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Lowe WL, Kuang A, Hayes MG, Hivert MF, Scholtens DM. Genetics of glucose homeostasis in pregnancy and postpartum. Diabetologia 2024:10.1007/s00125-024-06256-8. [PMID: 39180581 DOI: 10.1007/s00125-024-06256-8] [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: 03/07/2024] [Accepted: 07/02/2024] [Indexed: 08/26/2024]
Abstract
AIMS/HYPOTHESIS Pregnancy is accompanied by maternal metabolic adaptations to ensure fetal growth and development, including insulin resistance, which occurs primarily during the second and third trimesters of pregnancy, and a decrease in fasting blood sugar levels over the course of pregnancy. Glucose-related traits are regulated by genetic and environmental factors and modulated by physiological variations throughout the life course. We addressed the hypothesis that there are both overlaps and differences between genetic variants associated with glycaemia-related traits during and outside of pregnancy. METHODS Genome-wide SNP data were used to identify genetic variations associated with glycaemia-related traits measured during an OGTT performed at ~28 weeks' gestation in 8067 participants in the Hyperglycaemia and Adverse Pregnancy Outcome (HAPO) Study. Associations outside of pregnancy were determined in 3977 individuals who also participated in the HAPO Follow-Up Study at 11-14 years postpartum. A Bayesian classification algorithm was used to determine whether SNPs associated with fasting and 2 h glucose and fasting C-peptide during pregnancy had a pregnancy-predominant effect vs a similar effect during pregnancy and postpartum. RESULTS SNPs in six loci (GCKR, G6PC2, GCK, PPP1R3B, PCSK1 and MTNR1B) were significantly associated with fasting glucose during pregnancy, while SNPs in CDKAL1 and MTNR1B were associated with 1 h glucose and SNPs in MTNR1B and HKDC1 were associated with 2 h glucose. Variants in CDKAL1 and MTNR1B were associated with insulin secretion during pregnancy. Variants in multiple loci were associated with fasting C-peptide during pregnancy, including GCKR, IQSEC1, PPP1R3B, IGF1 and BACE2. GCKR and BACE2 were associated with 1 h C-peptide and GCKR, IQSEC1 and BACE2 with insulin sensitivity during pregnancy. The associations of MTNR1B with 2 h glucose, BACE2 with fasting and 1 h C-peptide and insulin sensitivity, and IQSEC1 with fasting C-peptide and insulin sensitivity that we identified during pregnancy have not been previously reported in non-pregnancy cohorts. The Bayesian classification algorithm demonstrated that the magnitude of effect of the lead SNP was greater during pregnancy compared with 11-14 years postpartum in PCSK1 and PPP1R3B with fasting glucose, in three loci, including MTNR1B, with 2 h glucose, and in six loci, including IGF1, with fasting C-peptide. CONCLUSIONS/INTERPRETATION Our findings support the hypothesis that there are both overlaps and differences between the genetic architecture of glycaemia-related traits during and outside of pregnancy. Genetic variants at several loci, including PCSK1, PPP1R3B, MTNR1B and IGF1, appear to influence glycaemic regulation in a unique fashion during pregnancy. Future studies in larger cohorts will be needed to replicate the present findings, fully characterise the genetics of maternal glycaemia during pregnancy and determine similarities to and differences from the non-gravid state.
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Affiliation(s)
- William L Lowe
- Department of Medicine, Northwestern University Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
| | - Alan Kuang
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - M Geoffrey Hayes
- Department of Medicine, Northwestern University Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Marie-France Hivert
- Diabetes Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Pilgrim Health Care Institute, Harvard Medical School, Boston, MA, USA
- Department of Medicine, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
- Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada
| | - Denise M Scholtens
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
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Shen F, Chu C, Chen J, Kuo C, Hsu C, Lin C, Sheen Y, Su S, Tien K, Lu C, Lee C, Yang Y, Tu S, Chen P, Chen C, Chien M, Li H, Sheu WH, Huang C, Wang C, Ou H. Optimizing lipid control in Taiwanese diabetic patients: A collaborative consensus by the Diabetes Association of the Republic of China (Taiwan) and the Taiwanese Association of Diabetes Educators. J Diabetes Investig 2024; 15:1151-1160. [PMID: 38676417 PMCID: PMC11292399 DOI: 10.1111/jdi.14222] [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: 04/06/2024] [Accepted: 04/10/2024] [Indexed: 04/28/2024] Open
Abstract
We present an in-depth analysis of dyslipidemia management strategies for patients with diabetes mellitus in Taiwan. It critically examines the disparity between established guideline recommendations and actual clinical practices, particularly in the context of evolving policies affecting statin prescriptions. The focus is on synthesizing the most recent findings concerning lipid management in patients with diabetes mellitus, with a special emphasis on establishing consensus regarding low-density lipoprotein cholesterol treatment targets. The article culminates in providing comprehensive, evidence-based recommendations tailored to the unique needs of those living with diabetes mellitus in Taiwan. It underscores the criticality of personalized care approaches, which incorporate multifaceted factors, and the integration of novel therapeutic options to enhance cardiovascular health outcomes.
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Affiliation(s)
- Feng‐Chih Shen
- Division of Endocrinology and Metabolism, Department of Internal MedicineKaohsiung Chang Gung Memorial HospitalKaohsiungTaiwan
- School of Medicine, College of MedicineChang Gung UniversityTaoyuanTaiwan
| | - Chih‐Hsun Chu
- Division of Endocrinology and Metabolism, Department of Internal MedicineKaohsiung Veterans General HospitalKaohsiungTaiwan
| | - Jung‐Fu Chen
- Division of Endocrinology and Metabolism, Department of Internal MedicineKaohsiung Chang Gung Memorial HospitalKaohsiungTaiwan
- School of Medicine, College of MedicineChang Gung UniversityTaoyuanTaiwan
| | - Chin‐Sung Kuo
- Institute of Clinical MedicineNational Yang Ming Chiao Tung UniversityTaipeiTaiwan
- Division of Endocrinology and Metabolism, Department of MedicineTaipei Veterans General HospitalTaipeiTaiwan
| | - Chih‐Yao Hsu
- Department of Internal MedicineTaipei City Hospital, Ren‐Ai BranchTaipeiTaiwan
| | - Ching‐Han Lin
- Department of Internal Medicine, National Cheng Kung University Hospital, College of MedicineNational Cheng Kung UniversityTainanTaiwan
| | - Yi‐Jing Sheen
- Division of Endocrinology and Metabolism, Department of Internal MedicineTaichung Veterans General HospitalTaichung CityTaiwan
- School of Medicine, College of MedicineNational Yang Ming Chiao Tung UniversityTaipeiTaiwan
- Department of Post‐Baccalaureate Medicine, College of MedicineNational Chung Hsing UniversityTaichungTaiwan
| | - Sheng‐Chiang Su
- Division of Endocrinology and Metabolism, Department of Internal MedicineTri‐Service General Hospital, National Defense Medical CenterTaipeiTaiwan
| | | | - Chieh‐Hua Lu
- Division of Endocrinology and Metabolism, Department of Internal MedicineTri‐Service General Hospital, National Defense Medical CenterTaipeiTaiwan
| | - Chun‐Chuan Lee
- Division of Endocrinology and Metabolism, Department of Internal MedicineMacKay Memorial HospitalTaipeiTaiwan
- Department of MedicineMacKay Medical CollegeNew Taipei CityTaiwan
| | - Yi‐Sun Yang
- Division of Endocrinology and Metabolism, Department of Internal MedicineChung Shan Medical University HospitalTaichungTaiwan
- School of MedicineChung Shan Medical UniversityTaichungTaiwan
| | - Shih‐Te Tu
- Division of Endocrinology and Metabolism, Department of MedicineChanghua Christian HospitalChanghuaTaiwan
| | | | - Ching‐Chu Chen
- Division of Endocrinology and Metabolism, Department of Internal MedicineChina Medical University HospitalTaichungTaiwan
- School of Chinese MedicineChina Medical UniversityTaichungTaiwan
| | - Ming‐Nan Chien
- Division of Endocrinology and Metabolism, Department of Internal MedicineMacKay Memorial HospitalTaipeiTaiwan
- Department of MedicineMacKay Medical CollegeNew Taipei CityTaiwan
| | - Hung‐Yuan Li
- Division of Endocrinology and Metabolism, Department of Internal MedicineNational Taiwan University HospitalTaipeiTaiwan
| | - Wayne Huey‐Herng Sheu
- School of Medicine, College of MedicineNational Yang Ming Chiao Tung UniversityTaipeiTaiwan
- Institute of Molecular and Genetic MedicineNational Health Research InstitutesMiaoliTaiwan
| | - Chien‐Ning Huang
- Division of Endocrinology and Metabolism, Department of Internal MedicineChung Shan Medical University HospitalTaichungTaiwan
- School of MedicineChung Shan Medical UniversityTaichungTaiwan
| | - Chih‐Yuan Wang
- Division of Endocrinology and Metabolism, Department of Internal MedicineNational Taiwan University HospitalTaipeiTaiwan
- Department of Internal MedicineNational Taiwan University College of MedicineTaipeiTaiwan
| | - Horng‐Yih Ou
- Department of Internal Medicine, National Cheng Kung University Hospital, College of MedicineNational Cheng Kung UniversityTainanTaiwan
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Øhman EA, Fossli M, Rasmussen KM, Winkvist A, Løland BF, Holven KB, Brekke HK. Effects of Breastfeeding Promotion Intervention and Dietary Treatment in Postpartum Women with Overweight and Obesity: Results from a Randomized Controlled Trial on Weight and Cardiometabolic Risk Factors. J Nutr 2024; 154:2448-2458. [PMID: 38901636 DOI: 10.1016/j.tjnut.2024.06.006] [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: 05/27/2024] [Accepted: 06/12/2024] [Indexed: 06/22/2024] Open
Abstract
BACKGROUND Childbearing increases the risk of weight gain and cardiometabolic disease. The reset hypothesis suggests that lactation has protective cardiometabolic effects on the mother. The hypothesis is based on observational studies, and the possible interacting role of weight loss needs to be elucidated. OBJECTIVES This study aimed to examine the individual and interaction effects of a breastfeeding promotion intervention (BPI) and dietary intervention for weight loss postpartum (Diet) on body weight and cardiometabolic risk factors at 6 mo postpartum. METHODS Pregnant women (n = 156) with a prepregnancy BMI of 25 to 35 kg/m2 were randomized to 4 groups in a 2 × 2 factorial design: BPI, Diet, both treatments, or no treatment. BPI consisted of individual counseling by a lactation consultant during pregnancy, at childbirth, and monthly thereafter or more frequently based on individual needs. Diet was initiated at 11 wk postpartum. Body weight, body composition, waist and hip circumferences, markers of lipid and glucose metabolism, and blood pressure were measured at 2 wk and 6 mo postpartum. We analyzed main and interaction effects using 2-way analysis of covariance adjusted for baseline values. RESULTS Among the participants attending both visits (n = 108), 99% practiced any breastfeeding at baseline and 97% at follow-up. The BPI did not affect rates of exclusive or partial breastfeeding, age at introduction of complementary foods, or have main effects on body weight or cardiometabolic risk factors. There was a main effect of Diet reducing body weight, fat mass, fat-free mass, percentage fat mass, waist and hip circumferences, fasting glucose, and insulin (all P ≤ 0.03), with no interactions between the treatments. CONCLUSIONS There were no effects of BPI on body weight or cardiometabolic risk factors at 6 mo postpartum. Diet caused weight loss and had favorable effects on risk factors for cardiovascular disease and type 2 diabetes. This study was registered at clinicaltrials.gov as NCT03580057.
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Affiliation(s)
- Elisabeth A Øhman
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Maria Fossli
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway; Norwegian Research Center for Women's Health, Oslo University Hospital, Oslo, Norway
| | | | - Anna Winkvist
- Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Beate F Løland
- Cluster for Research and Analysis of the Health Services, Norwegian Institute of Public Health, Oslo, Norway
| | - Kirsten B Holven
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway; Norwegian National Advisory Unit on Familial Hypercholesterolemia, Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway
| | - Hilde K Brekke
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway.
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Scifres CM, Lowe WL. Continuous Glucose Monitoring in Pregnancy: New Insights Into Gestational Diabetes With More to Learn. Diabetes Care 2024; 47:1319-1321. [PMID: 39052907 PMCID: PMC11272966 DOI: 10.2337/dci24-0036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2024] [Accepted: 05/22/2024] [Indexed: 07/27/2024]
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Qin Y, Wu Y, Zang H, Cong X, Shen Q, Chen L, Chen X. Lipid Metabolism in Pregnancy Women with Hypothyroidism and Potential Influence on Pregnancy Outcome. J Lipids 2024; 2024:5589492. [PMID: 39015803 PMCID: PMC11251789 DOI: 10.1155/2024/5589492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2024] [Revised: 06/07/2024] [Accepted: 06/17/2024] [Indexed: 07/18/2024] Open
Abstract
Thyroid hormone (TH) is essential for maintaining normal physiological processes during pregnancy, including the metabolism of energy materials in both the mother and fetus and the growth and development of fetal bone and nervous system. TH can act on the liver, fat, and other tissues and organs to participate in lipid synthesis and breakdown through multiple pathways. Consequently, abnormal thyroid function is often accompanied by lipid metabolism disorders. Both clinical and subclinical hypothyroidism, as well as dyslipidemia during pregnancy, have been shown to be associated with an increased risk of multiple adverse pregnancy outcomes. Recently, there has been an increased interest in studying the alteration of lipidomic and hypothyroidism (both clinical and subclinical hypothyroidism) during pregnancy. Studies have suggested that altered lipid molecules might be used as potential biomarker and associated with adverse maternal and neonatal outcome. Thus, we summarized the associations between lipid metabolism and clinical or subclinical hypothyroidism during pregnancy in this review. Then, we discussed the underlying mechanisms of thyroid dysfunction and lipid metabolism. In addition, we reviewed the possible effect of dyslipidemia on pregnancy and neonatal outcome. However, the relationship between hypothyroidism during pregnancy and changes in the lipid profile and how to intervene in the occurrence and development of adverse pregnancy outcomes require further study.
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Affiliation(s)
- Yuxin Qin
- Department of EndocrinologyThe Affiliated Suzhou Hospital of Nanjing Medical University, 26 Daoqian Road, Suzhou 215000, China
| | - Ying Wu
- Department of EndocrinologyThe Affiliated Suzhou Hospital of Nanjing Medical University, 26 Daoqian Road, Suzhou 215000, China
| | - Huanhuan Zang
- Department of EndocrinologyThe Affiliated Suzhou Hospital of Nanjing Medical University, 26 Daoqian Road, Suzhou 215000, China
| | - Xiangguo Cong
- Department of EndocrinologyThe Affiliated Suzhou Hospital of Nanjing Medical University, 26 Daoqian Road, Suzhou 215000, China
| | - Qiong Shen
- Department of EndocrinologyThe Affiliated Suzhou Hospital of Nanjing Medical University, 26 Daoqian Road, Suzhou 215000, China
| | - Lei Chen
- Department of EndocrinologyThe Affiliated Suzhou Hospital of Nanjing Medical University, 26 Daoqian Road, Suzhou 215000, China
| | - Xinxin Chen
- Department of EndocrinologyThe Affiliated Suzhou Hospital of Nanjing Medical University, 26 Daoqian Road, Suzhou 215000, China
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Jiang M, Li M, Li Y, Yu L, Zheng Y, Jiang R. Body composition in second trimester is associated with dyslipidemia in third trimester. Arch Gynecol Obstet 2024; 310:171-179. [PMID: 38491293 DOI: 10.1007/s00404-024-07407-3] [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: 01/28/2024] [Indexed: 03/18/2024]
Abstract
OBJECTIVE The aim of this study was to examine the correlation between maternal body composition during the second trimester and the occurrence of dyslipidemia in the third trimester. METHODS A cohort of 1508 pregnant women who underwent antenatal testing at Shanghai Sixth People's Hospital, affiliated with Shanghai Jiao Tong University School of Medicine, were included in this study. Maternal body composition was assessed using bioimpedance analysis between 14 and 22 weeks of gestation. RESULTS Among the 1508 participants, a total of 1420 individuals (94.2%) were diagnosed with dyslipidemia. Notably, there were significant differences in body composition between the normal lipid group and the dyslipidemia group. Logistic regression analysis revealed that various factors including BMI, total body water (TBW), intra-cellular water (ICW), extra-cellular water (ECW), percent body fat (PBF), visceral fat area (VFA), fat-free mass (FFM) and arm circumference (AC) during the second trimester were all found to be associated with dyslipidemia in the third trimester. CONCLUSION The present study found that maternal body composition was associated with dyslipidemia. The BMI, TBW, ICW, ECW, PBF, VFA, FFM and AC in second trimester were associated with dyslipidemia in third trimester.
