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Daida T, Shin BC, Cepeda C, Devaskar SU. Neurodevelopment Is Dependent on Maternal Diet: Placenta and Brain Glucose Transporters GLUT1 and GLUT3. Nutrients 2024; 16:2363. [PMID: 39064806 PMCID: PMC11279700 DOI: 10.3390/nu16142363] [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: 06/12/2024] [Revised: 07/09/2024] [Accepted: 07/19/2024] [Indexed: 07/28/2024] Open
Abstract
Glucose is the primary energy source for most mammalian cells and its transport is affected by a family of facilitative glucose transporters (GLUTs) encoded by the SLC2 gene. GLUT1 and GLUT3, highly expressed isoforms in the blood-brain barrier and neuronal membranes, respectively, are associated with multiple neurodevelopmental disorders including epilepsy, dyslexia, ADHD, and autism spectrum disorder (ASD). Dietary therapies, such as the ketogenic diet, are widely accepted treatments for patients with the GLUT1 deficiency syndrome, while ameliorating certain symptoms associated with GLUT3 deficiency in animal models. A ketogenic diet, high-fat diet, and calorie/energy restriction during prenatal and postnatal stages can also alter the placental and brain GLUTs expression with long-term consequences on neurobehavior. This review focuses primarily on the role of diet/energy perturbations upon GLUT isoform-mediated emergence of neurodevelopmental and neurodegenerative disorders.
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Affiliation(s)
- Tomoko Daida
- Department of Pediatrics, Division of Neonatology and Developmental Biology and Neonatal Research Center, at the UCLA Children’s Discovery and Innovation Institute, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA; (T.D.); (B.-C.S.)
| | - Bo-Chul Shin
- Department of Pediatrics, Division of Neonatology and Developmental Biology and Neonatal Research Center, at the UCLA Children’s Discovery and Innovation Institute, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA; (T.D.); (B.-C.S.)
| | - Carlos Cepeda
- Intellectual and Developmental Disabilities Research Center and Brain Research Institute, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA
| | - Sherin U. Devaskar
- Department of Pediatrics, Division of Neonatology and Developmental Biology and Neonatal Research Center, at the UCLA Children’s Discovery and Innovation Institute, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA; (T.D.); (B.-C.S.)
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Ghaneialvar H, Mohseni MM, Kenarkoohi A, Kakaee S. Are miR-26a and miR-26b microRNAs potent prognostic markers of gestational diabetes? Health Sci Rep 2024; 7:e2152. [PMID: 38831779 PMCID: PMC11144624 DOI: 10.1002/hsr2.2152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 03/02/2024] [Accepted: 05/08/2024] [Indexed: 06/05/2024] Open
Abstract
Background Gestational diabetes mellitus is a common public health problem, accompanied by complications for the mother and fetus. So, introducing new biomarkers to identify early diabetes is essential. As serum miRNAs are potentially appropriate markers, we investigated miR-26a and miR-26b expression levels in pregnant women with and without gestational diabetes. Method Demographic and clinical characteristics of 40 gestational diabetic patients and 40 healthy controls were assessed. The expression level of miR-26a and miR-26b microRNAs was measured by real-time PCR. Statistical analysis was done with GraphPad Prism software (version 8.4.3). Result The findings of this study showed that the expression level of miR-26a and miR-26b increased in women with gestational diabetes compared with healthy pregnant women, but the increase in expression was only significant for miR-26a (p < 0.05). Conclusion According to the statistical and ROC curves, we suggest miR-26a as a potential biomarker for the early diagnosis of gestational diabetes mellitus.
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Affiliation(s)
- Hori Ghaneialvar
- Biotechnology and Medicinal Plants Research CenterIlam University of Medical SciencesIlamIran
| | | | - Azra Kenarkoohi
- Department of Laboratory Sciences, School of Allied Medical SciencesIlam University of Medical SciencesIlamIran
| | - Saeed Kakaee
- Biotechnology and Medicinal Plants Research CenterIlam University of Medical SciencesIlamIran
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Abdalla MMI, Mohanraj J, Somanath SD. Adiponectin as a therapeutic target for diabetic foot ulcer. World J Diabetes 2023; 14:758-782. [PMID: 37383591 PMCID: PMC10294063 DOI: 10.4239/wjd.v14.i6.758] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 03/25/2023] [Accepted: 04/24/2023] [Indexed: 06/14/2023] Open
Abstract
The global burden of diabetic foot ulcers (DFUs) is a significant public health concern, affecting millions of people worldwide. These wounds cause considerable suffering and have a high economic cost. Therefore, there is a need for effective strategies to prevent and treat DFUs. One promising therapeutic approach is the use of adiponectin, a hormone primarily produced and secreted by adipose tissue. Adiponectin has demonstrated anti-inflammatory and anti-atherogenic properties, and researchers have suggested its potential therapeutic applications in the treatment of DFUs. Studies have indicated that adiponectin can inhibit the production of pro-inflammatory cytokines, increase the production of vascular endothelial growth factor, a key mediator of angiogenesis, and inhibit the activation of the intrinsic apoptotic pathway. Additionally, adiponectin has been found to possess antioxidant properties and impact glucose metabolism, the immune system, extracellular matrix remodeling, and nerve function. The objective of this review is to summarize the current state of research on the potential role of adiponectin in the treatment of DFUs and to identify areas where further research is needed in order to fully understand the effects of adiponectin on DFUs and to establish its safety and efficacy as a treatment for DFUs in the clinical setting. This will provide a deeper understanding of the underlying mechanisms of DFUs that can aid in the development of new and more effective treatment strategies.
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Affiliation(s)
- Mona Mohamed Ibrahim Abdalla
- Department of Physiology, Human Biology Division, School of Medicine, International Medical University, Kuala Lumpur 57000, Malaysia
| | - Jaiprakash Mohanraj
- Department of Biochemistry, Human Biology Division, School of Medicine, International Medical University, Kuala Lumpur 57000, Malaysia
| | - Sushela Devi Somanath
- Department of Microbiology, School of Medicine, International Medical University, Kuala Lumpur 57000, Malaysia
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Lara-Barea A, Sánchez-Lechuga B, Aguilar-Diosdado M, López-Tinoco C. Higher daytime systolic BP, prepregnancy BMI and an elevated sFlt-1/PlGF ratio predict the development of hypertension in normotensive pregnant women. Reprod Biol Endocrinol 2022; 20:175. [PMID: 36564806 PMCID: PMC9783759 DOI: 10.1186/s12958-022-01050-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 12/13/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The risk of hypertensive disorders of pregnancy (HDP) varies in women with gestational diabetes mellitus (GDM), depending on the degree of insulin resistance and is also influenced by obesity. The aim of this study was to evaluate clinical features, blood pressure (BP) profiles and inflammatory markers, to identify patients with an elevated risk of developing HDP. METHODS A total of 146 normotensive pregnant women were studied. We analysed the relationships of BP profiles detected by ambulatory blood pressure monitoring (ABPM) with serum biomarkers and angiogenic factors and their association with the development of HDP. RESULTS Fourteen (9.6%) women developed HDP, of which 11 had GDM and 8 had obesity. Women with HDP had higher values of 24-h and daytime systolic/diastolic BP (113/69 vs. 104/64; 115/72 vs. 106/66 mmHg, respectively; p < 0.05). Higher levels of leptin (10.97 ± 0.82 vs. 10.2 ± 1.11; p = 0.018) andmonocyte chemoattractant protein-1 (MCP-1) (5.24 ± 0.60 vs. 4.9 ± 0.55; p = 0.044) and a higher soluble fms-like tyrosine kinase-1/placental growth factor (sFlt-1/PlGF) ratio (4.37 ± 2.2 vs. 2.2 ± 1.43; p = 0.003) were also observed in the HDP patients. Multivariate analysis showed that a higher sFlt-1/PlGF ratio was associated with an increased risk of developing HDP [OR = 2.02; IC 95%: 1.35-3.05]. Furthermore, higher daytime systolic BP [OR = 1.27; IC 95% 1.00-1.26] and prepregnancy body mass index (BMI) [OR = 1.14; IC 95%: 1.01-1.30] significantly increased the risk of developing HDP. CONCLUSIONS Higher daytime systolic BP values, prepregnancy BMI and the sFlt-1/PlGF ratio are useful for identifying normotensive pregnant women with an increased risk of developing HDP.
