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Celik D, Campisi M, Cannella L, Pavanello S. The effect of low birth weight as an intrauterine exposure on the early onset of sarcopenia through possible molecular pathways. J Cachexia Sarcopenia Muscle 2024; 15:770-780. [PMID: 38553412 PMCID: PMC11154781 DOI: 10.1002/jcsm.13455] [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: 08/31/2023] [Revised: 02/19/2024] [Accepted: 02/26/2024] [Indexed: 06/07/2024] Open
Abstract
Sarcopenia, a musculoskeletal disease characterized by the progressive loss of skeletal muscle mass, strength, and physical performance, presents significant challenges to global public health due to its adverse effects on mobility, morbidity, mortality, and healthcare costs. This comprehensive review explores the intricate connections between sarcopenia and low birth weight (LBW), emphasizing the developmental origins of health and disease (DOHaD) hypothesis, inflammatory processes (inflammaging), mitochondrial dysfunction, circadian rhythm disruptions, epigenetic mechanisms, and genetic variations revealed through genome-wide studies (GWAS). A systematic search strategy was developed using PubMed to identify relevant English-language publications on sarcopenia, LBW, DOHaD, inflammaging, mitochondrial dysfunction, circadian disruption, epigenetic mechanisms, and GWAS. The publications consist of 46.2% reviews, 21.2% cohort studies, 4.8% systematic reviews, 1.9% cross-sectional studies, 13.4% animal studies, 4.8% genome-wide studies, 5.8% epigenome-wide studies, and 1.9% book chapters. The review identified key factors contributing to sarcopenia development, including the DOHaD hypothesis, LBW impact on muscle mass, inflammaging, mitochondrial dysfunction, the influence of clock genes, the role of epigenetic mechanisms, and genetic variations revealed through GWAS. The DOHaD theory suggests that LBW induces epigenetic alterations during foetal development, impacting long-term health outcomes, including the early onset of sarcopenia. LBW correlates with reduced muscle mass, grip strength, and lean body mass in adulthood, increasing the risk of sarcopenia. Chronic inflammation (inflammaging) and mitochondrial dysfunction contribute to sarcopenia, with LBW linked to increased oxidative stress and dysfunction. Disrupted circadian rhythms, regulated by genes such as BMAL1 and CLOCK, are associated with both LBW and sarcopenia, impacting lipid metabolism, muscle mass, and the ageing process. Early-life exposures, including LBW, induce epigenetic modifications like DNA methylation (DNAm) and histone changes, playing a pivotal role in sarcopenia development. Genome-wide studies have identified candidate genes and variants associated with lean body mass, muscle weakness, and sarcopenia, providing insights into genetic factors contributing to the disorder. LBW emerges as a potential early predictor of sarcopenia development, reflecting the impact of intrauterine exposures on long-term health outcomes. Understanding the complex interplay between LBW with inflammaging, mitochondrial dysfunction, circadian disruption, and epigenetic factors is essential for elucidating the pathogenesis of sarcopenia and developing targeted interventions. Future research on GWAS and the underlying mechanisms of LBW-associated sarcopenia is warranted to inform preventive strategies and improve public health outcomes.
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Affiliation(s)
- Dilek Celik
- Department of Pharmceutical and Pharmacological SciencesUniversity of PaduaPaduaItaly
| | - Manuela Campisi
- Department of Cardiac Thoracic Vascular Sciences and Public HealthUniversity of PaduaPaduaItaly
| | - Luana Cannella
- Department of Cardiac Thoracic Vascular Sciences and Public HealthUniversity of PaduaPaduaItaly
| | - Sofia Pavanello
- Department of Cardiac Thoracic Vascular Sciences and Public HealthUniversity of PaduaPaduaItaly
- University Hospital of PadovaPaduaItaly
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Su S, Fan J, Yang Y, Yang C, Jia X. Birth Weight, Cardiometabolic Factors, and Coronary Heart Disease: A Mendelian Randomization Study. J Clin Endocrinol Metab 2023; 108:e1245-e1252. [PMID: 37246707 DOI: 10.1210/clinem/dgad308] [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: 03/08/2023] [Revised: 04/25/2023] [Accepted: 05/26/2023] [Indexed: 05/30/2023]
Abstract
CONTEXT Observational studies have shown associations of birth weight (BW) with coronary heart disease (CHD), but results are inconsistent and do not distinguish the fetal or maternal effect of BW. OBJECTIVE This study aims to explore the causal association between BW and CHD, analyze the fetal and maternal contribution, and quantify mediating effects of cardiometabolic factors. METHODS Genetic variants from genome-wide association study summary-level data of own BW (N = 298 142), offspring BW (N = 210 267 mothers), and 16 cardiometabolic (anthropometric, glycemic, lipidemic, and blood pressure) factors were extracted as instrumental variables. We used two-sample Mendelian randomization study (MR) to estimate the causal effect of BW on CHD (60 801 cases and 123 504 controls from mixed ancestry) and explore the fetal and maternal contributions. Mediation analyses were conducted to analyze the potential mediating effects of 16 cardiometabolic factors using two-step MR. RESULTS Inverse variance weighted analysis showed that lower BW raised the CHD risk (β -.30; 95% CI: -0.40, -0.20) and consistent results were observed in fetal-specific/maternal-specific BW. We identified 5 mediators in the causal pathway from BW to CHD, including body mass index-adjusted hip circumference, triglycerides, fasting insulin, diastolic blood pressure, and systolic blood pressure (SBP), with mediated proportion ranging from 7.44% for triglycerides to 27.75% for SBP. Causality between fetal-specific and maternal-specific BW and CHD was mediated by glycemic factors and SBP, respectively. CONCLUSION Our findings supported that lower BW increased CHD risk and revealed that fetal-specific and maternal-specific BW may both contribute to this effect. The causality between BW and CHD was mediated by several cardiometabolic factors.
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Affiliation(s)
- Shuyao Su
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Jingwen Fan
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Yongli Yang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Chaojun Yang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Xiaocan Jia
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China
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Wibaek R, Andersen GS, Linneberg A, Hansen T, Grarup N, Thuesen ACB, Jensen RT, Wells JCK, Pilgaard KA, Brøns C, Vistisen D, Vaag AA. Low birthweight is associated with a higher incidence of type 2 diabetes over two decades independent of adult BMI and genetic predisposition. Diabetologia 2023; 66:1669-1679. [PMID: 37303008 PMCID: PMC10390608 DOI: 10.1007/s00125-023-05937-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Accepted: 04/13/2023] [Indexed: 06/13/2023]
Abstract
AIMS/HYPOTHESIS Low birthweight is a risk factor for type 2 diabetes. Most previous studies are based on cross-sectional prevalence data, not designed to study the timing of onset of type 2 diabetes in relation to birthweight. We aimed to examine associations of birthweight with age-specific incidence rate of type 2 diabetes in middle-aged to older adults over two decades. METHODS Adults aged 30-60 years enrolled in the Danish Inter99 cohort in 1999-2001 (baseline examination), with information on birthweight from original birth records from 1939-1971 and without diabetes at baseline, were eligible. Birth records were linked with individual-level data on age at diabetes diagnosis and key covariates. Incidence rates of type 2 diabetes as a function of age, sex and birthweight were modelled using Poisson regression, adjusting for prematurity status at birth, parity, polygenic scores for birthweight and type 2 diabetes, maternal and paternal diabetes history, socioeconomic status and adult BMI. RESULTS In 4590 participants there were 492 incident type 2 diabetes cases during a mean follow-up of 19 years. Type 2 diabetes incidence rate increased with age, was higher in male participants, and decreased with increasing birthweight (incidence rate ratio [95% CI per 1 kg increase in birthweight] 0.60 [0.48, 0.75]). The inverse association of birthweight with type 2 diabetes incidence was statistically significant across all models and in sensitivity analysis. CONCLUSIONS/INTERPRETATION A lower birthweight was associated with increased risk of developing type 2 diabetes independent of adult BMI and genetic risk of type 2 diabetes and birthweight.
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Affiliation(s)
- Rasmus Wibaek
- Clinical Research, Steno Diabetes Center Copenhagen, Herlev, Denmark.
| | | | - Allan Linneberg
- Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Torben Hansen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Niels Grarup
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Anne Cathrine B Thuesen
- Clinical Research, Steno Diabetes Center Copenhagen, Herlev, Denmark
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Rasmus T Jensen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jonathan C K Wells
- Childhood Nutrition Research Centre, Population Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Kasper A Pilgaard
- Clinical Research, Steno Diabetes Center Copenhagen, Herlev, Denmark
| | - Charlotte Brøns
- Clinical Research, Steno Diabetes Center Copenhagen, Herlev, Denmark
| | - Dorte Vistisen
- Clinical Research, Steno Diabetes Center Copenhagen, Herlev, Denmark
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Allan A Vaag
- Clinical Research, Steno Diabetes Center Copenhagen, Herlev, Denmark.
- Lund University Diabetes Centre, Lund University, Malmö, Sweden.
- Department of Endocrinology, Skåne University Hospital, Malmö, Sweden.
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Oh J, Riek AE, Bauerle KT, Dusso A, McNerney KP, Barve RA, Darwech I, Sprague JE, Moynihan C, Zhang RM, Kutz G, Wang T, Xing X, Li D, Mrad M, Wigge NM, Castelblanco E, Collin A, Bambouskova M, Head RD, Sands MS, Bernal-Mizrachi C. Embryonic vitamin D deficiency programs hematopoietic stem cells to induce type 2 diabetes. Nat Commun 2023; 14:3278. [PMID: 37311757 PMCID: PMC10264405 DOI: 10.1038/s41467-023-38849-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Accepted: 05/19/2023] [Indexed: 06/15/2023] Open
Abstract
Environmental factors may alter the fetal genome to cause metabolic diseases. It is unknown whether embryonic immune cell programming impacts the risk of type 2 diabetes in later life. We demonstrate that transplantation of fetal hematopoietic stem cells (HSCs) made vitamin D deficient in utero induce diabetes in vitamin D-sufficient mice. Vitamin D deficiency epigenetically suppresses Jarid2 expression and activates the Mef2/PGC1a pathway in HSCs, which persists in recipient bone marrow, resulting in adipose macrophage infiltration. These macrophages secrete miR106-5p, which promotes adipose insulin resistance by repressing PIK3 catalytic and regulatory subunits and down-regulating AKT signaling. Vitamin D-deficient monocytes from human cord blood have comparable Jarid2/Mef2/PGC1a expression changes and secrete miR-106b-5p, causing adipocyte insulin resistance. These findings suggest that vitamin D deficiency during development has epigenetic consequences impacting the systemic metabolic milieu.
