant patients with a diagnosis of endometriosis. STUDY DESIGN This cross-sectional study queried the Healthcare Cost and Utilization Project's National Inpatient Sample. Study population was 17,796,365 hospital deliveries from 2016 to 2020, excluded adenomyosis and uterine myoma. The exposure was endometriosis diagnosis. Main outcome measures were clinical and pregnancy characteristics and severe maternal morbidity at delivery related to endometriosis, assessed with multivariable regression model. RESULTS Endometriosis was diagnosed in 17,590 patients. The prevalence of endometriosis increased by 24 % from one in 1,191 patients in 2016 to one in 853 patients in 2020 (adjusted-odds ratio [aOR] 1.24, 95% confidence interval [CI] 1.19-1.30). Clinical and pregnancy characteristics that had greater than two-fold association to endometriosis included polycystic ovary syndrome, placenta previa, cesarean delivery, maternal age of ≥30 years, prior pregnancy loss, and anxiety disorder. Pregnant patients with endometriosis were more likely to have the diagnosis of measured severe maternal morbidity during the index hospitalization for delivery (47.8 vs 17.3 per 1,000 deliveries, aOR 1.91, 95%CI 1.78-2.06); these associations were more prominent following vaginal (aOR 2.82, 95%CI 2.41-3.30) compared to cesarean (aOR 1.85, 95%CI 1.71-2.00) deliveries. Among the individual morbidity indicators, endometriosis was most strongly associated with thromboembolism (aOR 5.05, 95%CI 3.70-6.91), followed by sepsis (aOR 2.39, 95%CI 1.85-3.09) and hysterectomy (aOR 2.18, 95%CI 1.85-2.56). When stratified for endometriosis anatomical site, odds of thromboembolism was increased in endometriosis at distant site (aOR 9.10, 95%CI 3.76-22.02) and adnexa (aOR 7.37, 95%CI 4.43-12.28); odds of sepsis was most increased in endometriosis at multi-classifier locations (aOR 7.33, 95%CI 2.93-18.31) followed by pelvic peritoneum (aOR 5.54, 95%CI 2.95-10.40); and odds of hysterectomy exceeded three-fold in endometriosis at adnexa (aOR 3.00, 95%CI 2.30-3.90), distant site (aOR 5.36, 95%CI 3.48-8.24), and multi-classifier location (aOR 4.46, 95%CI 2.11-9.41). CONCLUSION The results of this nationwide analysis suggest that pregnancy with endometriosis is uncommon but gradually increasing over time in the United States. The data also suggest that endometriosis during pregnancy is associated with increased risk of severe maternal morbidity at delivery, especially for thromboembolism, sepsis, and hysterectomy. These morbidity risks differed by the anatomical location of endometriosis.
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Affiliation(s)
- Caroline J Violette
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA
| | - Laurel S Aberle
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA
| | - Zachary S Anderson
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA
| | - Emi J Komatsu
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA
| | - Bonnie B Song
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA
| | - Rachel S Mandelbaum
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA
| | - Shinya Matsuzaki
- Department of Gynecology, Osaka International Cancer Institute, Osaka, Japan
| | - Joseph G Ouzounian
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA
| | - Koji Matsuo
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA; Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA, USA.
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15
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Faienza MF, Urbano F, Anaclerio F, Moscogiuri LA, Konstantinidou F, Stuppia L, Gatta V. Exploring Maternal Diet-Epigenetic-Gut Microbiome Crosstalk as an Intervention Strategy to Counter Early Obesity Programming. Curr Issues Mol Biol 2024; 46:4358-4378. [PMID: 38785533 PMCID: PMC11119222 DOI: 10.3390/cimb46050265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 04/21/2024] [Accepted: 04/30/2024] [Indexed: 05/25/2024] Open
Abstract
Alterations in a mother's metabolism and endocrine system, due to unbalanced nutrition, may increase the risk of both metabolic and non-metabolic disorders in the offspring's childhood and adulthood. The risk of obesity in the offspring can be determined by the interplay between maternal nutrition and lifestyle, intrauterine environment, epigenetic modifications, and early postnatal factors. Several studies have indicated that the fetal bowel begins to colonize before birth and that, during birth and nursing, the gut microbiota continues to change. The mother's gut microbiota is primarily transferred to the fetus through maternal nutrition and the environment. In this way, it is able to impact the establishment of the early fetal and neonatal microbiome, resulting in epigenetic signatures that can possibly predispose the offspring to the development of obesity in later life. However, antioxidants and exercise in the mother have been shown to improve the offspring's metabolism, with improvements in leptin, triglycerides, adiponectin, and insulin resistance, as well as in the fetal birth weight through epigenetic mechanisms. Therefore, in this extensive literature review, we aimed to investigate the relationship between maternal diet, epigenetics, and gut microbiota in order to expand on current knowledge and identify novel potential preventative strategies for lowering the risk of obesity in children and adults.
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Affiliation(s)
- Maria Felicia Faienza
- Pediatric Unit, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari “A. Moro”, 70124 Bari, Italy
| | - Flavia Urbano
- Giovanni XXIII Pediatric Hospital, 70126 Bari, Italy; (F.U.); (L.A.M.)
| | - Federico Anaclerio
- Department of Psychological Health and Territorial Sciences, School of Medicine and Health Sciences, “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy; (F.A.); (F.K.); (L.S.); (V.G.)
- Unit of Molecular Genetics, Center for Advanced Studies and Technology (CAST), “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy
| | | | - Fani Konstantinidou
- Department of Psychological Health and Territorial Sciences, School of Medicine and Health Sciences, “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy; (F.A.); (F.K.); (L.S.); (V.G.)
- Unit of Molecular Genetics, Center for Advanced Studies and Technology (CAST), “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy
| | - Liborio Stuppia
- Department of Psychological Health and Territorial Sciences, School of Medicine and Health Sciences, “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy; (F.A.); (F.K.); (L.S.); (V.G.)
- Unit of Molecular Genetics, Center for Advanced Studies and Technology (CAST), “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy
| | - Valentina Gatta
- Department of Psychological Health and Territorial Sciences, School of Medicine and Health Sciences, “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy; (F.A.); (F.K.); (L.S.); (V.G.)
- Unit of Molecular Genetics, Center for Advanced Studies and Technology (CAST), “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy
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16
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Ray GW, Zeng Q, Kusi P, Zhang H, Shao T, Yang T, Wei Y, Li M, Che X, Guo R. Genetic and inflammatory factors underlying gestational diabetes mellitus: a review. Front Endocrinol (Lausanne) 2024; 15:1399694. [PMID: 38694942 PMCID: PMC11061502 DOI: 10.3389/fendo.2024.1399694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 03/28/2024] [Indexed: 05/04/2024] Open
Abstract
Gestational diabetes mellitus (GDM) poses a significant global health concern, impacting both maternal and fetal well-being. Early detection and treatment are imperative to mitigate adverse outcomes during pregnancy. This review delves into the pivotal role of insulin function and the influence of genetic variants, including SLC30A8, CDKAL1, TCF7L2, IRS1, and GCK, in GDM development. These genetic variations affect beta-cell function and insulin activity in crucial tissues, such as muscle, disrupting glucose regulation during pregnancy. We propose a hypothesis that this variation may disrupt zinc transport, consequently impairing insulin production and secretion, thereby contributing to GDM onset. Furthermore, we discussed the involvement of inflammatory pathways, such as TNF-alpha and IL-6, in predisposing individuals to GDM. Genetic modulation of these pathways may exacerbate glucose metabolism dysregulation observed in GDM patients. We also discussed how GDM affects cardiovascular disease (CVD) through a direct correlation between pregnancy and cardiometabolic function, increasing atherosclerosis, decreased vascular function, dyslipidemia, and hypertension in women with GDM history. However, further research is imperative to unravel the intricate interplay between inflammatory pathways, genetics, and GDM. This understanding is pivotal for devising targeted gene therapies and pharmacological interventions to rectify genetic variations in SLC30A8, CDKAL1, TCF7L2, IRS1, GCK, and other pertinent genes. Ultimately, this review offers insights into the pathophysiological mechanisms of GDM, providing a foundation for developing strategies to mitigate its impact.
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Affiliation(s)
- Gyan Watson Ray
- Department of Internal Medicine, Shunde Women and Children’s Hospital (Maternity and Child Healthcare Hospital of Shunde Foshan), Guangdong Medical University, Foshan, China
- Key Laboratory of Research in Maternal and Child Medicine and Birth Defects, Guangdong Medical University, Foshan, China
- Matenal and Child Research Institute, Shunde Women and Children’s Hospital (Maternity and Child Healthcare Hospital of Shunde Foshan), Guangdong Medical University, Foshan, China
| | - Qiaoli Zeng
- Department of Internal Medicine, Shunde Women and Children’s Hospital (Maternity and Child Healthcare Hospital of Shunde Foshan), Guangdong Medical University, Foshan, China
- Key Laboratory of Research in Maternal and Child Medicine and Birth Defects, Guangdong Medical University, Foshan, China
- Matenal and Child Research Institute, Shunde Women and Children’s Hospital (Maternity and Child Healthcare Hospital of Shunde Foshan), Guangdong Medical University, Foshan, China
| | - Phidelia Kusi
- University of Ghana, Ministry of Fisheries and Aquaculture Development, Fisheries Commission, Accra, Ghana
| | - Hengli Zhang
- Department of Internal Medicine, Shunde Women and Children’s Hospital (Maternity and Child Healthcare Hospital of Shunde Foshan), Guangdong Medical University, Foshan, China
- Key Laboratory of Research in Maternal and Child Medicine and Birth Defects, Guangdong Medical University, Foshan, China
- Matenal and Child Research Institute, Shunde Women and Children’s Hospital (Maternity and Child Healthcare Hospital of Shunde Foshan), Guangdong Medical University, Foshan, China
| | - Taotao Shao
- Department of Internal Medicine, Shunde Women and Children’s Hospital (Maternity and Child Healthcare Hospital of Shunde Foshan), Guangdong Medical University, Foshan, China
- Key Laboratory of Research in Maternal and Child Medicine and Birth Defects, Guangdong Medical University, Foshan, China
| | - Taili Yang
- Matenal and Child Research Institute, Shunde Women and Children’s Hospital (Maternity and Child Healthcare Hospital of Shunde Foshan), Guangdong Medical University, Foshan, China
| | - Yue Wei
- Matenal and Child Research Institute, Shunde Women and Children’s Hospital (Maternity and Child Healthcare Hospital of Shunde Foshan), Guangdong Medical University, Foshan, China
| | - Mianqin Li
- Department of Obstetric, Shunde Women and Children’s Hospital (Maternity and Child Healthcare Hospital of Shunde Foshan), Guangdong Medical University, Foshan, Guangdong, China
| | - Xiaoqun Che
- Department of Obstetric, Shunde Women and Children’s Hospital (Maternity and Child Healthcare Hospital of Shunde Foshan), Guangdong Medical University, Foshan, Guangdong, China
- Reproductive Medicine Center, Shunde Women and Children’s Hospital (Maternity and Child Healthcare Hospital of Shunde Foshan), Guangdong Medical University, Foshan, Guangdong, China
| | - Runmin Guo
- Department of Internal Medicine, Shunde Women and Children’s Hospital (Maternity and Child Healthcare Hospital of Shunde Foshan), Guangdong Medical University, Foshan, China
- Key Laboratory of Research in Maternal and Child Medicine and Birth Defects, Guangdong Medical University, Foshan, China
- Matenal and Child Research Institute, Shunde Women and Children’s Hospital (Maternity and Child Healthcare Hospital of Shunde Foshan), Guangdong Medical University, Foshan, China
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17
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Peña A, Miller AM, Campbell AG, Holden RJ, Scifres CM. Mapping Lifestyle Interventions for Gestational Diabetes Prevention: A Scoping Review. Curr Diab Rep 2024; 24:74-83. [PMID: 38367172 DOI: 10.1007/s11892-024-01535-5] [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] [Accepted: 02/01/2024] [Indexed: 02/19/2024]
Abstract
PURPOSE OF REVIEW The purpose of this study was to conduct a scoping review to map intervention, sample, and physiologic measurement characteristics of lifestyle interventions for gestational diabetes mellitus (GDM) prevention. RECENT FINDINGS A total of 19 studies met selection criteria from 405 articles screened (PubMed, Web of Science). No studies were US-based (47% multi-site), and all were delivered in clinical settings. The most targeted nutrition components were low carbohydrate intake (sugar rich foods/added sugars, low glycemic index), low fat intake (mainly low-fat meat, dairy, and saturated fat), and increased fruits and vegetables. Many studies promoted 150 min/week moderate-intensity physical activity. Only two studies provided supervised physical activity sessions. Dietitians and nurses were the most common implementers. Samples were characterized as adults with obesity (mean age 31 yr, BMI 31 kg/m2). Asian populations were predominantly studied. Four studies used theoretical frameworks (75% of which used Social Cognitive Theory). GDM diagnostic criteria set forth by the American Diabetes Association were the most widely used. Insulin sensitivity was commonly assessed via fasting indices. There was a lack of multi-disciplinary, multi-level, and theory-based lifestyle interventions for reducing GDM risk. Addressing these gaps and prioritizing high-risk populations in the US with measurement of traditional and novel biomarkers will advance the field.