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Affiliation(s)
- Almudena Lara-Barea
- Department of Endocrinology and Nutrition, Puerta del Mar Hospital, 11009 Cádiz, Spain
- Biomedical Research and Innovation Institute of Cádiz (INiBICA), Puerta del Mar Hospital, 11009 Cádiz, Spain
| | | | - Manuel Aguilar-Diosdado
- Department of Endocrinology and Nutrition, Puerta del Mar Hospital, 11009 Cádiz, Spain
- Biomedical Research and Innovation Institute of Cádiz (INiBICA), Puerta del Mar Hospital, 11009 Cádiz, Spain
- Department of Medicine, Cadiz University (UCA), 11003 Cádiz, Spain
| | - Cristina López-Tinoco
- Department of Endocrinology and Nutrition, Puerta del Mar Hospital, 11009 Cádiz, Spain
- Biomedical Research and Innovation Institute of Cádiz (INiBICA), Puerta del Mar Hospital, 11009 Cádiz, Spain
- Department of Medicine, Cadiz University (UCA), 11003 Cádiz, Spain
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Blood Pressure Monitoring and Perinatal Outcomes in Normotensive Women with Gestational Diabetes Mellitus. J Clin Med 2022; 11:jcm11051435. [PMID: 35268526 PMCID: PMC8911501 DOI: 10.3390/jcm11051435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Revised: 02/25/2022] [Accepted: 03/04/2022] [Indexed: 11/26/2022] Open
Abstract
Alterations in ambulatory blood pressure detected by monitoring (ABPM) have been associated with perinatal complications in hypertensive pregnant women. Aim: To establish the relationships between the blood pressure (BP) profiles detected by ABPM and adverse perinatal outcomes in normotensive women with gestational diabetes mellitus (GDM). Methods: A prospective study of normotensive women in whom 24 h ABPM was performed at 28–32 weeks of pregnancy. The obstetric and perinatal outcomes were evaluated. Results: Two hundred patients were included. Thirty-seven women with GDM and obesity had significantly higher mean systolic BP (SBP) and nocturnal SBP and diastolic BP (DBP) compared to women with only GDM (n = 86). Nocturnal SBP (OR = 1.077; p = 0.015) and obesity (OR = 1.131; p = 0.035) were risk factors for the development of hypertensive disorders of pregnancy (HDPs). Mothers of newborns with neonatal complications (n = 27) had higher nocturnal SBP (103.8 vs. 100 mmHg; p = 0.047) and DBP (62.7 vs. 59.4; p = 0.016). Women who delivered preterm (n = 10) had higher BP and a non-dipper pattern (p = 0.005). Conclusions: Nocturnal SBP was a predictor of HDPs in normotensive women with obesity or GDM. Alterations in ABPM in these patients were associated with poor obstetric and perinatal outcomes.
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The correlation between serum inflammatory, antioxidant, glucose handling biomarkers, and Dietary Antioxidant Index (DAI) and the role of DAI in obesity/overweight causation: population-based case-control study. Int J Obes (Lond) 2021; 45:2591-2599. [PMID: 34417552 DOI: 10.1038/s41366-021-00944-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 07/23/2021] [Accepted: 08/11/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Obesity is a multifactorial disease, and about 40% of world adults are overweight, and about 20% are obese. Diet is one of the most important factors in the causality of obesity. The interactions between the diet and gut microbiota or chronic inflammation pathways highlight the importance of its various aspects in the incidence and prevalence of obesity. At the same time, diet is a combination of several antioxidants that are needed together for the body's antioxidant system. The Dietary Antioxidant Index (DAI) is a valid nutritional tool, and its correlation has been studied concerning total antioxidant capacity and malondialdehyde. The study aimed to examine the relationship between the DAI and the odds of obesity. We hypothesized that a higher DAI score indicating a predominantly antioxidant diet has a protective effect against odds of obesity. METHODS In this population-based case-control study, 812 participants with a higher body mass index (BMI) than 25 were selected as the case group. Also, 793 participants with BMI in the range of 17.9-24.9 were selected as the control group. A valid and reliable 124-item food frequency questionnaire (FFQ) was used to assess dietary intake. Based on FFQ data, we summed up the standardized intake of the major dietary antioxidants, including vitamin A, E, C, selenium, zinc, and manganese, to calculate DAI. RESULTS In a multivariable adjusting model, there was a significant association between DAI (as a continuous variable) and BMI (odds ratio (OR) = 0.95; 95% CI: 0.92-0.99; P value = 0.02). Also, there was a significant association between DAI (as a categorized variable) and body surface area with multivariable adjusting model (OR = 0.79; 95% CI: 0.64-0.98; P value = 0.04). CONCLUSION In conclusion, the DAI can accurately predict some serum antioxidant and anti-inflammatory levels along with glucose handling markers.