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Affiliation(s)
- Mingqi Jiang
- Department of Gynecology and Obstetrics, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 600 Yishan Road, Shanghai, 200233, China
| | - Ming Li
- Department of Gynecology and Obstetrics, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 600 Yishan Road, Shanghai, 200233, China
| | - Yu Li
- Department of Gynecology and Obstetrics, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 600 Yishan Road, Shanghai, 200233, China
| | - Lu Yu
- Department of Gynecology and Obstetrics, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 600 Yishan Road, Shanghai, 200233, China
| | - Yanwei Zheng
- Department of Gynecology and Obstetrics, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 600 Yishan Road, Shanghai, 200233, China.
| | - Rongzhen Jiang
- Department of Gynecology and Obstetrics, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 600 Yishan Road, Shanghai, 200233, China.
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Design, rationale and protocol for Glycemic Observation and Metabolic Outcomes in Mothers and Offspring (GO MOMs): an observational cohort study. BMJ Open 2024; 14:e084216. [PMID: 38851233 PMCID: PMC11163666 DOI: 10.1136/bmjopen-2024-084216] [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: 01/12/2024] [Accepted: 04/09/2024] [Indexed: 06/10/2024] Open
Abstract
INTRODUCTION Given the increasing prevalence of both obesity and pre-diabetes in pregnant adults, there is growing interest in identifying hyperglycaemia in early pregnancy to optimise maternal and perinatal outcomes. Multiple organisations recommend first-trimester diabetes screening for individuals with risk factors; however, the benefits and drawbacks of detecting glucose abnormalities more mild than overt diabetes in early gestation and the best screening method to detect such abnormalities remain unclear. METHODS AND ANALYSIS The goal of the Glycemic Observation and Metabolic Outcomes in Mothers and Offspring study (GO MOMs) is to evaluate how early pregnancy glycaemia, measured using continuous glucose monitoring and oral glucose tolerance testing, relates to the diagnosis of gestational diabetes (GDM) at 24-28 weeks' gestation (maternal primary outcome) and large-for-gestational-age birth weight (newborn primary outcome). Secondary objectives include relating early pregnancy glycaemia to other adverse pregnancy outcomes and comprehensively detailing longitudinal changes in glucose over the course of pregnancy. GO MOMs enrolment began in April 2021 and will continue for 3.5 years with a target sample size of 2150 participants. ETHICS AND DISSEMINATION GO MOMs is centrally overseen by Vanderbilt University's Institutional Review Board and an Observational Study Monitoring Board appointed by National Institute of Diabetes and Digestive and Kidney Diseases. GO MOMs has potential to yield data that will improve understanding of hyperglycaemia in pregnancy, elucidate better approaches for early pregnancy GDM screening, and inform future clinical trials of early GDM treatment. TRIAL REGISTRATION NUMBER NCT04860336.
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Patel N, Mittal N, Wilkinson MJ, Taub PR. Unique features of dyslipidemia in women across a lifetime and a tailored approach to management. Am J Prev Cardiol 2024; 18:100666. [PMID: 38634109 PMCID: PMC11021917 DOI: 10.1016/j.ajpc.2024.100666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 03/26/2024] [Accepted: 04/04/2024] [Indexed: 04/19/2024] Open
Abstract
Purpose of Review Cardiovascular disease is a leading cause of death worldwide. Dyslipidemia is a critical modifiable risk factor for the prevention of cardiovascular disease. Dyslipidemia affects a large population of women and is especially pervasive within racial/ethnic minorities. Recent Findings Dyslipidemia in pregnancy leads to worse outcomes for patients and creates increased cardiovascular risk for women at an older age. However, women remain underscreened and undertreated compared to men. Females also comprise a small portion of clinical trial participants for lipid lowering agents with increased disease prevalence compared to trial representation. However, recent lipid trials have shown different efficacies of therapies such as ezetimibe, inclisiran, and bempedoic acid with a greater relative benefit for women. Summary Pathophysiology of dyslipidemia varies between men and women and across a woman's lifetime. While increased lipid levels or lipid imbalances are more common in postmenopausal women over age 50, conditions such as PCOS and FH produce higher cardiovascular risk for young women.Best practices for management of women with dyslipidemia include early screening with lifestyle intervention and pharmacotherapy with statin and non-statin agents to achieve guideline directed LDL-C thresholds.
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Affiliation(s)
- Neeja Patel
- University of California, Los Angeles, United States
| | | | | | - Pam R. Taub
- University of California, San Diego, United States
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Tang B, Hao Y, Wang C, Deng Z, Kou Z, Zhou H, Zhang H, Fan F, Wang K, Wang D. Biological characteristics of pregnancy in captive Yangtze finless porpoises revealed by urinary metabolomics†. Biol Reprod 2024; 110:808-818. [PMID: 38169437 PMCID: PMC11017131 DOI: 10.1093/biolre/ioad175] [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: 07/07/2023] [Revised: 11/20/2023] [Accepted: 12/19/2023] [Indexed: 01/05/2024] Open
Abstract
The Yangtze finless porpoises (Neophocaena asiaeorientalis a.) are an endemic and critically endangered species in China. Intensive captive breeding is essential for understanding the biology of critically endangered species, especially their pregnancy characteristics, knowledge of which is crucial for effective breeding management. Urine metabolomics can reveal metabolic differences, arising from physiological changes across pregnancy stages. Therefore, we used the urinary metabolomic technology, to explore urinary metabolite changes in pregnant Yangtze finless porpoises. A total of 2281 metabolites were identified in all samples, which including organic acids and derivatives (24.45%), organoheterocyclic compounds (20.23%), benzenoids (18.05%), organic oxygen compounds (7.73%), and phenylpropanoids and polyketides (6.48%). There were 164, 387, and 522 metabolites demonstrating differential abundance during early pregnancy, mid pregnancy, and late pregnancy, respectively, from the levels observed in nonpregnancy. The levels of pregnenolone, 17α-hydroxyprogesterone, and tetrahydrocortisone were significantly higher during all pregnancy stages, indicating their important roles in fetal development. The differential metabolites between nonpregnancy and pregnancy were mainly associated with amino acid and carbohydrate metabolism. Moreover, metabolic activity varied across pregnancy stages; steroid hormone biosynthesis was predominant in early pregnancy, and amino acid biosynthesis and carbohydrate metabolism were predominant in mid pregnancy and late pregnancy, respectively. Our results provide new insights into metabolic characteristics in the Yangtze finless porpoises' urine during pregnancy, and indicate that the differential levels of urine metabolites can determine pregnancy in Yangtze finless porpoises, providing valuable information for the husbandry and management of pregnant Yangtze finless porpoises in captivity.
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Affiliation(s)
- Bin Tang
- Key Laboratory of Aquatic Biodiversity and Conservation, Institute of Hydrobiology, Chinese Academy of Sciences, Wuhan, China
| | - Yujiang Hao
- Key Laboratory of Aquatic Biodiversity and Conservation, Institute of Hydrobiology, Chinese Academy of Sciences, Wuhan, China
- National Aquatic Biological Resource Center, NABRC, Wuhan, China
| | - Chaoqun Wang
- Key Laboratory of Aquatic Biodiversity and Conservation, Institute of Hydrobiology, Chinese Academy of Sciences, Wuhan, China
- National Aquatic Biological Resource Center, NABRC, Wuhan, China
| | - Zhengyu Deng
- Key Laboratory of Aquatic Biodiversity and Conservation, Institute of Hydrobiology, Chinese Academy of Sciences, Wuhan, China
- National Aquatic Biological Resource Center, NABRC, Wuhan, China
| | - Zhangbing Kou
- Key Laboratory of Aquatic Biodiversity and Conservation, Institute of Hydrobiology, Chinese Academy of Sciences, Wuhan, China
| | - Haojie Zhou
- Key Laboratory of Aquatic Biodiversity and Conservation, Institute of Hydrobiology, Chinese Academy of Sciences, Wuhan, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Haobo Zhang
- Key Laboratory of Aquatic Biodiversity and Conservation, Institute of Hydrobiology, Chinese Academy of Sciences, Wuhan, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Fei Fan
- Key Laboratory of Aquatic Biodiversity and Conservation, Institute of Hydrobiology, Chinese Academy of Sciences, Wuhan, China
- National Aquatic Biological Resource Center, NABRC, Wuhan, China
| | - Kexiong Wang
- Key Laboratory of Aquatic Biodiversity and Conservation, Institute of Hydrobiology, Chinese Academy of Sciences, Wuhan, China
- National Aquatic Biological Resource Center, NABRC, Wuhan, China
| | - Ding Wang
- Key Laboratory of Aquatic Biodiversity and Conservation, Institute of Hydrobiology, Chinese Academy of Sciences, Wuhan, China
- National Aquatic Biological Resource Center, NABRC, Wuhan, China
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Lee JS, Choi ES, Lee H, Son S, Lee KS, Ahn KH. Machine learning analysis for the association between breast feeding and metabolic syndrome in women. Sci Rep 2024; 14:4138. [PMID: 38374105 PMCID: PMC10876622 DOI: 10.1038/s41598-024-53137-6] [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: 03/07/2023] [Accepted: 01/29/2024] [Indexed: 02/21/2024] Open
Abstract
This cross-sectional study aimed to develop and validate population-based machine learning models for examining the association between breastfeeding and metabolic syndrome in women. The artificial neural network, the decision tree, logistic regression, the Naïve Bayes, the random forest and the support vector machine were developed and validated to predict metabolic syndrome in women. Data came from 30,204 women, who aged 20 years or more and participated in the Korean National Health and Nutrition Examination Surveys 2010-2019. The dependent variable was metabolic syndrome. The 86 independent variables included demographic/socioeconomic determinants, cardiovascular disease, breastfeeding duration and other medical/obstetric information. The random forest had the best performance in terms of the area under the receiver-operating-characteristic curve, e.g., 90.7%. According to random forest variable importance, the top predictors of metabolic syndrome included body mass index (0.1032), medication for hypertension (0.0552), hypertension (0.0499), cardiovascular disease (0.0453), age (0.0437) and breastfeeding duration (0.0191). Breastfeeding duration is a major predictor of metabolic syndrome for women together with body mass index, diagnosis and medication for hypertension, cardiovascular disease and age.
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Affiliation(s)
- Jue Seong Lee
- Department of Pediatrics, Korea University College of Medicine, Korea University Anam Hospital, Seoul, South Korea
| | - Eun-Saem Choi
- Department of Obstetrics and Gynecology, Korea University College of Medicine, Korea University Anam Hospital, 73 Goryeodae-ro, Seongbuk-gu, Seoul, 02841, South Korea
| | - Hwasun Lee
- Department of Biostatistics, Korea University College of Medicine, Seoul, South Korea
| | - Serhim Son
- Department of Biostatistics, Korea University College of Medicine, Seoul, South Korea
| | - Kwang-Sig Lee
- AI Center, Korea University College of Medicine, Korea University Anam Hospital, 73 Goryeodae-ro, Seongbuk-gu, Seoul, 02841, South Korea.
| | - Ki Hoon Ahn
- Department of Obstetrics and Gynecology, Korea University College of Medicine, Korea University Anam Hospital, 73 Goryeodae-ro, Seongbuk-gu, Seoul, 02841, South Korea.
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Nichols AR, Chavarro JE, Oken E. Reproductive risk factors across the female lifecourse and later metabolic health. Cell Metab 2024; 36:240-262. [PMID: 38280383 PMCID: PMC10871592 DOI: 10.1016/j.cmet.2024.01.002] [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: 10/06/2023] [Revised: 12/08/2023] [Accepted: 01/05/2024] [Indexed: 01/29/2024]
Abstract
Metabolic health is characterized by optimal blood glucose, lipids, cholesterol, blood pressure, and adiposity. Alterations in these characteristics may lead to the development of type 2 diabetes mellitus or dyslipidemia. Recent evidence suggests that female reproductive characteristics may be overlooked as risk factors that contribute to later metabolic dysfunction. These reproductive traits include the age at menarche, menstrual irregularity, the development of polycystic ovary syndrome, gestational weight change, gestational dysglycemia and dyslipidemia, and the severity and timing of menopausal symptoms. These risk factors may themselves be markers of future dysfunction or may be explained by shared underlying etiologies that promote long-term disease development. Disentangling underlying relationships and identifying potentially modifiable characteristics have an important bearing on therapeutic lifestyle modifications that could ease long-term metabolic burden. Further research that better characterizes associations between reproductive characteristics and metabolic health, clarifies underlying etiologies, and identifies indicators for clinical application is warranted in the prevention and management of metabolic dysfunction.
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Affiliation(s)
- Amy R Nichols
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA.
| | - Jorge E Chavarro
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Emily Oken
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
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12
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Bendetson JG, Baffoe-Bonnie AW. Type 2 Diabetes Status, Diabetes Complication Severity Index Scores, and Their Relationship With COVID-19 Severity: A Retrospective Cohort Study of Hospitalized Patients in a Southwest Virginia Health System. Cureus 2024; 16:e53524. [PMID: 38445145 PMCID: PMC10912820 DOI: 10.7759/cureus.53524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/28/2024] [Indexed: 03/07/2024] Open
Abstract
Background Studies have shown that patients with type 2 diabetes mellitus (T2DM) tend to have poorer outcomes associated with COVID-19, including increased rates of hospitalization, ICU admission, need for ventilatory support, and mortality. Methods We performed a retrospective cohort study that included all non-pregnant adult patients who were hospitalized as a result of COVID-19 in a Southwest Virginia health system between March 18, 2020, and August 31, 2022. T2DM status was treated as a binary variable. T2DM severity was assessed using the Diabetes Complications Severity Index (DCSI). Multivariate logistic regression was used to assess the relationship between T2DM status and COVID-19 severity outcomes. Multivariate logistic regression was also used to assess the relationship between DCSI score and COVID-19 severity outcomes among patients with an established diagnosis of T2DM at the time of COVID-19 hospital admission. Results Patients with T2DM had 1.27 times the odds of experiencing a poor COVID-19 clinical outcome (95% CI: 1.13, 1.43) and 1.35 times the odds of in-hospital mortality (95% CI: 1.14, 1.59) compared to patients without diabetes. Among patients with T2DM, increasing DCSI score was significantly associated with increased odds of experiencing a poor COVID-19 clinical outcome and in-hospital mortality. Conclusions Diabetic patients in our sample were at increased odds of experiencing poor COVID-19 clinical outcomes and in-hospital mortality compared to individuals without diabetes. Amongst patients with T2DM, increasing DCSI score was associated with worse COVID-19 outcomes. Clinical decision support tools may be able to utilize DCSI scores as an indicator of COVID-19 severity risk to facilitate decisions regarding treatment aggressiveness and resource allocation.
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Affiliation(s)
- Jesse G Bendetson
- Department of Medicine, Virginia Tech Carilion School of Medicine, Roanoke, USA
| | - Anthony W Baffoe-Bonnie
- Section of Infectious Diseases, Department of Medicine, Virginia Tech Carilion School of Medicine, Roanoke, USA
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13
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Song Y, Lu R, Yu G, Rahman ML, Chen L, Zhu Y, Tsai MY, Fiehn O, Chen Z, Zhang C. Longitudinal lipidomic profiles during pregnancy and associations with neonatal anthropometry: findings from a multiracial cohort. EBioMedicine 2023; 98:104881. [PMID: 38006745 PMCID: PMC10709105 DOI: 10.1016/j.ebiom.2023.104881] [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: 06/04/2023] [Revised: 11/06/2023] [Accepted: 11/06/2023] [Indexed: 11/27/2023] Open
Abstract
BACKGROUND Maternal lipidomic profiling offers promise for characterizing lipid metabolites during pregnancy, but longitudinal data are limited. This study aimed to examine associations of longitudinal lipidomic profiles during pregnancy with multiple neonatal anthropometry using data from a multiracial cohort. METHODS We measured untargeted plasma lipidome profiles among 321 pregnant women from the NICHD Fetal Growth Study-Singletons using plasma samples collected longitudinally during four study visits at gestational weeks (GW) 10-14, 15-26, 23-31, and 33-39, respectively. We evaluated individual lipidomic metabolites at each study visit in association with neonatal anthropometry. We also evaluated the associations longitudinally by constructing lipid networks using weighted correlation network analysis and common networks using consensus network analysis across four visits using linear mixed-effects models with the adjustment of false discover rate. FINDINGS Multiple triglycerides (TG) were positively associated with birth weight (BW), BW Z-score, length and head circumference, while some cholesteryl ester (CE), phosphatidylcholine (PC), sphingomyelines (SM), phosphatidylethanolamines (PE), and lysophosphatidylcholines (LPC 20:3) families were inversely associated with BW, length, abdominal and head circumference at different GWs. Longitudinal trajectories of TG, PC, and glucosylcermides (GlcCer) were associated with BW, and CE (18:2) with BW z-score, length, and sum of skinfolds (SS), while some PC and PE were significantly associated with abdominal and head circumference. Modules of TG at GW 10-14 and 15-26 mainly were associated with BW. At GW 33-39, two networks of LPC (20:3) and of PC, TG, and CE, showed inverse associations with abdominal circumference. Distinct trajectories within two consensus modules with changes in TG, CE, PC, and LPC showed significant differences in BW and length. INTERPRETATION The results demonstrated that longitudinal changes of TGs during early- and mid-pregnancy and changes of PC, LPC, and CE during late-pregnancy were significantly associated with neonatal anthropometry. FUNDING National Institute of Child Health and Human Development intramural funding.