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Affiliation(s)
- Armando Peña
- Department of Health & Wellness Design, School of Public Health in Bloomington, Indiana University, Bloomington, IN, USA.
| | - Alison M Miller
- Department of Health & Wellness Design, School of Public Health in Bloomington, Indiana University, Bloomington, IN, USA
| | - Angela G Campbell
- Applied Health Sciences, School of Public Health in Bloomington, Indiana University, Bloomington, IN, USA
| | - Richard J Holden
- Department of Health & Wellness Design, School of Public Health in Bloomington, Indiana University, Bloomington, IN, USA
| | - Christina M Scifres
- Department of Obstetrics and Gynecology, School of Medicine, Indiana University, Indianapolis, IN, USA
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18
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Joshi N, Jadhav A, Godhamgaonkar A, Sundrani D, Randhir K, Pisal H, Wagh G, Krishnaveni G, Gupte S, Joshi S. Fatty acids and their metabolites (resolvins) are altered in women with gestational diabetes mellitus (GDM). Food Funct 2024; 15:3023-3035. [PMID: 38412051 DOI: 10.1039/d3fo05348b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
The maternal fatty acid status plays a key role in influencing pregnancy outcomes. Omega-3 fatty acids are the precursors for E-series (RvE) and D-series resolvins (RvD) and possess anti-inflammatory properties. Pregnancy complications like gestational diabetes mellitus (GDM) are associated with excess maternal inflammation. This study reports the levels of maternal fatty acids across gestation in GDM and non-GDM women, placental fatty acids, resolvins and their association with the maternal fatty acid status. Pregnant women were recruited at 11-14 (V1) weeks and followed at 18-22 (V2) and 26-28 (V3) weeks and at delivery (V4). A total of 209 women who were diagnosed as GDM and 207 non-GDM women were included in this study. Fatty acids were estimated using gas chromatography. The protein levels of resolvins (RvE1, RvE2, RvD1 and RvD2) were measured using ELISA kits. Total PUFAs, eicosapentaenoic acid (EPA), omega-6 fatty acids, linoleic acid (LA) and arachidonic acid (AA) were lower, while saturated fatty acid (SFA) and alpha-linolenic acid (ALA) levels were higher in GDM women at 18-22 weeks. Placental AA was lower (p < 0.05) in women with GDM. Placental protein levels of RvE1, RvD1 and RvD2 were lower (p < 0.001 for all) in the GDM group. The maternal delta 5 desaturase index was positively associated, while erythrocyte omega-3 and omega-6 fatty acids were negatively associated with RvE2 at 11-14 weeks. Placental LA and ALA were positively associated with RvD1 and RvD2 (p < 0.05, for both), respectively. Our findings suggest that the maternal fatty acid status influences pro-resolving mediators which may lead to increased inflammation in GDM.
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Affiliation(s)
- Nikita Joshi
- Mother and Child Health, ICMR-Collaborating Centre of Excellence (ICMR-CCoE), Interactive Research School for Health Affairs (IRSHA), Bharati Vidyapeeth (Deemed to be University), Pune- 411043, India.
| | - Anjali Jadhav
- Mother and Child Health, ICMR-Collaborating Centre of Excellence (ICMR-CCoE), Interactive Research School for Health Affairs (IRSHA), Bharati Vidyapeeth (Deemed to be University), Pune- 411043, India.
| | - Aditi Godhamgaonkar
- Mother and Child Health, ICMR-Collaborating Centre of Excellence (ICMR-CCoE), Interactive Research School for Health Affairs (IRSHA), Bharati Vidyapeeth (Deemed to be University), Pune- 411043, India.
| | - Deepali Sundrani
- Mother and Child Health, ICMR-Collaborating Centre of Excellence (ICMR-CCoE), Interactive Research School for Health Affairs (IRSHA), Bharati Vidyapeeth (Deemed to be University), Pune- 411043, India.
| | - Karuna Randhir
- Mother and Child Health, ICMR-Collaborating Centre of Excellence (ICMR-CCoE), Interactive Research School for Health Affairs (IRSHA), Bharati Vidyapeeth (Deemed to be University), Pune- 411043, India.
| | - Hemalata Pisal
- Mother and Child Health, ICMR-Collaborating Centre of Excellence (ICMR-CCoE), Interactive Research School for Health Affairs (IRSHA), Bharati Vidyapeeth (Deemed to be University), Pune- 411043, India.
| | - Girija Wagh
- Department of Obstetrics and Gynecology, Bharati Medical College and Hospital, Bharati Vidyapeeth University, Pune, India
| | - Ghattu Krishnaveni
- Epidemiology Research Unit, CSI Holdsworth Memorial Hospital, Mysore, India
| | | | - Sadhana Joshi
- Mother and Child Health, ICMR-Collaborating Centre of Excellence (ICMR-CCoE), Interactive Research School for Health Affairs (IRSHA), Bharati Vidyapeeth (Deemed to be University), Pune- 411043, India.
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19
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Cao WL, Yu CP, Zhang LL. Serum proteins differentially expressed in gestational diabetes mellitus assessed using isobaric tag for relative and absolute quantitation proteomics. World J Clin Cases 2024; 12:1395-1405. [PMID: 38576811 PMCID: PMC10989458 DOI: 10.12998/wjcc.v12.i8.1395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 01/08/2024] [Accepted: 02/18/2024] [Indexed: 03/12/2024] Open
Abstract
BACKGROUND As a well-known fact to the public, gestational diabetes mellitus (GDM) could bring serious risks for both pregnant women and infants. During this important investigation into the linkage between GDM patients and their altered expression in the serum, proteomics techniques were deployed to detect the differentially expressed proteins (DEPs) of in the serum of GDM patients to further explore its pathogenesis, and find out possible biomarkers to forecast GDM occurrence. AIM To investigation serum proteins differentially expressed in GDM were assessed using isobaric tag for relative and absolute quantitation (iTRAQ) proteomics and bioinformatics analyses. METHODS Subjects were divided into GDM and normal control groups according to the IADPSG diagnostic criteria. Serum samples were randomly selected from four cases in each group at 24-28 wk of gestation, and the blood samples were identified by applying iTRAQ technology combined with liquid chromatography-tandem mass spectrometry. Key proteins and signaling pathways associated with GDM were identified by bioinformatics analysis, and the expression of key proteins in serum from 12 wk to 16 wk of gestation was further verified using enzyme-linked immunosorbent assay (ELISA). RESULTS Forty-seven proteins were significantly differentially expressed by analyzing the serum samples between the GDM gravidas as well as the healthy ones. Among them, 31 proteins were found to be upregulated notably and the rest 16 proteins were downregulated remarkably. Bioinformatic data report revealed abnormal expression of proteins associated with lipid metabolism, coagulation cascade activation, complement system and inflammatory response in the GDM group. ELISA results showed that the contents of RBP4, as well as ANGPTL8, increased in the serum of GDM gravidas compared with the healthy ones, and this change was found to initiate from 12 wk to 16 wk of gestation. CONCLUSION GDM symptoms may involve abnormalities in lipid metabolism, coagulation cascade activation, complement system and inflammatory response. RBP4 and ANGPTL8 are expected to be early predictors of GDM.
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Affiliation(s)
- Wei-Li Cao
- Department of Women’s Health Care, Maternal and Child Health Hospital of Hubei Province, Wuhan 430070, Hubei Province, China
| | - Cui-Ping Yu
- Obstetrical Department, The First People’s Hospital of Jiangxia District Wuhan City (Union Jiangnan Hospital Huazhong University of Science and Technology), Wuhan 430200, Hubei Province, China
| | - Ling-Li Zhang
- Department of Gynecology, Maternal and Child Health Hospital of Hubei Province, Wuhan 430070, Hubei Province, China
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20
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Nielsen TC, Nassar N, Shand AW, Jones HF, Han VX, Patel S, Guastella AJ, Dale RC, Lain SJ. Association between cumulative maternal exposures related to inflammation and child attention-deficit/hyperactivity disorder: A cohort study. Paediatr Perinat Epidemiol 2024; 38:241-250. [PMID: 38009577 DOI: 10.1111/ppe.13022] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 11/10/2023] [Accepted: 11/11/2023] [Indexed: 11/29/2023]
Abstract
BACKGROUND Preclinical studies suggest synergistic effects of maternal inflammatory exposures on offspring neurodevelopment, but human studies have been limited. OBJECTIVES To examine the cumulative association and potential interactions between seven maternal exposures related to inflammation and child attention-deficit/hyperactivity disorder (ADHD). METHODS We conducted a population-based cohort study of children born from July 2001 to December 2011 in New South Wales, Australia, and followed up until December 2014. Seven maternal exposures were identified from birth data and hospital admissions during pregnancy: autoimmune disease, asthma, hospitalization for infection, mood or anxiety disorder, smoking, hypertension, and diabetes. Child ADHD was identified from stimulant prescription records. Multivariable Cox regression assessed the association between individual and cumulative exposures and ADHD and potential interaction between exposures, controlling for potential confounders. RESULTS The cohort included 908,770 children, one-third (281,724) with one or more maternal exposures. ADHD was identified in 16,297 children (incidence 3.5 per 1000 person-years) with median age of 7 (interquartile range 2) years at first treatment. Each exposure was independently associated with ADHD, and risk increased with additional exposures: one exposure (hazard ratio (HR) 1.59, 95% confidence interval (CI) 1.54, 1.65), two exposures (HR 2.25, 95% CI 2.13, 2.37), and three or more exposures (HR 3.28, 95% CI 2.95, 3.64). Positive interaction was found between smoking and infection. The largest effect size was found for cumulative exposure of asthma, infection, mood or anxiety disorder, and smoking (HR 6.12, 95% CI 3.47, 10.70). CONCLUSIONS This study identifies cumulative effects of multiple maternal exposures related to inflammation on ADHD, most potentially preventable or modifiable. Future studies should incorporate biomarkers of maternal inflammation and consider gene-environment interactions.
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Affiliation(s)
- Timothy C Nielsen
- Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Natasha Nassar
- Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Antonia W Shand
- Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
- Royal Hospital for Women, Randwick, New South Wales, Australia
| | - Hannah F Jones
- Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
- Starship Children's Hospital, Centre for Brain Research, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Velda X Han
- Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
- Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore City, Singapore
| | - Shrujna Patel
- Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Adam J Guastella
- Children's Hospital Westmead Clinical School, Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Russell C Dale
- Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Samantha J Lain
- Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
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Yildiz EG, Tanacan A, Okutucu G, Bastemur AG, Ipek G, Sahin D. Can System Inflammation Response Index or Systemic Immune Inflammation Index predict gestational diabetes mellitus in the first trimester? A prospective observational study. Int J Gynaecol Obstet 2024. [PMID: 38426227 DOI: 10.1002/ijgo.15442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 02/04/2024] [Accepted: 02/07/2024] [Indexed: 03/02/2024]
Abstract
OBJECTIVE To evaluate System Inflammation Response Index (SIRI) and Systemic Immune Inflammation Index (SII), which are the inflammatory indices, for the prediction of gestational diabetes mellitus (GDM) in the first trimester. METHODS This was a prospective observational study conducted in a tertiary center from April 2023 to September 2023. Ninety-four pregnant women with gestational diabetes and 107 healthy pregnant women were included. The two groups were compared according to first-trimester SIRI and SII values. A receiver operating characteristic (ROC) curve analysis was performed to determine the optimal cut-off levels of SII and SIRI in predicting GDM. RESULTS Significantly higher first-trimester SII and SIRI values were present in the gestational diabetes group (P < 0.001). Optimal cut-off values in the prediction of gestational diabetes were found to be 1.58 (area under the curve [AUC] 0.71, 67% sensitivity, 65% specificity, 95% confidence interval [CI] 0.64-0.78, P < 0.001) and 875 (AUC 0.70, 66% sensitivity, 65% specificity, 95% CI 0.63-0.77, P < 0.001) for SIRI and SII, respectively. Neutrophil counts, mean platelet volume (MPW), neutrophil to lymphocyte ratio (NLR), and red cell distribution width (RDW) were significantly higher in the GDM group (P < 0.001, P = 0.02, P = 0.01, P < 0.01, respectively). CONCLUSION Novel inflammatory indices SII and SIRI may be useful in the prediction of GDM in the first trimester, but their utility in the prediction of insulin requirement is questionable. They may be used as additional tools in routine clinical practice.
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Affiliation(s)
- Esra Gulen Yildiz
- Division of Perinatology, Department of Obstetrics and Gynecology, Ankara City Hospital, Ankara, Turkey
| | - Atakan Tanacan
- Division of Perinatology, Department of Obstetrics and Gynecology, Ankara City Hospital, Ankara, Turkey
| | - Gulcan Okutucu
- Division of Perinatology, Department of Obstetrics and Gynecology, Ankara City Hospital, Ankara, Turkey
| | - Ayse Gulcin Bastemur
- Division of Perinatology, Department of Obstetrics and Gynecology, Ankara City Hospital, Ankara, Turkey
| | - Goksun Ipek
- Division of Perinatology, Department of Obstetrics and Gynecology, Ankara City Hospital, Ankara, Turkey
| | - Dilek Sahin
- Division of Perinatology, Department of Obstetrics and Gynecology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
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22
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Niebrzydowska-Tatus M, Pełech A, Bień K, Mekler J, Santiago M, Kimber-Trojnar Ż, Trojnar M. Association of DPP-4 Concentrations with the Occurrence of Gestational Diabetes Mellitus and Excessive Gestational Weight Gain. Int J Mol Sci 2024; 25:1829. [PMID: 38339106 PMCID: PMC10855185 DOI: 10.3390/ijms25031829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 01/24/2024] [Accepted: 01/31/2024] [Indexed: 02/12/2024] Open
Abstract
Gestational diabetes mellitus (GDM) is considered one of the most common diseases that occur during pregnancy. In addition to increasing the risk of numerous complications throughout gestation, it is also believed to have a long-term potential to impact the risk of developing type 2 diabetes mellitus (T2DM) and cardiovascular disease for the mother and her offspring. While there are clear guidelines for healthy weight gain in pregnancy depending on pre-pregnancy BMI, as well as dietary and training recommendations to achieve this, an increasing number of women are experiencing excessive gestational weight gain (EGWG). Such patients have a higher risk of developing GDM and gestational hypertension, as well as requiring caesarian delivery. Dipeptidyl peptidase-4 (DPP-4) is a glycoprotein that seems to play an important role in glucose metabolism, and inhibition of its activity positively affects glucose regulation. The aim of our study was to compare DPP-4 concentrations in patients with GDM and EGWG with healthy women. DPP-4 levels were assessed in serum and urine samples collected on the day of delivery. The bioelectrical impedance analysis (BIA) method was also used to analyze the body composition of patients on the second day of the postpartum period. DPP-4 serum concentrations were significantly higher in patients in the GDM and EGWG groups compared to healthy women. Urinary DPP-4 concentrations were significantly higher in the control and GDM groups than in the EGWG group. Serum DPP-4 levels were positively correlated with BMI measured before pregnancy, on the delivery day, and in the early postpartum period, among other factors. According to our knowledge, this is the first study to determine DPP-4 levels in EGWG patients. DPP-4 may be related to the occurrence of GDM and EGWG; however, this requires further research.