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Ouyang H, Wu N. Effects of Different Glucose-Lowering Measures on Maternal and Infant Outcomes in Pregnant Women with Gestational Diabetes: A Network Meta-analysis. Diabetes Ther 2021; 12:2715-2753. [PMID: 34482529 PMCID: PMC8479018 DOI: 10.1007/s13300-021-01142-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 08/09/2021] [Indexed: 12/11/2022] Open
Abstract
INTRODUCTION A network meta-analysis was conducted to compare and rank the effects of different glucose-lowering measures on maternal and infant outcomes in pregnant women with gestational diabetes mellitus (GDM). METHODS We searched the PubMed, CNKI, Embase, Cochrane Library, Wanfang, and Weipu databases for relevant studies published between database establishment and June 2021. Study retrieval involved subject-heading and keyword searches. Randomized controlled trials (RCTs) with different glucose-lowering treatments for GDM patients were included. The Cochrane tool was used to assess bias risk. Pairwise and network meta-analyses were used to compare and rank the effects of different hypoglycemic measures on maternal and infant outcomes in pregnant women with GDM. RESULTS We included 41 RCTs involving 6245 pregnant women with GDM. Patients treated with insulin had a higher incidence of neonatal intensive care unit (NICU) occupancy (1.3, 95% CI 1.0-1.7) than those treated with metformin. The insulin (1.5, 95% CI 1.1-2.1 and 1.8, 95% CI 1.0-3.3) and glyburide (2.0, 95% CI 1.2-3.2 and 2.5, 95% CI 1.1-8.4) groups exhibited higher incidences of neonatal hypoglycemia and large for gestational age (LGA) newborns than the metformin group. The glyburide group exhibited a lower probability of cesarean section than the metformin (0.76, 95% CI 0.55-1.0) and insulin (0.71, 95% CI 0.52-0.96) groups. Preeclampsia incidence in the diet and exercise groups was significantly lower than in the metformin (0.19, 95% CI 0.043-0.72) and insulin (0.15, 95% CI 0.032-0.52) groups. No intervention significantly reduced the incidences of macrosomia, preterm birth, gestational hypertension, or respiratory distress syndrome (RDS). The ranking results showed that the metformin group had the lowest rates of neonatal hypoglycemia, macrosomia, LGA, and NICU occupancy. The glyburide group had the lowest NICU occupancy and cesarean section rates and the highest neonatal hypoglycemia, LGA, preeclampsia, and gestational hypertension rates. The diet and exercise group had the lowest preterm delivery and preeclampsia rates and the highest NICU occupancy rate. CONCLUSION Metformin is a potentially superior choice for GDM treatment because it is associated with minimal incidences of multiple adverse pregnancy outcome indicators and does not lead to high values of certain adverse outcome indices. Other hypoglycemic agent or diet groups exhibit high incidences of certain adverse outcomes. Therefore, when selecting a GDM treatment strategy, the efficacies and risks of different treatment programs should be evaluated according to the scenario in hand.
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Affiliation(s)
- Hong Ouyang
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Na Wu
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, China.
- Clinical Skills Practice Teaching Center, Shengjing Hospital of China Medical University, Shenyang, China.
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Abdalla MMI. Salivary resistin level and its association with insulin resistance in obese individuals. World J Diabetes 2021; 12:1507-1517. [PMID: 34630903 PMCID: PMC8472494 DOI: 10.4239/wjd.v12.i9.1507] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 05/11/2021] [Accepted: 07/15/2021] [Indexed: 02/06/2023] Open
Abstract
The escalating global burden of type 2 diabetes mellitus necessitates the implementation of strategies that are both more reliable and faster in order to improve the early identification of insulin resistance (IR) in high-risk groups, including overweight and obese individuals. The use of salivary biomarkers offers a promising alternative to serum collection because it is safer, more comfortable, and less painful to obtain saliva samples. As obesity is the foremost contributory factor in IR development, the adipocytokines such as leptin, adiponectin, resistin, and visfatin secreted from the adipose tissue have been studied as potential reliable biomarkers for IR. Measurement of salivary adipokines as predictors for IR has attracted widespread attention because of the strong correlation between their blood and salivary concentrations. One of the adipokines that is closely related to IR is resistin. However, there are conflicting findings on resistin’s potential role as an etiological link between obesity and IR and the reliability of measuring salivary resistin as a biomarker for IR. Hence this study reviewed the available evidence on the potential use of salivary resistin as a biomarker for IR in order to attempt to gain a better understanding of the role of resistin in the development of IR in obese individuals.
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Hewage SS, Wu S, Neelakantan N, Yoong J. Systematic review of effectiveness and cost-effectiveness of lifestyle interventions to improve clinical diabetes outcome measures in women with a history of GDM. Clin Nutr ESPEN 2019; 35:20-29. [PMID: 31987117 DOI: 10.1016/j.clnesp.2019.10.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 09/21/2019] [Accepted: 10/14/2019] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Lifestyle interventions have been shown to be both effective and cost-effective in reducing diabetes and metabolic risk in high-risk populations. We systematically reviewed the effectiveness and cost-effectiveness of lifestyle interventions on anthropometric, glycemic and cardiovascular outcomes in women with previous gestational diabetes mellitus (GDM). METHOD Relevant randomized control trials (RCT) were identified by searching multiple electronic databases through 20th June 2018. Data were pooled using random-effects models. The review protocol was registered on the PROSPERO international prospective register of systematic reviews (PROSPERO 2016: CRD42018108870). RESULTS Twenty-one studies met the inclusion criteria and 16 studies with outcome data were analyzed in the meta-analysis. No RCT studies included cost-effectiveness data on lifestyle interventions. The pooled estimate for postpartum weight showed a significant mean reduction in the intervention arm (-1.8 kg [95% CI: -2.9, -0.6; p = 0.002; I2 = 92.2%; p < 0.05]). Further, the effect of lifestyle intervention on weight change was significantly greater in studies of longer duration. Most of the other endpoints had modest improvements but only anthropometric endpoints were statistically significant. However, there was high heterogeneity between the studies. CONCLUSIONS Lifestyle interventions showed statistically and clinically significant improvements in anthropometric outcomes. However, more research is needed to explore lifestyle effects on glycemic and cardiovascular risk factors and to establish cost-effectiveness. Methodologically sound, large scale studies on diverse ethnicities and with longer follow-up would establish the real effect of lifestyle interventions to reduce diabetes risk in women with previous GDM.
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Affiliation(s)
- Sumali S Hewage
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore.
| | - Shishi Wu
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - Nithya Neelakantan
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - Joanne Yoong
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore; University of Southern California, Center for Economic and Social Research, USA
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Chatzakis C, Goulis DG, Mareti E, Eleftheriades M, Zavlanos A, Dinas K, Sotiriadis A. Prevention of gestational diabetes mellitus in overweight or obese pregnant women: A network meta-analysis. Diabetes Res Clin Pract 2019; 158:107924. [PMID: 31738997 DOI: 10.1016/j.diabres.2019.107924] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 10/26/2019] [Accepted: 11/06/2019] [Indexed: 12/27/2022]
Abstract
AIMS Several interventions have been implemented to prevent the development of gestational diabetes mellitus (GDM) in obese pregnant women, including physical exercise programs, and administration of metformin, vitamin D and probiotics. The aim of this network meta-analysis was to compare the efficiency of these interventions and identify the optimal. MATERIALS A network meta-analysis of randomized trials was performed comparing the different interventions for the development of GDM in overweight or obese women, either to each other or placebo/no intervention. A search was conducted in four electronic databases and grey literature sources. The primary outcome was the development of GDM; secondary outcomes were other complications of pregnancy. RESULTS The meta-analysis included 23 studies (4237 participants). None of the interventions was superior compared with placebo/no intervention for the prevention of GDM. Metformin and physical exercise were superior to placebo/no intervention for gestational weight gain (MD -1.21, 95% CI -2.14 to -0.28 and MD -0.96, 95% CI -1.69 to -0.22, respectively). Metformin was superior to placebo/no intervention for caesarean sections and admission to NICU. CONCLUSIONS Interventions aiming to prevent the development of GDM in overweight/obese women are not effective, when applied during pregnancy.