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Affiliation(s)
- Yiqing Song
- Department of Epidemiology, Indiana University Richard M. Fairbanks School of Public Health, Indianapolis, IN, USA
| | - Ruijin Lu
- Division of Biostatistics, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
| | - Guoqi Yu
- Global Center for Asian Women's Health, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Bia-Echo Asia Centre for Reproductive Longevity and Equality (ACRLE), Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Mohammad L Rahman
- National Cancer Institute, National Institutes of Health, Rockville, MD, USA
| | - Liwei Chen
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA, USA
| | - Yeiyi Zhu
- Kaiser Permanente Northern California Division of Research, Oakland, CA, USA
| | - Michael Y Tsai
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, USA
| | - Oliver Fiehn
- West Coast Metabolomics Center, UC Davis Genome Center, University of California, 451 Health Sciences Drive, Davis, CA, USA
| | - Zhen Chen
- Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institute of Health, Bethesda, MD, USA
| | - Cuilin Zhang
- Global Center for Asian Women's Health, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Bia-Echo Asia Centre for Reproductive Longevity and Equality (ACRLE), Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA.
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14
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da Silva ACR, Yadegari A, Tzaneva V, Vasanthan T, Laketic K, Shearer J, Bainbridge SA, Harris C, Adamo KB. Metabolomics to Understand Alterations Induced by Physical Activity during Pregnancy. Metabolites 2023; 13:1178. [PMID: 38132860 PMCID: PMC10745110 DOI: 10.3390/metabo13121178] [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: 10/30/2023] [Revised: 11/20/2023] [Accepted: 11/27/2023] [Indexed: 12/23/2023] Open
Abstract
Physical activity (PA) and exercise have been associated with a reduced risk of cancer, obesity, and diabetes. In the context of pregnancy, maintaining an active lifestyle has been shown to decrease gestational weight gain (GWG) and lower the risk of gestational diabetes mellitus (GDM), hypertension, and macrosomia in offspring. The main pathways activated by PA include BCAAs, lipids, and bile acid metabolism, thereby improving insulin resistance in pregnant individuals. Despite these known benefits, the underlying metabolites and biological mechanisms affected by PA remain poorly understood, highlighting the need for further investigation. Metabolomics, a comprehensive study of metabolite classes, offers valuable insights into the widespread metabolic changes induced by PA. This narrative review focuses on PA metabolomics research using different analytical platforms to analyze pregnant individuals. Existing studies support the hypothesis that exercise behaviour can influence the metabolism of different populations, including pregnant individuals and their offspring. While PA has shown considerable promise in maintaining metabolic health in non-pregnant populations, our comprehension of metabolic changes in the context of a healthy pregnancy remains limited. As a result, further investigation is necessary to clarify the metabolic impact of PA within this unique group, often excluded from physiological research.
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Affiliation(s)
- Ana Carolina Rosa da Silva
- School of Human Kinetics, Faculty of Health Science, University of Ottawa, Ottawa, ON K1N 6N5, Canada; (A.C.R.d.S.)
| | - Anahita Yadegari
- School of Human Kinetics, Faculty of Health Science, University of Ottawa, Ottawa, ON K1N 6N5, Canada; (A.C.R.d.S.)
| | - Velislava Tzaneva
- School of Human Kinetics, Faculty of Health Science, University of Ottawa, Ottawa, ON K1N 6N5, Canada; (A.C.R.d.S.)
| | - Tarushika Vasanthan
- Department of Chemistry and Biology, Toronto Metropolitan University, Toronto, ON M5G 2A7, Canada
| | - Katarina Laketic
- Alberta Children’s Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada
| | - Jane Shearer
- Department of Biochemistry and Molecular Biology, Faculty of Kinesiology, Cumming School of Medicine and Alberta Children’s Hospital Research Institute, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Shannon A. Bainbridge
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, Ottawa, ON K1N 6N5, Canada
- Department of Cellular and Molecular Medicine, Faculty of Medicine, University of Ottawa, Ottawa, ON K1H 8M5, Canada
| | - Cory Harris
- Department of Biology, University of Ottawa, Ottawa, ON K1N 6N5, Canada;
| | - Kristi B. Adamo
- School of Human Kinetics, Faculty of Health Science, University of Ottawa, Ottawa, ON K1N 6N5, Canada; (A.C.R.d.S.)
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15
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Yadav A, Katyal R, Mittal S, Kumar Saha T. Correlation of Maternal Thyroid Stimulating Hormone Levels With Lipid Profile in Pregnant Women With Hypothyroidism. Cureus 2023; 15:e37748. [PMID: 37214038 PMCID: PMC10193177 DOI: 10.7759/cureus.37748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/17/2023] [Indexed: 05/23/2023] Open
Abstract
Introduction Pregnancy leads to changes in hormonal levels and lipid profile. Thyroid hormones play a crucial role in embryonic growth and fetal development. Untreated thyroid disease during pregnancy can lead to a high risk of complications. Aim The aim of the study is to examine the correlation between thyroid stimulating hormone (TSH) and lipid profile in pregnant women with hypothyroidism. Materials and methods This cross-sectional case-control study was conducted at the Biochemistry Department, Alfalah School of Medical Science & Research Centre, Dhauj, Faridabad, Haryana, India. The study consisted of 500 patients (250 cases and 250 controls) who fulfilled the inclusion and exclusion criteria. Of the 250 cases recruited, 23 cases were in the 2nd trimester and 209 cases were in the 3rd trimester. Blood samples were collected from the participants to assess their lipid profile and TSH levels. Results The study showed a statistically significant difference between the mean TSH levels of hypothyroid pregnant females in the 2nd trimester (3.85 ± 0.59) and the 3rd trimester (4.71 ± 0.54). There was a significant positive correlation observed between TSH and Total Cholesterol, Triglycerides, and LDL-C in both the 2nd and 3rd trimesters. In the second trimester, there was a significant positive correlation observed between TSH & TC (r = 0.6634, p<0.0005), TSH & TG (r= 0.7346, p=0.00006), TSH & LDL (r= 0.5322, p= 0.008). In the third trimester, there was a significant positive correlation observed between TSH & TC (r = 0.8929, p<0.00001), TSH & TG (r= 0.430, p<0.00001), TSH & LDL (r= 0.168, p= 0.015). However, no significant correlation was found between TSH levels and HDL-C in either trimester. The correlation coefficient and p-value for TSH & HDL were r = 0.2083, p=0.340 in the second trimester, and r = 0.0189, p=0.2384 in the third trimester. Conclusion A significant increase in TSH levels in hypothyroid pregnant women was observed in the 3rd trimester compared to the second trimester. Moreover, a significant positive correlation was found between TSH and lipid profile (total cholesterol, triglycerides, and LDL) in both trimesters, but not with HDL. These findings highlight the importance of monitoring thyroid hormone levels in the later stages of pregnancy to avoid potential maternal & fetal complications.
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Affiliation(s)
- Alka Yadav
- Biochemistry, Al-Falah School of Medical Science and Research Centre, Faridabad, IND
| | - Ranjan Katyal
- Biochemistry, Al-Falah School of Medical Science and Research Centre, Faridabad, IND
| | - Shilpa Mittal
- Biochemistry, Noida International Institute of Medical Sciences, Noida, IND
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16
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Gleason B, Kuang A, Bain JR, Muehlbauer MJ, Ilkayeva OR, Scholtens DM, Lowe WL. Association of Maternal Metabolites and Metabolite Networks with Newborn Outcomes in a Multi-Ancestry Cohort. Metabolites 2023; 13:metabo13040505. [PMID: 37110162 PMCID: PMC10145069 DOI: 10.3390/metabo13040505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 03/23/2023] [Accepted: 03/28/2023] [Indexed: 04/03/2023] Open
Abstract
The in utero environment is important for newborn size at birth, which is associated with childhood adiposity. We examined associations between maternal metabolite levels and newborn birthweight, sum of skinfolds (SSF), and cord C-peptide in a multinational and multi-ancestry cohort of 2337 mother–newborn dyads. Targeted and untargeted metabolomic assays were performed on fasting and 1 h maternal serum samples collected during an oral glucose tolerance test performed at 24–32 week gestation in women participating in the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Study. Anthropometric measurements were obtained on newborns at birth. Following adjustment for maternal BMI and glucose, per-metabolite analyses demonstrated significant associations between maternal metabolite levels and birthweight, SSF, and cord C-peptide. In the fasting state, triglycerides were positively associated and several long-chain acylcarnitines were inversely associated with birthweight and SSF. At 1 h, additional metabolites including branched-chain amino acids, proline, and alanine were positively associated with newborn outcomes. Network analyses demonstrated distinct clusters of inter-connected metabolites significantly associated with newborn phenotypes. In conclusion, numerous maternal metabolites during pregnancy are significantly associated with newborn birthweight, SSF, and cord C-peptide independent of maternal BMI and glucose, suggesting that metabolites in addition to glucose contribute to newborn size at birth and adiposity.
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17
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Lowe WL. Genetics and Epigenetics: Implications for the Life Course of Gestational Diabetes. Int J Mol Sci 2023; 24:6047. [PMID: 37047019 PMCID: PMC10094577 DOI: 10.3390/ijms24076047] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 03/19/2023] [Accepted: 03/21/2023] [Indexed: 04/14/2023] Open
Abstract
Gestational diabetes (GDM) is one of the most common complications of pregnancy, affecting as many as one in six pregnancies. It is associated with both short- and long-term adverse outcomes for the mother and fetus and has important implications for the life course of affected women. Advances in genetics and epigenetics have not only provided new insight into the pathophysiology of GDM but have also provided new approaches to identify women at high risk for progression to postpartum cardiometabolic disease. GDM and type 2 diabetes share similarities in their pathophysiology, suggesting that they also share similarities in their genetic architecture. Candidate gene and genome-wide association studies have identified susceptibility genes that are shared between GDM and type 2 diabetes. Despite these similarities, a much greater effect size for MTNR1B in GDM compared to type 2 diabetes and association of HKDC1, which encodes a hexokinase, with GDM but not type 2 diabetes suggest some differences in the genetic architecture of GDM. Genetic risk scores have shown some efficacy in identifying women with a history of GDM who will progress to type 2 diabetes. The association of epigenetic changes, including DNA methylation and circulating microRNAs, with GDM has also been examined. Targeted and epigenome-wide approaches have been used to identify DNA methylation in circulating blood cells collected during early, mid-, and late pregnancy that is associated with GDM. DNA methylation in early pregnancy had some ability to identify women who progressed to GDM, while DNA methylation in blood collected at 26-30 weeks gestation improved upon the ability of clinical factors alone to identify women at risk for progression to abnormal glucose tolerance post-partum. Finally, circulating microRNAs and long non-coding RNAs that are present in early or mid-pregnancy and associated with GDM have been identified. MicroRNAs have also proven efficacious in predicting both the development of GDM as well as its long-term cardiometabolic complications. Studies performed to date have demonstrated the potential for genetic and epigenetic technologies to impact clinical care, although much remains to be done.
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Affiliation(s)
- William L Lowe
- Department of Medicine, Division of Endocrinology, Metabolism and Molecular Medicine, Northwestern University Feinberg School of Medicine, Rubloff 12, 420 E. Superior Street, Chicago, IL 60611, USA
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18
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Gut Microbial Succession Patterns and Metabolic Profiling during Pregnancy and Lactation in a Goat Model. Microbiol Spectr 2023; 11:e0295522. [PMID: 36700635 PMCID: PMC9927511 DOI: 10.1128/spectrum.02955-22] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
The maternal gut microbiome affects the duration of pregnancy, delivery, and lactation. It also coordinates the stability of maternal metabolism by regulating and modulating inflammatory cytokines and reproductive hormones. This has been shown in several species; however, the situation in ruminants remains a black box. Here, we aimed to elucidate the relationship between the hindgut microbiota, metabolism, and reproductive hormones in domestic goats (Capra hircus) during nonpregnancy, pregnancy, and lactation stages. The hindgut microbiota was altered during these three stages, with a drastic decrease in the abundance of Family_XIII_AD3011_group in the second and third trimesters of pregnancy. Additionally, a decline in the abundance of Christensenellaceae_R-7_group and Turicibacter was observed from the nonpregnancy stage to late gestation. Family_XIII_AD3011_group and Paeniclostridium were strongly correlated with decreased fecal estradiol and progesterone. Furthermore, we generated a metabolome atlas of the gut and serum from nonpregnancy to lactation to reveal the specific metabolic fingerprints of each physiological stage. Several specific gut metabolites, including carnitine C8:1, γ-aminobutyric acid, and indole-3-carboxylic acid, were negatively correlated with the fecal and serum estradiol concentrations. In contrast, 2'-deoxyinosine, deoxyadenosine, and 5'-deoxyadenosine were positively correlated with the fecal and serum estradiol concentrations. The levels of 2'-deoxyinosine, deoxyadenosine, and 5'-deoxyadenosine in fecal samples were positively correlated with Family_XIII_AD3011_group. Other serum metabolites, such as (±)12-HEPE (hydroxy eicosapentaenoic acid), (±)15-HEPE, (±)18-HEPE, cytidine, uracil, and 5-hydroxyindole-3-acetic acid, were negatively correlated with the serum concentrations of estradiol and progesterone. Finally, Corynebacterium and Clostridium_sensu_stricto_1 in the fecal samples were positively correlated with the abundance of 11,12-EET (epoxy-eicosatrienoic acid), (±)18-HEPE, (±)15-HEPE, and (±)12-HEPE in the serum. IMPORTANCE Our findings revealed that the activity of Family_XIII_AD3011_group and Corynebacterium is strongly correlated with the beneficial regulation of physiological hormones and metabolic changes during pregnancy and lactation. These findings are key for guiding targeted microbial therapeutic approaches to modulate microbiomes in gestating and lactating mammals.
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19
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Yeum D, Gilbert-Diamond D, Doherty B, Coker M, Stewart D, Kirchner D, McRitchie S, Sumner S, Karagas MR, Hoen AG. Associations of maternal plasma and umbilical cord plasma metabolomics profiles with birth anthropometric measures. Pediatr Res 2023:10.1038/s41390-022-02449-2. [PMID: 36627359 DOI: 10.1038/s41390-022-02449-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 10/11/2022] [Accepted: 12/15/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND The metabolomics profiles of maternal plasma during pregnancy and cord plasma at birth might influence fetal growth and birth anthropometry. The objective was to examine how maternal plasma and umbilical cord plasma metabolites are associated with newborn anthropometric measures, a known predictor of future health outcomes. METHODS Pregnant women between 24 and 28 weeks of gestation were recruited as part of a prospective cohort study. Blood samples from 413 women at enrollment and 787 infant cord blood samples were analyzed using the Biocrates AbsoluteIDQ® p180 kit. Multivariable linear regression models were used to examine associations of cord and maternal metabolites with infant anthropometry at birth. RESULTS In cord blood samples from this rural cohort from New Hampshire of largely white residents, 13 metabolites showed negative associations, and 10 metabolites showed positive associations with birth weight Z-score. Acylcarnitine C5 showed negative association, and 4 lysophosphatidylcholines showed positive associations with birth length Z-score. Maternal blood metabolites did not significantly correlate with birth weight and length Z-scores. CONCLUSIONS Consistent findings were observed for several acylcarnitines that play a role in utilization of energy sources, and a lysophosphatidylcholine that is part of oxidative stress and inflammatory response pathways in cord plasma samples. IMPACT The metabolomics profiles of maternal plasma during pregnancy and cord plasma at birth may influence fetal growth and birth anthropometry. This study examines the independent effects of maternal gestational and infant cord blood metabolomes across different classes of metabolites on birth anthropometry. Acylcarnitine species were negatively associated and glycerophospholipids species were positively associated with weight and length Z-scores at birth in the cord plasma samples, but not in the maternal plasma samples. This study identifies lipid metabolites in infants that possibly may affect early growth.