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Affiliation(s)
- Jisu Oh
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Amy E Riek
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Kevin T Bauerle
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
- Department of Medicine, VA Medical Center, St. Louis, MO, USA
| | - Adriana Dusso
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Kyle P McNerney
- Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, USA
| | - Ruteja A Barve
- Department of Genetics, Washington University School of Medicine, St. Louis, MO, USA
| | - Isra Darwech
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | | | - Clare Moynihan
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Rong M Zhang
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Greta Kutz
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Ting Wang
- Department of Genetics, Washington University School of Medicine, St. Louis, MO, USA
| | - Xiaoyun Xing
- Department of Genetics, Washington University School of Medicine, St. Louis, MO, USA
| | - Daofeng Li
- Department of Genetics, Washington University School of Medicine, St. Louis, MO, USA
| | - Marguerite Mrad
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Nicholas M Wigge
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | | | - Alejandro Collin
- Instituto de Investigaciones en Ciencias de la Salud (INICSA), CONICET, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Monika Bambouskova
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Richard D Head
- Department of Genetics, Washington University School of Medicine, St. Louis, MO, USA
| | - Mark S Sands
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
- Department of Cell Biology and Physiology, Washington University School of Medicine, St. Louis, MO, USA
| | - Carlos Bernal-Mizrachi
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA.
- Department of Medicine, VA Medical Center, St. Louis, MO, USA.
- Department of Cell Biology and Physiology, Washington University School of Medicine, St. Louis, MO, USA.
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Cauzzo C, Chiavaroli V, Di Valerio S, Chiarelli F. Birth size, growth trajectory and later cardio-metabolic risk. Front Endocrinol (Lausanne) 2023; 14:1187261. [PMID: 37342257 PMCID: PMC10277632 DOI: 10.3389/fendo.2023.1187261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 05/19/2023] [Indexed: 06/22/2023] Open
Abstract
There is increasing evidence of a strong association between intrauterine growth and subsequent development of chronic disease in adult life. Birth size and growth trajectory have been demonstrated to have an impact on cardio-metabolic health, both in childhood and adult life. Hence, careful observation of the children's growth pattern, starting from the intrauterine period and the first years of life, should be emphasized to detect the possible onset of cardio-metabolic sequelae. This allows to intervene on them as soon as they are detected, first of all through lifestyle interventions, whose efficacy seems to be higher when they are started early. Recent papers suggest that prematurity may constitute an independent risk factor for the development of cardiovascular disease and metabolic syndrome, regardless of birth weight. The purpose of the present review is to examine and summarize the available knowledge about the dynamic association between intrauterine and postnatal growth and cardio-metabolic risk, from childhood to adulthood.
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Affiliation(s)
- Chiara Cauzzo
- Department of Pediatrics, University of Chieti, Chieti, Italy
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Makker K, Zhang M, Wang G, Hong X, Zhang C, Wang X. Early-life determinants of childhood plasma insulin levels: implications for primordial prevention of diabetes. Pediatr Res 2023; 93:189-197. [PMID: 35449397 PMCID: PMC10184189 DOI: 10.1038/s41390-022-02070-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 01/31/2022] [Accepted: 02/27/2022] [Indexed: 01/28/2023]
Abstract
BACKGROUND We earlier reported prematurity as an independent risk factor for elevated insulin levels. Investigation is still lacking on the influence of prenatal and perinatal factors on childhood insulin levels. METHODS In this secondary analysis of a prospective birth cohort, plasma insulin levels were measured at birth and early childhood. Regression models identified early-life factors associated with the primary outcome: log-transformed childhood plasma insulin levels. RESULTS One thousand one hundred and nine children had insulin levels at birth and 825 at both time points. Compared to term, preterm infants had higher plasma insulin levels (geometric mean) at birth (612, 95% CI 552-679 vs. 372, 95% CI 345-402 pmol/ml) and in early childhood (547, 95% CI 494-605 vs. 445, 95% CI 417-475 pmol/ml). Factors associated with higher early childhood insulin levels included higher insulin level at birth, black race, female sex, maternal smoking during pregnancy, maternal perceived stress, in utero drug exposure, maternal pregestational diabetes mellitus, and maternal preconception overweight and obesity. CONCLUSIONS In this high-risk US birth cohort, we identified multiple prenatal and perinatal risk factors for higher early childhood insulin levels, in addition to prematurity. These findings lend support to primordial preventive strategies for diabetes mellitus. IMPACT In this secondary analysis of a large prospective study from a high-risk racially diverse cohort, we identify biological and social factors that contribute to elevated levels of plasma insulin in early childhood. Our study also investigates factors affecting plasma insulin in preterm infants along with comorbidities commonly seen during the neonatal intensive care stay. Our work reaffirms the importance of Developmental Origins of Health and Disease with regards to in utero programming of insulin levels. Our work supports the possibility that primordial preventive strategies for diabetes mellitus in high-risk populations may need to begin as early as the prenatal period.
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Affiliation(s)
- Kartikeya Makker
- Division of Neonatology, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD, USA.
| | - Mingyu Zhang
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Guoying Wang
- Center on the Early Life Origins of Disease, Department of Population Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Xiumei Hong
- Center on the Early Life Origins of Disease, Department of Population Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Cuilin Zhang
- Division of Intramural Population Health Research, NICHD, National Institutes of Health, Johns Hopkins School of Medicine, Baltimore, USA
| | - Xiaobin Wang
- Center on the Early Life Origins of Disease, Department of Population Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD, USA
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Carlson JM, Zanobetti A, Ettinger de Cuba S, Poblacion AP, Fabian PM, Carnes F, Rhee J, Lane KJ, Sandel MT, Janulewicz PA. Critical windows of susceptibility for the effects of prenatal exposure to heat and heat variability on gestational growth. ENVIRONMENTAL RESEARCH 2023; 216:114607. [PMID: 36279910 DOI: 10.1016/j.envres.2022.114607] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 10/11/2022] [Accepted: 10/14/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Studies have shown that prenatal heat exposure may impact fetal growth, but few studies have examined the critical windows of susceptibility. As extreme heat events and within season temperature variability is expected to increase in frequency, it is important to understand how this may impact gestational growth. OBJECTIVES We investigated associations between various measures of weekly prenatal heat exposure (mean and standard deviation (SD) of temperature and heat index (HI), derived using temperature in °C and dew point) and term birthweight or odds of being born small for gestational age (SGA) to identify critical windows of susceptibility. METHODS We analyzed data from mother-child dyads (n = 4442) in the Boston-based Children's HealthWatch cohort. Birthweights were collected from survey data and electronic health records. Daily temperature and HI values were obtained from 800 m gridded spatial climate datasets aggregated by the PRISM Climate Group. Distributed lag-nonlinear models were used to assess the effect of the four weekly heat metrics on measures of gestational growth (birthweight, SGA, and birthweight z-scores). Analyses were stratified by child sex and maternal homelessness status during pregnancy. RESULTS HI variability was significantly associated with decreased term birthweight during gestational weeks 10-29 and with SGA for weeks 9-26. Cumulative effects for these time periods were -287.4 g (95% CI: -474.1 g, -100.8 g for birthweight and 4.7 (95% CI: 1.6, 14.1) for SGA. Temperature variability was also significantly associated with decreased birthweight between weeks 15 and 26. The effects for mean heat measures on term birthweight and SGA were not significant for any gestational week. Stratification by sex revealed a significant effect on term birthweight in females between weeks 23-28 and in males between weeks 9-26. Strongest effects of HI variability on term birthweight were found in children of mothers who experienced homelessness during pregnancy. Weekly HI variability was the heat metric most strongly associated with measures of gestational growth. The effects observed were largest in males and those who experienced homelessness during pregnancy. DISCUSSION Given the impact of heat variability on birthweight and risk of SGA, it is important for future heat warnings to incorporate measure of heat index and temperature variability.
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Affiliation(s)
- Jeffrey M Carlson
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA.
| | - Antonella Zanobetti
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Stephanie Ettinger de Cuba
- Department of Pediatrics, School of Medicine, Boston University, Boston, MA, USA; Children's HealthWatch, USA
| | - Ana P Poblacion
- Children's HealthWatch, USA; Department of Pediatrics, Boston Medical Center, Boston, MA, USA
| | - Patricia M Fabian
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
| | - Fei Carnes
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
| | - Jongeun Rhee
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Kevin J Lane
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
| | - Megan T Sandel
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA; Department of Pediatrics, School of Medicine, Boston University, Boston, MA, USA
| | - Patricia A Janulewicz
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
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Duan M, Xi Y, Tian Q, Na B, Han K, Zhang X, Wang W, Zheng D, Wang Y. Prevalence, awareness, treatment and control of type 2 diabetes and its determinants among Mongolians in China: a cross-sectional analysis of IMAGINS 2015-2020. BMJ Open 2022; 12:e063893. [PMID: 36319058 PMCID: PMC9628690 DOI: 10.1136/bmjopen-2022-063893] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES This study aims to estimate the prevalence, awareness, treatment and control rates of type 2 diabetes (T2D) and pre-diabetes as well as to identify its associated factors among Mongolians living in the Inner Mongolia Autonomous Region, China. DESIGN Cross-sectional study. SETTING AND PARTICIPANTS This sample included 11 361 Mongolian participants from the Inner Mongolian Healthy Aging Intervention Study, a population-based screening project consisting of 141 255 adults aged above 35 years in Inner Mongolia from 2015 to 31 December 2020. OUTCOME MEASURES The prevalence and 95% CIs of T2D and pre-diabetes were calculated. Factors associated with the prevalence, awareness, treatment and control of T2D were explored by a binomial logistic regression. RESULTS A total of 17.2% (95% CI 16.5% to 17.9%) of the sample had T2D, of whom 34.0% (95% CI 31.9% to 36.1%) were aware of their diagnosis, 24.7% (95% CI 22.8% to 26.6%) were taking prescribed antidiabetic medications, 6.7% (95% CI 5.6% to 7.8%) had achieved control and 27.5% (95 % CI 26.7% to 28.3%) had pre-diabetes. The prevalence of T2D increased with increasing age, male, lower education level, smoking, obesity and a history of hypertension or dyslipidaemia (all p<0.05). CONCLUSIONS T2D is highly prevalent, with suboptimal awareness, treatment and control rates, and an escalating health challenge among the Mongolian population. Broad-based strategies, including diabetes prevention education, better screening and affordable treatment, should be implemented to raise awareness, treatment and control rates of T2D in Inner Mongolia.