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Affiliation(s)
- Magdalena Niebrzydowska-Tatus
- Chair and Department of Obstetrics and Perinatology, Medical University of Lublin, 20-090 Lublin, Poland; (M.N.-T.); (A.P.)
| | - Aleksandra Pełech
- Chair and Department of Obstetrics and Perinatology, Medical University of Lublin, 20-090 Lublin, Poland; (M.N.-T.); (A.P.)
| | - Katarzyna Bień
- Student’s Scientific Association at the Chair and Department of Obstetrics and Perinatology, Medical University of Lublin, 20-090 Lublin, Poland; (K.B.); (J.M.); (M.S.)
| | - Julia Mekler
- Student’s Scientific Association at the Chair and Department of Obstetrics and Perinatology, Medical University of Lublin, 20-090 Lublin, Poland; (K.B.); (J.M.); (M.S.)
| | - Miracle Santiago
- Student’s Scientific Association at the Chair and Department of Obstetrics and Perinatology, Medical University of Lublin, 20-090 Lublin, Poland; (K.B.); (J.M.); (M.S.)
| | - Żaneta Kimber-Trojnar
- Chair and Department of Obstetrics and Perinatology, Medical University of Lublin, 20-090 Lublin, Poland; (M.N.-T.); (A.P.)
| | - Marcin Trojnar
- Chair and Department of Internal Diseases, Medical University of Lublin, 20-059 Lublin, Poland;
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Shiadeh SMJ, Goretta F, Svedin P, Jansson T, Mallard C, Ardalan M. Long-term impact of maternal obesity on the gliovascular unit and ephrin signaling in the hippocampus of adult offspring. J Neuroinflammation 2024; 21:39. [PMID: 38308309 PMCID: PMC10837922 DOI: 10.1186/s12974-024-03030-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 01/24/2024] [Indexed: 02/04/2024] Open
Abstract
BACKGROUND Children born to obese mothers are at increased risk of developing mood disorders and cognitive impairment. Experimental studies have reported structural changes in the brain such as the gliovascular unit as well as activation of neuroinflammatory cells as a part of neuroinflammation processing in aged offspring of obese mothers. However, the molecular mechanisms linking maternal obesity to poor neurodevelopmental outcomes are not well established. The ephrin system plays a major role in a variety of cellular processes including cell-cell interaction, synaptic plasticity, and long-term potentiation. Therefore, in this study we determined the impact of maternal obesity in pregnancy on cortical, hippocampal development, vasculature and ephrin-A3/EphA4-signaling, in the adult offspring in mice. METHODS Maternal obesity was induced in mice by a high fat/high sugar Western type of diet (HF/HS). We collected brain tissue (prefrontal cortex and hippocampus) from 6-month-old offspring of obese and lean (control) dams. Hippocampal volume, cortical thickness, myelination of white matter, density of astrocytes and microglia in relation to their activity were analyzed using 3-D stereological quantification. mRNA expression of ephrin-A3, EphA4 and synaptic markers were measured by qPCR in the brain tissue. Moreover, expression of gap junction protein connexin-43, lipocalin-2, and vascular CD31/Aquaporin 4 were determined in the hippocampus by immunohistochemistry. RESULTS Volume of hippocampus and cortical thickness were significantly smaller, and myelination impaired, while mRNA levels of hippocampal EphA4 and post-synaptic density (PSD) 95 were significantly lower in the hippocampus in the offspring of obese dams as compared to offspring of controls. Further analysis of the hippocampal gliovascular unit indicated higher coverage of capillaries by astrocytic end-feet, expression of connexin-43 and lipocalin-2 in endothelial cells in the offspring of obese dams. In addition, offspring of obese dams demonstrated activation of microglia together with higher density of cells, while astrocyte cell density was lower. CONCLUSION Maternal obesity affects brain size, impairs myelination, disrupts the hippocampal gliovascular unit and decreases the mRNA expression of EphA4 and PSD-95 in the hippocampus of adult offspring. These results indicate that the vasculature-glia cross-talk may be an important mediator of altered synaptic plasticity, which could be a link between maternal obesity and neurodevelopmental/neuropsychiatric disorders in the offspring.
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Affiliation(s)
- Seyedeh Marziyeh Jabbari Shiadeh
- Department of Physiology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Clinical Medicine, Translational Neuropsychiatry Unit, Aarhus University, Aarhus, Denmark
| | - Fanny Goretta
- Department of Physiology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Pernilla Svedin
- Department of Physiology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Thomas Jansson
- Division of Reproductive Sciences, Department of OB/GYN, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA
| | - Carina Mallard
- Department of Physiology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Maryam Ardalan
- Department of Physiology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
- Department of Clinical Medicine, Translational Neuropsychiatry Unit, Aarhus University, Aarhus, Denmark.
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Mavroeidi I, Manta A, Asimakopoulou A, Syrigos A, Paschou SA, Vlachaki E, Nastos C, Kalantaridou S, Peppa M. The Role of the Glycemic Index and Glycemic Load in the Dietary Approach of Gestational Diabetes Mellitus. Nutrients 2024; 16:399. [PMID: 38337683 PMCID: PMC10857473 DOI: 10.3390/nu16030399] [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: 12/14/2023] [Revised: 01/19/2024] [Accepted: 01/20/2024] [Indexed: 02/12/2024] Open
Abstract
Gestational diabetes mellitus (GDM) is a common metabolic disorder that often develops during pregnancy, characterized by glucose intolerance and insulin resistance (IR). To ensure the well-being of both the mother and the fetus, the body undergoes multiple metabolic and immunological changes that result in peripheral IR and, under certain hereditary or acquired abnormalities, GDM in predisposed women. The adverse short- and long-term effects of GDM impact both the mother and the fetus. Nutrition seems to play an important role to prevent GDM or improve its evolution. An emphasis has been given to the proportion of carbohydrates (CHO) relative to protein and lipids, as well as dietary patterns, in GDM. The effects of CHO on postprandial glucose concentrations are reflected in the glycemic index (GI) and glycemic load (GL). Diets rich in GI and GL may induce or exacerbate IR, whereas diets low in GI and GL appear to enhance insulin sensitivity and improve glycemic control. These positive outcomes may be attributed to direct interactions with insulin and glucose homeostasis or indirect effects through improved body composition and weight management. This comprehensive narrative review aims to explore the significance of nutrition, with a focus on the critical evaluation of GI and GL in the dietary management of women with GDM.
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Affiliation(s)
- Ioanna Mavroeidi
- Endocrine Unit, 2nd Propaedeutic Department of Internal Medicine, Research Institute and Diabetes Center, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, 12461 Athens, Greece
| | - Aspasia Manta
- Endocrine Unit, 2nd Propaedeutic Department of Internal Medicine, Research Institute and Diabetes Center, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, 12461 Athens, Greece
| | - Athina Asimakopoulou
- 3rd Department of Internal Medicine, Sotiria General Hospital, 11527 Athens, Greece
| | - Alexandros Syrigos
- 3rd Department of Internal Medicine, Sotiria General Hospital, 11527 Athens, Greece
| | - Stavroula A Paschou
- Endocrine Unit and Diabetes Center, Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Efthimia Vlachaki
- Hematological Laboratory, 2nd Department of Internal Medicine, Hippokrateion Hospital, Aristotle University, 54640 Thessaloniki, Greece
| | - Constantinos Nastos
- 3rd Department of Surgery, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, 12461 Athens, Greece
| | - Sophia Kalantaridou
- Department of Obstetrics and Gynecology, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, 12461 Athens, Greece
| | - Melpomeni Peppa
- Endocrine Unit, 2nd Propaedeutic Department of Internal Medicine, Research Institute and Diabetes Center, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, 12461 Athens, Greece
- 3rd Department of Internal Medicine, Sotiria General Hospital, 11527 Athens, Greece
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25
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Wu H, Yi MH, Liu BG, Xu Y, Wu Q, Liu YH, Lu LP. Association of gestational metabolic syndrome with the Chinese Healthy Eating Index in mid-pregnancy: a cross-sectional study. Nutr Metab (Lond) 2024; 21:8. [PMID: 38279139 PMCID: PMC10811910 DOI: 10.1186/s12986-024-00780-5] [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: 02/17/2023] [Accepted: 01/15/2024] [Indexed: 01/28/2024] Open
Abstract
BACKGROUND This study aims to investigate the relationship between gestational metabolic syndrome (GMS) and the Chinese Healthy Eating Index (CHEI) in mid-pregnancy, and to identify potentially beneficial or high-risk dietary habits. We have developed a mid-pregnancy version of CHEI-2022, adapting the Chinese Healthy Eating Index to align with the food quantity recommendations outlined in the 2022 Dietary Guidelines for Chinese Residents for mid-pregnancy. METHODS Using the inclusion and exclusion criteria, data from 2411 mid-pregnant individuals were collected through interviews. The Total CHEI score and its component scores were determined through analysis of responses from the food frequency questionnaire. GMS diagnosis involved conducting physical examinations and performing blood biochemical tests. A logistic regression model was employed to analyze the relationship between GMS or related indices and both the total CHEI score and its component scores. RESULTS The study identified an overall GMS prevalence of 21.65% (522 out of 2411 participants). During mid-pregnancy, participants diagnosed with GMS exhibited higher BMI, FBG, 1hPBG, 2hPBG, TC, TG, HDL, SBP, as well as higher educational levels and daily activity, compared to those without GMS (P < 0.001). After adjusting for potential confounders, participants with higher total CHEI scores (≥ 80) were found to have lower odds of GMS or related indices (P < 0.05). Increasing dietary intake of potatoes, whole grains, beans, dark green vegetables, and fruits, as per the CHEI recommendations, was associated with reduced odds of GMS or related indices (P < 0.05). CONCLUSION A high-quality diet, as indicated by a total CHEI score of 80 or higher, and increased consumption of specific dietary components, namely potatoes, beans, dark green vegetables, and fruits, were found to effectively reduce the odds of GMS or related indices during mid-pregnancy.
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Affiliation(s)
- Hui Wu
- Department of Nutrition, Seventh People's Hospital of Shanghai University of Traditional Chinese Medicine, Shanghai, 200137, China
| | - Min-Hui Yi
- Department of Obstetrics and Gynecology, Seventh People's Hospital of Shanghai University of Traditional Chinese Medicine, Shanghai, 200137, China
| | - Bing-Gang Liu
- Department of Obstetrics and Gynecology, Seventh People's Hospital of Shanghai University of Traditional Chinese Medicine, Shanghai, 200137, China
| | - Yan Xu
- Department of Obstetrics and Gynecology, Seventh People's Hospital of Shanghai University of Traditional Chinese Medicine, Shanghai, 200137, China
| | - Qin Wu
- Department of Obstetrics and Gynecology, Seventh People's Hospital of Shanghai University of Traditional Chinese Medicine, Shanghai, 200137, China
| | - Yu-Hong Liu
- Department of Obstetrics and Gynecology, Seventh People's Hospital of Shanghai University of Traditional Chinese Medicine, Shanghai, 200137, China.
| | - Ling-Peng Lu
- Department of Clinical Lab, Seventh People's Hospital of Shanghai University of Traditional Chinese Medicine, Shanghai, 200137, China.
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Huang X, Li Y, Tong X, Wu Y, Zhang R, Sheng L, Xu J, Yu Z, Chen Z, Sun T, Wang F, Yang Q, Li Z, Gao C, Ma L, Ding H, Zang S, Yang N, Zhang TN, Liu J. Increased Circulating IL-32 Is Associated With Placenta Macrophage-derived IL-32 and Gestational Diabetes Mellitus. J Clin Endocrinol Metab 2024; 109:333-343. [PMID: 37708356 DOI: 10.1210/clinem/dgad531] [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: 06/20/2023] [Revised: 08/17/2023] [Accepted: 09/05/2023] [Indexed: 09/16/2023]
Abstract
OBJECTIVE Placenta-derived inflammation plays a vital role in the pathophysiology of gestational diabetes mellitus (GDM). IL-32 is a novel pro-inflammatory cytokine and metabolic regulator involved in the development of metabolic disease. We investigated the effect of IL-32 in GDM. MATERIALS AND METHODS First-trimester C-reactive protein (CRP) level was monitored in a case-control study of 186 women with GDM and 186 women without. Placental tissue was lysed and analyzed by high-resolution liquid chromatography-tandem mass spectrometry. Circulating level of inflammatory cytokines IL-32, IL-6, and TNF-α were measured by ELISA kits. The expression of placenta-derived macrophages, inflammatory cytokines, and related pathway proteins were assessed by reverse transcriptase-quantitative PCR, western blot, immunohistochemistry, or immunofluorescence. RESULTS First-trimester CRP level in peripheral blood was closely associated with glucose and insulin resistance index and was an independent correlation with the development of GDM. High-resolution liquid chromatography-tandem mass spectrometry revealed that placenta-derived CRP expression was dramatically elevated in women with GDM. Interestingly, the expression of placenta-derived IL-32 was also increased and located in the macrophages of placental tissue. Meanwhile, the expression of IL-6, TNF-α, and p-p38 were up-regulated in the placental tissues with GDM. Either IL-6 or TNF-α was colocated with IL-32 in the placental tissue. Importantly, circulating IL-32 throughout pregnancy was increased in GDM and was related to placental-derived IL-32 expression, circulating IL-6, and TNF-α, glucose and insulin resistance index. CONCLUSION Increased circulating IL-32 throughout pregnancy was closely associated with placenta macrophage-derived IL-32 expression and GDM. First trimester IL-32 level in peripheral blood may serve to predict the development of GDM.