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Affiliation(s)
- Christos Chatzakis
- 2(nd) Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Konstaninoupoleos 49, Thessaloniki, Greece
| | - Dimitrios G Goulis
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Ag. Pavlou 76, Thessaloniki, Greece
| | - Evangelia Mareti
- 2(nd) Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Konstaninoupoleos 49, Thessaloniki, Greece
| | - Makarios Eleftheriades
- 2(nd) Department of Obstetrics and Gynecology, Medical School, University of Athens, Aretaieio Hospital, Vas. Sofia 76, Athens, Greece
| | - Apostolos Zavlanos
- 2(nd) Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Konstaninoupoleos 49, Thessaloniki, Greece
| | - Konstantinos Dinas
- 2(nd) Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Konstaninoupoleos 49, Thessaloniki, Greece
| | - Alexandros Sotiriadis
- 2(nd) Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Konstaninoupoleos 49, Thessaloniki, Greece.
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Ngwira A. Spatial quantile regression with application to high and low child birth weight in Malawi. BMC Public Health 2019; 19:1593. [PMID: 31783829 PMCID: PMC6884851 DOI: 10.1186/s12889-019-7949-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Accepted: 11/13/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Child low and high birth weight are important public health problems. Many studies have looked at factors of low and high birth weight using mean regression. This study aimed at using quantile regression to find out determinants of low and high birth weight. METHODS Spatial quantile regression models at 0.05 and 0.95 percentiles of birth weight were fitted to 13,087 children birth weight in kilograms using Malawi demographic health survey data of 2010 study. Full Bayesian method by integrated nested Laplace approximations (INLA) was used to estimate the model. Second order random walk priors were assigned for mother age and antenatal visits for pregnancy while Gaussian markov random field prior was used for district of the child. RESULTS Residual spatial patterns reveal areas in the southern region promoting high birth weight while areas in the central and northern region promote low birth weight. Most fixed effects findings are consistent with the literature. Richest family, normal mother body mass index (BMI), mother over weight (BMI > 25 kg/m2), birth order 2-3, mother secondary education and height (≥150 cm) negate low birth weight while weight 45-70 kg promote low birth weight. Birth order category 6+, mother height (≥150 cm) and poor wealth quintile, promote high birth weight, while richer and richest wealth quintiles and education categories: primary, secondary, and higher, and mother overweight (BMI > 25 kg/m2) reduce high birth weight. Antenatal visits for pregnancy reduce both low and high birth weight. CONCLUSION Strategies to reduce low and high birth weight should simultaneously address mother education, weight gain during pregnancy and poverty while targeting areas increasing low and high birth weight.
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Affiliation(s)
- Alfred Ngwira
- Department of Basic Sciences, Lilongwe University of Agriculture and Natural Resources, Lilongwe, Malawi.
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Shin BC, Ghosh S, Dai Y, Byun SY, Calkins KL, Devaskar SU. Early life high-fat diet exposure maintains glucose tolerance and insulin sensitivity with a fatty liver and small brain size in the adult offspring. Nutr Res 2019; 69:67-81. [PMID: 31639589 PMCID: PMC6934265 DOI: 10.1016/j.nutres.2019.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 07/10/2019] [Accepted: 08/02/2019] [Indexed: 11/22/2022]
Abstract
Diet during pregnancy has long lasting consequences on the offspring, warranting a study on the impact of early exposure to a high fat diet on the adult offspring. We hypothesized that a prenatal n-6 enriched diet will have adverse metabolic outcomes on the adult offspring that may be reversed with a postnatal n-3 enriched diet. To test this hypothesis, we examined the adult offspring from three groups: (1) n-6 group: during gestation and lactation, dams consumed an n-6 polyunsaturated fatty acid enriched diet, (2) n-3 group: gestational n-6 diet was followed by an n-3 enriched diet during lactation, and (3) a control (CD) group that received standard diet throughout gestation and lactation. Offspring from all groups weaned to a control diet ad libitum. Beginning at postnatal day 2 (P < .03) and persisting at 360 days in males (P < .04), an increase in hypothalamic AgRP expression occurred in the n-6 and n-3 groups, with an increase in food intake (P = .01), and the n-3 group displaying lower body (P < .03) and brain (P < .05) weights. At 360 days, the n-6 and n-3 groups remained glucose tolerant and insulin sensitive, with increased phosphorylated-AMP-activated protein kinase (P < .05). n-6 group developed hepatic steatosis with reduced hepatic reflected as higher plasma microRNA-122 (P < .04) that targets pAMPK. We conclude that early life exposure to n-6 and n-3 led to hypothalamic AgRP-related higher food intake, with n-6 culminating in a fatty liver partially mitigated by postnatal n-3. While both diets preserved glucose tolerance and insulin sensitivity, postnatal n-3 displayed detrimental effects on the brain.
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Affiliation(s)
- Bo-Chul Shin
- Division of Neonatology and Developmental Biology, Neonatal Research Center, Department of Pediatrics, David Geffen School of Medicine UCLA, Los Angeles, CA 90095-1752
| | - Shubhamoy Ghosh
- Division of Neonatology and Developmental Biology, Neonatal Research Center, Department of Pediatrics, David Geffen School of Medicine UCLA, Los Angeles, CA 90095-1752
| | - Yun Dai
- Division of Neonatology and Developmental Biology, Neonatal Research Center, Department of Pediatrics, David Geffen School of Medicine UCLA, Los Angeles, CA 90095-1752
| | - Shin Yun Byun
- Division of Neonatology and Developmental Biology, Neonatal Research Center, Department of Pediatrics, David Geffen School of Medicine UCLA, Los Angeles, CA 90095-1752
| | - Kara L Calkins
- Division of Neonatology and Developmental Biology, Neonatal Research Center, Department of Pediatrics, David Geffen School of Medicine UCLA, Los Angeles, CA 90095-1752
| | - Sherin U Devaskar
- Division of Neonatology and Developmental Biology, Neonatal Research Center, Department of Pediatrics, David Geffen School of Medicine UCLA, Los Angeles, CA 90095-1752.
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13
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Giannakou K, Evangelou E, Yiallouros P, Christophi CA, Middleton N, Papatheodorou E, Papatheodorou SI. Risk factors for gestational diabetes: An umbrella review of meta-analyses of observational studies. PLoS One 2019; 14:e0215372. [PMID: 31002708 PMCID: PMC6474596 DOI: 10.1371/journal.pone.0215372] [Citation(s) in RCA: 74] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Accepted: 04/01/2019] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND/OBJECTIVE Gestational diabetes mellitus (GDM) is a common pregnancy complication, with complex disease mechanisms, and several risk factors may contribute to its onset. We performed an umbrella review to summarize the evidence from meta-analyses of observational studies on risk factors associated with GDM, evaluate whether there are indications of biases in this literature and identify which of the previously reported associations are supported by convincing evidence. METHODS We searched PubMed and ISI Web of Science from inception to December 2018 to identify meta-analyses examining associations between putative risk factors for GDM. For each meta-analysis we estimated the summary effect size, the 95% confidence interval, the 95% prediction interval, the between-study heterogeneity, evidence of small-study effects, and evidence of excess-significance bias. RESULTS Thirty eligible meta-analyses were identified, providing data on 61 associations. Fifty (82%) associations had nominally statistically significant findings (P<0.05), while only 15 (25%) were significant at P<10-6 under the random-effects model. Only four risk factors presented convincing evidence:, low vs. normal BMI (cohort studies), BMI ~30-35 kg/m2 vs. normal BMI, BMI >35 kg/m2 vs. normal BMI, and hypothyroidism. CONCLUSIONS The compilation of results from synthesis of observational studies suggests that increased BMI and hypothyroidism show the strongest consistent evidence for an association with GDM. Diet and lifestyle modifications in pregnancy should be tested in large randomized trials. Our findings suggest that women with known thyroid disease may be offered screening for GDM earlier in pregnancy.