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Affiliation(s)
- Mingrui Duan
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
| | - Yunfeng Xi
- The Inner Mongolia Autonomous Region Comprehensive Center or Disease Control and Prevention, Hohhot, China
| | - Qiuyue Tian
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
| | - Buqi Na
- The Inner Mongolia Autonomous Region Comprehensive Center or Disease Control and Prevention, Hohhot, China
| | - Ke Han
- The Inner Mongolia Autonomous Region Comprehensive Center or Disease Control and Prevention, Hohhot, China
| | - Xingguang Zhang
- School of Public Health, Inner Mongolia Medical University, Hohhot, China
| | - Wenrui Wang
- The Inner Mongolia Autonomous Region Comprehensive Center or Disease Control and Prevention, Hohhot, China
| | - Deqiang Zheng
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
| | - Youxin Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
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Dall'Asta A, Stampalija T, Mecacci F, Ramirez Zegarra R, Sorrentino S, Minopoli M, Ottaviani C, Fantasia I, Barbieri M, Lisi F, Simeone S, Castellani R, Fichera A, Rizzo G, Prefumo F, Frusca T, Ghi T. Incidence, clinical features and perinatal outcome in anomalous fetuses with late-onset growth restriction: cohort study. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2022; 60:632-639. [PMID: 35638182 PMCID: PMC9827976 DOI: 10.1002/uog.24961] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 05/05/2022] [Accepted: 05/17/2022] [Indexed: 05/31/2023]
Abstract
OBJECTIVE To describe the incidence, clinical features and perinatal outcome of late-onset fetal growth restriction (FGR) associated with genetic syndrome or aneuploidy, structural malformation or congenital infection. METHODS This was a retrospective multicenter cohort study of patients who attended one of four tertiary maternity hospitals in Italy. We included consecutive singleton pregnancies between 32 + 0 and 36 + 6 weeks' gestation with either fetal abdominal circumference (AC) or estimated fetal weight < 10th percentile for gestational age or a reduction in AC of > 50 percentiles from the measurement at an ultrasound scan performed between 18 and 32 weeks. The study group consisted of pregnancies with late-onset FGR and a genetic syndrome or aneuploidy, structural malformation or congenital infection (anomalous late-onset FGR). The presence of congenital anomalies was ascertained postnatally in neonates with abnormal findings on antenatal investigation or detected after birth. The control group consisted of pregnancies with structurally and genetically normal fetuses with late-onset FGR. Composite adverse perinatal outcome was defined as the presence of at least one of stillbirth, 5-min Apgar score < 7, admission to the neonatal intensive care unit (NICU), need for respiratory support at birth, neonatal jaundice and neonatal hypoglycemia. The primary aims of the study were to assess the incidence and clinical features of anomalous late-onset FGR, and to compare the perinatal outcome of such cases with that of fetuses with non-anomalous late-onset FGR. RESULTS Overall, 1246 pregnancies complicated by late-onset FGR were included in the study, of which 120 (9.6%) were allocated to the anomalous late-onset FGR group. Of these, 11 (9.2%) had a genetic syndrome or aneuploidy, 105 (87.5%) had an isolated structural malformation, and four (3.3%) had a congenital infection. The most frequent structural defects associated with late-onset anomalous FGR were genitourinary malformations (28/105 (26.7%)) and limb malformation (21/105 (20.0%)). Compared with the non-anomalous late-onset FGR group, fetuses with anomalous late-onset FGR had an increased incidence of composite adverse perinatal outcome (35.9% vs 58.3%; P < 0.01). Newborns with anomalous, compared to those with non-anomalous, late-onset FGR showed a higher frequency of need for respiratory support at birth (25.8% vs 9.0%; P < 0.01), intubation (10.0% vs 1.1%; P < 0.01), NICU admission (43.3% vs 22.6%; P < 0.01) and longer hospital stay (median, 24 days (range, 4-250 days) vs 11 days (range, 2-59 days); P < 0.01). CONCLUSIONS Most pregnancies complicated by anomalous late-onset FGR have structural malformations rather than genetic abnormality or infection. Fetuses with anomalous late-onset FGR have an increased incidence of complications at birth and NICU admission and a longer hospital stay compared with fetuses with isolated late-onset FGR. © 2022 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- A. Dall'Asta
- Department of Medicine and Surgery, Obstetrics and Gynecology UnitUniversity of ParmaParmaItaly
| | - T. Stampalija
- Unit of Fetal Medicine and Prenatal DiagnosisInstitute for Maternal and Child Health IRCCS Burlo GarofoloTriesteItaly
- Department of Medicine, Surgery and Health SciencesUniversity of TriesteTriesteItaly
| | - F. Mecacci
- Department of Biomedical, Experimental and Clinical Sciences, Division of Obstetrics and GynecologyUniversity of FlorenceFlorenceItaly
| | - R. Ramirez Zegarra
- Department of Medicine and Surgery, Obstetrics and Gynecology UnitUniversity of ParmaParmaItaly
- Department of Obstetrics and Gynecology, University Hospital Rechts der IsarTechnical University of MunichMunichGermany
| | - S. Sorrentino
- Department of Medicine and Surgery, Obstetrics and Gynecology UnitUniversity of ParmaParmaItaly
| | - M. Minopoli
- Department of Medicine and Surgery, Obstetrics and Gynecology UnitUniversity of ParmaParmaItaly
| | - C. Ottaviani
- Unit of Fetal Medicine and Prenatal DiagnosisInstitute for Maternal and Child Health IRCCS Burlo GarofoloTriesteItaly
| | - I. Fantasia
- Unit of Fetal Medicine and Prenatal DiagnosisInstitute for Maternal and Child Health IRCCS Burlo GarofoloTriesteItaly
| | - M. Barbieri
- Unit of Fetal Medicine and Prenatal DiagnosisInstitute for Maternal and Child Health IRCCS Burlo GarofoloTriesteItaly
| | - F. Lisi
- Department of Biomedical, Experimental and Clinical Sciences, Division of Obstetrics and GynecologyUniversity of FlorenceFlorenceItaly
| | - S. Simeone
- Department of Biomedical, Experimental and Clinical Sciences, Division of Obstetrics and GynecologyUniversity of FlorenceFlorenceItaly
| | - R. Castellani
- Department of Clinical and Experimental Sciences, Section of Maternal and Child HealthUniversity of BresciaBresciaItaly
| | - A. Fichera
- Department of Clinical and Experimental Sciences, Section of Maternal and Child HealthUniversity of BresciaBresciaItaly
| | - G. Rizzo
- Division of Maternal and Fetal MedicineUniversity of Rome Tor VergataRomeItaly
| | - F. Prefumo
- Department of Clinical and Experimental Sciences, Section of Maternal and Child HealthUniversity of BresciaBresciaItaly
| | - T. Frusca
- Department of Medicine and Surgery, Obstetrics and Gynecology UnitUniversity of ParmaParmaItaly
| | - T. Ghi
- Department of Medicine and Surgery, Obstetrics and Gynecology UnitUniversity of ParmaParmaItaly
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10
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Eberle C, Stichling S. Environmental health influences in pregnancy and risk of gestational diabetes mellitus: a systematic review. BMC Public Health 2022; 22:1572. [PMID: 35982427 PMCID: PMC9389831 DOI: 10.1186/s12889-022-13965-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 06/27/2022] [Indexed: 11/10/2022] Open
Abstract
Background Gestational diabetes mellitus (GDM) is one of the most common pregnancy complications globally. Environmental risk factors may lead to increased glucose levels and GDM, which in turn may affect not only the health of the mother but assuming hypotheses of "fetal programming", also the health of the offspring. In addition to traditional GDM risk factors, the evidence is growing that environmental influences might affect the development of GDM. We conducted a systematic review analyzing the association between several environmental health risk factors in pregnancy, including climate factors, chemicals and metals, and GDM. Methods We performed a systematic literature search in Medline (PubMed), EMBASE, CINAHL, Cochrane Library and Web of Science Core Collection databases for research articles published until March 2021. Epidemiological human and animal model studies that examined GDM as an outcome and / or glycemic outcomes and at least one environmental risk factor for GDM were included. Results Of n = 91 studies, we classified n = 28 air pollution, n = 18 persistent organic pollutants (POP), n = 11 arsenic, n = 9 phthalate n = 8 bisphenol A (BPA), n = 8 seasonality, n = 6 cadmium and n = 5 ambient temperature studies. In total, we identified two animal model studies. Whilst we found clear evidence for an association between GDM and air pollution, ambient temperature, season, cadmium, arsenic, POPs and phthalates, the findings regarding phenols were rather inconsistent. There were clear associations between adverse glycemic outcomes and air pollution, ambient temperature, season, POPs, phenols, and phthalates. Findings regarding cadmium and arsenic were heterogeneous (n = 2 publications in each case). Conclusions Environmental risk factors are important to consider in the management and prevention of GDM. In view of mechanisms of fetal programming, the environmental risk factors investigated may impair the health of mother and offspring in the short and long term. Further research is needed. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13965-5.
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Affiliation(s)
- Claudia Eberle
- Medicine With Specialization in Internal Medicine and General Medicine, Hochschule Fulda, University of Applied Sciences, Leipziger Strasse 123, 36037, Fulda, Germany.
| | - Stefanie Stichling
- Medicine With Specialization in Internal Medicine and General Medicine, Hochschule Fulda, University of Applied Sciences, Leipziger Strasse 123, 36037, Fulda, Germany
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11
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Blood and Urinary Biomarkers of Antipsychotic-Induced Metabolic Syndrome. Metabolites 2022; 12:metabo12080726. [PMID: 36005598 PMCID: PMC9416438 DOI: 10.3390/metabo12080726] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 07/29/2022] [Accepted: 08/03/2022] [Indexed: 12/15/2022] Open
Abstract
Metabolic syndrome (MetS) is a clustering of at least three of the following five medical conditions: abdominal obesity, high blood pressure, high blood sugar, high serum triglycerides, and low serum high-density lipoprotein (HDL). Antipsychotic (AP)-induced MetS (AIMetS) is the most common adverse drug reaction (ADR) of psychiatric pharmacotherapy. Herein, we review the results of studies of blood (serum and plasma) and urinary biomarkers as predictors of AIMetS in patients with schizophrenia (Sch). We reviewed 1440 studies examining 38 blood and 19 urinary metabolic biomarkers, including urinary indicators involved in the development of AIMetS. Among the results, only positive associations were revealed. However, at present, it should be recognized that there is no consensus on the role of any particular urinary biomarker of AIMetS. Evaluation of urinary biomarkers of the development of MetS and AIMetS, as one of the most common concomitant pathological conditions in the treatment of patients with psychiatric disorders, may provide a key to the development of strategies for personalized prevention and treatment of the condition, which is considered a complication of AP therapy for Sch in clinical practice.