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Affiliation(s)
- Xinmei Huang
- Department of Endocrinology, Shanghai Fifth People's Hospital, Fudan University, Shanghai 200240, China
| | - Yue Li
- Department of Endocrinology, Shanghai Fifth People's Hospital, Fudan University, Shanghai 200240, China
| | - Xiaoxu Tong
- Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang 110004, China
| | - Yueyue Wu
- Department of Endocrinology, Shanghai Fifth People's Hospital, Fudan University, Shanghai 200240, China
| | - Rui Zhang
- Department of Endocrinology, Shanghai Fifth People's Hospital, Fudan University, Shanghai 200240, China
| | - Li Sheng
- Department of Endocrinology, Shanghai Fifth People's Hospital, Fudan University, Shanghai 200240, China
| | - Jiong Xu
- Department of Endocrinology, Shanghai Fifth People's Hospital, Fudan University, Shanghai 200240, China
| | - Zhiyan Yu
- Department of Endocrinology, Shanghai Fifth People's Hospital, Fudan University, Shanghai 200240, China
| | - Zaoping Chen
- Department of Endocrinology, Shanghai Fifth People's Hospital, Fudan University, Shanghai 200240, China
| | - Tiange Sun
- Department of Endocrinology, Shanghai Fifth People's Hospital, Fudan University, Shanghai 200240, China
| | - Fang Wang
- Department of Endocrinology, Shanghai Fifth People's Hospital, Fudan University, Shanghai 200240, China
| | - Qian Yang
- Department of Endocrinology, Shanghai Fifth People's Hospital, Fudan University, Shanghai 200240, China
| | - Zhangyan Li
- Department of Endocrinology, Shanghai Fifth People's Hospital, Fudan University, Shanghai 200240, China
| | - Cuijun Gao
- Department of Obstetrics, Wujing Hospital, Shanghai 200241, China
| | - Ling Ma
- Department of Obstetrics, Wujing Hospital, Shanghai 200241, China
| | - Heyuan Ding
- Department of Endocrinology, Shanghai Fifth People's Hospital, Fudan University, Shanghai 200240, China
| | - Shufei Zang
- Department of Endocrinology, Shanghai Fifth People's Hospital, Fudan University, Shanghai 200240, China
| | - Ni Yang
- Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang 110004, China
| | - Tie-Ning Zhang
- Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang 110004, China
| | - Jun Liu
- Department of Endocrinology, Shanghai Fifth People's Hospital, Fudan University, Shanghai 200240, China
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Sahoo PK, Krishnamoorthy C, Wood JR, Hanson C, Anderson-Berry A, Mott JL, Natarajan SK. Palmitate induces integrated stress response and lipoapoptosis in trophoblasts. Cell Death Dis 2024; 15:31. [PMID: 38212315 PMCID: PMC10784287 DOI: 10.1038/s41419-023-06415-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 12/19/2023] [Accepted: 12/22/2023] [Indexed: 01/13/2024]
Abstract
Maternal obesity increases the risk of childhood obesity and programs the offspring to develop metabolic syndrome later in their life. Palmitate is the predominant saturated free fatty acid (FFA) that is transported across the placenta to the fetus. We have recently shown that saturated FFA in the maternal circulation as a result of increased adipose tissue lipolysis in third trimester of pregnancy induces trophoblast lipoapoptosis. Here, we hypothesized that palmitate induces integrated stress response by activating mitogen-activated protein kinases (MAPKs), endoplasmic reticulum (ER) stress and granular stress and lipoapoptosis in trophoblasts. Choriocarcinoma-derived third-trimester placental trophoblast-like cells (JEG-3 and JAR) referred as trophoblasts were exposed to various concentrations of palmitate (PA). Apoptosis was assessed by nuclear morphological changes and caspase 3/7 activity. Immunoblot and immunofluorescence analysis was performed to measure the activation of MAPKs, ER stress and granular stress response pathways. Trophoblasts exposed to pathophysiological concentrations of PA showed a concentration-dependent increase in trophoblast lipoapoptosis. PA induces a caspase-dependent trophoblast lipoapoptosis. Further, PA induces MAPK activation (JNK and ERK) via phosphorylation, and activation of ER stress as evidenced by an increased phosphorylation eIF2α & IRE1α. PA also induces the activation of stress granules formation. Two pro-apoptotic transcriptional mediators of PA-induced trophoblast lipoapoptosis, CHOP and FoxO3 have increased nuclear translocation. Mechanistically, PA-induced JNK is critical for trophoblast lipoapoptosis. However, PA-induced activation of ERK and stress granule formation were shown to be cell survival signals to combat subcellular stress due to PA exposure. In conclusion, PA induces the activation of integrated stress responses, among which small molecule inhibition of JNK demonstrated that activation of JNK is critical for PA-induced trophoblast lipoapoptosis and small molecule activation of stress granule formation significantly prevents PA-induced trophoblast lipoapoptosis.
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Affiliation(s)
- Prakash Kumar Sahoo
- Department of Nutrition and Health Sciences, University of Nebraska-Lincoln, Lincoln, NE, USA
| | - Chandan Krishnamoorthy
- Department of Nutrition and Health Sciences, University of Nebraska-Lincoln, Lincoln, NE, USA
| | - Jennifer R Wood
- Department of Animal Sciences, University of Nebraska-Lincoln, Lincoln, NE, USA
| | - Corrine Hanson
- College of Allied Health Professions Medical Nutrition Education, University of Nebraska Medical Center, Omaha, NE, USA
| | - Ann Anderson-Berry
- Department of Pediatrics, University of Nebraska Medical Center, Omaha, NE, USA
| | - Justin L Mott
- Department of Biochemistry and Molecular Biology, University of Nebraska Medical Center, Omaha, NE, USA
| | - Sathish Kumar Natarajan
- Department of Nutrition and Health Sciences, University of Nebraska-Lincoln, Lincoln, NE, USA.
- College of Allied Health Professions Medical Nutrition Education, University of Nebraska Medical Center, Omaha, NE, USA.
- Department of Biochemistry, University of Nebraska-Lincoln, Lincoln, NE, USA.
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Wolfova K, Miller EC. Impact of adverse pregnancy outcomes on brain vascular health and cognition. Res Pract Thromb Haemost 2024; 8:102331. [PMID: 38404945 PMCID: PMC10884518 DOI: 10.1016/j.rpth.2024.102331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 12/19/2023] [Accepted: 01/07/2024] [Indexed: 02/27/2024] Open
Abstract
A State of the Art lecture titled "Impact of Adverse Pregnancy Outcomes on Brain Vascular Health and Cognition" was presented at the International Society on Thrombosis and Haemostasis Congress in 2023. Adverse pregnancy outcomes, encompassing conditions such as gestational hypertension, eclampsia, preeclampsia, preterm birth, fetal growth restriction, stillbirth, and gestational diabetes, may form part of an underrecognized pathway from early adulthood reproductive health factors to later-life vascular cognitive impairment and dementia in women. Adverse pregnancy outcomes are caused by dysregulated vascular and metabolic adaptations during pregnancy, and these pathophysiological changes may persist after delivery. Adverse pregnancy outcomes may contribute to the increased risk of cognitive impairment and dementia directly through vascular and metabolic dysregulation and subsequent development of cardiovascular diseases, or other biological processes may be at play, such as shared maternal risk factors. Extensive epidemiologic evidence has shown that many cognitive impairment and dementia cases may be prevented or delayed by strategies targeting midlife cardiovascular health. Despite the recognized importance of adverse pregnancy outcomes for cardiovascular health, the literature on associated long-term health outcomes is limited. In this State of the Art review article, we summarize the current epidemiologic evidence on the relationship between adverse pregnancy outcomes and cognitive impairment and dementia and provide an overview of the potential pathophysiological mechanisms. Finally, we summarize relevant new data on this topic presented during the 2023 International Society on Thrombosis and Haemostasis Congress.
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Affiliation(s)
- Katrin Wolfova
- Department of Neurology, Columbia University, New York, New York, USA
- Department of Epidemiology, 2nd Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Eliza C. Miller
- Department of Neurology, Columbia University, New York, New York, USA
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29
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Ergani SY, Yücel KY, Şahin B, Ateş C, Reis YA, Köse C, Özden MP, Akpınar F, Çelen Ş, Üstün Y. The role of inflammation in cases with gestational diabetes mellitus: Systemic immune inflammatory index according to trimesters. Am J Reprod Immunol 2024; 91:e13806. [PMID: 38282603 DOI: 10.1111/aji.13806] [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: 10/23/2023] [Revised: 12/06/2023] [Accepted: 12/10/2023] [Indexed: 01/30/2024] Open
Abstract
PROBLEM This study aims to investigate the role of the systemic immune-inflammatory index (SII) in inflammation by analyzing SII values by trimester in gestational diabetes mellitus (GDM). METHOD OF STUDY Between May 2019 and June 2020, we retrospectively enrolled 467 pregnant women who were followed from the first trimester to delivery in our hospital. We evaluated the sociodemographic characteristics, laboratory test results, SII values, Apgar scores, and newborn birth weights of pregnant women diagnosed with GDM. We also compared the SII values of GDM for the 1st, 2nd, and 3rd trimesters with the control group. RESULTS When examining the SII values of the GDM group in these three trimesters, without including the control group, we found that the SII value of the GDM group in the 3rd trimester was significantly higher than in the 1st trimester, with a gradual increase with each trimester (p = .007). Additionally, the SII value was higher in the GDM group compared to the control group (p = .008). We conducted a Receiver Operating Characteristic (ROC) analysis of the SII value between the groups by trimester. The diagnostic significance of SII between the GDM and control groups was observed in the 3rd trimester, as the area under the curve (AUC) was close to 0.5 and not associated with a specific cutoff value. When examining the relationship between 3rd-trimester SII and study parameters, we found it had a positive and low correlation with the length of prepartum hospitalization, 50 g Oral Glucose Tolerance Test (OGTT), and maximal vertical pocket. CONCLUSION SII levels were significantly higher in third-trimester GDM patients; however, despite elevated levels of inflammation, fetuses did not experience harm.
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Affiliation(s)
- Seval Yılmaz Ergani
- Department of Perinatology, Etlik Zubeyde Hanım Women's Health Training and Research Hospital, Ankara, Turkey
| | - Kadriye Yakut Yücel
- Department of Perinatology, Etlik Zubeyde Hanım Women's Health Training and Research Hospital, Ankara, Turkey
| | - Büşra Şahin
- Department of Obstetrics and Gynecology, Etlik Zubeyde Hanım Women's Health Training and Research Hospital, Ankara, Turkey
| | - Cağlayan Ateş
- Department of Obstetrics and Gynecology, Etlik Zubeyde Hanım Women's Health Training and Research Hospital, Ankara, Turkey
| | - Yıldız Akdaş Reis
- Department of Obstetrics and Gynecology, Etlik Zubeyde Hanım Women's Health Training and Research Hospital, Ankara, Turkey
| | - Caner Köse
- Department of Obstetrics and Gynecology, Etlik Zubeyde Hanım Women's Health Training and Research Hospital, Ankara, Turkey
| | | | - Funda Akpınar
- Department of Obstetrics and Gynecology, Etlik Zubeyde Hanım Women's Health Training and Research Hospital, Ankara, Turkey
| | - Şevki Çelen
- Department of Perinatology, Etlik Zubeyde Hanım Women's Health Training and Research Hospital, Ankara, Turkey
| | - Yaprak Üstün
- Department of Obstetrics and Gynecology, Etlik Zubeyde Hanım Women's Health Training and Research Hospital, Ankara, Turkey
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Chandel S, Kumaragurubaran R, Giri H, Dixit M. Isolation and Culture of Human Umbilical Vein Endothelial Cells (HUVECs). Methods Mol Biol 2024; 2711:147-162. [PMID: 37776455 DOI: 10.1007/978-1-0716-3429-5_12] [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: 10/02/2023]
Abstract
This protocol describes a simple and an economical method for isolation of endothelial cells from human umbilical vein. Umbilical cord is easily available postpartum following informed consent, and the method for its collection is noninvasive with few ethical concerns. Thus, umbilical vein is an ideal source for isolation of endothelial cells of human origin. Endothelial cells are isolated from umbilical vein by collagenase digestion. This is followed by their culture on extracellular matrix (ECM) protein coated tissue culture flasks in presence of endothelial cell growth medium. In the last few decades, human umbilical vein endothelial cells (HUVECs) have come to be regarded as a standard model system by vascular biologists to understand general principles of endothelial cell biology and dysfunction. Here, we describe isolation, culture, as well as validation of HUVECs.
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Affiliation(s)
- Shivam Chandel
- Laboratory of Vascular Biology, Centre of Excellence in Molecular Medicine, Department of Biotechnology, Bhupat and Jyoti Mehta School of Biosciences, Indian Institute of Technology Madras , Chennai, India
| | - Rathnakumar Kumaragurubaran
- Single Cell Genomics, Cincinnati Children's Hospital Medical Centre , University of Cincinnati School of Medicine , Cincinnati, OH, USA
| | - Hemant Giri
- Oklahoma Medical Research Foundation , Oklahoma City, OK, USA
| | - Madhulika Dixit
- Laboratory of Vascular Biology, Centre of Excellence in Molecular Medicine, Department of Biotechnology, Bhupat and Jyoti Mehta School of Biosciences, Indian Institute of Technology Madras , Chennai, India.
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31
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Chen C, Yang Z, Qiu Z. Bioinformatics Prediction and Experimental Validation of the Role of Macrophage Polarization and Ferroptosis in Gestational Diabetes Mellitus. J Inflamm Res 2023; 16:6087-6105. [PMID: 38107385 PMCID: PMC10725703 DOI: 10.2147/jir.s440826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 12/03/2023] [Indexed: 12/19/2023] Open
Abstract
Purpose Gestational diabetes mellitus (GDM) is a common metabolic disorder during pregnancy that is associated with placental inflammation and adverse pregnancy outcomes. However, the mechanisms of inflammation in GDM are still unclear. Methods Bulk transcriptome, single-cell transcriptome, clinical information, and samples were collected from GSE154414, GSE70493, GSE173193 and a retrospective cohort. Bioinformatics prediction was used to explore the mechanisms of placental inflammation, and multiplex immunofluorescence was used to validate the results. Results First, we found that GDM is characterized by low-grade inflammation and is linked to several adverse pregnancy outcomes, as supported by our collected clinical data. Additionally, we identified ten hub genes (FCGR3B, CXCR1, MMP9, ITGAX, CCL5, GZMB, S100A8, LCN2, TGFB1, and LTF) as potential therapy targets and confirmed the binding of corresponding predictive therapeutic agents by molecular docking. Transcriptome sequencing analysis has shown that macrophages are primarily responsible for the emergence of placental inflammation, and that M1 macrophage polarization increased while M2 macrophage polarization decreased in GDM when compared to the control sample. Multiplex immunofluorescence staining of CD68, CD80, and ACSL4 was performed and suggested that ferroptosis of macrophages may contribute to placental inflammation in GDM. Conclusion In conclusion, our findings provide a better understanding of the mechanisms of inflammation in GDM and suggest potential therapeutic targets for this condition.