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Affiliation(s)
- Konstantinos Giannakou
- Cyprus International Institute for Environmental & Public Health, Cyprus University of Technology, Limassol, Cyprus
| | - Evangelos Evangelou
- Department of Hygiene and Epidemiology, University of Ioannina, School of Medicine, University Campus, Ioannina, Greece
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, Norfolk Place, London, United Kingdom
| | | | - Costas A. Christophi
- Cyprus International Institute for Environmental & Public Health, Cyprus University of Technology, Limassol, Cyprus
| | - Nicos Middleton
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| | | | - Stefania I. Papatheodorou
- Cyprus International Institute for Environmental & Public Health, Cyprus University of Technology, Limassol, Cyprus
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, Massachusetts, United States of America
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Brown AM, Rajeswari D, Williams P, Lowndes A. Managing gestational diabetes mellitus: Audit data of outcomes for women and neonates. ACTA ACUST UNITED AC 2018. [DOI: 10.12968/bjom.2018.26.12.775] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Anna-Maria Brown
- Midwifery Teaching Fellow, Faculty of Health and Medical Sciences, University of Surrey
| | - Devannas Rajeswari
- Obstetrics and Gynaecology consultant, Ashford and St Peter's NHS Foundation Trust
| | - Peter Williams
- Statistical consultant, Department of Maths, University of Surrey
| | - Alison Lowndes
- Maternity systems and coding administrator, Ashford and St Peter's NHS Foundation Trust
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Ryan DK, Haddow L, Ramaesh A, Kelly R, Johns EC, Denison FC, Dover AR, Reynolds RM. Early screening and treatment of gestational diabetes in high-risk women improves maternal and neonatal outcomes: A retrospective clinical audit. Diabetes Res Clin Pract 2018; 144:294-301. [PMID: 30244050 DOI: 10.1016/j.diabres.2018.09.013] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 09/04/2018] [Accepted: 09/13/2018] [Indexed: 11/30/2022]
Abstract
AIMS Evidence suggests that screening for gestational diabetes (GDM) occurs too late in pregnancy, when changes in glucose metabolism and fetal growth rates can already be detected. In August 2016 NHS Lothian began screening women with risk factors for GDM during early pregnancy (11-13 weeks). We hypothesised that an earlier identification and treatment of dysglycaemia would improve pregnancy outcomes compared to previous standard care. METHODS We compared management and outcomes for singleton pregnancies with GDM delivering at Royal Infirmary Edinburgh, UK, diagnosed through routine or early screening from 01/01/2015-31/10/2017 (routine screening n = 335, early screening n = 241). RESULTS Early screening increased the proportion of women diagnosed before 24 weeks' gestation (n = 59/335, 17.6% vs n = 103/241, 42.7%, p < 0.001) but did not change the average monthly rate of diagnosis. Early screening increased the median duration of GDM during pregnancy (71 vs 93 days of gestation, p < 0.001) with no significant changes in the pharmacological management. Early screening improved the primary composite outcome (emergency caesarean section, neonatal hypoglycaemia and macrosomia; n = 138/335, 41.2% vs n = 73/241, 30.3%, adjusted Odds Ratio [95% confidence interval] 0.62 [0.43-0.91]. CONCLUSIONS There is a role for early screening and management of GDM however it is unclear whether this represents a cost-effective intervention.
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Affiliation(s)
| | | | | | - Rod Kelly
- NHS Lothian - Neonatology, Royal Infirmary of Edinburgh, Scottish Specialist Transport and Retrieval Service, Neonatal Transport, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - Emma C Johns
- Tommy's Centre for Maternal and Fetal Health, MRC Centre for Reproductive Health, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Fiona C Denison
- Tommy's Centre for Maternal and Fetal Health, MRC Centre for Reproductive Health, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Anna R Dover
- Edinburgh Centre for Endocrinology and Diabetes, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - Rebecca M Reynolds
- Tommy's Centre for Maternal and Fetal Health, MRC Centre for Reproductive Health, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK; Edinburgh Centre for Endocrinology and Diabetes, Royal Infirmary of Edinburgh, Edinburgh, UK; University/British Heart Foundation Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK.
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Parveen T, Sheikh Z, Jam S, Akhtar AZ, Hassan AA, Ghayas S. Optimal Gestational Weight Gain Based on Different Body Mass Index and its Relation with Adverse Pregnancy Outcome in a Tertiary Care Hospital. ACTA ACUST UNITED AC 2018. [DOI: 10.21089/njhs.32.0054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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17
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Sánchez-Lechuga B, Lara-Barea A, Córdoba-Doña JA, Montero Galván A, Abal Cruz A, Aguilar-Diosdado M, López-Tinoco C. Usefulness of blood pressure monitoring in patients with gestational diabetes mellitus. ACTA ACUST UNITED AC 2018; 65:394-401. [PMID: 29680782 DOI: 10.1016/j.endinu.2018.02.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 02/15/2018] [Accepted: 02/20/2018] [Indexed: 10/17/2022]
Abstract
BACKGROUND AND OBJECTIVE Gestational diabetes mellitus (GDM) is associated to an increased risk of pregnancy-induced hypertension (PIH). Ambulatory blood pressure monitoring (ABPM) has been used to detect PIH and preeclampsia, but few data are currently available on its use in women with GDM. The aim of this study was to achieve early identification in women with GDM of BP profiles (detected by ABPM) that could define a population at greater risk of developing PIH and preeclampsia. MATERIAL AND METHODS A prospective study of 93 normotensive women with GDM in whom 24-h ABPM was performed (using a Spacelabs 90207 monitor) at 28-32 weeks of pregnancy. Clinical and laboratory variable and obstetric and perinatal outcomes were analyzed. RESULTS Mean age was 34.8±4.39years, and 5.4% of patients developed PIH. Higher levels of HbA1c (P=.005) and microalbumin (P=.001) were seen in patients with PIH. Patients with non-dipper patterns (50.5%) had higher values of night-time systolic BP (106.7 vs 98.4mmHg) and night-time diastolic BP (64.8 vs 57.2mmHg) (P<.001). Lower birth weights (3,084.57 vs 3,323.7) (P=.021) and shorter gestational age at delivery (38.67 vs 39.27 weeks) (P=.04) were found in women with non-dipper pattern. High night-time systolic BP significantly increased the chance of developing PIH (OR: 1.18; 95%CI: 1.00-1.39; P=.043). CONCLUSIONS Patients with GDM have BP changes, with predominance of the non-dipper pattern and higher night-time systolic and diastolic BP, changes that could be useful predictors of PIH. High night-time systolic BP values increase the risk of developing PIH. Further studies are needed to ascertain the relationships between BP changes and obstetric and perinatal complications.