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12
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Long-Term Health Associated with Small and Large for Gestational Age Births among Young Thai Adults. CHILDREN 2022; 9:children9060779. [PMID: 35740716 PMCID: PMC9221860 DOI: 10.3390/children9060779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 05/14/2022] [Accepted: 05/19/2022] [Indexed: 11/16/2022]
Abstract
We examined the long-term health outcomes associated with being born small for gestational age (SGA) or large for gestational age (LGA). A total of 632 young adults aged ≈20.6 years were recruited from a longitudinal study (Chiang Mai, Thailand) in 2010: 473 born appropriate for gestational age (AGA), 142 SGA, and 17 LGA. The clinical assessments included anthropometry, blood pressure (BP), lipid profile, and an oral glucose tolerance test (OGTT). Young adults born SGA were 1.8 and 3.2 cm shorter than AGA (p = 0.0006) and LGA (p = 0.019) participants, respectively. The incidence of short stature was 8% among SGA compared with 3% in AGA and no cases among LGA participants, with the adjusted relative risk (aRR) of short stature among SGA 2.70 times higher than that of AGA counterparts (p = 0.013). SGA participants also had a 2 h glucose 7% higher than that of the AGA group (105 vs. 99 mg/dL; p = 0.006). Young adults born LGA had a BMI greater by 2.42 kg/m2 (p = 0.025) and 2.11 kg/m2 (p = 0.040) than those of SGA and AGA, respectively. Thus, the rate of overweight/obesity was 35% in the LGA group compared with 14.2% and 16.6% of SGA and AGA groups, respectively, with corresponding aRR of overweight/obesity of 2.95 (p = 0.011) and 2.50 (p = 0.017), respectively. LGA participants had markedly higher rates of BP abnormalities (prehypertension and/or hypertension) with an aRR of systolic BP abnormalities of 2.30 (p = 0.023) and 2.79 (p = 0.003) compared with SGA and AGA groups, respectively. Thai young adults born SGA had an increased risk of short stature and displayed some impairment in glucose metabolism. In contrast, those born LGA were at an increased risk of overweight/obesity and elevated blood pressure. The long-term follow-up of this cohort is important to ascertain whether these early abnormalities accentuate over time, leading to overt cardiometabolic conditions.
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13
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Karaer A, Mumcu A, Arda Düz S, Tuncay G, Doğan B. Metabolomics analysis of placental tissue obtained from patients with fetal growth restriction. J Obstet Gynaecol Res 2022; 48:920-929. [PMID: 35104920 DOI: 10.1111/jog.15173] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 01/07/2022] [Accepted: 01/20/2022] [Indexed: 12/13/2022]
Abstract
AIM The aim of this study was to determine whether there was a difference in placental metabolite profiles between patients with fetal growth restriction (FGR) and healthy controls. METHODS The study included 10 patients with FGR diagnosis with 14 healthy controls with both matched maternal age and body mass index. 1 H HR-MAS NMR spectroscopy data obtained from placental tissue samples of patients with FGR and healthy control group were analyzed with bioinformatics methods. The obtained results of metabolite levels were further validated with the internal standard (IS) quantification method. RESULTS Principal component analysis (PCA) and the partial least squares discriminant analysis (PLS-DA) score plots obtained with the multivariate statistical analysis of preprocessed spectral data shows a separation between the samples from patients with FGR and healthy controls. Bioinformatics analysis results suggest that the placental levels of lactate, glutamine, glycerophosphocholine, phosphocholine, taurine, and myoinositol are increased in patients with FGR compared to the healthy controls. CONCLUSIONS Placental metabolic dysfunctions are a common occurrence in FGR.
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Affiliation(s)
- Abdullah Karaer
- Reproductive Sciences & Advanced Bioinformatics Application & Research Center, Inonu University, Malatya, Turkey.,Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Inonu University, School of Medicine, Malatya, Turkey
| | - Akın Mumcu
- Reproductive Sciences & Advanced Bioinformatics Application & Research Center, Inonu University, Malatya, Turkey.,Laboratory of NMR, Scientific and Technological Research Center, Inonu University, Malatya, Turkey
| | - Senem Arda Düz
- Reproductive Sciences & Advanced Bioinformatics Application & Research Center, Inonu University, Malatya, Turkey.,Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Inonu University, School of Medicine, Malatya, Turkey
| | - Görkem Tuncay
- Reproductive Sciences & Advanced Bioinformatics Application & Research Center, Inonu University, Malatya, Turkey.,Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Inonu University, School of Medicine, Malatya, Turkey
| | - Berat Doğan
- Reproductive Sciences & Advanced Bioinformatics Application & Research Center, Inonu University, Malatya, Turkey.,Department of Biomedical Engineering, School of Engineering, Inonu University, Malatya, Turkey
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14
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Pham A, Mitanchez D, Forhan A, Perin L, Le Bouc Y, Brioude F, Sobrier ML, Heude B, Netchine I. Low Maternal DLK1 Levels at 26 Weeks Is Associated With Small for Gestational Age at Birth. Front Endocrinol (Lausanne) 2022; 13:836731. [PMID: 35295988 PMCID: PMC8919710 DOI: 10.3389/fendo.2022.836731] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 01/26/2022] [Indexed: 11/13/2022] Open
Abstract
Detecting SGA (small for gestational age) during pregnancy improves the fetal and neonatal prognosis. To date, there is no valid antenatal biomarker of SGA used in clinical practice. Maternal circulating DLK1 (delta-like non-canonical notch ligand 1) levels have been shown to be significantly lower in pregnant women at 36 weeks of gestation (WG) who delivered a SGA newborn than in controls. Data in the literature are contradictory on the association between maternal circulating DLK1 levels and placental vascular dysfunction. The objective was to determine if maternal DLK1 levels in the second trimester of pregnancy are predictive of SGA, and to assess whether the measurement of DLK1 levels in maternal blood could be a means to distinguish SGA with placental vascular dysfunction from that due to other causes. We conducted a nested cased-control study within the EDEN mother-child cohort. 193 SGA (birth weight < 10th percentile) and 370 mother-child control (birth weight between the 25th and 75th percentile) matched pairs were identified in the EDEN cohort. Maternal circulating DLK1 levels at 26 WG were significantly lower for children born SGA than for controls (27.7 ± 8.7 ng/mL vs 30.4 ± 10.6 ng/mL, p = 0.001). Maternal blood DLK1 levels in the first quartile (DLK1 < 22.85 ng/mL) were associated with an odds ratio for SGA of 1.98 [1.15 - 3.37]. DLK1 was less predictive of SGA than ultrasound, with an area under the curve of 0.578. Maternal circulating DLK1 levels were not significantly different in cases of SGA with signs of placental vascular dysfunction (n = 63, 27.1 ± 9.2 ng/mL) than in those without placental dysfunction (n = 129, 28.0 ± 8.5 ng/mL, p = 0.53). The level of circulating DLK1 is reduced in the second trimester of pregnancy in cases of SGA at birth, independently of signs of placental vascular dysfunction. However, DLK1 alone cannot predict the risk of SGA.
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Affiliation(s)
- Aurelie Pham
- Sorbonne Université, INSERM, Centre de Recherche Saint Antoine, APHP, Hôpital Armand Trousseau, Service de Néonatologie, Paris, France
| | - Delphine Mitanchez
- Sorbonne Université, INSERM, Centre de Recherche Saint Antoine, Paris, France
- Centre Hospitalier Régional Universitaire (CHRU) de Tours, Hôpital Bretonneau, Service de Néonatologie, Tours, France
| | - Anne Forhan
- Université de Paris Cité, INSERM, INRAE, Centre of Research in Epidemiology and StatisticS (CRESS), Paris, France
| | - Laurence Perin
- Sorbonne Université, APHP, Hôpital Armand Trousseau, Explorations Fonctionnelles Endocriniennes, Endocrinologie Moléculaire et Pathologies d’Empreinte, Paris, France
| | - Yves Le Bouc
- Sorbonne Université, INSERM, Centre de Recherche Saint Antoine, Paris, France
| | - Frederic Brioude
- Sorbonne Université, INSERM, Centre de Recherche Saint Antoine, APHP, Hôpital Armand Trousseau, Explorations Fonctionnelles Endocriniennes, Endocrinologie Moléculaire et Pathologies d'Empreinte, Paris, France
| | - Marie-Laure Sobrier
- Sorbonne Université, INSERM, Centre de Recherche Saint Antoine, Paris, France
| | - Barbara Heude
- Université de Paris Cité, INSERM, INRAE, Centre of Research in Epidemiology and StatisticS (CRESS), Paris, France
| | - Irene Netchine
- Sorbonne Université, INSERM, Centre de Recherche Saint Antoine, APHP, Hôpital Armand Trousseau, Explorations Fonctionnelles Endocriniennes, Endocrinologie Moléculaire et Pathologies d'Empreinte, Paris, France
- *Correspondence: Irene Netchine,
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15
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Carrillo-Larco RM, Cajachagua-Torres KN, Guzman-Vilca WC, Quezada-Pinedo HG, Tarazona-Meza C, Huicho L. National and subnational trends of birthweight in Peru: Pooled analysis of 2,927,761 births between 2012 and 2019 from the national birth registry. ACTA ACUST UNITED AC 2021; 1:None. [PMID: 34568863 PMCID: PMC8447569 DOI: 10.1016/j.lana.2021.100017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 05/18/2021] [Accepted: 05/25/2021] [Indexed: 11/28/2022]
Abstract
Background National and subnational characterization of birthweight profiles lacks in low- and middle-income countries, yet these are needed for monitoring the progress of national and global nutritional targets. We aimed to describe birthweight indicators at the national and subnational levels in Peru (2012-2019), and by selected correlates. Methods We studied mean birthweight (g), low birthweight (<2,500 g) and small for gestational age (according to international growth curves) prevalences. We analysed the national birth registry and summarized the three birthweight indicators at the national, regional, and province level, also by geographic area (Coast, Highlands, and Amazon). With individual-level data from the mother, we described the birthweight indicators by age, educational level and healthcare provider. Following an ecological approach (province level), we described the birthweight indicators by human development index (HDI), altitude above sea level, proportion of the population living in poverty and proportion of rural population. Findings Mean birthweight was always the lowest in the Highlands (2,954 g in 2019) yet the highest in the Coast (3,516 g in 2019). The same was observed for low birthweight and small for gestational age. In regions with Coast and Highlands, the birthweight indicators worsen from the Coast to the Highlands; the largest absolute difference in mean birthweight between Coast and Highlands in the same region was 367 g. All birthweight indicators were the worst in mothers with none/initial education, while they improved with higher HDI. Interpretation This analysis suggests that interventions are needed at the province level, given the large differences observed between Coast and Highlands even in the same region. Funding Wellcome Trust (214185/Z/18/Z).