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Affiliation(s)
- Dabin Yeum
- Department of Epidemiology, The Geisel School of Medicine at Dartmouth, Lebanon, NH, USA.
| | - Diane Gilbert-Diamond
- Department of Epidemiology, The Geisel School of Medicine at Dartmouth, Lebanon, NH, USA.,Children's Environmental Health and Disease Prevention Center at Dartmouth, Hanover, NH, USA
| | - Brett Doherty
- Department of Epidemiology, The Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
| | - Modupe Coker
- Department of Oral Biology, Rutgers School of Dental Medicine, Rutgers State University of New Jersey, Newark, NJ, USA
| | - Delisha Stewart
- Department of Nutrition, Gillings School of Global Public Health, Nutrition Research Institute, University of North Carolina at Chapel Hill, Kannapolis, NC, USA
| | - David Kirchner
- Department of Nutrition, Gillings School of Global Public Health, Nutrition Research Institute, University of North Carolina at Chapel Hill, Kannapolis, NC, USA
| | - Susan McRitchie
- Department of Nutrition, Gillings School of Global Public Health, Nutrition Research Institute, University of North Carolina at Chapel Hill, Kannapolis, NC, USA
| | - Susan Sumner
- Department of Nutrition, Gillings School of Global Public Health, Nutrition Research Institute, University of North Carolina at Chapel Hill, Kannapolis, NC, USA
| | - Margaret R Karagas
- Department of Epidemiology, The Geisel School of Medicine at Dartmouth, Lebanon, NH, USA.,Children's Environmental Health and Disease Prevention Center at Dartmouth, Hanover, NH, USA
| | - Anne G Hoen
- Department of Epidemiology, The Geisel School of Medicine at Dartmouth, Lebanon, NH, USA.,Department of Biomedical Data Science, Geisel School of Medicine, Lebanon, NH, USA
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20
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Considerations for treatment of lipid disorders during pregnancy and breastfeeding. Prog Cardiovasc Dis 2022; 75:33-39. [PMID: 36400231 DOI: 10.1016/j.pcad.2022.11.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Accepted: 11/06/2022] [Indexed: 11/17/2022]
Abstract
Adequate management of lipid disorders during pregnancy is essential given the association of dyslipidemia with adverse pregnancy outcomes. While there are physiologic changes in lipid levels that occur with normal pregnancy, abnormal alterations in lipids can lead to increased future risk of atherosclerotic cardiovascular disease. There are inherent challenges in the treatment of dyslipidemias during pregnancy and the postpartum period given the lack of adequate data in this population and the contraindication of traditional therapeutic agents. However, it remains of utmost importance to optimize screening and identification of patients at high-risk for atherosclerotic cardiovascular disease so that proper counseling can be provided and the risk for pregnancy complications and downstream cardiovascular complications can be addressed. In this review, we summarize the literature on the association of dyslipidemia in pregnancy with adverse outcomes and discuss considerations for the management of lipid disorders during both pregnancy and breastfeeding.
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21
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Zhu Y, Barupal DK, Ngo AL, Quesenberry CP, Feng J, Fiehn O, Ferrara A. Predictive Metabolomic Markers in Early to Mid-pregnancy for Gestational Diabetes Mellitus: A Prospective Test and Validation Study. Diabetes 2022; 71:1807-1817. [PMID: 35532743 PMCID: PMC9490360 DOI: 10.2337/db21-1093] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 04/13/2022] [Indexed: 11/13/2022]
Abstract
Gestational diabetes mellitus (GDM) predisposes pregnant individuals to perinatal complications and long-term diabetes and cardiovascular diseases. We developed and validated metabolomic markers for GDM in a prospective test-validation study. In a case-control sample within the PETALS cohort (GDM n = 91 and non-GDM n = 180; discovery set), a random PETALS subsample (GDM n = 42 and non-GDM n = 372; validation set 1), and a case-control sample within the GLOW trial (GDM n = 35 and non-GDM n = 70; validation set 2), fasting serum untargeted metabolomics were measured by gas chromatography/time-of-flight mass spectrometry. Multivariate enrichment analysis examined associations between metabolites and GDM. Ten-fold cross-validated LASSO regression identified predictive metabolomic markers at gestational weeks (GW) 10-13 and 16-19 for GDM. Purinone metabolites at GW 10-13 and 16-19 and amino acids, amino alcohols, hexoses, indoles, and pyrimidine metabolites at GW 16-19 were positively associated with GDM risk (false discovery rate <0.05). A 17-metabolite panel at GW 10-13 outperformed the model using conventional risk factors, including fasting glycemia (area under the curve: discovery 0.871 vs. 0.742, validation 1 0.869 vs. 0.731, and validation 2 0.972 vs. 0.742; P < 0.01). Similar results were observed with a 13-metabolite panel at GW 17-19. Dysmetabolism is present early in pregnancy among individuals progressing to GDM. Multimetabolite panels in early pregnancy can predict GDM risk beyond conventional risk factors.
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Affiliation(s)
- Yeyi Zhu
- Division of Research, Kaiser Permanente Northern California, Oakland, CA
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA
- Corresponding author: Yeyi Zhu,
| | - Dinesh K. Barupal
- National Institutes of Health West Coast Metabolomics Center, University of California Davis, Davis, CA
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Amanda L. Ngo
- Division of Research, Kaiser Permanente Northern California, Oakland, CA
| | | | - Juanran Feng
- Division of Research, Kaiser Permanente Northern California, Oakland, CA
| | - Oliver Fiehn
- National Institutes of Health West Coast Metabolomics Center, University of California Davis, Davis, CA
| | - Assiamira Ferrara
- Division of Research, Kaiser Permanente Northern California, Oakland, CA
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22
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Grant JK, Snow S, Kelsey M, Rymer J, Schaffer AE, Patel MR, McGarrah RW, Pagidipati NJ, Shah NP. Lipid-Lowering Therapy in Woman of Childbearing Age: a Review and Stepwise Clinical Approach. Curr Cardiol Rep 2022; 24:1373-1385. [PMID: 35904667 DOI: 10.1007/s11886-022-01751-z] [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] [Accepted: 07/17/2022] [Indexed: 11/28/2022]
Abstract
PURPOSE OF REVIEW Women are less often recognized to have cardiovascular disease (CVD) risk and are underrepresented in randomized trials of lipid-lowering therapy. Here, we summarize non-pharmacologic and pharmacologic strategies for lipid-lowering in women of childbearing age, lipid changes during pregnancy and lactation, discuss sex-specific outcomes in currently available literature, and discuss future areas of research. RECENT FINDINGS While lifestyle interventions form the backbone of CVD prevention, some women of reproductive age have an indication for pharmacologic lipid-lowering. Sex-based evidence is limited but suggests that both statin and non-statin lipid-lowering agents are beneficial regardless of sex, especially at high cardiovascular risk. Pharmacologic lipid-lowering therapies, both during the pregnancy period and during lactation, have historically been and continue to be limited by safety concerns. This oftentimes limits lipid-lowering options in women of childbearing age. In this review, we summarize lipid-lowering strategies in women of childbearing age and the impact of therapies during pregnancy and lactation. The limited sex-specific data regarding efficacy, adverse events, and cardiovascular outcomes underscore the need for a greater representation of women in randomized controlled trials. More data on lipid-lowering teratogenicity are needed, and through increased clinician awareness and reporting to incidental exposure registries, more data can be harvested.
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Affiliation(s)
- Jelani K Grant
- Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Sarah Snow
- Division of Cardiology, Duke University School of Medicine, 2301 Erwin Rd, Durham, NC, 27705, USA
| | - Michelle Kelsey
- Division of Cardiology, Duke University School of Medicine, 2301 Erwin Rd, Durham, NC, 27705, USA
| | - Jennifer Rymer
- Division of Cardiology, Duke University School of Medicine, 2301 Erwin Rd, Durham, NC, 27705, USA
| | - Anna E Schaffer
- Division of Endocrinology, Metabolism, and Nutrition, Duke University School of Medicine, Durham, NC, USA
| | - Manesh R Patel
- Division of Cardiology, Duke University School of Medicine, 2301 Erwin Rd, Durham, NC, 27705, USA
| | - Robert W McGarrah
- Division of Cardiology, Duke University School of Medicine, 2301 Erwin Rd, Durham, NC, 27705, USA
| | - Neha J Pagidipati
- Division of Cardiology, Duke University School of Medicine, 2301 Erwin Rd, Durham, NC, 27705, USA
| | - Nishant P Shah
- Division of Cardiology, Duke University School of Medicine, 2301 Erwin Rd, Durham, NC, 27705, USA.
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23
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Liu Y, Xia YY, Zhang T, Yang Y, Cannon RD, Mansell T, Novakovic B, Saffery R, Han TL, Zhang H, Baker PN. Complex Interactions Between Circulating Fatty Acid Levels, Desaturase Activities, and the Risk of Gestational Diabetes Mellitus: A Prospective Cohort Study. Front Nutr 2022; 9:919357. [PMID: 35898714 PMCID: PMC9313599 DOI: 10.3389/fnut.2022.919357] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 06/13/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectiveMaternal abnormal fatty acid desaturation has previously been linked to gestational diabetes mellitus (GDM). However, few studies have investigated this relationship longitudinally throughout pregnancy. In this study, we investigated the relationship between GDM and desaturase activities across the pregnancy trimesters.MethodsA total of 661 women (GDM = 189, non-GDM = 472) were selected from the Complex Lipids in Mothers and Babies (CLIMB) cohort study. Clinical information and maternal serum were collected at 11–14, 22–28, and 32–34 weeks of gestation. Totally, 20 serum fatty acids were quantified using gas chromatography–mass spectrometry (GC-MS) analysis at each timepoint. Polyunsaturated fatty acid (PUFA) product-to-precursor ratios were used to estimate desaturase and elongase activities including delta-5 desaturase, delta-6 desaturase, stearoyl-CoA desaturase, and elongase.ResultsAfter adjusting for major potential confounders including maternal age, BMI, primiparity, smoking, and alcohol consumption, we observed a significant increase in the levels of γ-linolenic acid (GLA) and eicosatrienoic acid (DGLA) in the first trimester of women with GDM, whereas GLA and DGLA were reduced in the third trimester, when compared to the non-GDM group. Arachidonic acid (AA) showed an upward trend in the GDM group throughout pregnancy. Estimated delta-6 desaturase and delta-5 desaturase activity were elevated in the first trimester (OR = 1.40, 95% CI 1.03–1.91; OR = 0.56, 95% CI 0.32–0.96) but attenuated in the third trimester (OR = 0.78, 95% CI 0.58–1.07; OR = 2.64, 95% CI 1.46–4.78) in GDM pregnancies, respective to controls. Estimated delta-9–18 desaturase activity (OR = 3.70, 95% CI 1.49–9.19) was increased in women with GDM in later pregnancy.ConclusionsOur study highlights the potential importance of fatty acid desaturase activities, particularly estimated delta-5 desaturase and delta-9–18 desaturase in the pathophysiology of GDM. These findings may have applications for the early diagnosis and management of GDM.
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Affiliation(s)
- Yue Liu
- Department of Obstetrics and Gynaecology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Department of Occupational and Environmental Hygiene, School of Public Health and Management, Research Center for Medicine and Social Development, Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, China
- Mass Spectrometry Center of Maternal Fetal Medicine, Institute of Life Sciences, Chongqing Medical University, Chongqing, China
| | - Yin-Yin Xia
- Department of Occupational and Environmental Hygiene, School of Public Health and Management, Research Center for Medicine and Social Development, Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, China
- Mass Spectrometry Center of Maternal Fetal Medicine, Institute of Life Sciences, Chongqing Medical University, Chongqing, China
| | - Ting Zhang
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Stomatological Hospital of Chongqing Medical University, Chongqing, China
| | - Yang Yang
- Department of Obstetrics and Gynaecology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Mass Spectrometry Center of Maternal Fetal Medicine, Institute of Life Sciences, Chongqing Medical University, Chongqing, China
| | - Richard D. Cannon
- Department of Oral Sciences, Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Toby Mansell
- Molecular Immunity, Murdoch Childrens Research Institute, Melbourne, VIC, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
| | - Boris Novakovic
- Molecular Immunity, Murdoch Childrens Research Institute, Melbourne, VIC, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
| | - Richard Saffery
- Molecular Immunity, Murdoch Childrens Research Institute, Melbourne, VIC, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
| | - Ting-Li Han
- Mass Spectrometry Center of Maternal Fetal Medicine, Institute of Life Sciences, Chongqing Medical University, Chongqing, China
- Department of Obstetrics and Gynaecology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Institute of Life Sciences, Chongqing Medical University, Chongqing, China
- Ting-Li Han
| | - Hua Zhang
- Department of Obstetrics and Gynaecology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Mass Spectrometry Center of Maternal Fetal Medicine, Institute of Life Sciences, Chongqing Medical University, Chongqing, China
- *Correspondence: Hua Zhang
| | - Philip N. Baker
- College of Medicine, Biological Sciences and Psychology, University of Leicester, Leicester, United Kingdom
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24
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Mashayekh-Amiri S, Mohammad-Alizadeh-Charandabi S, Abdolalipour S, Mirghafourvand M. Myo-inositol supplementation for prevention of gestational diabetes mellitus in overweight and obese pregnant women: a systematic review and meta-analysis. Diabetol Metab Syndr 2022; 14:93. [PMID: 35794663 PMCID: PMC9258131 DOI: 10.1186/s13098-022-00862-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Accepted: 06/18/2022] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND The prevalence of gestational diabetes mellitus [GDM] and of its most important predisposing factor, i.e. overweight and obesity, have increased dramatically over the past 20 years. Therefore, the aim of this study was to systematically review the articles on the effect of myo-inositol supplementation on the prevention of GDM in pregnant women with overweight and obesity. METHODS We conducted a systematic literature search in electronic database (MEDLINE, Cochrane Library, ClinicalTrials.gov, Embase, ProQuest, PubMed, Google scholar, Scopus, Web of science and forward and backward citations) to identify all randomized controlled trials (RCTs) published until 21 December 2021. Finally, Among the 118 identified records, four studies were eligible and were included in this systematic review. The meta-analysis results were reported in the form of odds ratio (OR) to compare the incidence of GDM and pregnancy outcomes. They were also presented in the form of mean difference (MD) to compare fasting glucose (FG), 1-h and 2-h oral glucose tolerance test (OGTT) levels between the two groups. This study was registered on PROSPERO, number CRD42021290570. RESULTS The results showed that the incidence of GDM was significantly lower in the myo-inositol group (OR 0.32, 95% CI 0.21 to 0.48; P < 0.001; I2 = 0%; Moderate certainty evidence). Moreover, FG-OGTT (MD - 2.64 mg/dl, 95% CI - 4.12 to - 1.17; P < 0.001; I2 = 0%; Moderate certainty evidence), 1-h-OGTT (MD - 7.47 mg/dl, 95% CI - 12.24 to - 2.31; P = 0.005; I2 = 27%; Low certainty evidence) and 2-h-OGTT levels (MD - 10.51 mg/dl, 95% CI - 16.88 to - 4.14; P = 0.001; I2 = 59%; Low certainty evidence) in the myo-inositol group were significantly lower than in the control group. Regarding the pregnancy outcomes, the incidence of gestational hypertension and preterm delivery was significantly lower in the myo-inositol group. However, no between-group difference was observed in the other outcomes. CONCLUSIONS Based on the results, myo-inositol has shown to be a new and safe preventive strategy in reducing the incidence of GDM and in regulating FG and 1-h and 2-h OGTT levels, and also in reducing the incidence of GDM complications such as preterm delivery and gestational hypertension in pregnant women with overweight and obesity.
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Affiliation(s)
- Sepideh Mashayekh-Amiri
- Department of Midwifery, Faculty of Nursing & Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Somaiyeh Abdolalipour
- Department of Midwifery, Faculty of Nursing & Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mojgan Mirghafourvand
- Department of Midwifery, Faculty of Nursing & Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
- Menopause Andropause Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Social Determinants of Health Research Center, Tabriz University of Medical sciences, Tabriz, Iran
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Thakkar A, Hailu T, Blumenthal RS, Martin SS, Harrington CM, Yeh DD, French KA, Sharma G. Cardio-Obstetrics: the Next Frontier in Cardiovascular Disease Prevention. Curr Atheroscler Rep 2022; 24:493-507. [PMID: 35524915 PMCID: PMC9076812 DOI: 10.1007/s11883-022-01026-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/01/2022] [Indexed: 12/05/2022]
Abstract
PURPOSE OF REVIEW Internationally, cardiovascular disease (CVD) is the leading cause of death in women. With risk factors for CVD continuing to rise, early identification and management of chronic diseases such as hypertension, diabetes, and obstructive sleep apnea is necessary for prevention. Pregnancy is a natural stress test for women with risk factors who may be predisposed to CVD and offers a unique opportunity to not only recognize disease but also implement effective and long-lasting strategies for prevention. RECENT FINDINGS Prevention begins before pregnancy, as preconception screening, counseling, and optimization of chronic diseases can improve maternal and fetal outcomes. Throughout pregnancy, women should maintain close follow-up, continued reevaluation of risk factors, with counseling when necessary. Continued healthcare engagement during the "fourth trimester," 3 months following delivery, allows clinicians to continue monitoring the evolution of chronic diseases, encourage ongoing lifestyle counseling, and connect women with primary care and appropriate specialists if needed. Unfortunately, this postpartum period represents a major care gap, as a significant proportion of most women do not attend their scheduled visits. Social determinants of health including decreased access to care and economic instability lead to increased risk factors throughout pregnancy but particularly play a role in poor compliance with postpartum follow-up. The use of telemedicine clinics and remote monitoring may prove to be effective interventions, bridging the gap between physicians and patients and improving follow-up for at-risk women. While many clinicians are beginning to understand the impact of CVD on women, screening and prevention strategies are not often implemented until much later in life. Pregnancy creates an opportunity to begin engaging women in cardiovascular protective strategies before the development of the disease.