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Affiliation(s)
- Begoña Sánchez-Lechuga
- Servicio de Endocrinología y Nutrición, Hospital Universitario Puerta del Mar, Cádiz, España
| | - Almudena Lara-Barea
- Servicio de Endocrinología y Nutrición, Hospital Universitario Puerta del Mar, Cádiz, España
| | | | - Ana Montero Galván
- Servicio de Endocrinología y Nutrición, Hospital Universitario Puerta del Mar, Cádiz, España
| | - Alicia Abal Cruz
- Servicio de Endocrinología y Nutrición, Hospital Universitario Puerta del Mar, Cádiz, España
| | - Manuel Aguilar-Diosdado
- Servicio de Endocrinología y Nutrición, Hospital Universitario Puerta del Mar, Facultad de Medicina, Universidad de Cádiz, Cádiz, España
| | - Cristina López-Tinoco
- Servicio de Endocrinología y Nutrición, Hospital Universitario Puerta del Mar, Facultad de Medicina, Universidad de Cádiz, Cádiz, España.
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Collins K, Oehmen R, Mehta S. Effect of obesity on neonatal hypoglycaemia in mothers with gestational diabetes: A comparative study. Aust N Z J Obstet Gynaecol 2017; 58:291-297. [DOI: 10.1111/ajo.12717] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2017] [Accepted: 08/16/2017] [Indexed: 11/29/2022]
Affiliation(s)
| | - Raoul Oehmen
- School of Medicine; University of Notre Dame Australia; Fremantle Western Australia Australia
| | - Shailender Mehta
- School of Medicine; University of Notre Dame Australia; Fremantle Western Australia Australia
- Department of Neonatology; Fiona Stanley Hospital; Perth Western Australia Australia
- Telethon Kids Institute; Perth Western Australia Australia
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Nilsson C, Andersson C, Ursing D, Strevens H, Landin-Olsson M. Outcomes of women with gestational diabetes mellitus in Sweden. Eur J Obstet Gynecol Reprod Biol 2015; 193:132-5. [PMID: 26295790 DOI: 10.1016/j.ejogrb.2015.07.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2015] [Revised: 06/18/2015] [Accepted: 07/30/2015] [Indexed: 01/24/2023]
Abstract
OBJECTIVE The number of women with gestational diabetes mellitus (GDM) during pregnancy is increasing around the world and in our region in the south Sweden 1.2% of all pregnant women received the GDM diagnosis in the 90s and now it is about 2.2%. The aim of this study was to compare women with GDM 1995-99 against women with GDM 2012-13 regarding eventual differences in demographics and pregnancy outcome. STUDY DESIGN In our region in Sweden, all pregnant women are tested for GDM with a 2-h 75g oral glucose tolerance test and the 2-h cut off value for GDM is ≥10.0mmol/l in capillary plasma glucose. 1995-99 there were 131 women with GDM and their medical journals were compared against the 210 women with GDM during 2012-13. The same screening and diagnostic method was uses during the whole time period. RESULTS In the 2012-13 GDM pregnancies there were more non-Scandinavian women, more women with insulin treatment during pregnancy and a higher frequency of cesarean deliveries compared to 1995. First weight of the women during GDM pregnancy 2012-13 was significantly higher than the weight of women with GDM 1995-99, 71kg (43-138; n=201) and 65kg (43-133; n=125) (p=0.008) respectively. However, there was no significant difference in weight of the mother at delivery. Birth weight of the child in GDM pregnancies 1995-99 was 3722.4g±578.2 (n=109; p=0.009), and in GDM pregnancies 2012-13 3555.6g±465.8 (n=162). CONCLUSION Even though women with GDM 2012-13 weigh more when they start the pregnancy there is no difference in weight at delivery compared to women with GDM 1995-99. This is also reflected on the newborn, that 2012-13 had significantly lower birth weight but with the same gestational length as 1995-1999. We believe that this is due to a more active and intense treatment of women with GDM during pregnancy together with higher frequency of cesarean delivery. Prevention of large infants is crucial to avoid complications during delivery.
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Affiliation(s)
- Charlotta Nilsson
- Department of Pediatrics, Institution of Clinical Science, Helsingborg Hospital, Lund University, Sweden.
| | - Caroline Andersson
- Department of Pediatrics, Institution of Clinical Science, Helsingborg Hospital, Lund University, Sweden
| | - Dag Ursing
- Department of Endocrinology, Institution of Clinical Science, Skåne University Hospital, Lund University, Sweden
| | - Helena Strevens
- Department of Obstetrics and Gynecology, Institution of Clinical Science, Skåne University Hospital, Lund University, Sweden
| | - Mona Landin-Olsson
- Department of Endocrinology, Institution of Clinical Science, Skåne University Hospital, Lund University, Sweden
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20
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Ibero-Baraibar I, Perez-Cornago A, Ramirez MJ, Martínez JA, Zulet MA. An Increase in Plasma Homovanillic Acid with Cocoa Extract Consumption Is Associated with the Alleviation of Depressive Symptoms in Overweight or Obese Adults on an Energy Restricted Diet in a Randomized Controlled Trial. J Nutr 2015; 146:897S-904S. [PMID: 26962189 DOI: 10.3945/jn.115.222828] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Revised: 10/08/2015] [Accepted: 12/08/2015] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Obesity has been associated with various health disorders, including psychological alterations. Cocoa consumption and weight management may produce a beneficial effect on these problems. OBJECTIVE The purpose of this study was to investigate the effect of cocoa extract supplementation as part of an energy-restricted diet on psychological status and peripheral dopaminergic activity in overweight or obese middle-aged subjects. METHODS In a 4-wk, double-blind, randomized, placebo-controlled parallel nutritional intervention, 22 men and 25 women [mean ± SD age: 57 ± 5 y; body mass index (kg/m2): 30.6 ± 2.3] were studied. After a 1-wk run-in period, volunteers consumed 15% energy-restricted diets; one-half of the volunteers were randomly assigned to receive ready-to-eat meals supplemented with 1.4 g cocoa extract/d (645 mg total polyphenols/d), whereas the rest of the volunteers received the same meals without cocoa supplementation. Plasma monoamines [dopamine, dopac, and homovanillic acid (HVA)], monoamine oxidase (MAO), and psychological status (anxiety and depressive symptoms) were analyzed in fasting participants at baseline and endpoint. Data were analyzed over time, and regression and correlation analyses were conducted to determine the relation between variables. RESULTS Depressive symptoms decreased in both groups after the intervention (control: -9.4%, P < 0.001; cocoa: -6.3%, P = 0.008), but anxiety symptoms did not. The increase in plasma HVA was 11.5% greater in the cocoa group than in the control group (P = 0.016), but plasma dopamine, dopac, and MAO changes did not differ between groups. A negative relation between changes in depressive symptoms and changes in plasma HVA was observed in the cocoa group (β = -0.39, P = 0.029). Moreover, the change in plasma dopamine was positively associated with the change in methyl-catechin-O-glucoronide in the cocoa-supplemented group (r = 0.69, P = 0.019). CONCLUSION The intake of cocoa extract by participants consuming a 15% energy-restricted diet contributed to an increase in plasma HVA concentrations. This change was associated with a reduction in depressive symptoms, suggesting a potential effect of cocoa extract intake on this relation. The present results are secondary analyses of a clinical trial that was registered at www.clinicaltrials.gov as NCT01596309.