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Affiliation(s)
- Rodrigo M Carrillo-Larco
- CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru.,Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Kim N Cajachagua-Torres
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.,The Department of Paediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.,Centro de Investigación en Salud Materna e Infantil and Centro de Investigación para el Desarrollo Integral y Sostenible, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Wilmer Cristobal Guzman-Vilca
- CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru.,School of Medicine "Alberto Hurtado", Universidad Peruana Cayetano Heredia, Lima, Peru.,Sociedad Científica de Estudiantes de Medicina Cayetano Heredia (SOCEMCH), Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Hugo G Quezada-Pinedo
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.,The Department of Paediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.,Centro de Investigación en Salud Materna e Infantil and Centro de Investigación para el Desarrollo Integral y Sostenible, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Carla Tarazona-Meza
- Center for Global Non-Communicable Disease Research and Training, Johns Hopkins University, Baltimore MD, USA.,Universidad Cientifica del Sur, Lima, Peru
| | - Luis Huicho
- Centro de Investigación en Salud Materna e Infantil and Centro de Investigación para el Desarrollo Integral y Sostenible, Universidad Peruana Cayetano Heredia, Lima, Peru.,School of Medicine "Alberto Hurtado", Universidad Peruana Cayetano Heredia, Lima, Peru
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16
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Cocucci SE, Di Carlo MB, Touzón MS, Santacruz MG, Payalef SN, Reyes AP, Ruda Vega H, Vazquez Blanco M, Perazzi BE. Biochemical profiling study in umbilical cord blood in mothers with metabolic disorders. J Matern Fetal Neonatal Med 2021; 35:8317-8326. [PMID: 34496692 DOI: 10.1080/14767058.2021.1973994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND During pregnancy metabolic disorders that affect differently the fetus, are known. These could be early or late disorders. OBJECTIVES To analyze different biochemical parameters in umbilical cord blood (UCB) of healthy and pathological newborns from mothers with metabolic disorders. MATERIALS AND METHODS Samples from UCB (121) were analyzed of newborn from mothers with metabolic disorders who attended at Obstetrics Division. Patients were consecutive, prospective and transversally studied. Newborn were classified as healthy (n = 65) and pathological (n = 56). The maternal metabolic disorders were gestational or non-gestational diabetes, glucose intolerance, insulin resistance and/or obesity).The disorders of the pathological newborns were intrauterine growth restriction (IUGR) and/or fetal distress. Glucose (Glu), urea, creatinine, uric acid (UA), total bilirubin (TB), total proteins (TP), albumin (Alb), transaminases (ALT/AST), alkaline-phosphatase (ALP), gammaglutamyltranspeptidase (GGT), creatinkinasa (CK), lactatedehydrogenase, amylase (amy), pseudocholinesterase, iron, calcium, phosphorus, magnesium (Mg), sodium, potassium, chlorine, cholesterol (Chol), HDL-Chol, LDL-Chol, triglycerides (TG), high sensitivity C reactive protein (hsCRP) were determined by recommended methods. T-Student's and Mann Withney tests were applied, p < .05. RESULTS Pathological neonates (n: 56) showed a significant decrease in maternal gestation weeks (GW) and in newborn weight (NW) with respect to healthy newborns (n: 65) from mothers with metabolic disorders (p < .0001). Pathological neonates from mothers with metabolic pathologies (n: 56) showed significant increases in Chol, TG, TB (p < .01), LDL-Chol, UA, Mg, hsCRP, ALP levels (p < .05) and significant decreases in TP, Alb (p < .0001) and Glu, ALT, CK, GGT, amy (p < .05) in UCB with respect to healthy newborns. CONCLUSIONS In pathological newborn, the decrease in GW and NW would be related to IUGR that accompany these metabolic disorders. The increases observed of the analyzed parameters would be related to cellular destruction associated to maternal pathology and decreases of the parameters to IUGR with hepatic immaturity.
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Affiliation(s)
- Silvina Ema Cocucci
- Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Departamento de Bioquímica Clínica., Hospital de Clínicas "José de San Martín", Buenos Aires, Argentina
| | - María Beatriz Di Carlo
- Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Departamento de Bioquímica Clínica., Hospital de Clínicas "José de San Martín", Buenos Aires, Argentina.,Universidad de Buenos Aires, Instituto de Fisiopatología y Bioquímica Clínica (INFIBIOC), Buenos Aires, Argentina
| | - María Sol Touzón
- Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Departamento de Bioquímica Clínica., Hospital de Clínicas "José de San Martín", Buenos Aires, Argentina
| | - Mirtha Gabriela Santacruz
- Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Departamento de Bioquímica Clínica., Hospital de Clínicas "José de San Martín", Buenos Aires, Argentina
| | - Sandra Noemi Payalef
- Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Departamento de Bioquímica Clínica., Hospital de Clínicas "José de San Martín", Buenos Aires, Argentina
| | - Ana Paula Reyes
- Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Departamento de Bioquímica Clínica., Hospital de Clínicas "José de San Martín", Buenos Aires, Argentina
| | - Hilda Ruda Vega
- Universidad de Buenos Aires, Hospital de Clínicas "José de San Martín", División Obstetricia, Buenos Aires, Argentina
| | - Manuel Vazquez Blanco
- Universidad de Buenos Aires, Hospital de Clínicas "José de San Martín", División Cardiología, Buenos Aires, Argentina
| | - Beatriz Elizabeth Perazzi
- Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Departamento de Bioquímica Clínica., Hospital de Clínicas "José de San Martín", Buenos Aires, Argentina.,Universidad de Buenos Aires, Instituto de Fisiopatología y Bioquímica Clínica (INFIBIOC), Buenos Aires, Argentina
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17
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Chae SA, Son JS, Du M. Prenatal exercise in fetal development: a placental perspective. FEBS J 2021; 289:3058-3071. [PMID: 34449982 DOI: 10.1111/febs.16173] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 08/09/2021] [Accepted: 08/26/2021] [Indexed: 02/06/2023]
Abstract
Maternal obesity (MO) and gestational diabetes mellitus (GDM) are common in Western societies, which impair fetal development and predispose offspring to metabolic dysfunction. Placenta is the organ linking the mother to her fetus, and MO suppresses the development of vascular system and expression of nutrient transporters in placenta, thereby affecting fetal development. For maintaining its proper physiological function, placenta is energy demanding, which is met through extensive oxidative phosphorylation. However, the oxidative capacity of placenta is suppressed due to MO and GDM. Recently, several studies showed that physical activity during pregnancy enhances oxidative metabolism and improves placental function, which might be partially mediated by exerkines, referring to cytokines elicited by exercise. In addition, as an endocrine organ, placenta secretes cytokines, termed placentokines, including apelin, superoxide dismutase 3, irisin, and adiponectin, which mediate fetal development and maternal metabolism. Possible molecular mechanisms linking maternal exercise and placentokines to placental and fetal development are further discussed. As an emerging field, up to now, available studies are limited, mostly conducted in rodents. Given the epidemics of obesity and metabolic disorders, as well as the prevalence of maternal sedentary lifestyle, the effects of exercise of pregnant women on placental function and placentokine secretion, as well as their impacts on fetal development, need to be further examined.
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Affiliation(s)
- Song Ah Chae
- Nutrigenomics and Growth Biology Laboratory, Department of Animal Sciences, Washington State University, Pullman, WA, USA
| | - Jun Seok Son
- Laboratory of Perinatal Kinesioepigenetics, Department of Obstetrics, Gynecology & Reproductive Sciences, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Min Du
- Nutrigenomics and Growth Biology Laboratory, Department of Animal Sciences, Washington State University, Pullman, WA, USA
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Birthweight-for-gestational-age z-scores are associated with early childhood cardiometabolic health in the Peri/Postnatal Epigenetic Twin Study. J Dev Orig Health Dis 2021; 13:514-522. [PMID: 34420534 DOI: 10.1017/s2040174421000465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Birthweight has been consistently related to risk of cardiometabolic disorders in later life. Twins are at higher risk of low birthweight than singletons, so understanding the links between birthweight and cardiometabolic health may be particularly important for twins. However, evidence for the association of birthweight with childhood markers of cardiometabolic health in twins is currently lacking. Previous studies have often failed to appropriately adjust for gestational age or fully implement twin regression models. Therefore, we aimed to evaluate the association of birthweight-for-gestational-age z-scores with childhood cardiometabolic health in twins, using within-between regression models. The Peri/Postnatal Epigenetic Twins Study is a Melbourne-based prospective cohort study of 250 twin pairs. Birthweight was recorded at delivery, and childhood anthropometric measures were taken at 18-month and 6-year follow-up visits. Associations of birthweight with markers of cardiometabolic health were assessed at the individual, between- and within-pair level using linear regression with generalised estimating equations. Birthweight-for-gestational-age z-scores were associated with height, weight and BMI at 18 months and 6 years, but not with blood pressure (twins-as-individual SBP: β = 0.15, 95% CI: -0.81, 1.11; twins-as-individual DBP: β = 0.22, 95% CI: -0.34, 0.77). We found little evidence to indicate that the within-between models improved on the twins-as-individuals models. Birthweight was associated with childhood anthropometric measures, but not blood pressure, after appropriately adjusting for gestational age. These associations were consistent across the within-between and twins-as-individuals models. After adjusting for gestational age, results from the twins-as-individuals models are consistent with singleton studies, so these results can be applied to the general population.
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Disruption of O-Linked N-Acetylglucosamine Signaling in Placenta Induces Insulin Sensitivity in Female Offspring. Int J Mol Sci 2021; 22:ijms22136918. [PMID: 34203166 PMCID: PMC8267851 DOI: 10.3390/ijms22136918] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 06/19/2021] [Accepted: 06/20/2021] [Indexed: 12/15/2022] Open
Abstract
Placental dysfunction can lead to fetal growth restriction which is associated with perinatal morbidity and mortality. Fetal growth restriction increases the risk of obesity and diabetes later in life. Placental O-GlcNAc transferase (OGT) has been identified as a marker and a mediator of placental insufficiency in the setting of prenatal stress, however, its role in the fetal programming of metabolism and glucose homeostasis remains unknown. We aim to determine the long-term metabolic outcomes of offspring with a reduction in placental OGT. Mice with a partial reduction and a full knockout of placenta-specific OGT were generated utilizing the Cre-Lox system. Glucose homeostasis and metabolic parameters were assessed on a normal chow and a high-fat diet in both male and female adult offspring. A reduction in placental OGT did not demonstrate differences in the metabolic parameters or glucose homeostasis compared to the controls on a standard chow. The high-fat diet provided a metabolic challenge that revealed a decrease in body weight gain (p = 0.02) and an improved insulin tolerance (p = 0.03) for offspring with a partially reduced placental OGT but not when OGT was fully knocked out. Changes in body weight were not associated with changes in energy homeostasis. Offspring with a partial reduction in placental OGT demonstrated increased hepatic Akt phosphorylation in response to insulin treatment (p = 0.02). A partial reduction in placental OGT was protective from weight gain and insulin intolerance when faced with the metabolic challenge of a high-fat diet. This appears to be, in part, due to increased hepatic insulin signaling. The findings of this study contribute to the greater understanding of fetal metabolic programming and the effect of placental OGT on peripheral insulin sensitivity and provides a target for future investigation and clinical applications.