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Affiliation(s)
- Aarti Thakkar
- Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Blalock 559, 600 N. Wolfe Street, Baltimore, MD, 21287, USA
| | - Tigist Hailu
- Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Blalock 559, 600 N. Wolfe Street, Baltimore, MD, 21287, USA
| | - Roger S Blumenthal
- Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Blalock 559, 600 N. Wolfe Street, Baltimore, MD, 21287, USA
| | - Seth S Martin
- Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Blalock 559, 600 N. Wolfe Street, Baltimore, MD, 21287, USA
| | - Colleen M Harrington
- Division of Cardiovascular Medicine, University of Massachusetts Memorial Healthcare, Worcester, MA, USA
| | - Doreen DeFaria Yeh
- Division of Cardiology, Adult Congenital Heart Disease Program, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Katharine A French
- Lifespan Cardiovascular Institute, Division of Cardiology, Warren Alpert School of Medicine, Brown University, Providence, RI, USA
| | - Garima Sharma
- Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Blalock 559, 600 N. Wolfe Street, Baltimore, MD, 21287, USA.
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Fayezi S, Mehdizadeh A, Germeyer A, Strowitzki T, Fayyazpour P, Nowrouzi Z, Zarezadeh R. Maternal erythrocyte fatty acid composition as a predictive marker for pregnancy health. Biofactors 2022; 48:763-778. [PMID: 35357720 DOI: 10.1002/biof.1840] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 03/14/2022] [Indexed: 12/11/2022]
Abstract
Pregnancy is accompanied by a surge in demand for fatty acids (FAs) in order to support maternal health, as well as fetal growth and development. Of particular demand is essential for long-chain polyunsaturated FAs. FAs are primarily obtained from dietary sources and are distributed in the body. In comparison with the use of self-reporting approaches, measuring the FA levels within different blood compartments can present a more accurate image of nutritional, and thus tissue, FA composition. Hence, the FA profile of plasma or serum is commonly used for physiological analyses. Nevertheless, plasma and serum FAs are not yet incorporated into cell membranes, and consequently may not be a suitable reflection of the FA status of body tissues. The evaluation of erythrocyte FA levels offers a superior possibility for the following reasons: the biological fluctuation of erythrocyte FA composition is low, phospholipids account for almost all the lipid content of erythrocytes, and the FA profiles of erythrocytes represent those of tissues. Here, we elaborate on whether the status of maternal erythrocyte FAs can serve as a prognostic biomarker for reproductive health and fetomaternal complications, including embryonic and fetoplacental development, gestational length, and preeclampsia. In addition, factors with the potential of altering the maternal erythrocyte FAs such as maternal diet, lifestyle habits, genetics, and body composition are discussed.
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Affiliation(s)
- Shabnam Fayezi
- Department of Gynecologic Endocrinology and Fertility Disorders, Women's Hospital, Ruprecht-Karls University of Heidelberg, Heidelberg, Germany
- Department of Reproductive Biology, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Amir Mehdizadeh
- Hematology and Oncology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ariane Germeyer
- Department of Gynecologic Endocrinology and Fertility Disorders, Women's Hospital, Ruprecht-Karls University of Heidelberg, Heidelberg, Germany
| | - Thomas Strowitzki
- Department of Gynecologic Endocrinology and Fertility Disorders, Women's Hospital, Ruprecht-Karls University of Heidelberg, Heidelberg, Germany
| | - Parisa Fayyazpour
- Department of Biochemistry and Clinical Laboratories, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
- Student's Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Zahra Nowrouzi
- Department of Biochemistry and Clinical Laboratories, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
- Student's Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Reza Zarezadeh
- Department of Biochemistry and Clinical Laboratories, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
- Student's Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
- Endocrine Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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Pham A, Polic A, Nguyen L, Thompson JL. Statins in Pregnancy: Can We Justify Early Treatment of Reproductive Aged Women? Curr Atheroscler Rep 2022; 24:663-670. [PMID: 35699821 DOI: 10.1007/s11883-022-01039-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/15/2022] [Indexed: 11/27/2022]
Abstract
PURPOSE OF REVIEW Statins are the pillar of secondary prevention in reducing cardiovascular disease in high-risk adults. However, statin discontinuation is the standard recommendation in pregnant and lactating patients. This review evaluates whether we can justify the early treatment of reproductive aged women with statin therapy. RECENT FINDINGS Statins have several potential benefits including its antioxidant, anti-inflammatory, and anti-thrombogenic properties that may prevent the worsening of atherosclerosis in high-risk women. Nevertheless, most studies on statins and teratogenicity have a limited sample size and the effects of long-term statin use on fetal and neonatal health remain unknown. Not all statins may be safe and pravastatin's cholesterol-lowering properties may be too limited to provide much maternal benefit in pregnancy. While emerging evidence supports the use of pravastatin in pregnancy, we need to better assess the risk of early cardiovascular disease and acute progression of atherosclerosis before and during pregnancy to better understand the risks and benefits of statin use.
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Affiliation(s)
- Amelie Pham
- Department of Obstetrics and Gynecology, Vanderbilt University Medical Center, Medical Center North, 1161 21stAvenue, South B-1100, Nashville, TN, 37212, USA
| | - Aleksandra Polic
- Department of Obstetrics and Gynecology, Vanderbilt University Medical Center, Medical Center North, 1161 21stAvenue, South B-1100, Nashville, TN, 37212, USA
| | - Lynsa Nguyen
- Department of Obstetrics and Gynecology, Vanderbilt University Medical Center, Medical Center North, 1161 21stAvenue, South B-1100, Nashville, TN, 37212, USA
| | - Jennifer L Thompson
- Department of Obstetrics and Gynecology, Vanderbilt University Medical Center, Medical Center North, 1161 21stAvenue, South B-1100, Nashville, TN, 37212, USA.
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Li L, Fang J. Myo-inositol supplementation for the prevention of gestational diabetes: A meta-analysis of randomized controlled trials. Eur J Obstet Gynecol Reprod Biol 2022; 273:38-43. [PMID: 35460931 DOI: 10.1016/j.ejogrb.2022.04.009] [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: 11/21/2021] [Revised: 03/18/2022] [Accepted: 04/09/2022] [Indexed: 11/16/2022]
Abstract
INTRODUCTION It is elusive to use myo-inositol supplementation to prevent gestational diabetes, and this meta-analysis aims to study the efficacy of myo-inositol supplementation for the prevention of gestational diabetes. METHODS Several databases including PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases were systemically searched from inception to October 2021, and we included the randomized controlled trials (RCTs) assessing the effect of myo-inositol supplementation on the incidence of gestational diabetes. RESULTS Seven eligible RCTs were included in this meta-analysis. Compared with control group in pregnant women, myo-inositol supplementation could lead to remarkably reduced incidence of gestational diabetes (OR = 0.32; 95% CI = 0.15 to 0.72; P = 0.005), reduced 2-h glucose OGTT (MD = -5.29; 95% CI = -10.24 to -0.34; P = 0.04), increased gestational age at birth (MD = 0.96; 95% CI = -1.67 to 3.87; P = 0.005) and decreased incidence of preterm delivery (OR = 0.35; 95% CI = 0.17 to 0.70; P = 0.003), but exhibited no obvious influence on birth weight (MD = -22.82; 95% CI = -121.95 to 76.32; P = 0.65). CONCLUSIONS Myo-inositol supplementation is recommended to prevent gestational diabetes with caution due to some heterogeneity.
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Affiliation(s)
- Liang Li
- Department of Obstetrics and Gynecology, Chongqing Bishan District People's Hospital, China
| | - JunDan Fang
- Department of Obstetrics and Gynecology, Chongqing Bishan District People's Hospital, China.
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Coetzee A, Hall DR, Conradie M. Hyperglycemia First Detected in Pregnancy in South Africa: Facts, Gaps, and Opportunities. FRONTIERS IN CLINICAL DIABETES AND HEALTHCARE 2022; 3:895743. [PMID: 36992779 PMCID: PMC10012101 DOI: 10.3389/fcdhc.2022.895743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 04/01/2022] [Indexed: 06/19/2023]
Abstract
This review contextualizes hyperglycemia in pregnancy from a South-African perspective. It aims to create awareness of the importance of hyperglycemia in pregnancy in low-middle-income countries. We address unanswered questions to guide future research on sub-Saharan African women with hyperglycemia first detected in pregnancy (HFDP). South African women of childbearing age have the highest prevalence of obesity in sub-Saharan Africa. They are predisposed to Type 2 diabetes (T2DM), the leading cause of death in South African women. T2DM remains undiagnosed in many African countries, with two-thirds of people living with diabetes unaware. With the South African health policy's increased focus on improving antenatal care, women often gain access to screening for non-communicable diseases for the first time in pregnancy. While screening practices and diagnostic criteria for gestational diabetes mellitus (GDM) differ amongst geographical areas in South Africa (SA), hyperglycemia of varying degrees is often first detected in pregnancy. This is often erroneously ascribed to GDM, irrespective of the degree of hyperglycemia and not overt diabetes. T2DM and GDM convey a graded increased risk for the mother and fetus during and after pregnancy, with cardiometabolic risk accumulating across the lifespan. Resource limitations and high patient burden have hampered the opportunity to implement accessible preventative care in young women at increased risk of developing T2DM in the broader public health system in SA. All women with HFDP, including those with true GDM, should be followed and undergo glucose assessment postpartum. In SA, studies conducted early postpartum have noted persistent hyperglycemia in a third of women after GDM. Interpregnancy care is advantageous and may attain a favourable metabolic legacy in these young women, but the yield of return following delivery is suboptimal. We review the current best evidence regarding HFDP and contextualize the applicability in SA and other African or low-middle-income countries. The review identifies gaps and shares pragmatic solutions regarding clinical factors that may improve awareness, identification, diagnosis, and management of women with HFDP.
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Affiliation(s)
- Ankia Coetzee
- Department of Medicine, Division of Endocrinology Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa
| | - David R. Hall
- Department of Obstetrics and Gynecology, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa
| | - Magda Conradie
- Department of Medicine, Division of Endocrinology Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa
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Sibiak R, Ozegowska K, Wender-Ozegowska E, Gutaj P, Mozdziak P, Kempisty B. Fetomaternal Expression of Glucose Transporters (GLUTs)-Biochemical, Cellular and Clinical Aspects. Nutrients 2022; 14:2025. [PMID: 35631166 PMCID: PMC9146575 DOI: 10.3390/nu14102025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 04/28/2022] [Accepted: 05/11/2022] [Indexed: 12/10/2022] Open
Abstract
Several types of specialized glucose transporters (GLUTs) provide constant glucose transport from the maternal circulation to the developing fetus through the placental barrier from the early stages of pregnancy. GLUT1 is a prominent protein isoform that regulates placental glucose transfer via glucose-facilitated diffusion. The GLUT1 membrane protein density and permeability of the syncytial basal membrane (BM) are the main factors limiting the rate of glucose diffusion in the fetomaternal compartment in physiological conditions. Besides GLUT1, the GLUT3 and GLUT4 isoforms are widely expressed across the human placenta. Numerous medical conditions and molecules, such as hormones, adipokines, and xenobiotics, alter the GLUT's mRNA and protein expression. Diabetes upregulates the BM GLUT's density and promotes fetomaternal glucose transport, leading to excessive fetal growth. However, most studies have found no between-group differences in GLUTs' placental expression in macrosomic and normal control pregnancies. The fetomaternal GLUTs expression may also be influenced by several other conditions, such as chronic hypoxia, preeclampsia, and intrahepatic cholestasis of pregnancy.
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Affiliation(s)
- Rafal Sibiak
- Department of Histology and Embryology, Poznan University of Medical Sciences, 60-701 Poznan, Poland;
- Doctoral School, Poznan University of Medical Sciences, 60-701 Poznan, Poland
| | - Katarzyna Ozegowska
- Department of Infertility and Reproductive Endocrinology, Poznan University of Medical Sciences, 61-701 Poznan, Poland;
| | - Ewa Wender-Ozegowska
- Department of Reproduction, Poznan University of Medical Sciences, 61-701 Poznan, Poland; (E.W.-O.); (P.G.)
| | - Pawel Gutaj
- Department of Reproduction, Poznan University of Medical Sciences, 61-701 Poznan, Poland; (E.W.-O.); (P.G.)
| | - Paul Mozdziak
- Prestage Department of Poultry Science, North Carolina State University, Raleigh, NC 27695, USA;
| | - Bartosz Kempisty
- Department of Histology and Embryology, Poznan University of Medical Sciences, 60-701 Poznan, Poland;
- Prestage Department of Poultry Science, North Carolina State University, Raleigh, NC 27695, USA;
- Department of Anatomy, Poznan University of Medical Sciences, 60-701 Poznan, Poland
- Department of Veterinary Surgery, Institute of Veterinary Medicine, Nicolaus Copernicus University in Torun, 87-100 Torun, Poland
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Alves LNR, Pereira M, Dos Santos JA, Dos Santos EDVW, Carvalho GQ, Santana JDM, Tavares EA, Fernandes MDB, Dos Santos DB, Louro ID. Investigation of maternal polymorphisms in genes related to glucose homeostasis and the influence on birth weight: a cohort study. J Pediatr (Rio J) 2022; 98:296-302. [PMID: 34508664 PMCID: PMC9432150 DOI: 10.1016/j.jped.2021.06.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 06/19/2021] [Accepted: 06/21/2021] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES To contribute to a better understanding of the maternal genetic mechanisms that influence obstetric outcomes and that are involved in maternal and child health, this study aimed to evaluate the association between maternal genetic variants and the offspring birth weight by analyzing single-nucleotide polymorphisms (SNPs) in genes related to glucose homeostasis. METHODS Three polymorphisms were analyzed (GCK rs1799884, TCF7L2 rs7903146 and LEPR rs1137101) in 250 pregnant women who participated in a Brazilian prospective cohort study. Genotyping was performed by Real-Time Polymerase Chain Reaction (qPCR) using pre-designed TaqMan® SNP genotyping assays. Vitamin D dosage was performed by chemiluminescence. Variance, Pearson's chi-square test and multiple linear regression were used for the statistical analysis. RESULTS It was possible to verify a significant association between birth weight and maternal GCK rs1799884 when obstetric outcomes, clinical and anthropometric characteristics were taken into consideration. The children of homozygous women for the minor allele GCK rs1799884 presented lower birth weight (β = -335.25, 95% CI = -669.39; -1.17, p = 0.04). Furthermore, a direct link between a leptin receptor variant and gestational duration was found (p = 0.037). CONCLUSION The variant GCK rs1799884 (mm) was associated with a reduction in newborn weight in the miscegenated Brazilian population.
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Affiliation(s)
- Lyvia Neves Rebello Alves
- Universidade Federal do Espírito Santo, Departamento de Ciências Biológicas, Núcleo de Genética Humana e Molecular, Vitória, ES, Brazil; Universidade Federal do Espírito Santo, Programa de Pós-Graduação em Biotecnologia, Vitória, ES, Brazil.
| | - Marcos Pereira
- Universidade Federal da Bahia, Instituto de Saúde Coletiva, Salvador, BA, Brazil
| | - Jéssica Aflávio Dos Santos
- Universidade Federal do Espírito Santo, Departamento de Ciências Biológicas, Núcleo de Genética Humana e Molecular, Vitória, ES, Brazil
| | | | - Gisele Queiroz Carvalho
- Universidade Federal de Juiz de Fora, Departamento de Nutrição, Governador Valadares, MG, Brazil
| | - Jerusa da Mota Santana
- Universidade Federal do Recôncavo da Bahia, Centro de Ciências da Saúde, Santo Antônio de Jesus, BA, Brazil
| | - Eric Arrivabene Tavares
- Universidade Federal do Espírito Santo, Departamento de Ciências Biológicas, Núcleo de Genética Humana e Molecular, Vitória, ES, Brazil; Universidade Federal do Espírito Santo, Programa de Pós-Graduação em Biotecnologia, Vitória, ES, Brazil
| | | | | | - Iúri Drumond Louro
- Universidade Federal do Espírito Santo, Departamento de Ciências Biológicas, Núcleo de Genética Humana e Molecular, Vitória, ES, Brazil; Universidade Federal do Espírito Santo, Programa de Pós-Graduação em Biotecnologia, Vitória, ES, Brazil
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Obesity and Leptin Resistance in the Regulation of the Type I Interferon Early Response and the Increased Risk for Severe COVID-19. Nutrients 2022; 14:nu14071388. [PMID: 35406000 PMCID: PMC9002648 DOI: 10.3390/nu14071388] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 03/23/2022] [Accepted: 03/23/2022] [Indexed: 02/06/2023] Open
Abstract
Obesity, and obesity-associated conditions such as hypertension, chronic kidney disease, type 2 diabetes, and cardiovascular disease, are important risk factors for severe Coronavirus disease-2019 (COVID-19). The common denominator is metaflammation, a portmanteau of metabolism and inflammation, which is characterized by chronically elevated levels of leptin and pro-inflammatory cytokines. These induce the “Suppressor Of Cytokine Signaling 1 and 3” (SOCS1/3), which deactivates the leptin receptor and also other SOCS1/3 sensitive cytokine receptors in immune cells, impairing the type I and III interferon early responses. By also upregulating SOCS1/3, Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV)-2 adds a significant boost to this. The ensuing consequence is a delayed but over-reactive immune response, characterized by high-grade inflammation (e.g., cytokine storm), endothelial damage, and hypercoagulation, thus leading to severe COVID-19. Superimposing an acute disturbance, such as a SARS-CoV-2 infection, on metaflammation severely tests resilience. In the long run, metaflammation causes the “typical western” conditions associated with metabolic syndrome. Severe COVID-19 and other serious infectious diseases can be added to the list of its short-term consequences. Therefore, preventive measures should include not only vaccination and the well-established actions intended to avoid infection, but also dietary and lifestyle interventions aimed at improving body composition and preventing or reversing metaflammation.