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Affiliation(s)
- Idoia Ibero-Baraibar
- Department of Nutrition, Food Science, and Physiology, University of Navarra, Pamplona, Spain.,Center for Nutrition Research, University of Navarra, Pamplona, Spain
| | - Aurora Perez-Cornago
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain
| | - Maria J Ramirez
- Department of Pharmacology and Toxicology, University of Navarra, Pamplona, Spain.,Navarra Institute for Health Research, Pamplona, Spain
| | - J Alfredo Martínez
- Department of Nutrition, Food Science, and Physiology, University of Navarra, Pamplona, Spain.,Center for Nutrition Research, University of Navarra, Pamplona, Spain.,Navarra Institute for Health Research, Pamplona, Spain.,Biomedical Research Centre Network in Physiopathology of Obesity and Nutrition, National Institute of Health Carlos III, Madrid, Spain
| | - M Angeles Zulet
- Department of Nutrition, Food Science, and Physiology, University of Navarra, Pamplona, Spain.,Center for Nutrition Research, University of Navarra, Pamplona, Spain.,Navarra Institute for Health Research, Pamplona, Spain.,Biomedical Research Centre Network in Physiopathology of Obesity and Nutrition, National Institute of Health Carlos III, Madrid, Spain
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21
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McDonald R, Karahalios A, Le T, Said J. A Retrospective Analysis of the Relationship between Ethnicity, Body Mass Index, and the Diagnosis of Gestational Diabetes in Women Attending an Australian Antenatal Clinic. Int J Endocrinol 2015; 2015:297420. [PMID: 26504462 PMCID: PMC4609521 DOI: 10.1155/2015/297420] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2015] [Revised: 08/10/2015] [Accepted: 08/13/2015] [Indexed: 12/13/2022] Open
Abstract
Purpose. To estimate the prevalence of gestational diabetes mellitus (GDM) in a multiethnic population, assess the association between country of birth (COB) and GDM, and assess whether the association varies by body mass index (BMI). Methods. A retrospective study of 5260 pregnant women attending Sunshine Hospital, Australia, between 1st July 2012 and 30th June 2013. We fitted logistic regression models to assess the association between COB and GDM. An interaction between BMI and COB was assessed by likelihood ratio test. Results. In the 4610 included in our analysis, most common were women born in Australia or New Zealand (ANZ, 1932, 41.9%) and in Southeast Asia (922, 20%). GDM was diagnosed in 606 (13.2%) women. After adjusting for confounders, women from East Asia were most likely to develop GDM (37, 24.0%) and 5-fold more likely than women from ANZ (OR = 4.77, 95% CI: 3.12, 7.31, p < 0.001). Women from other Asian countries had a 3-fold increased risk of GDM compared to women from ANZ. There was no evidence of an interaction by BMI (p = 0.24). Conclusions. Women born in Asia have higher risk of GDM compared to women born in ANZ. These data provide support for including COB in GDM management policies.
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Affiliation(s)
- Rebecca McDonald
- Monash Women's, Monash Health, 246 Clayton Road, Clayton, VIC 3168, Australia
- Women's and Children's Health, Sunshine Hospital, Western Health, 176 Furlong Road, Saint Albans, VIC 3021, Australia
| | - Amalia Karahalios
- Office for Research, Western Centre for Health Research & Education, 176 Furlong Road, Saint Albans, VIC 3021, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie Street, Carlton, VIC 3053, Australia
| | - Thao Le
- Women's and Children's Health, Sunshine Hospital, Western Health, 176 Furlong Road, Saint Albans, VIC 3021, Australia
- Department of Obstetrics and Gynaecology, The University of Melbourne, Parkville, VIC 3052, Australia
| | - Joanne Said
- Department of Obstetrics and Gynaecology, The University of Melbourne, Parkville, VIC 3052, Australia
- Maternal Fetal Medicine, Sunshine Hospital, Western Health, 176 Furlong Road, Saint Albans, VIC 3021, Australia
- *Joanne Said:
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Hallam MC, Barile D, Meyrand M, German JB, Reimer RA. Maternal high-protein or high-prebiotic-fiber diets affect maternal milk composition and gut microbiota in rat dams and their offspring. Obesity (Silver Spring) 2014; 22:2344-51. [PMID: 25056822 DOI: 10.1002/oby.20849] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2014] [Accepted: 07/09/2014] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Maternal gut microbiota and milk composition could modify offspring microbiota and therefore disease susceptibility. The effect of maternal high-protein (HP) or prebiotic diets on maternal milk composition and gut microbiota in rat dams and offspring was examined. METHODS Wistar rat dams were fed a control, HP (40% wt/wt), or high-prebiotic-fiber (21.6% wt/wt) (HF) diet throughout pregnancy and lactation. Pups were challenged with a high-fat/sucrose diet from 14.5 to 22.5 weeks of age. Dam milk was analyzed for fat, protein, and oligosaccharides (OS). Fecal microbiota was analyzed in dams at parturition and 2 weeks post-partum and in offspring at 5 and 22 weeks along with cecal digesta at termination. RESULTS Maternal milk differed only in OS content, each diet group being distinguishable. HF1 and HP1 offspring had decreased plasma lipopolysaccharide compared with C1. Offspring sex, maternal diet, and time (5 weeks vs. 22 weeks of age) affected the microbial groups examined. Bifidobacteria was higher in HF dams and offspring. CONCLUSIONS Increasing protein or fiber content in maternal diet during pregnancy and lactation modifies milk OS content and gut microbiota of dams which may influence establishment of gut microbiota in offspring.
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Affiliation(s)
- Megan C Hallam
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
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Martin JE, Hure AJ, Macdonald‐Wicks L, Smith R, Collins CE. Predictors of post-partum weight retention in a prospective longitudinal study. MATERNAL & CHILD NUTRITION 2014; 10:496-509. [PMID: 22974518 PMCID: PMC6860352 DOI: 10.1111/j.1740-8709.2012.00437.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Post-partum weight retention (WR) occurs in 60-80% of women with some retaining ≥10 kg with contributing factors reported as pre-pregnancy body mass index (BMI), gestational weight gain (GWG) and breastfeeding. A longitudinal study of pregnancy, with 12-month post-partum follow-up was conducted to determine factors associated with WR. Pregnant women (n = 152) were recruited from the John Hunter Hospital antenatal clinic in New South Wales, Australia. Pre-pregnancy weight was self-reported; weight was measured four times during pregnancy (for GWG) and in the first 12 months post-partum. Infant feeding data were obtained via questionnaires. Breastfeeding was categorised as exclusive, predominant, complementary or not breastfeeding. Linear mixed models tested the predictors of WR, with and without adjustment for potential confounders. Compared with pre-pregnancy weight, 68% of women retained weight at 12 months, median (interquartile range) [4.5 kg (2.1-8.9)]. After adjustment, GWG was positively associated with WR (P < 0.01), but pre-pregnancy weight did not predict WR. For each additional week of any breastfeeding, 0.04 kg less weight was retained. Compared with women who retained weight, those women who did retain had higher rates of exclusive breastfeeding at three months (P < 0.05), but the number of weeks of exclusive breastfeeding failed to predict WR for all women. WR following childbirth is common and associated with GWG, while the number of weeks of 'any' breastfeeding contributed to post-partum weight loss. Whether these factors are modifiable strategies to optimise the weight status of women at this life stage requires further research.