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Kuiper-Makris C, Selle J, Nüsken E, Dötsch J, Alejandre Alcazar MA. Perinatal Nutritional and Metabolic Pathways: Early Origins of Chronic Lung Diseases. Front Med (Lausanne) 2021; 8:667315. [PMID: 34211985 PMCID: PMC8239134 DOI: 10.3389/fmed.2021.667315] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 05/12/2021] [Indexed: 12/12/2022] Open
Abstract
Lung development is not completed at birth, but expands beyond infancy, rendering the lung highly susceptible to injury. Exposure to various influences during a critical window of organ growth can interfere with the finely-tuned process of development and induce pathological processes with aberrant alveolarization and long-term structural and functional sequelae. This concept of developmental origins of chronic disease has been coined as perinatal programming. Some adverse perinatal factors, including prematurity along with respiratory support, are well-recognized to induce bronchopulmonary dysplasia (BPD), a neonatal chronic lung disease that is characterized by arrest of alveolar and microvascular formation as well as lung matrix remodeling. While the pathogenesis of various experimental models focus on oxygen toxicity, mechanical ventilation and inflammation, the role of nutrition before and after birth remain poorly investigated. There is accumulating clinical and experimental evidence that intrauterine growth restriction (IUGR) as a consequence of limited nutritive supply due to placental insufficiency or maternal malnutrition is a major risk factor for BPD and impaired lung function later in life. In contrast, a surplus of nutrition with perinatal maternal obesity, accelerated postnatal weight gain and early childhood obesity is associated with wheezing and adverse clinical course of chronic lung diseases, such as asthma. While the link between perinatal nutrition and lung health has been described, the underlying mechanisms remain poorly understood. There are initial data showing that inflammatory and nutrient sensing processes are involved in programming of alveolarization, pulmonary angiogenesis, and composition of extracellular matrix. Here, we provide a comprehensive overview of the current knowledge regarding the impact of perinatal metabolism and nutrition on the lung and beyond the cardiopulmonary system as well as possible mechanisms determining the individual susceptibility to CLD early in life. We aim to emphasize the importance of unraveling the mechanisms of perinatal metabolic programming to develop novel preventive and therapeutic avenues.
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Affiliation(s)
- Celien Kuiper-Makris
- Department of Pediatric and Adolescent Medicine, Translational Experimental Pediatrics—Experimental Pulmonology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Jaco Selle
- Department of Pediatric and Adolescent Medicine, Translational Experimental Pediatrics—Experimental Pulmonology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Eva Nüsken
- Department of Pediatric and Adolescent Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Jörg Dötsch
- Department of Pediatric and Adolescent Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Miguel A. Alejandre Alcazar
- Department of Pediatric and Adolescent Medicine, Translational Experimental Pediatrics—Experimental Pulmonology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- Center for Molecular Medicine Cologne (CMMC), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- Excellence Cluster on Stress Responses in Aging-associated Diseases (CECAD), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- Member of the German Centre for Lung Research (DZL), Institute for Lung Health, University of Giessen and Marburg Lung Centre (UGMLC), Gießen, Germany
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21
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Casasnovas J, Damron CL, Jarrell J, Orr KS, Bone RN, Archer-Hartmann S, Azadi P, Kua KL. Offspring of Obese Dams Exhibit Sex-Differences in Pancreatic Heparan Sulfate Glycosaminoglycans and Islet Insulin Secretion. Front Endocrinol (Lausanne) 2021; 12:658439. [PMID: 34108935 PMCID: PMC8181410 DOI: 10.3389/fendo.2021.658439] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 04/20/2021] [Indexed: 12/12/2022] Open
Abstract
Offspring of obese mothers suffer higher risks of type 2 diabetes due to increased adiposity and decreased β cell function. To date, the sex-differences in offspring islet insulin secretion during early life has not been evaluated extensively, particularly prior to weaning at postnatal day 21 (P21). To determine the role of maternal obesity on offspring islet insulin secretion, C57BL/6J female dams were fed chow or western diet from 4 weeks prior to mating to induce maternal obesity. First, offspring of chow-fed and obese dams were evaluated on postnatal day 21 (P21) prior to weaning for body composition, glucose and insulin tolerance, and islet phasic insulin-secretion. Compared to same-sex controls, both male and female P21 offspring born to obese dams (MatOb) had higher body adiposity and exhibited sex-specific differences in glucose tolerance and insulin secretion. The male MatOb offspring developed the highest extent of glucose intolerance and lowest glucose-induced insulin secretion. In contrast, P21 female offspring of obese dams had unimpaired insulin secretion. Using SAX-HPLC, we found that male MatOb had a decrease in pancreatic heparan sulfate glycosaminoglycan, which is a macromolecule critical for islet health. Notably, 8-weeks-old offspring of obese dams continued to exhibit a similar pattern of sex-differences in glucose intolerance and decreased islet insulin secretion. Overall, our study suggests that maternal obesity induces sex-specific changes to pancreatic HSG in offspring and a lasting effect on offspring insulin secretion, leading to the sex-differences in glucose intolerance.
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Affiliation(s)
- Jose Casasnovas
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Christopher Luke Damron
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, United States
| | - James Jarrell
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Kara S. Orr
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Robert N. Bone
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, United States
| | | | - Parastoo Azadi
- Complex Carbohydrate Research Center, University of Georgia, Athens, GA, United States
| | - Kok Lim Kua
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, United States
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22
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Dall'asta A, Cagninelli G, Galli L, Frusca T, Ghi T. Monitoring fetal well-being in labor in late fetal growth restriction. Minerva Obstet Gynecol 2021; 73:453-461. [PMID: 33949824 DOI: 10.23736/s2724-606x.21.04819-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Late-onset fetal growth restriction (FGR) accounts for approximately 70-80% of all cases of FGR secondary to uteroplacental insufficiency. It is associated with an increased incidence of adverse antepartum and perinatal events, which in most instances result from hypoxic insults either present at the onset of labor or supervening during labor as a result of uterine contractions. Labor represents a stressful event for the fetoplacental unit being uterine contractions associated with an up-to 60% reduction of the uteroplacental perfusion. Intrapartum fetal heart rate monitoring by means of cardiotocography (CTG) currently represents the mainstay for the identification of fetal hypoxia during labor and is recommended for the fetal surveillance during labor in the case of FGR or other conditions associated with an increased risk of intrapartum hypoxia. In this review we discuss the potential implications of an impaired placental function on the intrapartum adaptation to the hypoxic stress and the role of the CTG and alternative techniques for the intrapartum monitoring of the fetal wellbeing in the context of FGR secondary to uteroplacental insufficiency.
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Affiliation(s)
- Andrea Dall'asta
- Unit of Obstetrics and Gynecology, Department of Medicine and Surgery, University of Parma, Parma, Italy - .,Department of Metabolism, Digestion and Reproduction, Institute of Reproductive and Developmental Biology, Imperial College London, London, UK -
| | - Greta Cagninelli
- Unit of Obstetrics and Gynecology, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Letizia Galli
- Unit of Obstetrics and Gynecology, AUSL-IRCCS Reggio Emilia, Reggio Emilia, Italy
| | - Tiziana Frusca
- Unit of Obstetrics and Gynecology, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Tullio Ghi
- Unit of Obstetrics and Gynecology, Department of Medicine and Surgery, University of Parma, Parma, Italy
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23
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Ni Y, Beckmann J, Hurst JR, Morris JK, Marlow N. Size at birth, growth trajectory in early life, and cardiovascular and metabolic risks in early adulthood: EPICure study. Arch Dis Child Fetal Neonatal Ed 2021; 106:149-155. [PMID: 32796060 PMCID: PMC7116791 DOI: 10.1136/archdischild-2020-319328] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 07/13/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To investigate whether size at birth and growth trajectories in infancy and childhood are associated with determinants of cardiovascular and metabolic risks in young adults born extremely preterm (EP, <26 weeks of gestation). METHODS We used longitudinal data from the EPICure study of 129 EP survivors up to 19 years in the UK and Ireland in 1995. Determinants of cardiovascular and metabolic risks at 19 years included the presence of metabolic syndrome, body mass index (BMI) and systolic blood pressure (SBP). Predictors were birth weight for gestation and gain in weight z-scores in the following periods: birth-postmenstrual age of 40 weeks (term), infancy (term-2.5 years), early childhood (2.5-6.0 years) and late childhood (6-11 years). RESULTS Metabolic syndrome was present in 8.7% of EP participants at 19 years. Compared with subjects without metabolic syndrome, those with metabolic syndrome tended to have a smaller size at birth (difference in means: -0.55 SD, 95% CI -1.10 to 0.01, p=0.053) and a greater increase in weight z-scores from term to 2.5 years (difference in means: 1.00 SD, 95% CI -0.17 to 2.17, p=0.094). BMI at 19 years was positively related to growth from 2.5 to 6.0 years ( β : 1.03, 95% CI 0.31 to 1.75, p=0.006); an inverse association with birthweight z-scores was found in the lower socioeconomic status group ( β : -1.79, 95% CI -3.41 to -0.17, p=0.031). Central SBP was positively related to growth from 2.5 to 6.0 years ( β : 1.75, 95% CI 0.48 to 3.02, p=0.007). CONCLUSION Size at EP birth and increased catch-up in weight from 2.5 to 6.0 years were associated with BMI and central SBP in early adulthood.
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Affiliation(s)
- Yanyan Ni
- UCL EGA Institute for Women's Health, University College London, London, UK
| | - Joanne Beckmann
- Institute for Women’s Health, University College London, London, UK
| | - John R Hurst
- UCL Respiratory, University College London, London, UK
| | - Joan K Morris
- Population Health Research Institute, St George’s, University of London, UK
| | - Neil Marlow
- Institute for Women’s Health, University College London, London, UK
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24
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Pedersen DC, Bjerregaard LG, Rasmussen KM, Nohr EA, Baker JL. Risk of gestational diabetes mellitus in nulliparous women - Associations with early life body size and change in body mass index from childhood to adulthood. Diabetes Res Clin Pract 2021; 171:108564. [PMID: 33271232 DOI: 10.1016/j.diabres.2020.108564] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 11/06/2020] [Accepted: 11/16/2020] [Indexed: 11/24/2022]
Abstract
AIMS We examined whether a woman's birthweight, childhood height, body mass index (BMI), and BMI changes from childhood to pregnancy were associated with risks of gestational diabetes mellitus (GDM). METHODS We studied 13,031 women from the Copenhagen School Health Records Register born 1959-1996 with birthweight and measured anthropometric information at ages 7 and/or 13. The diagnosis of GDM (n = 255) was obtained from a national health register. Risk ratios (RR) were estimated using log-linear binomial regression. RESULTS Own birthweight and childhood height were inversely associated with GDM. Girls with overweight at age 7 had a higher risk of GDM than girls with normal-weight (RR: 1.79, 95% CI: 1.31, 2.47). Compared to women with normal-weight in childhood and adulthood, risks of GDM were higher in women who developed overweight from age 7 to pregnancy (RR: 4.62; 3.48, 6.14) or had overweight at both times (RR: 4.71; 3.24, 6.85). In women whose BMI normalized from age 7 to pregnancy the RR for GDM was 1.08 (0.47, 2.46). CONCLUSIONS Lower birthweight, shorter childhood height, and higher childhood BMI are associated with increased risks of GDM. Efforts to help girls maintain a normal BMI before pregnancy may be warranted to minimize risks of GDM.
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Affiliation(s)
- Dorthe C Pedersen
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, The Capital Region, Copenhagen, Denmark
| | - Lise G Bjerregaard
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, The Capital Region, Copenhagen, Denmark
| | | | - Ellen A Nohr
- Research Unit of Obstetrics and Gynecology, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Jennifer L Baker
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, The Capital Region, Copenhagen, Denmark.