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HYPERLIPIDEMIA AND RISK FOR PRECLAMPSIA. J Clin Lipidol 2022; 16:253-260. [DOI: 10.1016/j.jacl.2022.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Revised: 01/27/2022] [Accepted: 02/14/2022] [Indexed: 11/22/2022]
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Dreisbach C, Morgan H, Cochran C, Gyamfi A, Henderson WA, Prescott S. Metabolic and Microbial Changes Associated With Diet and Obesity During Pregnancy: What Can We Learn From Animal Studies? Front Cell Infect Microbiol 2022; 11:795924. [PMID: 35118010 PMCID: PMC8804207 DOI: 10.3389/fcimb.2021.795924] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 12/13/2021] [Indexed: 12/22/2022] Open
Abstract
The intestinal microbiota changes throughout pregnancy and influences maternal metabolic adaptations to support fetal growth. Obesity induces alterations to the microbiota that include decreased microbial diversity and shifts in microbial composition, though specific species changes are inconsistent between published studies. In animal models, probiotics and exercise moderate maternal weight gain and partially correct the maternal microbiota. Supplemental Escherichia coli, however, exacerbate maternal obesity during the perinatal period, lending weight to the theory that inflammation-induced gut epithelial barrier leak influences metabolic dysregulation. Although birth weight is not always altered when offspring are exposed to an obesogenic diet during gestation, insulin resistance and lipid metabolism are impacted through adulthood in association with this exposure and can lead to increased body weight in adulthood. Postnatal offspring growth is accelerated in response to maternal overnutrition during lactation. Offspring microbiota, metabolism, and behavior are altered in response to early exposure to high fat and high sucrose diets. Consequences to this exposure include impaired glucose and insulin homeostasis, fatty liver, and neurobehavioral deficits that can be ameliorated by improving the microbial environment. In this mini review, we provide an overview of the use of translational animal models to understand the mechanisms associated with changes to the gastrointestinal microbiota due to maternal obesity and the microbial impact on the metabolic changes of pregnancy.
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Affiliation(s)
- Caitlin Dreisbach
- Data Science Institute, Columbia University, New York, NY, United States
| | - Hailey Morgan
- College of Nursing, University of South Florida, Tampa, FL, United States
| | - Caroline Cochran
- School of Nursing, Columbia University, New York, NY, United States
| | - Adwoa Gyamfi
- School of Medicine, University of Connecticut, Farmington, CT, United States
| | - Wendy Ann Henderson
- School of Medicine, University of Connecticut, Farmington, CT, United States
- School of Nursing, University of Connecticut, Storrs, CT, United States
| | - Stephanie Prescott
- College of Nursing, University of South Florida, Tampa, FL, United States
- *Correspondence: Stephanie Prescott,
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Nuclear Receptors in Pregnancy and Outcomes: Clinical Perspective. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2022; 1390:3-19. [DOI: 10.1007/978-3-031-11836-4_1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Song Y, Lyu C, Li M, Rahman ML, Chen Z, Zhu Y, Hinkle SN, Chen L, Mitro SD, Li LJ, Weir NL, Tsai MY, Zhang C. Plasma Acylcarnitines during Pregnancy and Neonatal Anthropometry: A Longitudinal Study in a Multiracial Cohort. Metabolites 2021; 11:metabo11120885. [PMID: 34940643 PMCID: PMC8704426 DOI: 10.3390/metabo11120885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 12/05/2021] [Accepted: 12/14/2021] [Indexed: 11/16/2022] Open
Abstract
As surrogate readouts reflecting mitochondrial dysfunction, elevated levels of plasma acylcarnitines have been associated with cardiometabolic disorders, such as obesity, gestational diabetes, and type 2 diabetes. This study aimed to examine prospective associations of acylcarnitine profiles across gestation with neonatal anthropometry, including birthweight, birthweight z score, body length, sum of skinfolds, and sum of body circumferences. We quantified 28 acylcarnitines using electrospray ionization tandem mass spectrometry in plasma collected at gestational weeks 10–14, 15–26, 23–31, and 33–39 among 321 pregnant women from the National Institute of Child Health and Human Development (NICHD) Fetal Growth Studies-Singletons. A latent-class trajectory approach was applied to identify trajectories of acylcarnitines across gestation. We examined the associations of individual acylcarnitines and distinct trajectory groups with neonatal anthropometry using weighted generalized linear models adjusting for maternal age, race/ethnicity, education, parity, gestational age at blood collection, and pre-pregnancy body mass index (BMI). We identified three distinct trajectory groups in C2, C3, and C4 and two trajectory groups in C5, C10, C5–DC, C8:1, C10:1, and C12, respectively. Women with nonlinear decreasing C12 levels across gestation (5.7%) had offspring with significantly lower birthweight (−475 g; 95% CI, −942, −6.79), birthweight z score (−0.39, −0.71, −0.06), and birth length (−1.38 cm, −2.49, −0.27) than those with persistently stable C12 levels (94.3%) (all nominal p value < 0.05). Women with consistently higher levels of C10 (6.1%) had offspring with thicker sum of skinfolds (4.91 mm, 0.85, 8.98) than did women with lower levels (93.9%) during pregnancy, whereas women with lower C10:1 levels (12.6%) had offspring with thicker sum of skinfolds (3.23 mm, 0.19, 6.27) than did women with abruptly increasing levels (87.4%) (p < 0.05). In conclusion, this study suggests that distinctive trajectories of C10, C10:1, and C12 acylcarnitine levels throughout pregnancy were significantly associated with neonatal anthropometry.
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Affiliation(s)
- Yiqing Song
- Department of Epidemiology, Indiana University Richard M. Fairbanks School of Public Health, Indianapolis, IN 46202, USA;
| | - Chen Lyu
- Department of Population Health, Division of Biostatistics, NYU Grossman School of Medicine, NYU Langone Health, New York, NY 10016, USA;
| | - Ming Li
- Department of Epidemiology and Biostatistics, School of Public Health, Indiana University, Bloomington, IN 47405, USA;
| | - Mohammad L. Rahman
- Department of Population Medicine and Harvard Pilgrim Healthcare Institute, Harvard Medical School, Boston, MA 02215, USA;
| | - Zhen Chen
- Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institute of Health, Bethesda, MD 20817, USA; (Z.C.); (S.D.M.)
| | - Yeyi Zhu
- Kaiser Permanente Northern California Division of Research, Oakland, CA 94612, USA;
| | - Stefanie N. Hinkle
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA;
| | - Liwei Chen
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA 90095, USA;
| | - Susanna D. Mitro
- Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institute of Health, Bethesda, MD 20817, USA; (Z.C.); (S.D.M.)
| | - Ling-Jun Li
- Department of O&G, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore;
| | - Natalie L. Weir
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN 55455, USA; (N.L.W.); (M.Y.T.)
| | - Michael Y. Tsai
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN 55455, USA; (N.L.W.); (M.Y.T.)
| | - Cuilin Zhang
- Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institute of Health, Bethesda, MD 20817, USA; (Z.C.); (S.D.M.)
- Correspondence: ; Tel.: +1-301-435-6917
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Shashikadze B, Flenkenthaler F, Stöckl JB, Valla L, Renner S, Kemter E, Wolf E, Fröhlich T. Developmental Effects of (Pre-)Gestational Diabetes on Offspring: Systematic Screening Using Omics Approaches. Genes (Basel) 2021; 12:1991. [PMID: 34946940 PMCID: PMC8701487 DOI: 10.3390/genes12121991] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 12/06/2021] [Accepted: 12/10/2021] [Indexed: 12/27/2022] Open
Abstract
Worldwide, gestational diabetes affects 2-25% of pregnancies. Due to related disturbances of the maternal metabolism during the periconceptional period and pregnancy, children bear an increased risk for future diseases. It is well known that an aberrant intrauterine environment caused by elevated maternal glucose levels is related to elevated risks for increased birth weights and metabolic disorders in later life, such as obesity or type 2 diabetes. The complexity of disturbances induced by maternal diabetes, with multiple underlying mechanisms, makes early diagnosis or prevention a challenging task. Omics technologies allowing holistic quantification of several classes of molecules from biological fluids, cells, or tissues are powerful tools to systematically investigate the effects of maternal diabetes on the offspring in an unbiased manner. Differentially abundant molecules or distinct molecular profiles may serve as diagnostic biomarkers, which may also support the development of preventive and therapeutic strategies. In this review, we summarize key findings from state-of-the-art Omics studies addressing the impact of maternal diabetes on offspring health.
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Affiliation(s)
- Bachuki Shashikadze
- Laboratory for Functional Genome Analysis (LAFUGA), Gene Center, LMU Munich, 81377 Munich, Germany; (B.S.); (F.F.); (J.B.S.)
| | - Florian Flenkenthaler
- Laboratory for Functional Genome Analysis (LAFUGA), Gene Center, LMU Munich, 81377 Munich, Germany; (B.S.); (F.F.); (J.B.S.)
| | - Jan B. Stöckl
- Laboratory for Functional Genome Analysis (LAFUGA), Gene Center, LMU Munich, 81377 Munich, Germany; (B.S.); (F.F.); (J.B.S.)
| | - Libera Valla
- Chair for Molecular Animal Breeding and Biotechnology, Gene Center and Department of Veterinary Sciences, LMU Munich, 81377 Munich, Germany; (L.V.); (S.R.); (E.K.)
| | - Simone Renner
- Chair for Molecular Animal Breeding and Biotechnology, Gene Center and Department of Veterinary Sciences, LMU Munich, 81377 Munich, Germany; (L.V.); (S.R.); (E.K.)
- Center for Innovative Medical Models (CiMM), LMU Munich, 85764 Oberschleißheim, Germany
- German Center for Diabetes Research (DZD), 85764 Neuherberg, Germany
| | - Elisabeth Kemter
- Chair for Molecular Animal Breeding and Biotechnology, Gene Center and Department of Veterinary Sciences, LMU Munich, 81377 Munich, Germany; (L.V.); (S.R.); (E.K.)
- Center for Innovative Medical Models (CiMM), LMU Munich, 85764 Oberschleißheim, Germany
- German Center for Diabetes Research (DZD), 85764 Neuherberg, Germany
| | - Eckhard Wolf
- Laboratory for Functional Genome Analysis (LAFUGA), Gene Center, LMU Munich, 81377 Munich, Germany; (B.S.); (F.F.); (J.B.S.)
- Chair for Molecular Animal Breeding and Biotechnology, Gene Center and Department of Veterinary Sciences, LMU Munich, 81377 Munich, Germany; (L.V.); (S.R.); (E.K.)
- Center for Innovative Medical Models (CiMM), LMU Munich, 85764 Oberschleißheim, Germany
- German Center for Diabetes Research (DZD), 85764 Neuherberg, Germany
| | - Thomas Fröhlich
- Laboratory for Functional Genome Analysis (LAFUGA), Gene Center, LMU Munich, 81377 Munich, Germany; (B.S.); (F.F.); (J.B.S.)
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Saliu MA, Salihu A, Mada SB, Owolabi OA. Dyslipidaemia-related cardiovascular risk among pregnant women attending Aminu Kano Teaching Hospital Kano: A longitudinal study. J Taibah Univ Med Sci 2021; 16:870-877. [PMID: 34899132 PMCID: PMC8626804 DOI: 10.1016/j.jtumed.2021.07.004] [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: 03/22/2021] [Revised: 06/26/2021] [Accepted: 07/10/2021] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Maternal dyslipidaemia and atherogenic lipid profiles have undesirable effects on maternal and foetal well-being throughout gestation. This study investigates the changes in serum lipid profiles, the prevalence of dyslipidaemia, and the risk of cardiovascular disease among pregnant women attending the antenatal care unit of the Aminu Kano Teaching Hospital (AKTH), Kano. METHODS A total of 112 pregnant women visiting AKTH in their second trimester were recruited and followed up within their third trimester. The demographic characteristics, daily dietary consumption patterns, and lipid profiles of all women were assessed using standard methods. RESULTS The results revealed that the mean age and gestational age of the pregnant women were approximately 29 ± 6 years and 20 ± 3 weeks, respectively. Most pregnant women were multiparous (76) and multigravida (93). Regarding daily dietary consumption patterns, 20.5%, 63.4%, 13.4%, and 8.0% of the pregnant women consumed nuts, palm oil, butter, and sardines at least one to three times, respectively. Moreover, the serum lipid profiles revealed that the prevalence of dyslipidaemia, hypercholesterolaemia, hypertriglyceridaemia, increased low-density lipoprotein levels, and decreased high-density lipoprotein levels among pregnant women during the second trimester were 69.6%, 19.6%, 36.6%, 18.8%, and 49.1%, respectively. All these parameters significantly increased to 91.8%, 54.1%, 75.3%, 40.0%, and 62.4%, respectively, in the third trimester. Pregnant women showed a high risk of cardiovascular disease in both the second (81.0%) and third (85.0%) trimesters. CONCLUSION Progression from mid-pregnancy to delivery is associated with an increased risk of maternal dyslipidaemia and cardiovascular diseases among pregnant women.
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Affiliation(s)
- Muhammad A. Saliu
- Department of Biochemistry, Faculty of Life Sciences, Ahmadu Bello University, Zaria, Nigeria
| | - Aliyu Salihu
- Department of Biochemistry, Faculty of Life Sciences, Ahmadu Bello University, Zaria, Nigeria
| | - Sanusi B. Mada
- Department of Biochemistry, Faculty of Life Sciences, Ahmadu Bello University, Zaria, Nigeria
| | - Olumuyiwa A. Owolabi
- Department of Biochemistry, Faculty of Life Sciences, Ahmadu Bello University, Zaria, Nigeria
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Stern C, Schwarz S, Moser G, Cvitic S, Jantscher-Krenn E, Gauster M, Hiden U. Placental Endocrine Activity: Adaptation and Disruption of Maternal Glucose Metabolism in Pregnancy and the Influence of Fetal Sex. Int J Mol Sci 2021; 22:ijms222312722. [PMID: 34884524 PMCID: PMC8657775 DOI: 10.3390/ijms222312722] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 11/16/2021] [Accepted: 11/17/2021] [Indexed: 02/07/2023] Open
Abstract
The placenta is an endocrine fetal organ, which secretes a plethora of steroid- and proteo-hormones, metabolic proteins, growth factors, and cytokines in order to adapt maternal physiology to pregnancy. Central to the growth of the fetus is the supply with nutrients, foremost with glucose. Therefore, during pregnancy, maternal insulin resistance arises, which elevates maternal blood glucose levels, and consequently ensures an adequate glucose supply for the developing fetus. At the same time, maternal β-cell mass and function increase to compensate for the higher insulin demand. These adaptations are also regulated by the endocrine function of the placenta. Excessive insulin resistance or the inability to increase insulin production accordingly disrupts physiological modulation of pregnancy mediated glucose metabolism and may cause maternal gestational diabetes (GDM). A growing body of evidence suggests that this adaptation of maternal glucose metabolism differs between pregnancies carrying a girl vs. pregnancies carrying a boy. Moreover, the risk of developing GDM differs depending on the sex of the fetus. Sex differences in placenta derived hormones and bioactive proteins, which adapt and modulate maternal glucose metabolism, are likely to contribute to this sexual dimorphism. This review provides an overview on the adaptation and maladaptation of maternal glucose metabolism by placenta-derived factors, and highlights sex differences in this regulatory network.
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Affiliation(s)
- Christina Stern
- Department of Obstetrics and Gynecology, Medical University of Graz, 8036 Graz, Austria; (C.S.); (S.S.); (E.J.-K.)
| | - Sarah Schwarz
- Department of Obstetrics and Gynecology, Medical University of Graz, 8036 Graz, Austria; (C.S.); (S.S.); (E.J.-K.)
| | - Gerit Moser
- Division of Cell Biology, Histology and Embryology, Gottfried Schatz Research Center, Medical University of Graz, 8010 Graz, Austria;
| | - Silvija Cvitic
- Research Unit of Analytical Mass Spectrometry, Cell Biology and Biochemistry of Inborn Errors of Metabolism, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, 8036 Graz, Austria;
| | - Evelyn Jantscher-Krenn
- Department of Obstetrics and Gynecology, Medical University of Graz, 8036 Graz, Austria; (C.S.); (S.S.); (E.J.-K.)
| | - Martin Gauster
- Division of Cell Biology, Histology and Embryology, Gottfried Schatz Research Center, Medical University of Graz, 8010 Graz, Austria;
- Correspondence: (M.G.); (U.H.); Tel.: +43-316385-71896 (M.G.); +43-136385-17837 (U.H.)
| | - Ursula Hiden
- Department of Obstetrics and Gynecology, Medical University of Graz, 8036 Graz, Austria; (C.S.); (S.S.); (E.J.-K.)