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Affiliation(s)
- Julia Elizabeth Martin
- Mothers and Babies Research Centre, Faculty of Healthniversity of NewcastleCallaghanAustralia
- Hunter Medical Research InstituteJohn Hunter HospitalNew LambtonAustralia
- Priority Research Centre in Physical Activity and NutritionUniversity of NewcastleCallaghanAustralia
| | - Alexis Jayne Hure
- Mothers and Babies Research Centre, Faculty of Healthniversity of NewcastleCallaghanAustralia
- Research Centre for Gender, Health and Ageing, School of Medicine and Public HealthUniversity of NewcastleCallaghanAustralia
| | - Lesley Macdonald‐Wicks
- Hunter Medical Research InstituteJohn Hunter HospitalNew LambtonAustralia
- School of Health Sciences, Faculty of HealthUniversity of NewcastleCallaghanAustralia
- Priority Research Centre in Physical Activity and NutritionUniversity of NewcastleCallaghanAustralia
| | - Roger Smith
- Mothers and Babies Research Centre, Faculty of Healthniversity of NewcastleCallaghanAustralia
- Hunter Medical Research InstituteJohn Hunter HospitalNew LambtonAustralia
| | - Clare Elizabeth Collins
- Hunter Medical Research InstituteJohn Hunter HospitalNew LambtonAustralia
- School of Health Sciences, Faculty of HealthUniversity of NewcastleCallaghanAustralia
- Priority Research Centre in Physical Activity and NutritionUniversity of NewcastleCallaghanAustralia
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O'Reilly JR, Reynolds RM. The risk of maternal obesity to the long-term health of the offspring. Clin Endocrinol (Oxf) 2013; 78:9-16. [PMID: 23009645 DOI: 10.1111/cen.12055] [Citation(s) in RCA: 185] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2012] [Revised: 09/18/2012] [Accepted: 09/19/2012] [Indexed: 01/22/2023]
Abstract
The prevalence of maternal obesity has risen dramatically in recent years, with approximately one in five pregnant women in the UK now classed as obese (body mass index ≥ 30 kg/m(2) ) at antenatal booking. Obesity during pregnancy has been hypothesized to exert long-term health effects on the developing child through 'early life programming'. While this phenomenon has been well studied in a maternal undernutrition paradigm, the processes by which the programming effects of maternal obesity are mediated are less well understood. In humans, maternal obesity has been associated with a number of long-term adverse health outcomes in the offspring, including lifelong risk of obesity and metabolic dysregulation with increased insulin resistance, hypertension and dyslipidaemia, as well as behavioural problems and risk of asthma. The complex relationships between the maternal metabolic milieu and the developing foetus, as well as the potential influence of postnatal lifestyle and environment, have complicated efforts to study the programming effects of maternal overnutrition in humans. This review will examine the emerging evidence from human studies linking maternal obesity to adverse offspring outcomes.
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Affiliation(s)
- James R O'Reilly
- Centre for Cardiovascular Sciences, Queen's Medical Research Institute, Endocrinology Unit, University of Edinburgh, Edinburgh, UK
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25
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Maternal adaptations and inheritance in the transgenerational programming of adult disease. Cell Tissue Res 2012; 349:863-80. [PMID: 22526629 DOI: 10.1007/s00441-012-1411-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2012] [Accepted: 03/08/2012] [Indexed: 12/17/2022]
Abstract
Adverse exposures in utero have long been linked with an increased susceptibility to adult cardio-renal and metabolic diseases. Clear gender differences exist, whereby growth-restricted females, although exhibiting some phenotypic modifications, are often protected from overt disease outcomes. One of the greatest physiological challenges facing the female gender, however, is that of pregnancy; yet little research has focused on the outcomes associated with this, as a potential 'second-hit' for those who were small at birth. We review the limited evidence suggesting that pregnancy may unmask cardio-renal and metabolic disease states and the consequences for long-term maternal health in females who were born small. Additionally, a growing area of research in this programming field is in the transgenerational transmission of low birth weight and disease susceptibility. Pathways for transmission might include an abnormal adaptation to pregnancy by the growth-restricted mother and/or inheritance via the parental germline. Strategies to optimise the pregnancy environment and/or prevent the consequences of inheritance of programmed deficits and dysfunction are of critical importance for future generations.
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Dishi M, Enquobahrie DA, Abetew DF, Qiu C, Rudra CB, Williams MA. Age at menarche, menstrual cycle characteristics and risk of gestational diabetes. Diabetes Res Clin Pract 2011; 93:437-42. [PMID: 21816498 DOI: 10.1016/j.diabres.2011.07.001] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2011] [Revised: 06/15/2011] [Accepted: 07/04/2011] [Indexed: 11/22/2022]
Abstract
AIMS We examined associations of age at menarche and menstrual cycle characteristics with gestational diabetes mellitus (GDM) risk. METHODS Study participants (N=3490) recruited prior to 16 weeks of gestation were followed until delivery. Menstrual history data were collected using questionnaires. GDM was diagnosed using the American Diabetes Association 2003 guidelines. Logistic regression was used to estimate odds-ratios (OR) and 95% confidence intervals (CI). RESULTS Age at menarche was not associated with GDM risk. Women who had long menstrual cycles (>36 days) had higher risk of GDM compared with women who had normal cycle length (25-30 days) (OR=1.6; 95%CI0.98-2.67). Women who had long menstrual cycles and were either overweight or gained >5kg in adulthood had 4-5-fold higher GDM risk compared with women who had normal cycle length and were non-obese or gained <5kg in adulthood, respectively (OR=4.03; 95%CI:2.08-7.81 and OR=4.62, 95%CI:2.65-8.07, respectively). CONCLUSION Longer menstrual cycles are significantly associated with increased risk of GDM, particularly among women who were either overweight or obese pre-pregnancy, or had ≥5kg weight gain in adult hood. Menstrual history may help identify women with increased risk of GDM.
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Affiliation(s)
- Michal Dishi
- Center for Perinatal Studies, Swedish Medical Center, Seattle, WA, USA.
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Changes in prepregnancy body mass index between pregnancies and risk of gestational and type 2 diabetes. Arch Gynecol Obstet 2011; 284:235-40. [DOI: 10.1007/s00404-011-1917-7] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2010] [Accepted: 04/21/2011] [Indexed: 10/18/2022]
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