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25
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Moen GH, Brumpton B, Willer C, Åsvold BO, Birkeland KI, Wang G, Neale MC, Freathy RM, Smith GD, Lawlor DA, Kirkpatrick RM, Warrington NM, Evans DM. Mendelian randomization study of maternal influences on birthweight and future cardiometabolic risk in the HUNT cohort. Nat Commun 2020; 11:5404. [PMID: 33106479 PMCID: PMC7588432 DOI: 10.1038/s41467-020-19257-z] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 10/02/2020] [Indexed: 12/11/2022] Open
Abstract
There is a robust observational relationship between lower birthweight and higher risk of cardiometabolic disease in later life. The Developmental Origins of Health and Disease (DOHaD) hypothesis posits that adverse environmental factors in utero increase future risk of cardiometabolic disease. Here, we explore if a genetic risk score (GRS) of maternal SNPs associated with offspring birthweight is also associated with offspring cardiometabolic risk factors, after controlling for offspring GRS, in up to 26,057 mother-offspring pairs (and 19,792 father-offspring pairs) from the Nord-Trøndelag Health (HUNT) Study. We find little evidence for a maternal (or paternal) genetic effect of birthweight associated variants on offspring cardiometabolic risk factors after adjusting for offspring GRS. In contrast, offspring GRS is strongly related to many cardiometabolic risk factors, even after conditioning on maternal GRS. Our results suggest that the maternal intrauterine environment, as proxied by maternal SNPs that influence offspring birthweight, is unlikely to be a major determinant of adverse cardiometabolic outcomes in population based samples of individuals.
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Affiliation(s)
- Gunn-Helen Moen
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
- The University of Queensland Diamantina Institute, The University of Queensland, Woolloongabba, QLD, 4102, Australia.
- K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Trondheim, Norway.
- Population Health Science, Bristol Medical School, University of Bristol, Bristol, UK.
| | - Ben Brumpton
- K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Thoracic and Occupational Medicine, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
- Medical Research Council Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
| | - Cristen Willer
- Department of Biostatistics and Center for Statistical Genetics, University of Michigan, Ann Arbor, USA
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
- Department of Human Genetics, University of Michigan, Ann Arbor, MI, USA
| | - Bjørn Olav Åsvold
- K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Endocrinology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Kåre I Birkeland
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Geng Wang
- The University of Queensland Diamantina Institute, The University of Queensland, Woolloongabba, QLD, 4102, Australia
| | - Michael C Neale
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA
| | - Rachel M Freathy
- Institute of Biomedical and Clinical Science, College of Medicine and Health, University of Exeter, Exeter, UK
| | - George Davey Smith
- Population Health Science, Bristol Medical School, University of Bristol, Bristol, UK
- Medical Research Council Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- Bristol NIHR Biomedical Research Centre, Bristol, UK
| | - Deborah A Lawlor
- Population Health Science, Bristol Medical School, University of Bristol, Bristol, UK
- Medical Research Council Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- Bristol NIHR Biomedical Research Centre, Bristol, UK
| | - Robert M Kirkpatrick
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA
| | - Nicole M Warrington
- The University of Queensland Diamantina Institute, The University of Queensland, Woolloongabba, QLD, 4102, Australia
- K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
- Medical Research Council Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
| | - David M Evans
- The University of Queensland Diamantina Institute, The University of Queensland, Woolloongabba, QLD, 4102, Australia.
- Medical Research Council Integrative Epidemiology Unit at the University of Bristol, Bristol, UK.
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Ashtree DN, McGuinness AJ, Plummer M, Sun C, Craig JM, Scurrah KJ. Developmental origins of cardiometabolic health outcomes in twins: A systematic review and meta-analysis. Nutr Metab Cardiovasc Dis 2020; 30:1609-1621. [PMID: 32682747 DOI: 10.1016/j.numecd.2020.06.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 05/21/2020] [Accepted: 06/15/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND AND AIMS Studies of twins can reduce confounding and provide additional evidence about the causes of disease, due to within-pair matching for measured and unmeasured factors. Although findings from twin studies are typically applicable to the general population, few studies have taken full advantage of the twin design to explore the developmental origins of cardiometabolic health outcomes. We aimed to systematically review the evidence from twin studies and generate pooled estimates for the effects of early-life risk factors on later-life cardiometabolic health. METHODS AND RESULTS An initial search was conducted in March 2018, with 55 studies of twins included in the review. Risk of bias was assessed using the Newcastle-Ottawa Scale, and eligible studies were included in a meta-analysis, where pooled estimates were calculated. Twenty-six studies analysed twins as individuals, and found that higher birthweight was associated with lower SBP (β = -2.02 mmHg, 95%CI: -3.07, -0.97), higher BMI (β = 0.52 kg/m2, 95%CI: 0.20, 0.84) and lower total cholesterol (β = -0.07 mmol/L, 95%CI: -0.11, -0.04). However, no associations were reported in studies which adjusted for gestational age. Few of the included studies separated their analyses into within-pair and between-pair associations. CONCLUSIONS Early-life risk factors were associated with cardiometabolic health outcomes in twin studies. However, many estimates from studies in this review were likely to have been confounded by gestational age, and few fully exploited the twin design to assess the developmental origins of cardiometabolic health outcomes.
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Affiliation(s)
- Deborah N Ashtree
- Centre for Epidemiology and Biostatistics, School of Population and Global Health, University of Melbourne, Parkville, Australia; Twins Research Australia, Centre for Epidemiology and Biostatistics, School of Population and Global Health, University of Melbourne, Parkville, Australia.
| | - Amelia J McGuinness
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia
| | - Michelle Plummer
- Adelaide Medical School, Robinson Research Institute, University of Adelaide, Australia
| | - Cong Sun
- Murdoch Children's Research Institute, Parkville, Australia
| | - Jeffrey M Craig
- Murdoch Children's Research Institute, Parkville, Australia; Centre for Molecular and Medical Research, School of Medicine, Faculty of Health, Deakin University, Waurn Ponds, Australia
| | - Katrina J Scurrah
- Centre for Epidemiology and Biostatistics, School of Population and Global Health, University of Melbourne, Parkville, Australia; Twins Research Australia, Centre for Epidemiology and Biostatistics, School of Population and Global Health, University of Melbourne, Parkville, Australia
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27
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Altered Transcription Factor Binding and Gene Bivalency in Islets of Intrauterine Growth Retarded Rats. Cells 2020; 9:cells9061435. [PMID: 32527043 PMCID: PMC7348746 DOI: 10.3390/cells9061435] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 05/30/2020] [Accepted: 06/04/2020] [Indexed: 12/16/2022] Open
Abstract
Intrauterine growth retardation (IUGR), which induces epigenetic modifications and permanent changes in gene expression, has been associated with the development of type 2 diabetes. Using a rat model of IUGR, we performed ChIP-Seq to identify and map genome-wide histone modifications and gene dysregulation in islets from 2- and 10-week rats. IUGR induced significant changes in the enrichment of H3K4me3, H3K27me3, and H3K27Ac marks in both 2-wk and 10-wk islets, which were correlated with expression changes of multiple genes critical for islet function in IUGR islets. ChIP-Seq analysis showed that IUGR-induced histone mark changes were enriched at critical transcription factor binding motifs, such as C/EBPs, Ets1, Bcl6, Thrb, Ebf1, Sox9, and Mitf. These transcription factors were also identified as top upstream regulators in our previously published transcriptome study. In addition, our ChIP-seq data revealed more than 1000 potential bivalent genes as identified by enrichment of both H3K4me3 and H3K27me3. The poised state of many potential bivalent genes was altered by IUGR, particularly Acod1, Fgf21, Serpina11, Cdh16, Lrrc27, and Lrrc66, key islet genes. Collectively, our findings suggest alterations of histone modification in key transcription factors and genes that may contribute to long-term gene dysregulation and an abnormal islet phenotype in IUGR rats.
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Gatford KL, Andraweera PH, Roberts CT, Care AS. Animal Models of Preeclampsia: Causes, Consequences, and Interventions. Hypertension 2020; 75:1363-1381. [PMID: 32248704 DOI: 10.1161/hypertensionaha.119.14598] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Preeclampsia is a common pregnancy complication, affecting 2% to 8% of pregnancies worldwide, and is an important cause of both maternal and fetal morbidity and mortality. Importantly, although aspirin and calcium are able to prevent preeclampsia in some women, there is no cure apart from delivery of the placenta and fetus, often necessitating iatrogenic preterm birth. Preclinical models of preeclampsia are widely used to investigate the causes and consequences of preeclampsia and to evaluate safety and efficacy of potential preventative and therapeutic interventions. In this review, we provide a summary of the published preclinical models of preeclampsia that meet human diagnostic criteria, including the development of maternal hypertension, together with new-onset proteinuria, maternal organ dysfunction, and uteroplacental dysfunction. We then discuss evidence from preclinical models for multiple causal factors of preeclampsia, including those implicated in early-onset and late-onset preeclampsia. Next, we discuss the impact of exposure to a preeclampsia-like environment for later maternal and progeny health. The presence of long-term impairment, particularly cardiovascular outcomes, in mothers and progeny after an experimentally induced preeclampsia-like pregnancy, implies that later onset or reduced severity of preeclampsia will improve later maternal and progeny health. Finally, we summarize published intervention studies in preclinical models and identify gaps in knowledge that we consider should be targets for future research.
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Affiliation(s)
- Kathryn L Gatford
- From the Adelaide Medical School and Robinson Research Institute, The University of Adelaide, Australia
| | - Prabha H Andraweera
- From the Adelaide Medical School and Robinson Research Institute, The University of Adelaide, Australia
| | - Claire T Roberts
- From the Adelaide Medical School and Robinson Research Institute, The University of Adelaide, Australia
| | - Alison S Care
- From the Adelaide Medical School and Robinson Research Institute, The University of Adelaide, Australia
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Spiroski AM, Oliver MH, Jaquiery AL, Gunn TD, Harding JE, Bloomfield FH. Effects of intrauterine insulin-like growth factor-1 therapy for fetal growth restriction on adult metabolism and body composition are sex specific. Am J Physiol Endocrinol Metab 2020; 318:E568-E578. [PMID: 32101029 DOI: 10.1152/ajpendo.00481.2019] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Fetal growth restriction (FGR) is associated with compromised growth and metabolic function throughout life. Intrauterine therapy of FGR with intra-amniotic insulin-like growth factor-1 (IGF1) enhances fetal growth and alters perinatal metabolism and growth in a sex-specific manner, but the adult effects are unknown. We investigated the effects of intra-amniotic IGF1 treatment of FGR on adult growth and body composition, adrenergic sensitivity, and glucose-insulin axis regulation. Placental embolization-induced FGR was treated with four weekly doses of 360 µg intra-amniotic IGF1 (FGRI) or saline (FGRS). Offspring were raised to adulthood (18 mo: FGRI, n = 12 females, 12 males; FGRS, n = 13 females, 10 males) alongside offspring from unembolized and untreated sheep (CON; n = 12 females, 21 males). FGRI females had increased relative lean mass compared with CON but not FGRS (P < 0.05; 70.6 ± 8.2% vs. 61.4 ± 8.2% vs. 67.6 ± 8.2%), decreased abdominal adipose compared with CON and FGRS (P < 0.05; 43.7 ± 1.2% vs. 49.3 ± 0.9% vs. 48.5 ± 1.0%), increased glucose utilization compared with FGRS but not CON (P < 0.05; 9.6 ± 1.0 vs. 6.0 ± 0.9 vs. 7.6 ± 0.9 mg·kg-1·min-1), and increased β-hydroxybutyric acid:nonesterified fatty acid ratio in response to adrenaline compared with CON and FGRS (P < 0.05; 3.9 ± 1.4 vs. 1.1 ± 1.4 vs. 1.8 ± 1.4). FGRS males were smaller and lighter compared with CON but not FGRI (P < 0.05; 86.8 ± 6.3 vs. 93.5 ± 6.1 vs. 90.7 ± 6.3 kg), with increased peak glucose concentration (10%) in response to a glucose load but few other differences. These effects of intra-amniotic IGF1 therapy on adult body composition, glucose-insulin axis function, and adrenergic sensitivity could indicate improved metabolic regulation during young adulthood in female FGR sheep.