- Correspondence: (M.G.); (U.H.); Tel.: +43-316385-71896 (M.G.); +43-136385-17837 (U.H.)
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Yang Y, Wu J, Wang X, Yao J, Lao KS, Qiao Y, Xu Y, Hu Y, Feng Y, Cui Y, Shi S, Zhang J, Liang M, Pan Y, Xie K, Yan K, Li Q, Ye D, Wang Y. Circulating fibroblast growth factor 21 as a potential biomarker for missed abortion in humans. Fertil Steril 2021; 116:1040-1049. [PMID: 34167789 DOI: 10.1016/j.fertnstert.2021.05.098] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 05/20/2021] [Accepted: 05/21/2021] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To investigate whether serum levels of fibroblast growth factor 21 (FGF21) and fatty acid-binding protein-4 (FABP4) are associated with missed abortion (MA) in humans. DESIGN Cross-sectional study. SETTING University-affiliated hospital. PATIENT(S) Patients with MA at 8-12 weeks of gestation. INTERVENTION(S) None. MAIN OUTCOME MEASURES(S) Serum levels of FGF21 and FABP4 were tested by enzyme-linked immunosorbent assay. Placental samples were collected during dilation and curettage surgery, and the expression of FGF21 and its related genes were measured using quantitative polymerase chain reaction. RESULT(S) In the discovery cohort, 78 patients with MA and 79 healthy pregnant women matched for maternal age and body mass index were nested from a prospective cohort. Circulating levels of FGF21 and FABP4 were significantly and independently elevated in patients with MA relative to the levels in the healthy controls. A single measurement of FGF21 serum level effectively discriminated MA with an area under the receiver operating characteristics curve of 0.80 (95% confidence interval: 0.73-0.87). Importantly, in our external validation cohort that comprised subjects with MA (n = 34) or induced abortion (n = 27), the FGF21 serum levels achieved an area under the receiver operating characteristics curve of 0.85 (95% confidence interval: 0.75-0.96) when identifying those with MA. Nevertheless, expression of FGF21 in the placenta was not associated with its serum concentration. Placental tissues from patients with MA exhibited impaired FGF21 signaling. CONCLUSION(S) Our results suggested that serum levels of FGF21 and FABP4 were associated with MA. Circulating FGF21 may serve as a potential biomarker for the recognition of MA.
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Affiliation(s)
- Yongkang Yang
- The Second Clinical Medical College, Shaanxi University of Chinese Medicine, Xianyang, People's Republic of China; Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang, People's Republic of China
| | - Jiaming Wu
- State Key Laboratory of Pharmaceutical Biotechnology, the University of Hong Kong, Hong Kong SAR, People's Republic of China; Department of Medicine, the University of Hong Kong, Hong Kong SAR, People's Republic of China
| | - Xia Wang
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang, People's Republic of China
| | - Jianyu Yao
- Joint Laboratory between Guangdong and Hong Kong on Metabolic Diseases, Guangdong Pharmaceutical University, Guangzhou, People's Republic of China; Guangdong Research Center of Metabolic Diseases of Integrated Western and Chinese Medicine, Guangdong Pharmaceutical University, Guangzhou, People's Republic of China
| | - Kim Shijian Lao
- Department of Pharmaceutical and Pharmacy, the University of Hong Kong, Hong Kong SAR, People's Republic of China
| | - Yumei Qiao
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang, People's Republic of China
| | - Ying Xu
- School of Clinical Medicine, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, People's Republic of China
| | - Yue Hu
- State Key Laboratory of Pharmaceutical Biotechnology, the University of Hong Kong, Hong Kong SAR, People's Republic of China; Department of Medicine, the University of Hong Kong, Hong Kong SAR, People's Republic of China
| | - Yanhong Feng
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang, People's Republic of China
| | - Yanchao Cui
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang, People's Republic of China
| | - Shuai Shi
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang, People's Republic of China
| | - Jing Zhang
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang, People's Republic of China
| | - Man Liang
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang, People's Republic of China
| | - Yong Pan
- School of Biomedicine Science, Shenzhen University, Shenzhen, People's Republic of China
| | - Kang Xie
- Joint Laboratory between Guangdong and Hong Kong on Metabolic Diseases, Guangdong Pharmaceutical University, Guangzhou, People's Republic of China; Guangdong Research Center of Metabolic Diseases of Integrated Western and Chinese Medicine, Guangdong Pharmaceutical University, Guangzhou, People's Republic of China
| | - Kaixuan Yan
- Joint Laboratory between Guangdong and Hong Kong on Metabolic Diseases, Guangdong Pharmaceutical University, Guangzhou, People's Republic of China; Guangdong Research Center of Metabolic Diseases of Integrated Western and Chinese Medicine, Guangdong Pharmaceutical University, Guangzhou, People's Republic of China
| | - Qin Li
- The Second Clinical Medical College, Shaanxi University of Chinese Medicine, Xianyang, People's Republic of China; Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang, People's Republic of China
| | - Dewei Ye
- Joint Laboratory between Guangdong and Hong Kong on Metabolic Diseases, Guangdong Pharmaceutical University, Guangzhou, People's Republic of China; Guangdong Research Center of Metabolic Diseases of Integrated Western and Chinese Medicine, Guangdong Pharmaceutical University, Guangzhou, People's Republic of China
| | - Yao Wang
- State Key Laboratory of Pharmaceutical Biotechnology, the University of Hong Kong, Hong Kong SAR, People's Republic of China; Department of Medicine, the University of Hong Kong, Hong Kong SAR, People's Republic of China.
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Gojnic-Dugalic M, Stefanovic K, Stefanovic A, Jotic A, Lalic N, Petronijevic-Vrzic S, Petronijevic M, Milicic T, Lukic L, Todorovic J, Dugalic S, Pantic I, Nesic D, Stoiljkovic M, Stanisavljevic D, Perovic M. Distribution of normal and pathological OGTTs among pregnant population and non-pregnant women with PCOS - the cross-sectional study. Medicine (Baltimore) 2021; 100:e27232. [PMID: 34664864 PMCID: PMC8448046 DOI: 10.1097/md.0000000000027232] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 08/28/2021] [Indexed: 01/07/2023] Open
Abstract
Both pregnancy, as physiological, and polycystic ovary syndrome (PCOS), as a pathological condition, carry the risk for developing glucose metabolism abnormalities. In this retrospective cross-sectional study, we hypothesized that pregnancy as a physiological condition carries a higher likelihood for abnormal oral glucose tolerance test (OGTT) results than PCOS as a pathological condition.We have compared the prevalence and likelihood ratios for abnormal OGTT results between non-pregnant women with PCOS (Group A) and pregnant women at 24 to 28 weeks of gestation (Group B). Participants of both study groups underwent glucose tolerance testing with 75 g glucose OGTT. During the study period, 7411 women were tested, 3932 women encompassed Group A, and 3479 women comprised Group B.The numbers of yearly tested pregnant women and the corresponding proportion of tested women among all study participants have decreased during the study period, from 766 to 131 and 89.1% to 20.5%, respectively. Group A had a significantly lower prevalence (4.4%) of pathological OGTT results compared to Group B (8.1%). This has resulted in a 45.427 likelihood ratio (P < .001) for abnormal OGTT results in pregnant women compared to non-pregnant women with PCOS.We might conclude that pregnancy could have a more challenging influence on glucose metabolism and that carries higher risks for abnormal glucose metabolism than PCOS. The awareness of obstetricians regarding physiological changes during pregnancy that predisposes abnormal glucose metabolism is decreasing over time and the compliance concerning OGTT testing of pregnant women is decreasing too.
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Affiliation(s)
- Miroslava Gojnic-Dugalic
- Clinical Centre of Serbia, Clinic for Gynaecology and Obstetrics, Serbia
- Faculty of Medicine, University of Belgrade, Serbia
| | - Katarina Stefanovic
- Clinical Centre of Serbia, Clinic for Gynaecology and Obstetrics, Serbia
- Faculty of Medicine, University of Belgrade, Serbia
| | - Aleksandar Stefanovic
- Clinical Centre of Serbia, Clinic for Gynaecology and Obstetrics, Serbia
- Faculty of Medicine, University of Belgrade, Serbia
| | - Aleksandra Jotic
- Faculty of Medicine, University of Belgrade, Serbia
- Clinical Centre of Serbia, Clinic for Endocrinology, Diabetes and Metabolic Disease, Serbia
| | - Nebojsa Lalic
- Faculty of Medicine, University of Belgrade, Serbia
- Clinical Centre of Serbia, Clinic for Endocrinology, Diabetes and Metabolic Disease, Serbia
| | - Svetlana Petronijevic-Vrzic
- Clinical Centre of Serbia, Clinic for Gynaecology and Obstetrics, Serbia
- Faculty of Medicine, University of Belgrade, Serbia
| | - Milos Petronijevic
- Clinical Centre of Serbia, Clinic for Gynaecology and Obstetrics, Serbia
- Faculty of Medicine, University of Belgrade, Serbia
| | - Tanja Milicic
- Faculty of Medicine, University of Belgrade, Serbia
- Clinical Centre of Serbia, Clinic for Endocrinology, Diabetes and Metabolic Disease, Serbia
| | - Ljiljana Lukic
- Faculty of Medicine, University of Belgrade, Serbia
- Clinical Centre of Serbia, Clinic for Endocrinology, Diabetes and Metabolic Disease, Serbia
| | - Jovana Todorovic
- Institute of Social Medicine, Faculty of Medicine, University of Belgrade, Serbia
| | - Stefan Dugalic
- Clinical Centre of Serbia, Clinic for Gynaecology and Obstetrics, Serbia
- Faculty of Medicine, University of Belgrade, Serbia
| | - Igor Pantic
- Institute of Medical Physiology, Faculty of Medicine, University of Belgrade, Serbia
| | - Dejan Nesic
- Institute of Medical Physiology, Faculty of Medicine, University of Belgrade, Serbia
| | - Milica Stoiljkovic
- Faculty of Medicine, University of Belgrade, Serbia
- Clinical Centre of Serbia, Clinic for Endocrinology, Diabetes and Metabolic Disease, Serbia
| | - Dejana Stanisavljevic
- Institute of Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, Serbia
| | - Milan Perovic
- Faculty of Medicine, University of Belgrade, Serbia
- Clinic for Gynaecology and Obstetrics “Narodni front,” Belgrade, Serbia
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42
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Gomes PRL, Vilas-Boas EA, Leite EDA, Munhoz AC, Lucena CF, Amaral FGD, Carpinelli AR, Cipolla-Neto J. Melatonin regulates maternal pancreatic remodeling and B-cell function during pregnancy and lactation. J Pineal Res 2021; 71:e12717. [PMID: 33460489 DOI: 10.1111/jpi.12717] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 12/16/2020] [Accepted: 01/07/2021] [Indexed: 01/23/2023]
Abstract
The endocrine pancreas of pregnant rats shows evident plasticity, which allows the morphological structures to return to the nonpregnant state right after delivery. Furthermore, it is well-known the role of melatonin in the maintenance of the endocrine pancreas and its tropism. Studies indicate increasing nocturnal serum concentrations of maternal melatonin during pregnancy in both humans and rodents. The present study investigated the role of melatonin on energy metabolism and in pancreatic function and remodeling during pregnancy and early lactation in rats. The results confirm that the absence of melatonin during pregnancy impairs glucose metabolism. In addition, there is a dysregulation in insulin secretion at various stages of the development of pregnancy and an apparent failure in the glucose-stimulated insulin secretion during the lactation period, evidencing the role of melatonin on the regulation of insulin secretion. This mechanism seems not to be dependent on the antioxidant effect of melatonin and probably dependent on MT2 receptors. We also observed changes in the mechanisms of death and cell proliferation at the end of pregnancy and beginning of lactation, crucial periods for pancreatic remodeling. The present observations strongly suggest that both functionality and remodeling of the endocrine pancreas are impaired in the absence of melatonin and its adequate replacement, mimicking the physiological increase seen during pregnancy, is able to reverse some of the damage observed. Thus, we conclude that pineal melatonin is important to metabolic adaptation to pregnancy and both the functionality of the beta cells and the remodeling of the pancreas during pregnancy and early lactation, ensuring the return to nonpregnancy conditions.
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Affiliation(s)
| | - Eloisa Aparecida Vilas-Boas
- Department of Physiology and Biophysics, Institute of Biomedical Sciences, University of Sao Paulo, São Paulo, Brazil
| | - Eduardo de Almeida Leite
- Department of Physiology and Biophysics, Institute of Biomedical Sciences, University of Sao Paulo, São Paulo, Brazil
| | - Ana Cláudia Munhoz
- Department of Physiology and Biophysics, Institute of Biomedical Sciences, University of Sao Paulo, São Paulo, Brazil
| | - Camila Ferraz Lucena
- Department of Physiology and Biophysics, Institute of Biomedical Sciences, University of Sao Paulo, São Paulo, Brazil
| | | | - Angelo Rafael Carpinelli
- Department of Physiology and Biophysics, Institute of Biomedical Sciences, University of Sao Paulo, São Paulo, Brazil
| | - José Cipolla-Neto
- Department of Physiology and Biophysics, Institute of Biomedical Sciences, University of Sao Paulo, São Paulo, Brazil
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43
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Delgadillo-Velázquez JA, Nambo-Venegas R, Patiño N, Meraz-Cruz N, Razo-Azamar M, Guevara-Cruz M, Fonseca M, Pale Montero LE, Ibarra-González I, Vela-Amieva M, Vadillo-Ortega F, Palacios-González B. Metabolic flexibility during normal pregnancy allows appropriate adaptation during gestation independently of BMI. Clin Nutr ESPEN 2021; 44:254-262. [PMID: 34330475 DOI: 10.1016/j.clnesp.2021.06.007] [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: 08/21/2020] [Revised: 02/22/2021] [Accepted: 06/08/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND & AIMS Overweight and obesity in reproductive-age women hasten the development of insulin resistance and increase risk for deterioration of pregnancy metabolism. These pregnancy-associated metabolic changes are similar to those of the metabolic syndrome. Thus, some metabolic flexibility must allow appropriate adaptation to the metabolic load that pregnancy imposes. We evaluated metabolic flexibility during uncomplicated pregnancy in women with pre-gestational normal weight or overweight. METHODS In 20 women with singleton pregnancies, pre-pregnancy BMI was categorized as normal-weight (Nw) or overweight (Ow). The women were seen quarterly, and fasting and postprandial blood samples were collected at each visit. Indirect fasting and/postprandial calorimetry was performed to evaluate metabolic flexibility (Δrespiratory quotient (RQ) = RQpostprandial - RQfasting). RESULTS In the first trimester, metabolic flexibility was lower in the Ow group compared to the Nw group (0.031 ± 0.0131 vs 0.077 ± 0.018, respectively) without a statistically significant difference (p = 0.053). In the second trimester, the Ow group was significantly more flexible than the Nw group (0.190 ± 0.016 vs 0.077 ± 0.015, respectively (p = 0.004)). For the third trimester, the Ow and Nw groups did not differ in metabolic flexibility (0.074 ± 0.013 vs 0.087 ± 0.021, respectively) (p = 0.40). The most influential variables for metabolic flexibility during pregnancy were lactate, leptin, β-hydroxybutyrate, glycerol, aromatic amino acids, medium and long chain acylcarnitine's. CONCLUSIONS Our findings indicate that metabolic flexibility changes throughout pregnancy, independently of pre-pregnancy BMI. These changes maintain metabolic homeostasis between the mother and foetus, allowing for appropriate adjustments during pregnancy.
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Affiliation(s)
- Jaime A Delgadillo-Velázquez
- Unidad de Vinculación Científica de La Facultad de Medicina UNAM-INMEGEN, Instituto Nacional de Medicina Genómica, Mexico City, Mexico; Facultad de Química, Universidad Nacional Autónoma de México, México City, Mexico
| | - Rafael Nambo-Venegas
- Laboratorio de Bioquímica de Enfermedades Crónicas, Instituto Nacional de Medicina Genómica, Mexico City, Mexico
| | - Nayelli Patiño
- Unidad de Vinculación Científica de La Facultad de Medicina UNAM-INMEGEN, Instituto Nacional de Medicina Genómica, Mexico City, Mexico; Escuela de Dietética y Nutrición Del ISSSTE, Mexico City, Mexico
| | - Noemí Meraz-Cruz
- Unidad de Vinculación Científica de La Facultad de Medicina UNAM-INMEGEN, Instituto Nacional de Medicina Genómica, Mexico City, Mexico
| | - Melissa Razo-Azamar
- Unidad de Vinculación Científica de La Facultad de Medicina UNAM-INMEGEN, Instituto Nacional de Medicina Genómica, Mexico City, Mexico
| | - Martha Guevara-Cruz
- Fisiología de La Nutrición, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Mexico City, Mexico
| | - Mayali Fonseca
- Escuela de Dietética y Nutrición Del ISSSTE, Mexico City, Mexico
| | | | | | - Marcela Vela-Amieva
- Laboratorio de Errores Innatos Del Metabolismo, Instituto Nacional de Pediatría, Mexico City, Mexico
| | - Felipe Vadillo-Ortega
- Unidad de Vinculación Científica de La Facultad de Medicina UNAM-INMEGEN, Instituto Nacional de Medicina Genómica, Mexico City, Mexico
| | - Berenice Palacios-González
- Unidad de Vinculación Científica de La Facultad de Medicina UNAM-INMEGEN, Instituto Nacional de Medicina Genómica, Mexico City, Mexico.