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Affiliation(s)
- Chujun Chen
- Key Specialty of Clinical Pharmacy, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, 510080, People’s Republic of China
| | - Zerui Yang
- Key Specialty of Clinical Pharmacy, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, 510080, People’s Republic of China
| | - Zhikun Qiu
- Key Specialty of Clinical Pharmacy, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, 510080, People’s Republic of China
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Neri C, Ciliberti A, Dessì DA, Airoldi C, Basello K, Costanzi A, Familiari A, Tersigni C, Cappelletti M, Speciani AF, Lanzone A. B-cell-activating factor (BAFF) and platelet-activating factor (PAF) in pregnancies complicated by maternal obesity and diabetes: a preliminary study. J Matern Fetal Neonatal Med 2023; 36:2272010. [PMID: 37872771 DOI: 10.1080/14767058.2023.2272010] [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: 07/03/2023] [Accepted: 10/12/2023] [Indexed: 10/25/2023]
Abstract
OBJECTIVE In pregnancies complicated by maternal obesity and diabetes, a disruption in inflammatory mediators occurs, resulting in endothelial microvascular dysfunction, oxidative stress, tissue damage, and maternal and feto-neonatal complications. To outline this proinflammatory status, an innovative approach is represented by the measurement of proinflammatory cytokines. Among these biomarkers, B-cell-activating factor (BAFF) and platelet-activating factor (PAF) play a key role in metabolic regulation, immune response to infections, tissue homeostasis, and "food-related inflammation." The aim of the present study is to investigate the blood expression of BAFF and PAF in a cohort of pregnant women affected by obesity and diabetes compared with a control group of healthy pregnant women. METHODS A prospective longitudinal cohort study has been conducted on pregnant women referred to Fondazione Policlinico Universitario Gemelli IRCCS in Rome. For each pregnant woman, a capillary sample was collected with a swab in three different consecutive evaluations carried out in the three trimesters of pregnancy. RESULTS A total of 77 pregnant women have been enrolled. No significant differences in BAFF and PAF levels were longitudinally observed between groups. Focusing on the exposed group, in the third trimester of pregnancy, both PAF and BAFF levels were lower than the basal time. Among the selected group of patients who developed Gestational Diabetes, only PAF values were longitudinally lower when compared to other groups. The multivariate analysis showed that BAFF levels were positively correlated with thyroid-stimulating hormone levels. No macrosomia, no shoulder dystocia, no major perineal lacerations at birth, and no intrauterine growth restriction were observed in the whole population. CONCLUSIONS This study supports the involvement of metabolic and proinflammatory biomarkers in the mechanisms related to pregnancy complications. Improving a good metabolic environment for obese and diabetic pregnant women could break the vicious cycle connecting inflammation, oxidative stress, and metabolic disorders.
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Affiliation(s)
- Caterina Neri
- Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - Alessandra Ciliberti
- Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - Davide Archelao Dessì
- Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - Chiara Airoldi
- Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
| | | | | | - Alessandra Familiari
- Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - Chiara Tersigni
- Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | | | | | - Antonio Lanzone
- Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
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Wang S, Ma L, Ji J, Huo R, Dong S, Bai Y, Hua L, Lei J, Tian S, Wang M, Yu Y. Protective effect of soy isolate protein against streptozotocin induced gestational diabetes mellitus via TLR4/MyD88/NF-κB signaling pathway. Biomed Pharmacother 2023; 168:115688. [PMID: 37890205 DOI: 10.1016/j.biopha.2023.115688] [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: 07/23/2023] [Revised: 10/04/2023] [Accepted: 10/09/2023] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND Gestational diabetes mellitus (GDM) is a serious complication of pregnancy that is characterized by high blood sugar levels that occur due to insulin resistance and dysfunction in glucose metabolism during pregnancy. It usually develops in the second or third trimester of pregnancy and affects about 7 % of all pregnancies worldwide. In this experimental study, we scrutinized the GDM protective effect of soy isolate protein against streptozotocin (STZ) induced GDM in rats and explore the underlying mechanism. MATERIAL AND METHODS Sprague-Dawley (SD) rats were used in this experimental study. A 55 mg/kg intraperitoneal injection of streptozotocin (STZ) was administered to induce diabetes in female rats, followed by oral administration of soy isolate protein for 18 days. Body weight, glucose levels, and insulin were measured at different time intervals (0, 9, and 18 days). Lipid profiles, antioxidant levels, inflammatory cytokines, apoptosis parameters, and mRNA expression were also assessed. Pancreatic and liver tissues were collected for histopathological examination during the experimental study. RESULTS Soy isolate protein significantly (P < 0.001) reduced the glucose level and enhanced the insulin level and body weight. Soy isolate protein remarkably decreased the placental weight and increased the fetal weight. Soy isolate protein significantly (P < 0.001) decreased the HbA1c, hepatic glycogen, serum C-peptide and increased the level of free fatty acid. Soy isolate protein significantly (P < 0.001) altered the level of lipid, antioxidant and inflammatory cytokines. Soy isolate protein significantly (P < 0.001) improved the level of adiponectin, visfatin and suppressed the level of leptin and ICAM-1. Soy isolate protein significantly (P < 0.001) altered the mRNA expression and also restored the alteration of histopathology. CONCLUSION Based on the result, soy isolate protein exhibited the GDM protective effect against the STZ induced GDM in rats via alteration of TLR4/MyD88/NF-κB signaling pathway.
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Affiliation(s)
- Shuijing Wang
- School of Public Health, Xi'an Jiaotong University, Xi'an, Shaanxi 710061, China; Shaanxi SANZ Pharmaceutical Co., Ltd, Xi'an, Shaanxi 710086, China
| | - Liangkun Ma
- Department of Obstetrics and Gynecology, National Clinical Research Center for Obstetric & Gynecologic Diseases, PUMC Hospital, CAMS and PUMC, Beijing100730, China
| | - Jing Ji
- Northwest Women's and Children's Hospital, Xi'an, Shaanxi 710061, China
| | - Ruichao Huo
- Pingyao Agriculture and Rural Bureau, Pingyao, Shanxi 031100, China
| | - Shan Dong
- Nutritional Department, Maternal and Child Health Care Hospital of HaiDian District, Beijing 100000, China
| | - Yunfeng Bai
- School of Public Health, Shaanxi University of Chinese Medicine, Xianyang 712046, China
| | - Linlin Hua
- Department of Advanced Medical Research, The Second Affiliated Hospital of Zhengzhou University, Jingba road, Jinshui district, Zhengzhou 450014, China
| | - Jiao Lei
- Shaanxi SANZ Pharmaceutical Co., Ltd, Xi'an, Shaanxi 710086, China
| | - Sasa Tian
- Shaanxi SANZ Pharmaceutical Co., Ltd, Xi'an, Shaanxi 710086, China
| | - Manning Wang
- Shaanxi SANZ Pharmaceutical Co., Ltd, Xi'an, Shaanxi 710086, China
| | - Yan Yu
- School of Public Health, Xi'an Jiaotong University, Xi'an, Shaanxi 710061, China.
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Kouthouridis S, Sotra A, Khan Z, Alvarado J, Raha S, Zhang B. Modeling the Progression of Placental Transport from Early- to Late-Stage Pregnancy by Tuning Trophoblast Differentiation and Vascularization. Adv Healthc Mater 2023; 12:e2301428. [PMID: 37830445 DOI: 10.1002/adhm.202301428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 09/18/2023] [Indexed: 10/14/2023]
Abstract
The early-stage placental barrier is characterized by a lack of fetal circulation and by a thick trophoblastic barrier, whereas the later-stage placenta consists of vascularized chorionic villi encased in a thin, differentiated trophoblast layer, ideal for nutrient transport. In this work, predictive models of early- and late-stage placental transport are created using blastocyst-derived placental stem cells (PSCs) by modulating PSC differentiation and model vascularization. PSC differentiation results in a thinner, fused trophoblast layer, as well as an increase in human chorionic gonadotropin secretion, barrier permeability, and secretion of certain inflammatory cytokines, which are consistent with in vivo findings. Further, gene expression confirms this shift toward a differentiated trophoblast subtype. Vascularization results in a molecule type- and size-dependent change in dextran and insulin permeability. These results demonstrate that trophoblast differentiation and vascularization have critical effects on placental barrier permeability and that this model can be used as a predictive measure to assess fetal toxicity of xenobiotic substances at different stages of pregnancy.
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Affiliation(s)
- Sonya Kouthouridis
- Department of Chemical Engineering, McMaster University, Hamilton, ON, L8S 4L8, Canada
| | - Alexander Sotra
- School of Biomedical Engineering, McMaster University, Hamilton, ON, L8S 4L8, Canada
| | - Zaim Khan
- Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, ON, L8S 4L8, Canada
| | - Justin Alvarado
- Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, ON, L8S 4L8, Canada
| | - Sandeep Raha
- Department of Pediatrics and the Graduate Programme in Medical Sciences, McMaster University, Hamilton, ON, L8S 4L8, Canada
| | - Boyang Zhang
- Department of Chemical Engineering, McMaster University, Hamilton, ON, L8S 4L8, Canada
- School of Biomedical Engineering, McMaster University, Hamilton, ON, L8S 4L8, Canada
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Zhou Y, Yin S, Sheng Q, Yang J, Liu J, Li H, Yuan P, Zhao Y. Association of maternal age with adverse pregnancy outcomes: A prospective multicenter cohort study in China. J Glob Health 2023; 13:04161. [PMID: 38038697 PMCID: PMC10691438 DOI: 10.7189/jogh.13.04161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2023] Open
Abstract
Background Although maternal age might affect pregnancy outcomes, it remains unclear whether this relationship is linear or curvilinear and if it differs between nulliparous and multiparous women. We aimed to characterize the relationship between maternal age and risks of pregnancy outcomes in a diverse sample of Chinese singleton pregnant women and to evaluate whether the relationship varied by parity. Methods We based this prospective multicenter cohort study on data from 18 495 singleton pregnant women who participated in the University Hospital Advanced Age Pregnant Cohort Study, conducted in eight Chinese public hospitals from 2016 to 2021. We used restricted cubic splines to model nonlinear relationships between maternal age continuum and adverse outcomes, and performed multivariable log-binomial regression to estimate the adjusted relative risk (RR) and 95% confidence interval (CI). Results Among 18 495 singleton pregnant women (mean age 35.7, standard deviation (SD) = 4.2 years), maternal age was not related to postpartum hemorrhage or small for gestational age, but showed a positive, nonlinear relationship to gestational diabetes mellitus, hypertensive disorders of pregnancy, preeclampsia, placenta accreta spectrum, placenta previa, cesarean delivery, preterm birth, large for gestational age, macrosomia, and fetal congenital anomaly, with inflection points around 35.6-40.4 years. Compared to women younger than 35 years, older women had higher risks of adverse pregnancy outcomes, except for postpartum hemorrhage and small for gestational age. The risks of placenta accreta spectrum, placenta previa, large for gestational age, and macrosomia were highest for women aged 40-44 years, and risks of gestational diabetes mellitus, hypertensive disorders of pregnancy, preeclampsia, cesarean delivery, preterm birth and congenital anomaly were highest for those aged ≥45 years. Most risks were more pronounced in nulliparous than multiparous women (P for interaction <0.02). Conclusions Delayed childbirth was related to increased risks of adverse pregnancy outcomes, especially for nulliparous women. Appropriate childbearing age, generally before 35 years, is recommended for optimising pregnancy outcomes.
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Affiliation(s)
- Yubo Zhou
- Institute of Reproductive and Child Health/National Health Commission Key Laboratory of Reproductive Health, Peking University Health Science Center, Beijing, China
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Shaohua Yin
- Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- National Center for Healthcare Quality Management in Obstetrics, Peking University Third Hospital, Beijing, China
- National Clinical Research Centre for Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
| | - Qing Sheng
- Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- National Clinical Research Centre for Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
| | - Jing Yang
- Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- National Clinical Research Centre for Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
| | - Jianmeng Liu
- Institute of Reproductive and Child Health/National Health Commission Key Laboratory of Reproductive Health, Peking University Health Science Center, Beijing, China
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Hongtian Li
- Institute of Reproductive and Child Health/National Health Commission Key Laboratory of Reproductive Health, Peking University Health Science Center, Beijing, China
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Pengbo Yuan
- Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- National Clinical Research Centre for Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
| | - Yangyu Zhao
- Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- National Center for Healthcare Quality Management in Obstetrics, Peking University Third Hospital, Beijing, China
- National Clinical Research Centre for Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
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Frazier JA, Li X, Kong X, Hooper SR, Joseph RM, Cochran DM, Kim S, Fry RC, Brennan PA, Msall ME, Fichorova RN, Hertz-Picciotto I, Daniels JL, Lai JS, Boles RE, Zvara BJ, Jalnapurkar I, Schweitzer JB, Singh R, Posner J, Bennett DH, Kuban KCK, O'Shea TM. Perinatal Factors and Emotional, Cognitive, and Behavioral Dysregulation in Childhood and Adolescence. J Am Acad Child Adolesc Psychiatry 2023; 62:1351-1362. [PMID: 37207889 PMCID: PMC10654259 DOI: 10.1016/j.jaac.2023.05.010] [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: 09/02/2022] [Revised: 03/01/2023] [Accepted: 05/10/2023] [Indexed: 05/21/2023]
Abstract
OBJECTIVE This cohort study assessed perinatal factors known to be related to maternal and neonatal inflammation and hypothesized that several would be associated with emotional, cognitive, and behavioral dysregulation in youth. METHOD The Environmental influences on Child Health Outcomes (ECHO) is a research consortium of 69 pediatric longitudinal cohorts. A subset of 18 cohorts that had both Child Behavior Checklist (CBCL) data on children (6-18 years) and information on perinatal exposures including maternal prenatal infections was used. Children were classified as having the CBCL-Dysregulation Profile (CBCL-DP) if the sum of their T scores for 3 CBCL subscales (attention, anxious/depressed, and aggression) was ≥180. Primary exposures were perinatal factors associated with maternal and/or neonatal inflammation, and associations between these and outcome were assessed. RESULTS Approximately 13.4% of 4,595 youth met criteria for CBCL-DP. Boys were affected more than girls (15.1% vs 11.5%). More youth with CBCL-DP (35%) were born to mothers with prenatal infections compared with 28% of youth without CBCL-DP. Adjusted odds ratios indicated the following were significantly associated with dysregulation: having a first-degree relative with a psychiatric disorder; being born to a mother with lower educational attainment, who was obese, had any prenatal infection, and/or who smoked tobacco during pregnancy. CONCLUSION In this large study, a few modifiable maternal risk factors with established roles in inflammation (maternal lower education, obesity, prenatal infections, and smoking) were strongly associated with CBCL-DP and could be targets for interventions to improve behavioral outcomes of offspring. DIVERSITY & INCLUSION STATEMENT We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented sexual and/or gender groups in science. We actively worked to promote sex and gender balance in our author group. The author list of this paper includes contributors from the location and/or community where the research was conducted who participated in the data collection, design, analysis, and/or interpretation of the work.