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44
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Akerele OA, Manning SJ, Dixon SE, Lacey AE, Cheema SK. Maternal omega-3 fatty acids maintained positive maternal lipids and cytokines profile, and improved pregnancy outcomes of C57BL/6 mice. J Nutr Biochem 2021; 98:108813. [PMID: 34242722 DOI: 10.1016/j.jnutbio.2021.108813] [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: 09/02/2020] [Revised: 06/22/2021] [Accepted: 06/23/2021] [Indexed: 10/20/2022]
Abstract
Omega (n)-3 polyunsaturated fatty acids (PUFA) are known to regulate lipid metabolism and inflammation; however, the regulation of maternal lipid metabolism and cytokines profile by n-3 PUFA during different gestation stages, and its impact on fetal sustainability is not known. We investigated the effects of maternal diet varying in n-3 PUFA prior to, and during gestation, on maternal metabolic profile, placental inflammatory cytokines, and fetal outcomes. Female C57BL/6 mice were fed either a high, low or very low (9, 3 or 1% w/w n-3 PUFA) diet, containing n-6:n-3 PUFA of 5:1, 20:1 and 40:1, respectively for two weeks before mating, and throughout pregnancy. Animals were sacrificed prior to mating (NP), and during pregnancy at gestation days 6.5, 12.5 and 18.5. Maternal metabolic profile, placental cytokines and fetal outcomes were determined. Our results show for the first time that a maternal diet high in n-3 PUFA prevented dyslipidemia in NP mice, and maintained the expected lipid profile during pregnancy. However, females fed the very low n-3 PUFA diet became hyperlipidemic prior to pregnancy, and carried this profile into pregnancy. Maternal diet high in n-3 PUFA maintained maternal plasma progesterone and placental pro-inflammatory cytokines profile, and sustained fetal numbers throughout pregnancy, while females fed the low and very-low n-3 PUFA diet had fewer fetuses. Our findings demonstrate the importance of maternal diet before, and during pregnancy, to maintain maternal metabolic profile and fetus sustainability. These findings are important when designing dietary strategies to optimize maternal metabolism during pregnancy for successful pregnancy outcome.
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Affiliation(s)
- Olatunji Anthony Akerele
- Department of Biochemistry, Memorial University of Newfoundland, Newfoundland and Labrador, Canada
| | - Sarah Jane Manning
- Department of Biochemistry, Memorial University of Newfoundland, Newfoundland and Labrador, Canada
| | - Sarah Emily Dixon
- Department of Biochemistry, Memorial University of Newfoundland, Newfoundland and Labrador, Canada
| | - Amelia Estelle Lacey
- Department of Biochemistry, Memorial University of Newfoundland, Newfoundland and Labrador, Canada
| | - Sukhinder Kaur Cheema
- Department of Biochemistry, Memorial University of Newfoundland, Newfoundland and Labrador, Canada.
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45
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Yaqub L, Ayo J, Habibu B, Kawu M, Rekwot P. Haematological responses and erythrocyte osmotic fragility in pregnant Yankasa ewes and their lambs. Small Rumin Res 2021. [DOI: 10.1016/j.smallrumres.2021.106352] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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46
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Alfarhan A, Alquayt M, Alshalhoub M, Alnahdi MA, Masuadi E, Alhabshan F. Risk factors for transposition of the great arteries in Saudi population. Saudi Med J 2021; 41:1054-1062. [PMID: 33026045 PMCID: PMC7841512 DOI: 10.15537/smj.2020.10.25418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Objectives: To assess potential risk factors and their effect on the development of transposition of the great arteries (TGA). Methods: A retrospective case-control study of all patients diagnosed with TGA between 1999 to 2016 at King Abdulaziz Medical City, Riyadh, Saudi Arabia. Age and gender-matched controls were selected. Risk factors, including consanguinity, gestational diabetes, family history of congenital heart disease, parental age, and maternal parity, were collected. Regression modeling was used to analyze the effects of risk factors on the development of TGA. Results: A total of 206 patients with transposition of the great arteries were enrolled in the study. Transposition of the great arteries cases were divided into simple and complex TGA. Selected healthy controls were 446. In the studied cases, consanguinity was found in 95 (46%) of cases, gestational diabetes was diagnosed in 36 (17.5%) mothers, and 35 (17%) had a confirmed family history of congenital heart disease. When risk factors of the cases were compared to the controls, consanguinity, gestational diabetes, maternal age, and parity were found to significantly increase the incidence of TGA. Conclusion: Our study revealed significant risk factors for the development of transposition of great arteries including first degree consanguineous marriages, gestational diabetes, family history of congenital cardiac anomalies, and increasing maternal age and parity. These factors increased the risk by at least 2 folds.
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Affiliation(s)
- Abdulrahman Alfarhan
- Department of Cardiac Sciences, Ministry of National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia. E-mail.
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47
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Easey KE, Wootton RE, Sallis HM, Haan E, Schellhas L, Munafò MR, Timpson NJ, Zuccolo L. Characterization of alcohol polygenic risk scores in the context of mental health outcomes: Within-individual and intergenerational analyses in the Avon Longitudinal Study of Parents and Children. Drug Alcohol Depend 2021; 221:108654. [PMID: 33676074 PMCID: PMC8047864 DOI: 10.1016/j.drugalcdep.2021.108654] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 02/17/2021] [Accepted: 02/17/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND Heavy alcohol consumption often co-occurs with mental health problems; this could be due to confounding, shared biological mechanisms, or causal effects. Polygenic risk scores (PRS) for alcohol use can be used to explore this association at critical life stages. DESIGN We characterized a PRS reliably associated with patterns of adult alcohol consumption by 1) validating whether it predicts own alcohol use at different life-stages (pregnancy, adolescence) of interest for mental health impact. Additionally, we explored associations of alcohol PRS on mental health phenotypes 2) within-individuals (using own alcohol PRS on own phenotypes) and 3) intergenerationally (using maternal alcohol PRS on offspring phenotypes). We used data from the Avon Longitudinal Study of Parents and Children (ALSPAC) (n = 960-7841). Additional substance abuse behaviors and mental health/behavioral outcomes were investigated (alcohol phenotypes n = 22; health phenotypes n = 91). FINDINGS Maternal alcohol PRS was associated with consumption during pregnancy (strongest signal: alcohol frequency at 18 weeks' gestation: β = 0.041, 95%CI = 0.0.02-0.06), p = 1.01 × 10-5, adjusted R2 = 1.6 %), offspring alcohol PRS did not predict offspring alcohol consumption. We found evidence for an association of maternal alcohol PRS with own perinatal depression (OR = 1.10, 95% CI = 1.02 to 1.18, p = 0.022) and decreased offspring intellectual ability (β=-0.209, 95% CI -0.38 to -0.04, p= 0.016). CONCLUSIONS These alcohol PRS are a valid proxy for maternal alcohol use in pregnancy. Offspring alcohol PRS was not associated with drinking in adolescence. Consistently with results from different study designs, we found evidence that maternal alcohol PRS are associated with both prenatal depression and decreased offspring intellectual ability.
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Affiliation(s)
- Kayleigh E Easey
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK; Department of Population Health Sciences, Bristol Medical School, University of Bristol, UK.
| | - Robyn E Wootton
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK; Department of Population Health Sciences, Bristol Medical School, University of Bristol, UK
| | - Hannah M Sallis
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK; Department of Population Health Sciences, Bristol Medical School, University of Bristol, UK; School of Psychological Science, University of Bristol, Bristol, UK; Centre for Academic Mental Health, Bristol Medical School, University of Bristol, UK
| | - Elis Haan
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK; School of Psychological Science, University of Bristol, Bristol, UK
| | - Laura Schellhas
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK; School of Psychological Science, University of Bristol, Bristol, UK
| | - Marcus R Munafò
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK; School of Psychological Science, University of Bristol, Bristol, UK
| | - Nicholas J Timpson
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK; Department of Population Health Sciences, Bristol Medical School, University of Bristol, UK
| | - Luisa Zuccolo
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK; Department of Population Health Sciences, Bristol Medical School, University of Bristol, UK
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Lu J, Zhang S, Jiang H, Yang L, Hao D, Yang Y, Li X, Chen A, Shao J, Liu X. Gestational diabetes mellitus prediction model: A risk factors analysis of pregnant women with gestational diabetes mellitus but have normal oral glucose tolerance test results in the second trimester of pregnancy. Technol Health Care 2021; 29:57-63. [PMID: 33682745 PMCID: PMC8150482 DOI: 10.3233/thc-218006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND: Oral glucose tolerance test (OGTT) is a standard for the diagnosis of gestational diabetes mellitus (GDM). However, clinically, some cases with normal results were diagnosed as GDM in the third trimester. OBJECTIVE: To establish a risk model based on energy metabolism, epidemiology, and biochemistry that could predict the GDM pregnant women with normal OGTT results in the second trimester. METHODS: Qualitative and quantitative data were analyzed to find out the risk factors, and the binary logistic backward LR regression was used to establish the prediction model of each factor and comprehensive factor, respectively. RESULTS: The risk factors including the rest energy expenditure per kilogram of body weight, oxygen consumption per kilogram of body weight, if more than the weight gain criteria of the Institute of Medicine, the increase of body mass index between the second trimester and pre-pregnancy, and fasting blood glucose. By comparison, the comprehensive model had the best prediction performance, indicating that 85% of high-risk individuals were correctly classified. CONCLUSION: Energy metabolism, epidemiology, and biochemistry had better recognition ability for the GDM pregnant women with normal OGTT results in the second trimester. The addition of metabolic factors in the second trimester also improved the overall prediction performance.
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Affiliation(s)
- Jiayu Lu
- Faculty of Environment and Life Sciences, Beijing University of Technology, Intelligent Physiological Measurement and Clinical Translation, Beijing International Base for Scientific and Technological Cooperation, Beijing, 100124, China
| | - Song Zhang
- Faculty of Environment and Life Sciences, Beijing University of Technology, Intelligent Physiological Measurement and Clinical Translation, Beijing International Base for Scientific and Technological Cooperation, Beijing, 100124, China
| | - Hongqing Jiang
- Haidian Maternal and Children Health Hospital, Beijing, 100080, China
| | - Lin Yang
- Faculty of Environment and Life Sciences, Beijing University of Technology, Intelligent Physiological Measurement and Clinical Translation, Beijing International Base for Scientific and Technological Cooperation, Beijing, 100124, China
| | - Dongmei Hao
- Faculty of Environment and Life Sciences, Beijing University of Technology, Intelligent Physiological Measurement and Clinical Translation, Beijing International Base for Scientific and Technological Cooperation, Beijing, 100124, China
| | - Yimin Yang
- Faculty of Environment and Life Sciences, Beijing University of Technology, Intelligent Physiological Measurement and Clinical Translation, Beijing International Base for Scientific and Technological Cooperation, Beijing, 100124, China
| | - Xuwen Li
- Faculty of Environment and Life Sciences, Beijing University of Technology, Intelligent Physiological Measurement and Clinical Translation, Beijing International Base for Scientific and Technological Cooperation, Beijing, 100124, China
| | - Aiqing Chen
- Beijing Yes Medical Devices Co. Ltd., Beijing, 100152, China
| | - Jing Shao
- Beijing Yes Medical Devices Co. Ltd., Beijing, 100152, China
| | - Xiaohong Liu
- Beijing Yes Medical Devices Co. Ltd., Beijing, 100152, China
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49
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Continuous glucose monitoring during pregnancy in healthy mice. Sci Rep 2021; 11:4450. [PMID: 33627830 PMCID: PMC7904906 DOI: 10.1038/s41598-021-83901-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 01/20/2021] [Indexed: 12/30/2022] Open
Abstract
During pregnancy, metabolic adaptations occur to maintain the balance between maternal and foetal growth, including increased insulin secretion and decreased insulin sensitivity. When the body fails to adjust, gestational diabetes mellitus develops. To gain insight in the pregnancy-induced adaptations, we applied continuous glucose monitoring via telemetric transmitters. We show that continuous glucose monitoring in conscious, non-stressed, freely moving mice throughout the full pregnancy is feasible, accurate and safe. We show that healthy mice during a full pregnancy develop adaptations in glucose homeostasis reminiscent of those in pregnant women. Furthermore, continuous glucose monitoring allows the complete analysis of all aspects of glucose excursions associated with spontaneous feeding episodes, and the thorough analysis of glycaemic variability. In conclusion, continuous glucose monitoring allows a detailed description of the glycaemic status during pregnancy, which will help to unravel specific mechanisms for gestational diabetes mellitus.
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50
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Zhang T, Jiang WR, Xia YY, Mansell T, Saffery R, Cannon RD, De Seymour J, Zou Z, Xu G, Han TL, Zhang H, Baker PN. Complex patterns of circulating fatty acid levels in gestational diabetes mellitus subclasses across pregnancy. Clin Nutr 2021; 40:4140-4148. [PMID: 33610418 DOI: 10.1016/j.clnu.2021.01.046] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 01/03/2021] [Accepted: 01/30/2021] [Indexed: 12/28/2022]
Abstract
BACKGROUND & AIMS To investigate the relationship between maternal serum fatty acid levels and gestational diabetes mellitus (GDM) subtypes across pregnancy. METHODS A total of 680 singleton mothers enrolled in the Complex Lipids in Mothers and Babies (CLIMB) study in Chongqing, China were included. Clinical information and serum samples were collected at gestational weeks (GWs) 11-14, 22-28, and 32-34. 75 g Oral Glucose Tolerance Test (OGTT) was conducted at GW 24-28 and GDM subtypes divided into three groups using International Association of Diabetes and Pregnancy Study Group (IADPSG) guidelines criteria: elevated fasting plasma glucose (FPG group; n = 59); 1-h and/or 2-h post-load glucose (1h/2h-PG group; n = 94); combined group (FPG&1h/2h-PG group; n = 42). Non-GDM pregnancies were included (n = 485) as controls. Twenty fatty acids were quantified in serum using gas chromatography-mass spectrometry (GC-MS) analysis. RESULTS Overall, most serum fatty acid concentrations increased rapidly from the first to second trimester, followed by a plateauing or reduction in the third trimester (p < 0.001). In cross sectional analysis, fatty acid concentrations were significantly higher in the FPG group at GW 11-14 and decreased in the 1h/2h-PG group at GW 32-34, relative to controls. Moreover, higher α-linolenic acid (ALA; the second tertile: adjusted odds ratio [aOR] = 2.53, 95% CI: 1.17 to 5.47; the third tertile: aOR = 2.60, 95% CI: 1.20 to 5.65) and docosahexaenoic acid (DHA; the second tertile: aOR = 2.34, 95% CI: 1.10 to 4.97; the third tertile: aOR = 2.16, 95% CI: 1.00 to 4.63) were significantly associated with a higher risk of GDM in women with elevated fasting plasma glucose at GW 11-14 (first tertile as reference). CONCLUSIONS Our findings highlight the importance of considering GDM subtypes for the individualised management of GDM in pregnancy. ALA and DHA in early pregnancy are associated with a higher risk of FPG-GDM subtype. This has widespread implications when recommending n-3 PUFAs supplementation for women with GDM.
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Affiliation(s)
- Ting Zhang
- Department of Obstetrics and Gynaecology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China; State Key Laboratory of Maternal and Fetal Medicine of Chongqing Municipality, Chongqing Medical University, Chongqing 400016, China
| | - Wen-Rong Jiang
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing 401147, PR China; Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing 401147, China; Stomatological Hospital of Chongqing Medical University, Chongqing 401147, China
| | - Yin-Yin Xia
- School of Public Health and Management, Chongqing Medical University, Chongqing 400016, China
| | - Toby Mansell
- Cancer & Disease Epigenetics, Murdoch Children's Research Institute and Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
| | - Richard Saffery
- Cancer & Disease Epigenetics, Murdoch Children's Research Institute and Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
| | - Richard D Cannon
- Department of Oral Sciences, Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Jamie De Seymour
- Liggins Institute, The University of Auckland, Auckland 1023, New Zealand
| | - Zhen Zou
- Institute of Life Sciences, Chongqing Medical University, Chongqing 400016, China
| | - Ge Xu
- Institute of Life Sciences, Chongqing Medical University, Chongqing 400016, China
| | - Ting-Li Han
- Department of Obstetrics and Gynaecology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China; School of Public Health and Management, Chongqing Medical University, Chongqing 400016, China; Institute of Life Sciences, Chongqing Medical University, Chongqing 400016, China.
| | - Hua Zhang
- Department of Obstetrics and Gynaecology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China; State Key Laboratory of Maternal and Fetal Medicine of Chongqing Municipality, Chongqing Medical University, Chongqing 400016, China.
| | - Philip N Baker
- College of Medicine, Biological Sciences and Psychology, University of Leicester, UK
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