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Affiliation(s)
- Jean A Frazier
- Eunice Kennedy Shriver Center, UMass Chan Medical School, Worchester, Massachusetts.
| | - Xiuhong Li
- Johns Hopkins University, Baltimore, Maryland
| | | | | | | | - David M Cochran
- Eunice Kennedy Shriver Center, UMass Chan Medical School, Worchester, Massachusetts
| | - Sohye Kim
- Eunice Kennedy Shriver Center, UMass Chan Medical School, Worchester, Massachusetts
| | | | | | - Michael E Msall
- University of Chicago Comer Children's Hospital, Chicago, Illinois, and Kennedy Research Center on Intellectual and Neurodevelopmental Disabilities, The University of Chicago, Chicago, Illinois
| | - Raina N Fichorova
- Brigham and Women's Hospital, Boston, Massachusetts, and Harvard Medical School, Boston, Massachusetts
| | | | | | - Jin-Shei Lai
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Richard E Boles
- University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | | | - Isha Jalnapurkar
- Eunice Kennedy Shriver Center, UMass Chan Medical School, Worchester, Massachusetts
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Hsu MC, Lin CH, Lin MC. Maternal gestational diabetes mellitus and risk of allergic diseases in offspring. Pediatr Neonatol 2023:S1875-9572(23)00216-4. [PMID: 38052685 DOI: 10.1016/j.pedneo.2023.06.012] [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] [Received: 04/14/2023] [Revised: 05/21/2023] [Accepted: 06/07/2023] [Indexed: 12/07/2023] Open
Abstract
BACKGROUND Gestational diabetes mellitus has been linked to inflammation, immune dysregulation in offspring, and changes in the microbiota. It may have long-term implications for the health of children. The aim of this study was to determine if gestational diabetes mellitus increases the risk of allergic diseases in offspring. METHODS The data source was the National Health Insurance Research Database (NHIRD) of Taiwan. The pairing of mothers and children was established by connecting the NHIRD with the Taiwan Maternal and Child Health Database. First-time pregnant mothers between 2004 and 2019 were enrolled. The GDM group consisted of 22,741 cases. The control group was selected from individuals without GDM matched by maternal age, neonatal gender, and neonatal birthdate at a ratio of 1-4. The primary endpoint was the incidence of childhood allergic diseases, such as asthma, allergic rhinitis, atopic dermatitis, and urticaria. The secondary endpoint was the risk associated with the development of allergic diseases in offspring, considering the presence or absence of insulin therapy. RESULTS The development of allergic rhinitis, atopic dermatitis, and urticaria were found to be significantly associated with GDM. However, no significant association was observed between GDM and asthma. GDM control without insulin was associated with an increased risk of developing allergic rhinitis, urticaria, and atopic dermatitis. However, in the group receiving insulin treatment, there was no significant elevation in the risk of any allergic diseases. CONCLUSION GDM may elevate the risk of certain atopic diseases in offspring, such as allergic rhinitis, atopic dermatitis, and urticaria.
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Affiliation(s)
- Min-Che Hsu
- Children's Medical Center, Taichung Veterans General Hospital, Taichung, Taiwan; Department of Food and Nutrition, Providence University, Taichung, Taiwan; Taichung Hospital, Ministry of Health and Welfare, Taichung, Taiwan
| | - Chien-Heng Lin
- Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Ming-Chih Lin
- Children's Medical Center, Taichung Veterans General Hospital, Taichung, Taiwan; Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Food and Nutrition, Providence University, Taichung, Taiwan; School of Medicine, Chung Shan Medical University, Taichung, Taiwan.
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Zhang Y, Qian Y, Liu C, Fan X, Li X, Song Y, Fan Y, Hu Z, Yang J. Association between white blood cell count and adverse pregnancy outcomes: a retrospective cohort study from a tertiary hospital in China. BMJ Open 2023; 13:e072633. [PMID: 37993163 PMCID: PMC10668327 DOI: 10.1136/bmjopen-2023-072633] [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: 03/01/2023] [Accepted: 10/25/2023] [Indexed: 11/24/2023] Open
Abstract
OBJECTIVES This study aimed to clarify the relationship between white blood cell (WBC) and adverse pregnancy outcomes. DESIGN A total of 25 270 pregnant women underwent peripheral blood white blood cell count tests in the first, second and third trimesters. Adverse pregnancy outcomes were gestational hypertension, pre-eclampsia, gestational diabetes mellitus, preterm birth, low birth weight, caesarean delivery, macrosomia and fetal distress. Due to acute infectious disease or other diseases, 1127 were excluded. SETTING Minhang Hospital, China. PARTICIPANTS A total of 24 143 pregnant women were included in this study. PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcome was the adverse pregnancy outcomes. RESULTS For the 24 143 participants, we calculated adjusted ORs for adverse pregnancy outcomes associated with an increased WBC count. For gestational hypertension, the ORs were 1.18 (95% CI, 1.05 to 1.24) in the first trimester and 1.10 (1.06 to 1.13) in the second trimester; for pre-eclampsia, ORs were 1.14 (95% CI, 1.47 to 1.64) in the first trimester and 1.10 (1.05 to 1.16) in the second trimester; for gestational diabetes mellitus, ORs were 1.06 (95% CI, 1.00 to 1.13) in the first trimester and 1.10 (1.04 to 1.16) in the second trimester; for preterm birth, ORs were 1.12 (95% CI, 1.06 to 1.18) in the first trimester, 1.10 (1.06 to 1.13) in the second trimester and 1.12 (1.09 to 1.15) in the third trimester; for low birth weight, ORs were 1.09 (95% CI, 1.02 to 1.17) in the first trimester, 1.03 (0.99 to 1.08) in the second trimester and 1.12 (1.08 to 1.16) in the third trimester. Significant associations were not observed obviously for caesarean delivery, macrosomia and fetal distress. CONCLUSIONS Our results indicate strong, continuous associations of maternal WBC count with increased risks of adverse pregnancy outcomes.
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Affiliation(s)
- Yu Zhang
- Department of Endocrinology and Metabolism, Minhang Hospital, Fudan University, Shanghai, China
| | - Yiling Qian
- Department of Endocrinology and Metabolism, Minhang Hospital, Fudan University, Shanghai, China
| | - Chuanwei Liu
- Department of Endocrinology and Metabolism, Minhang Hospital, Fudan University, Shanghai, China
| | - Xiaofang Fan
- Department of Endocrinology and Metabolism, Minhang Hospital, Fudan University, Shanghai, China
| | - Xuesong Li
- Department of Endocrinology and Metabolism, Minhang Hospital, Fudan University, Shanghai, China
| | - Yuping Song
- Department of Endocrinology and Metabolism, Minhang Hospital, Fudan University, Shanghai, China
| | - Yujuan Fan
- Department of Endocrinology and Metabolism, Minhang Hospital, Fudan University, Shanghai, China
| | - Zheng Hu
- Department of Obstetrics and Gynecology, Minhang Hospital, Fudan University, Shanghai, China
| | - Jialin Yang
- Department of Endocrinology and Metabolism, Minhang Hospital, Fudan University, Shanghai, China
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Matuszewska J, Nowacka-Woszuk J, Radziejewska A, Grzęda E, Pruszyńska-Oszmałek E, Dylewski Ł, Chmurzyńska A, Sliwowska JH. Maternal cafeteria diet influences kisspeptin (Kiss1), kisspeptin receptor(Gpr54), and sirtuin (Sirt1) genes, hormonal and metabolic profiles, and reproductive functions in rat offspring in a sex-specific manner†. Biol Reprod 2023; 109:654-668. [PMID: 37665248 PMCID: PMC10651067 DOI: 10.1093/biolre/ioad101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 07/27/2023] [Accepted: 08/31/2023] [Indexed: 09/05/2023] Open
Abstract
Kisspeptin (KP, encoded by Kiss1, binding to the Gpr54 receptor) is a neuropeptide conveying information on the metabolic status to the hypothalamic-pituitary-gonadal axis. KP acts together with dynorphin A (encoded by Pdyn) and neurokinin B (encoded by Tac2) to regulate reproduction. KP is crucial for the onset of puberty and is under the control of sirtuin (encoded by Sirt1). We hypothesize that the maternal cafeteria (CAF) diet has adverse effects on the offspring's hormonal, metabolic, and reproductive functions due to sex-specific alterations in the expression of Kiss1, Gpr54, Pdyn, Tac2, and Sirt1 in the hypothalamus, and Kiss1, Gpr54, and Sirt1 in the liver. Rats were fed a CAF diet before pregnancy, during pregnancy, and during lactation. The vaginal opening was monitored. Offspring were sacrificed in three age points: PND 30, PND 35, and PND 60 (females) and PND 40, PND 45, and PND 60 (males). Their metabolic and hormonal status was assessed. mRNA for Kiss1, Gpr54, Pdyn, Tac2, and Sirt1 were measured by real-time PCR in the hypothalamus and/or livers. We found that CAF offspring had lower weight and altered body composition; increased cholesterol and triglyceride levels, sex-specific changes in glucose and insulin levels; sex-dependent changes in Sirt1/Kiss1 mRNA ratio in the hypothalamus; sex-specific alterations in Kiss1 and Sirt1 mRNA in the liver with more diversity in males; and a delayed puberty onset in females. We concluded that the mother's CAF diet leads to sex-specific alterations in metabolic and reproductive outcomes via Kiss1/Gpr54 and Sirt1 systems in offspring.
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Affiliation(s)
- Julia Matuszewska
- Laboratory of Neurobiology, Faculty of Veterinary Medicine and Animal Science, Poznan University of Life Sciences, Poznan, Poland
| | - Joanna Nowacka-Woszuk
- Department of Genetics and Animal Breeding, Faculty of Veterinary Medicine and Animal Science, Poznan University of Life Sciences, Poznan, Poland
| | - Anna Radziejewska
- Department of Human Nutrition and Dietetics, Poznan University of Life Sciences, Poznan, Poland
| | - Emilia Grzęda
- Laboratory of Neurobiology, Faculty of Veterinary Medicine and Animal Science, Poznan University of Life Sciences, Poznan, Poland
| | - Ewa Pruszyńska-Oszmałek
- Department of Animal Physiology, Biochemistry and Biostructure, Faculty of Veterinary Medicine and Animal Science, Poznan University of Life Sciences, Poznan, Poland
| | - Łukasz Dylewski
- Department of Zoology, Faculty of Veterinary Medicine and Animal Science, Poznan University of Life Sciences, Poznan, Poland
| | - Agata Chmurzyńska
- Department of Human Nutrition and Dietetics, Poznan University of Life Sciences, Poznan, Poland
| | - Joanna H Sliwowska
- Laboratory of Neurobiology, Faculty of Veterinary Medicine and Animal Science, Poznan University of Life Sciences, Poznan, Poland
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Mazur D, Satora M, Rekowska AK, Kabała Z, Łomża A, Kimber-Trojnar Ż, Leszczyńska-Gorzelak B. Influence of Breastfeeding on the State of Meta-Inflammation in Obesity-A Narrative Review. Curr Issues Mol Biol 2023; 45:9003-9018. [PMID: 37998742 PMCID: PMC10670570 DOI: 10.3390/cimb45110565] [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: 10/28/2023] [Revised: 11/06/2023] [Accepted: 11/08/2023] [Indexed: 11/25/2023] Open
Abstract
Obesity has become an emerging health issue worldwide that continues to grow in females of reproductive age as well. Obesity, as a multisystem and chronic disease, is associated with metabolic inflammation, which is defined as chronic low-grade systemic inflammation mediated by, i.a., adipose tissue macrophages. Lactation has been proven to have a beneficial influence on maternal health and could help restore metabolic balance, especially in the state of maternal obesity. In this review, we aimed to analyze the influence of breastfeeding on chronic low-grade meta-inflammation caused by obesity. We performed a comprehensive literature review using the PubMed, Science Direct, and Google Scholar electronic databases. For this purpose, we searched for "metabolic inflammation"; "meta-inflammation"; "obesity"; "breastfeeding"; "fetal programming"; "energy metabolism"; "postpartum"; "immunity"; "immune system"; and "inflammation" keyword combinations. While the clinical impact of breastfeeding on maternal and offspring health is currently well known, we decided to gain insight into more specific metabolic effects of adiposity, lipid, and glucose homeostasis, and immunological effects caused by the activity of cytokines, macrophages, and other immune system cells. Further research on the immunological and metabolic effects of breastfeeding in obese patients is key to understanding and potentially developing obesity therapeutic strategies.
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Affiliation(s)
| | | | | | | | | | - Żaneta Kimber-Trojnar
- Chair and Department of Obstetrics and Perinatology, Medical University of Lublin, 20-059 Lublin, Poland; (D.M.); (M.S.); (A.K.R.); (Z.K.); (A.Ł.); (B.L.-G.)
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Shuffrey LC, Morales S, Jacobson MH, Enlow MB, Ghassabian A, Margolis AE, Lucchini M, Carroll KN, Crum RM, Dabelea D, Deutsch A, Fifer WP, Goldson B, Hockett CW, Mason WA, Jacobson LT, O’Connor TG, Pini N, Rayport Y, Sania A, Trasande L, Wright RJ, Lee S, Monk C. Association of Gestational Diabetes Mellitus and Perinatal Maternal Depression with Early Childhood Behavioral Problems: An Environmental Influences on Child Health Outcomes (ECHO) Study. Child Dev 2023; 94:1595-1609. [PMID: 37132048 PMCID: PMC10620104 DOI: 10.1111/cdev.13938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 03/16/2023] [Accepted: 03/31/2023] [Indexed: 05/04/2023]
Abstract
This study examined the association of gestational diabetes mellitus (GDM), prenatal, and postnatal maternal depressive symptoms with externalizing, internalizing, and autism spectrum problems on the Preschool Child Behavior Checklist in 2379 children aged 4.12 ± 0.60 (48% female; 47% White, 32% Black, 15% Mixed Race, 4% Asian, <2% American Indian/Alaskan Native, <2% Native Hawaiian; 23% Hispanic). Data were collected from the NIH Environmental influences on Child Health Outcomes (ECHO) Program from 2009-2021. GDM, prenatal, and postnatal maternal depressive symptoms were each associated with increased child externalizing and internalizing problems. GDM was associated with increased autism behaviors only among children exposed to perinatal maternal depressive symptoms above the median level. Stratified analyses revealed a relation between GDM and child outcomes in males only.
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Affiliation(s)
- Lauren C. Shuffrey
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA
| | - Santiago Morales
- Department of Psychology, University of Southern California, Los Angeles, California, USA
| | - Melanie H. Jacobson
- Department of Pediatrics, Division of Environmental Pediatrics, New York University School of Medicine, New York, New York, USA
| | - Michelle Bosquet Enlow
- Department of Psychiatry and Behavioral Sciences, Boston Children’s Hospital, Boston, Massachusetts, USA
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Akhgar Ghassabian
- Department of Pediatrics, New York University School of Medicine, New York, New York, USA
| | - Amy E. Margolis
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA
| | - Maristella Lucchini
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA
| | - Kecia N. Carroll
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Rosa M. Crum
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Dana Dabelea
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | | | - William P. Fifer
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA
- Division of Developmental Neuroscience, New York State Psychiatric Institute
| | - Brandon Goldson
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Christine W. Hockett
- Avera Research Institute; Sioux Falls, South Dakota, USA
- Department of Pediatrics, University of South Dakota School of Medicine, Sioux Falls, South Dakota, USA
| | - W. Alex Mason
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Lisette T. Jacobson
- Department of Population Health, Department of Obstetrics & Gynecology, University of Kansas School of Medicine, Wichita, Kansas, USA
| | - Thomas G O’Connor
- Departments of Psychiatry, Psychology, Neuroscience, and Obstetrics and Gynecology, University of Rochester, Rochester, New York, USA
| | - Nicolò Pini
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA
| | - Yael Rayport
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA
| | - Ayesha Sania
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA
| | - Leonardo Trasande
- Department of Pediatrics, New York University Grossman School of Medicine, New York, New York, USA
| | | | - Seonjoo Lee
- Mailman School of Public Health, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA
| | - Catherine Monk
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA
- Departments of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York, New York, USA
- Division of Behavioral Medicine, New York State Psychiatric Institute, New York, New York, USA
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Zhong T, Huang YQ, Wang GM. Causal relationship association of cheese intake with gestational hypertension and diabetes result from a Mendelian randomization study. World J Clin Cases 2023; 11:7318-7328. [PMID: 37969456 PMCID: PMC10643065 DOI: 10.12998/wjcc.v11.i30.7318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 09/17/2023] [Accepted: 09/28/2023] [Indexed: 10/25/2023] Open
Abstract
BACKGROUND The evidence from observational studies has been inconclusive on the causal relationship between cheese intake and gestational hypertension or diabetes. AIM To determine whether cheese consumption was causally related to hypertension and diabetes during pregnancy. METHODS This was a two-sample Mendelian randomized (MR) study. Summary-level genetic data for cheese intake was exposure and corresponding outcome data for gestational hypertension and gestational diabetes were extracted from the IEU OpenGWAS database. MR analysis was conducted using inverse variance weighting. For sensitivity analyses, MR-Egger regression, weighted median, weighted mode, and leave-one-out methods were conducted. A fixed-effect model was used to meta-analyze two sample MR estimates. The traits of gestational hypertension were pregnancy hypertension (123579 individuals) and oedema, proteinuria and hypertensive disorders in pregnancy, childbirth and the puerperium (123579 individuals), and traits of gestational diabetes were gestational diabetes (123579 individuals) and diabetes mellitus in pregnancy (116363 individuals), respectively. RESULTS Cheese intake per standard deviation increase has causally reduced the risks of gestational hypertension [odds ratio (OR) = 0.60, 95% confidence interval (CI): 0.47-0.76, P < 0.001] and gestational diabetes (OR = 0.41, 95%CI: 0.30-0.55, P < 0.001) in inverse variance weighted analysis. Sensitivity analysis showed no heterogeneity (all P > 0.05) nor horizontal pleiotropy (all P > 0.05) in the relationship between cheese intake and gestational hypertension, but heterogeneity presented (all P < 0.05) in relation to gestational diabetes in the two-sample MR analysis. CONCLUSION Cheese intake was inversely associated with gestational hypertension and gestational diabetes in MR analysis, suggesting that cheese consumption may be beneficial in preventing hypertension and diabetes during pregnancy.
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Affiliation(s)
- Tao Zhong
- Department of Cardiology, The First Hospital of Nanchang, Nanchang 330008, Jiangxi Province, China
| | - Yu-Qing Huang
- Department of Cardiology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, Guangdong Province, China
| | - Gui-Ming Wang
- Department of Cardiology, The First Hospital of Nanchang, Nanchang 330008, Jiangxi Province, China
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Chen W, Shi J, Zhang W. Administration of Akebia Saponin D Improved Blood Lipid Levels and Pregnancy Outcomes in Mice with Gestational Diabetes Mellitus. Balkan Med J 2023; 40:422-429. [PMID: 37815409 PMCID: PMC10613745 DOI: 10.4274/balkanmedj.galenos.2023.2023-6-82] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 09/12/2023] [Indexed: 10/11/2023] Open
Abstract
Background Gestational diabetes mellitus (GDM) is a prevalent and severe metabolic disease in pregnant women that is characterized by a high incidence. Placental oxidative stress and inflammation are recognized as the primary contributors to GDM pathogenesis. The repressive effect of akebia saponin D (ASD) on oxidative stress and inflammation has been demonstrated in various diseases. Aims To investigate the impact of ASD on GDM. Study Design Animal experimental study. Methods GDM mice were intraperitoneally treated with ASD. The effect of ASD on GDM symptoms, blood lipid levels, pancreatic tissue damage, gestational outcomes, oxidative stress, and inflammation was assessed via intraperitoneal glucose and insulin tolerance tests, serum glucose and insulin level determination, lipid biochemistry analysis, pathological staining, oxidative stress evaluation, western blot analysis, and enzyme-linked immunosorbent assay. Results ASD reduced the GDM-induced increase in body weight and blood glucose levels while restoring the decreased insulin levels associated with GDM. In addition, ASD improved the serum lipid parameters, pancreatic tissue damage, and gestational outcomes in GDM mice. Furthermore, ASD reversed the decreased levels of superoxide dismutase and glutathione while reducing the elevated concentrations of malondialdehyde and myeloperoxidase in GDM mice. In addition, ASD rescued the relative protein expression of nuclear factor-E2-related factor 2 and heme oxygenase-1 in the placenta of GDM mice. Additionally, ASD counteracted the increase in tumor necrosis factor-α, interleukin (IL)-6, and IL-1β levels in the sera and placenta of GDM mice. Conclusion ASD suppressed oxidative stress and inflammation to effectively relieve symptoms and gestational outcomes of the GDM mice.
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Affiliation(s)
- Wei Chen
- Department of Obstetrical, The People’s Hospital of Danyang, Affiliated Danyang Hospital of Nantong University, Nantong, China
| | - Juan Shi
- Department of Obstetrical, The People’s Hospital of Danyang, Affiliated Danyang Hospital of Nantong University, Nantong, China
| | - Wei Zhang
- Department of Obstetrical, The People’s Hospital of Danyang, Affiliated Danyang Hospital of Nantong University, Nantong, China
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Gerszi D, Orosz G, Török M, Szalay B, Karvaly G, Orosz L, Hetthéssy J, Vásárhelyi B, Török O, Horváth EM, Várbíró S. Risk Estimation of Gestational Diabetes Mellitus in the First Trimester. J Clin Endocrinol Metab 2023; 108:e1214-e1223. [PMID: 37247379 PMCID: PMC10584002 DOI: 10.1210/clinem/dgad301] [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: 11/02/2022] [Revised: 05/05/2023] [Accepted: 05/24/2023] [Indexed: 05/31/2023]
Abstract
CONTEXT There is no early, first-trimester risk estimation available to predict later (gestational week 24-28) gestational diabetes mellitus (GDM); however, it would be beneficial to start an early treatment to prevent the development of complications. OBJECTIVE We aimed to identify early, first-trimester prediction markers for GDM. METHODS The present case-control study is based on the study cohort of a Hungarian biobank containing biological samples and follow-up data from 2545 pregnant women. Oxidative-nitrative stress-related parameters, steroid hormone, and metabolite levels were measured in the serum/plasma samples collected at the end of the first trimester from 55 randomly selected control and 55 women who developed GDM later. RESULTS Pregnant women who developed GDM later during the pregnancy were older and had higher body mass index. The following parameters showed higher concentration in their serum/plasma samples: fructosamine, total antioxidant capacity, testosterone, cortisone, 21-deoxycortisol; soluble urokinase plasminogen activator receptor, dehydroepiandrosterone sulfate, dihydrotestosterone, cortisol, and 11-deoxycorticosterone levels were lower. Analyzing these variables using a forward stepwise multivariate logistic regression model, we established a GDM prediction model with a specificity of 96.6% and sensitivity of 97.5% (included variables: fructosamine, cortisol, cortisone, 11-deoxycorticosterone, SuPAR). CONCLUSION Based on these measurements, we accurately predict the development of later-onset GDM (24th-28th weeks of pregnancy). Early risk estimation provides the opportunity for targeted prevention and the timely treatment of GDM. Prevention and slowing the progression of GDM result in a lower lifelong metabolic risk for both mother and offspring.
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Affiliation(s)
- Dóra Gerszi
- Department of Obstetrics and Gynecology, Faculty of Medicine, Semmelweis University, Budapest H-1082, Hungary
- Department of Physiology, Faculty of Medicine, Semmelweis University, Budapest H-1094, Hungary
| | - Gergő Orosz
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Debrecen Medical and Health Science Centre, Debrecen H-4032, Hungary
| | - Marianna Török
- Department of Obstetrics and Gynecology, Faculty of Medicine, Semmelweis University, Budapest H-1082, Hungary
- Workgroup for Science Management, Doctoral School, Semmelweis University, Budapest H-1085, Hungary
| | - Balázs Szalay
- Department of Laboratory Medicine, Semmelweis University, Budapest H-1083, Hungary
| | - Gellért Karvaly
- Laboratory of Mass Spectrometry and Separation Technology, Department of Laboratory Medicine, Semmelweis University, Budapest H-1089, Hungary
| | - László Orosz
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Debrecen Medical and Health Science Centre, Debrecen H-4032, Hungary
| | - Judit Hetthéssy
- Workgroup for Science Management, Doctoral School, Semmelweis University, Budapest H-1085, Hungary
| | - Barna Vásárhelyi
- Department of Laboratory Medicine, Semmelweis University, Budapest H-1083, Hungary
| | - Olga Török
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Debrecen Medical and Health Science Centre, Debrecen H-4032, Hungary
| | - Eszter M Horváth
- Department of Physiology, Faculty of Medicine, Semmelweis University, Budapest H-1094, Hungary
| | - Szabolcs Várbíró
- Department of Obstetrics and Gynecology, Faculty of Medicine, Semmelweis University, Budapest H-1082, Hungary
- Workgroup for Science Management, Doctoral School, Semmelweis University, Budapest H-1085, Hungary
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Decrue F, Townsend R, Miller MR, Newby DE, Reynolds RM. Ambient air pollution and maternal cardiovascular health in pregnancy. Heart 2023; 109:1586-1593. [PMID: 37217298 DOI: 10.1136/heartjnl-2022-322259] [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: 02/28/2023] [Accepted: 04/18/2023] [Indexed: 05/24/2023] Open
Abstract
In this review, we summarise the current epidemiological and experimental evidence on the association of ambient (outdoor) air pollution exposure and maternal cardiovascular health during pregnancy. This topic is of utmost clinical and public health importance as pregnant women represent a potentially susceptible group due to the delicate balance of the feto-placental circulation, rapid fetal development and tremendous physiological adaptations to the maternal cardiorespiratory system during pregnancy.Several meta-analyses including up to 4 245 170 participants provide robust evidence that air pollutants, including particulate matter, nitrogen oxides and others, have adverse effects on the development of hypertensive disorders of pregnancy, gestational diabetes mellitus and cardiovascular events during labour. Potential underlying biological mechanisms include oxidative stress with subsequent endothelial dysfunction and vascular inflammation, β-cell dysfunction and epigenetic changes. Endothelial dysfunction can lead to hypertension by impairing vasodilatation and promoting vasoconstriction. Air pollution and the consequent oxidative stress can additionally accelerate β-cell dysfunction, which in turn triggers insulin resistance leading to gestational diabetes mellitus. Epigenetic changes in placental and mitochondrial DNA following air pollution exposures can lead to altered gene expression and contribute to placental dysfunction and induction of hypertensive disorders of pregnancy.The maternal and fetal consequences of such cardiovascular and cardiometabolic disease during pregnancy can be serious and long lasting, including preterm birth, increased risk of type 2 diabetes mellitus or cardiovascular disease later in life. Acceleration of efforts to reduce air pollution is therefore urgently needed to realise the full health benefits for pregnant mothers and their children.
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Affiliation(s)
- Fabienne Decrue
- Centre for Cardiovascular Science, The University of Edinburgh, Edinburgh, UK
| | - Rosemary Townsend
- Centre for Cardiovascular Science, The University of Edinburgh, Edinburgh, UK
| | - Mark R Miller
- Centre for Cardiovascular Science, The University of Edinburgh, Edinburgh, UK
| | - David E Newby
- Centre for Cardiovascular Science, The University of Edinburgh, Edinburgh, UK
| | - Rebecca M Reynolds
- Centre for Cardiovascular Science, The University of Edinburgh, Edinburgh, UK
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Sominsky L, O'Hely M, Drummond K, Cao S, Collier F, Dhar P, Loughman A, Dawson S, Tang ML, Mansell T, Saffery R, Burgner D, Ponsonby AL, Vuillermin P. Pre-pregnancy obesity is associated with greater systemic inflammation and increased risk of antenatal depression. Brain Behav Immun 2023; 113:189-202. [PMID: 37437818 DOI: 10.1016/j.bbi.2023.07.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 06/29/2023] [Accepted: 07/05/2023] [Indexed: 07/14/2023] Open
Abstract
BACKGROUND Pre-pregnancy obesity is an emerging risk factor for perinatal depression. However, the underlying mechanisms remain unclear. We investigated the association between pre-pregnancy body mass index (BMI) and perinatal depressive symptoms in a large population-based pre-birth cohort, the Barwon Infant Study. We also assessed whether the levels of circulating inflammatory markers during pregnancy mediated this relationship. METHODS Depressive symptoms were assessed in 883 women using the Edinburgh Postnatal Depression Scale (EPDS) and psychological stress using the Perceived Stress Scale (PSS) at 28 weeks gestation and 4 weeks postpartum. Glycoprotein acetyls (GlycA), high-sensitivity C-reactive protein (hsCRP) and cytokines were assessed at 28 weeks gestation. We performed regression analyses, adjusted for potential confounders, and investigated mediation using nested counterfactual models. RESULTS The estimated effect of pre-pregnancy obesity (BMI ≥ 30 kg/m2) on antenatal EPDS scores was 1.05 points per kg/m2 increase in BMI (95% CI: 0.20, 1.90; p = 0.02). GlycA, hsCRP, interleukin (IL) -1ra and IL-6 were higher in women with obesity, compared to healthy weight women, while eotaxin and IL-4 were lower. Higher GlycA was associated with higher EPDS and PSS scores and partially mediated the association between pre-pregnancy obesity and EPDS/PSS scores in unadjusted models, but this association attenuated upon adjustment for socioeconomic adversity. IL-6 and eotaxin were negatively associated with EPDS/PSS scores, however there was no evidence for mediation. CONCLUSIONS Pre-pregnancy obesity increases the risk of antenatal depressive symptoms and is also associated with systemic inflammation during pregnancy. While discrete inflammatory markers are associated with antenatal depressive symptoms and perceived stress, their role in mediating the effects of pre-pregnancy obesity on antenatal depression requires further investigation.
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Affiliation(s)
- Luba Sominsky
- Barwon Health, Geelong, Victoria, Australia; Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, Victoria, Australia.
| | - Martin O'Hely
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, Victoria, Australia; Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia
| | - Katherine Drummond
- The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria, Australia
| | - Sifan Cao
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, Victoria, Australia
| | - Fiona Collier
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, Victoria, Australia
| | - Poshmaal Dhar
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, Victoria, Australia
| | - Amy Loughman
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, Victoria, Australia
| | - Samantha Dawson
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, Victoria, Australia
| | - Mimi Lk Tang
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia; The University of Melbourne, Parkville, Victoria, Australia; Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Toby Mansell
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia; The University of Melbourne, Parkville, Victoria, Australia
| | - Richard Saffery
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia
| | - David Burgner
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia; The University of Melbourne, Parkville, Victoria, Australia; Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Anne-Louise Ponsonby
- The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria, Australia
| | - Peter Vuillermin
- Barwon Health, Geelong, Victoria, Australia; Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, Victoria, Australia; Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia.
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Bittner JMP, Gilman SE, Zhang C, Chen Z, Cheon BK. Relationships between early-life family poverty and relative socioeconomic status with gestational diabetes, preeclampsia, and hypertensive disorders of pregnancy later in life. Ann Epidemiol 2023; 86:8-15. [PMID: 37573949 PMCID: PMC10538385 DOI: 10.1016/j.annepidem.2023.08.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 08/04/2023] [Accepted: 08/08/2023] [Indexed: 08/15/2023]
Abstract
PURPOSE Low early-life absolute and relative socioeconomic status (SES) may contribute to socioeconomic disparities in pregnancy complications (i.e., gestational diabetes mellitus [GDM], preeclampsia/eclampsia [PE], hypertensive disorders of pregnancy [HDP; preeclampsia/eclampsia, gestational hypertension, chronic hypertension]), but their independent associations with pregnancy complications have not been studied. This study investigated associations of early-life poverty and relative SES with risks of GDM, PE, and HDP. METHODS National Longitudinal Study of Adolescent to Adult Health data were used (GDM n = 802; PE n = 813; HDP n = 801). Objective poverty was defined as wave I low-income or receipt of federal nutrition assistance benefits. Relative SES was self-reported at wave V (ages 33-39) by asking whether the participant's family was financially worse off than average when growing up. Logistic regressions assessed relationships between poverty, relative SES, and self-reported lifetime diagnoses of GDM, PE, or HDP. RESULTS Lifetime prevalences of GDM, PE, and HDP were 9.23%, 12.00%, and 21.93%, respectively. Low relative SES (odds ratio: 2.04 [1.07, 3.89]) and poverty (odds ratio: 1.81 [0.97, 3.38]) were independently associated with GDM but not with PE or HDP. CONCLUSIONS Early-life poverty and relative SES are associated with GDM; understanding the mechanisms underlying these associations may help identify novel intervention targets to reduce socioeconomic disparities in GDM.
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Affiliation(s)
- Julia M P Bittner
- Social and Behavioral Sciences Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD.
| | - Stephen E Gilman
- Social and Behavioral Sciences Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD; Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Cuilin Zhang
- Global Center for Asian Women's Health, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Zhen Chen
- Biostatistics and Bioinformatics Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD
| | - Bobby K Cheon
- Social and Behavioral Sciences Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD
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Layden AJ, Bertolet M, Parks WT, Adibi JJ, Roberts JM, Catov JM. Prepregnancy obesity and risk of placental inflammation at term: a selection bias analysis. Ann Epidemiol 2023; 86:25-33.e7. [PMID: 37302673 PMCID: PMC10546767 DOI: 10.1016/j.annepidem.2023.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 05/20/2023] [Accepted: 06/06/2023] [Indexed: 06/13/2023]
Abstract
PURPOSE Placental histopathology is a resource for investigating obesity-associated pregnancy conditions. However, studies oversample adverse pregnancies, biasing findings. We examine the association between prepregnancy obesity (risk factor for inflammation) and histologic placental inflammation (correlated with impaired infant neurodevelopment) and how selection bias may influence the association. METHODS Singleton term deliveries between 2008 and 2012 from the Magee Obstetric Maternal and Infant database were analyzed. Prepregnancy body mass index (BMI) was categorized as underweight, lean (referent), overweight, and obese. Outcomes were diagnoses of acute (acute chorioamnionitis and fetal inflammation) and chronic placental inflammation (chronic villitis). Risk ratios for associations between BMI and placental inflammation were estimated using selection bias approaches: complete case, exclusion of pregnancy complications, multiple imputation, and inverse probability weighting. E-values approximated how susceptible estimates were to residual selection bias. RESULTS Across methods, obesity was associated with an 8-15% lower risk of acute chorioamnionitis, a 7%-14% lower risk of acute fetal inflammation, and a 12%-30% higher risk of chronic villitis relative to lean women. E-values indicated modest residual selection bias could explain away associations, though few measured indications of placental evaluations met this threshold. CONCLUSIONS Obesity may contribute to placental inflammation, and we highlight robust methods to analyze clinical data susceptible to selection bias.
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Affiliation(s)
| | - Marnie Bertolet
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA; Department of Biostatistics, University of Pittsburgh, Pittsburgh, PA; Clinical and Translational Sciences Institute, University of Pittsburgh, Pittsburgh, PA
| | - W Tony Parks
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, CA
| | - Jennifer J Adibi
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA; Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh, Pittsburgh, PA
| | - James M Roberts
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA; Clinical and Translational Sciences Institute, University of Pittsburgh, Pittsburgh, PA; Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh, Pittsburgh, PA; Magee-Womens Research Institute, Pittsburgh, PA
| | - Janet M Catov
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA; Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh, Pittsburgh, PA; Magee-Womens Research Institute, Pittsburgh, PA
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He M, Guo X, Jia J, Zhang J, Zhou X, Wei L, Yu J, Wang S, Feng L. Regulatory mechanisms underlying endoplasmic reticulum stress involvement in the development of gestational diabetes mellitus entail the CHOP-PPARα-NF-κB pathway. Placenta 2023; 142:46-55. [PMID: 37639950 DOI: 10.1016/j.placenta.2023.08.070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 07/25/2023] [Accepted: 08/22/2023] [Indexed: 08/31/2023]
Abstract
OBJECTIVE We investigated the proinflammatory functions of endoplasmic reticulum stress and peroxisome proliferator-activated receptor α (PPARα) in the development of gestational diabetes mellitus (GDM) and their relationship in regulating inflammation in GDM. METHODS This study was performed on placentas of normal pregnant women, women with GDM, and HTR8 cells. Transmission electron microscopy, immunohistochemistry, Western blot analysis, and RT-PCR were performed to analyze ERS and PPARα expression on both normal and GDM pregnancy placentas. ELISA was performed to analyze inflammatory biomarkers. To generate models of the GDM-like state, placentas of normal pregnancy were treated with LPS and polyinosinic-polycytidylic acid (poly [I:C]). TG, CHOP plasmid, and CHOP siRNA were assessed as to their regulation of HTR8 cells to discern the relationship between ERS and PPARα in regulating the inflammation associated with GDM. RESULTS ERS was elevated in GDM placentas, induced the secretion of IL-6 and TNF-α, and attenuated the expression of GLUT-4. PPARα was diminished in GDM placentas and inhibited the inflammatory responses via the NF-κB nuclear-transport process. 4-PBA reduced CHOP and augmented PPARα, and it decreased IL-6 and TNF-α in our GDM-like explant. However, with both 4-PBA and MK886 treatment, we noted no significant difference in CHOP expression. The level of PPARα was reduced, and that of NF-κB p65 in the nucleus was elevated with TG treatment in the HTR8/Svneo. Knockdown of CHOP increased PPARα and reduced NF-κB p65, while expression of PPARα declined, and that of NF-κB p65 rose with the application of CHOP when HTR8 cells were treated with TG. CONCLUSIONS ERS contributes to the pathophysiology of GDM in pregnancy via the CHOP-PPARα-NF-κB-signalling pathway by inducing aberrant activation of inflammation and insulin resistance.
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Affiliation(s)
- Mengzhou He
- Department of Gynecology and Obstetrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Xijiao Guo
- Department of Gynecology and Obstetrics, Wuhan Maternal and Child Health Hospital, Wuhan, Hubei, PR China
| | - Jing Jia
- Department of Gynecology and Obstetrics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, PR China
| | - Jingyi Zhang
- Department of Gynecology and Obstetrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Xuan Zhou
- Department of Gynecology and Obstetrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Lijie Wei
- Department of Gynecology and Obstetrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Jun Yu
- Department of Gynecology and Obstetrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Shaoshuai Wang
- Department of Gynecology and Obstetrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China.
| | - Ling Feng
- Department of Gynecology and Obstetrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China.
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Fato BR, Beard S, Binder NK, Pritchard N, Kaitu’u-Lino TJ, de Alwis N, Hannan NJ. The Regulation of Endothelin-1 in Pregnancies Complicated by Gestational Diabetes: Uncovering the Vascular Effects of Insulin. Biomedicines 2023; 11:2660. [PMID: 37893034 PMCID: PMC10603897 DOI: 10.3390/biomedicines11102660] [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: 08/10/2023] [Revised: 09/22/2023] [Accepted: 09/25/2023] [Indexed: 10/29/2023] Open
Abstract
Gestational diabetes mellitus (GDM) is a condition of pregnancy defined by new-onset hyperglycemia. GDM is associated with impaired maternal endothelial and vascular reactivity. Endothelin-1 (ET-1) is a potent vasoconstrictor that contributes to endothelial dysfunction, however, its abundance and actions in GDM are unclear. Maternal plasma was obtained from pregnancies complicated by GDM (n = 24) and gestation-matched controls (n = 42); circulating ET-1 levels were assessed by ELISA. Human omental arteries from healthy pregnancies and those complicated by GDM were dissected from omental fat biopsies and collected at cesarean section. mRNA expression of ET-1 and its receptors, ETA and ETB, in addition to vascular cell adhesion molecule-1 (VCAM1) and intercellular adhesion molecule-1 (ICAM1) were assessed by qPCR (n = 28). Using wire myography, we investigated vascular constriction to ET-1 (10-11-10-4 M) in omental arteries from pregnancies complicated by GDM, compared to gestation-matched controls (n = 7). GDM cases were stratified by clinical management, diet intervention (n = 5), or insulin treatment (n = 6). Additionally, arteries from healthy pregnancies were treated with insulin (1 mU/mL (n = 7) and 10 mU/mL (n = 5)) or vehicle control. Vasoactive response to ET-1 was measured via wire myography. Circulating ET-1 levels and mRNA expression of the ET-1 system in omental arteries were not found to be significantly different between pregnancies complicated by GDM compared to healthy controls. However, we found insulin treatment during pregnancy and in ex vivo models reduced ET-1 vasoconstriction of maternal vasculature in GDM. These data suggest insulin may improve vascular function in GDM, however, further investigation is needed to define the role of ET-1 in pregnancy.
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Affiliation(s)
- Bianca R. Fato
- Therapeutics Discovery and Vascular Function in Pregnancy Group, Mercy Hospital for Women, University of Melbourne, Heidelberg, VIC 3084, Australia; (B.R.F.); (S.B.); (N.K.B.); (N.d.A.)
- Department of Obstetrics and Gynaecology, Mercy Hospital for Women, University of Melbourne, Heidelberg, VIC 3084, Australia; (N.P.); (T.J.K.-L.)
| | - Sally Beard
- Therapeutics Discovery and Vascular Function in Pregnancy Group, Mercy Hospital for Women, University of Melbourne, Heidelberg, VIC 3084, Australia; (B.R.F.); (S.B.); (N.K.B.); (N.d.A.)
- Department of Obstetrics and Gynaecology, Mercy Hospital for Women, University of Melbourne, Heidelberg, VIC 3084, Australia; (N.P.); (T.J.K.-L.)
| | - Natalie K. Binder
- Therapeutics Discovery and Vascular Function in Pregnancy Group, Mercy Hospital for Women, University of Melbourne, Heidelberg, VIC 3084, Australia; (B.R.F.); (S.B.); (N.K.B.); (N.d.A.)
- Department of Obstetrics and Gynaecology, Mercy Hospital for Women, University of Melbourne, Heidelberg, VIC 3084, Australia; (N.P.); (T.J.K.-L.)
| | - Natasha Pritchard
- Department of Obstetrics and Gynaecology, Mercy Hospital for Women, University of Melbourne, Heidelberg, VIC 3084, Australia; (N.P.); (T.J.K.-L.)
| | - Tu’uhevaha J. Kaitu’u-Lino
- Department of Obstetrics and Gynaecology, Mercy Hospital for Women, University of Melbourne, Heidelberg, VIC 3084, Australia; (N.P.); (T.J.K.-L.)
- Diagnostic Discovery and Reverse Translation in Pregnancy Group, Mercy Hospital for Women, University of Melbourne, Heidelberg, VIC 3084, Australia
| | - Natasha de Alwis
- Therapeutics Discovery and Vascular Function in Pregnancy Group, Mercy Hospital for Women, University of Melbourne, Heidelberg, VIC 3084, Australia; (B.R.F.); (S.B.); (N.K.B.); (N.d.A.)
- Department of Obstetrics and Gynaecology, Mercy Hospital for Women, University of Melbourne, Heidelberg, VIC 3084, Australia; (N.P.); (T.J.K.-L.)
| | - Natalie J. Hannan
- Therapeutics Discovery and Vascular Function in Pregnancy Group, Mercy Hospital for Women, University of Melbourne, Heidelberg, VIC 3084, Australia; (B.R.F.); (S.B.); (N.K.B.); (N.d.A.)
- Department of Obstetrics and Gynaecology, Mercy Hospital for Women, University of Melbourne, Heidelberg, VIC 3084, Australia; (N.P.); (T.J.K.-L.)
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