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Affiliation(s)
| | - Mark Hope Oliver
- The Liggins Institute, University of Auckland, Auckland, New Zealand
| | | | - Travis Dane Gunn
- The Liggins Institute, University of Auckland, Auckland, New Zealand
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Liu Y, Téllez-Rojo M, Sánchez BN, Ettinger AS, Osorio-Yáñez C, Solano M, Hu H, Peterson KE. Association between fluoride exposure and cardiometabolic risk in peripubertal Mexican children. ENVIRONMENT INTERNATIONAL 2020; 134:105302. [PMID: 31726363 PMCID: PMC6904509 DOI: 10.1016/j.envint.2019.105302] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Revised: 10/30/2019] [Accepted: 11/01/2019] [Indexed: 05/06/2023]
Abstract
BACKGROUND Several animal studies have suggested that fluoride exposure may increase the levels of cardiometabolic risk factors, but little is known about whether fluoride exposure is associated with such risk in humans. OBJECTIVES We examined the cross-sectional association between peripubertal exposure to fluoride and markers of cardiometabolic risk in 280 girls and 256 boys at age 10-18 years living in Mexico City. METHODS We measured plasma fluoride concentration using a microdiffusion method. We collected data on anthropometry including BMI, waist circumference (WC) and trunk fat percentage. We measured serum markers of cardiometabolic risk, including fasting glucose, insulin and lipids. All the indicators of outcome were converted to age- and sex-specific z-scores. We also calculated a summary cardiometabolic risk score for each participant. Multivariable linear regression models were used to examine these associations. RESULTS The geometric mean (95% confidence interval (CI)) of plasma fluoride was 0.21 μmol/L (0.20, 0.23 μmol/L) in the total sample. In girls, plasma fluoride concentrations were associated with higher z-scores for all the individual markers (except for lipids) and for the combined cardiometabolic risk score (risk score: β = 1.28, 95% CI: 0.57-2.00, p-sex interaction = 0.02)), adjusting for covariates. No associations were found in boys. CONCLUSIONS We found that higher peripubertal fluoride exposure at the levels observed in this study population was significantly associated with increased levels of cardiometabolic risk factors in Mexican girls but not boys. Future studies with a longitudinal design are needed to confirm our findings and further elucidate the role of fluoride in cardiometabolic risk.
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Affiliation(s)
- Yun Liu
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Martha Téllez-Rojo
- Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico.
| | - Brisa N Sánchez
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Adrienne S Ettinger
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Citlalli Osorio-Yáñez
- Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico; Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Ciudad de México, Mexico
| | - Maritsa Solano
- Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Howard Hu
- Department of Environmental and Occupational Health Sciences, University of Washington School of Public Health, Seattle, USA; Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Karen E Peterson
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
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O'Connor TG, Williams J, Blair C, Gatzke-Kopp LM, Francis L, Willoughby MT. Predictors of Developmental Patterns of Obesity in Young Children. Front Pediatr 2020; 8:109. [PMID: 32266187 PMCID: PMC7105829 DOI: 10.3389/fped.2020.00109] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 03/03/2020] [Indexed: 12/22/2022] Open
Abstract
Introduction: The current study characterizes longitudinal patterns in obesity in young children and their prediction from developmental programming and social determinant hypotheses. Materials and Methods: The data are based on the Family Life Project, a prospective longitudinal study of 1,292 families recruited from low-income, racially diverse, rural communities in Pennsylvania, and North Carolina. Pre-natal, peri-natal, and post-natal risks for childhood obesity were collected from 2 months of age; in-person assessments of child growth were used to identity obesity on multiple occasions from 24 to 90 months of age. Results: Two major novel findings emerged. First, longitudinal analyses identified four distinct obesity development profiles: stable obesity, later-onset obesity, moderate/declining obesity, and non-obese; these groups had distinct risk profiles. Second, prediction analyses favored developmental programming explanations for obesity, including evidence even in early childhood that both low- and high birth weight was associated with stable obesity. There was no indication that pre- and peri-natal and post-natal factors predicted obesity differently in non-minority and minority children. Discussion: Factors derived from the developmental programming model of obesity overlapped with, but predicted early onset obesity independently from, risks associated with social determinant models of obesity.
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Affiliation(s)
- Thomas G O'Connor
- Department of Psychiatry, University of Rochester, Rochester, NY, United States.,Department of Psychology, University of Rochester, Rochester, NY, United States.,Department of Neuroscience, University of Rochester, Rochester, NY, United States.,Department of Obstetrics and Gynecology, University of Rochester, Rochester, NY, United States.,Wynne Center for Family Research, University of Rochester, Rochester, NY, United States
| | - Jason Williams
- RTI International, Research Triangle Park, Durham, NC, United States
| | - Clancy Blair
- Department of Population Health, New York University, New York, NY, United States
| | - Lisa M Gatzke-Kopp
- Department of Human Development and Family Studies, The Pennsylvania State University, State College, PA, United States
| | - Lori Francis
- Department of Biobehavioral Health, The Pennsylvania State University, State College, PA, United States
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Wu WC, Li HY, Chiang CC, Sung FC, Wei JN, Chuang LM. Screening for diabetes in asymptomatic children: A simple and efficient method. J Formos Med Assoc 2019; 119:974-981. [PMID: 31607628 DOI: 10.1016/j.jfma.2019.09.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 08/23/2019] [Accepted: 09/23/2019] [Indexed: 10/25/2022] Open
Abstract
BACKGROUND/PURPOSE Type 2 diabetes has become an important cause of diabetes in children. Since most children with type 2 diabetes are asymptomatic, a screening method is needed. However, physicians are required in the screening methods recommended by professional associations. We aimed to develop a simple and efficient screening method for children with diabetes. METHODS A nationwide survey was conducted, which included 2,270,496 seventh-grade students. Students with two abnormal results in sequential urinalyses were given a fasting blood test. Three screening methods were developed. RESULTS Among the screening methods, method C is simple, and can be performed by parents, teachers, or school nurses. It suggests children with two abnormal results in sequential urinalyses and who are overweight or have a family history of diabetes receive blood tests. As a result, 0.10% of boys and 0.16% of girls were recommended to receive blood tests, and 7.0% of boys and 6.7% of girls receiving blood tests were diagnosed diabetes. On average, 15,002 boys and 9056 girls had to be screened to find one child with diabetes. The cost per 1000 children by method C was 2466.84 US dollars. CONCLUSION Urinalysis screening followed by evaluation of risk factors is a simple and efficient way to identify children with diabetes in schools.
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Affiliation(s)
- Wan-Chen Wu
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, 100, Taiwan
| | - Hung-Yuan Li
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, 100, Taiwan
| | | | - Fung-Chang Sung
- Institute of Environmental Health, China Medical University College of Public Health, Taichung, 404, Taiwan
| | - Jung-Nan Wei
- Chia Nan University of Pharmacy and Science, Tainan, 717, Taiwan.
| | - Lee-Ming Chuang
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, 100, Taiwan.
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Esmeijer K, de Vries AP, Mook-Kanamori DO, de Fijter JW, Rosendaal FR, Rabelink TJ, Smit RAJ, de Mutsert R, Hoogeveen EK. Low Birth Weight and Kidney Function in Middle-Aged Men and Women: The Netherlands Epidemiology of Obesity Study. Am J Kidney Dis 2019; 74:751-760. [PMID: 31358312 DOI: 10.1053/j.ajkd.2019.05.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Accepted: 05/03/2019] [Indexed: 01/06/2023]
Abstract
RATIONALE & OBJECTIVE Chronic kidney disease (CKD), defined as estimated glomerular filtration rate (eGFR)<60mL/min/1.73m2, is a risk factor for cardiovascular morbidity and mortality. Little is known about low birth weight and risk for CKD in middle-aged adults in the general population. We estimated the causal association between birth weight and eGFR in a Dutch cohort of middle-aged men and women. STUDY DESIGN Retrospective cohort study. SETTING & PARTICIPANTS 6,671 participants in the Netherlands Epidemiology of Obesity (NEO) Study. Replication study using data for 133,814 participants studied by the CKDGen consortium. EXPOSURE Birth weight was self-reported and also based on an instrumental variable, 59 birth weight-associated genetic variants, derived from an independent data source. OUTCOME eGFR at the age of 45 to 65 years. ANALYTICAL APPROACH We assessed the association between self-reported birth weight and eGFR in the NEO Study using multivariable linear regression, adjusted for age, sex, education, smoking, and alcohol use. The effect of the instrument on eGFR was estimated using separate 2-sample Mendelian randomization analyses: one using individual data from the NEO cohort and one using summary data from the CKDGen consortium. RESULTS At baseline, mean eGFR was 86±12.4 (SD) mL/min/1.73m2. After multivariable adjustment, self-reported birth weight was not associated with kidney function in middle age. Two-sample Mendelian randomization analysis showed that in the NEO cohort, for each 500-g lower birth weight defined using genetic variants, there was a 3.7 (95% CI, 0.5-6.9)-mL/min/1.73m2 lower eGFR at the age of 45 to 65 years. However, using CKDGen summary-level data, there was a smaller nonsignificant relationship between birth weight and eGFR. LIMITATIONS Birth weight was self-reported. CONCLUSIONS Lower birth weight defined using genetic variants was associated with lower eGFRs in Dutch middle-aged adults. However, this finding was not replicated within the CKDGen consortium.
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Affiliation(s)
- Kevin Esmeijer
- Department of Nephrology, Leiden University Medical Center, Leiden, the Netherlands; Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands.
| | - Aiko P de Vries
- Department of Nephrology, Leiden University Medical Center, Leiden, the Netherlands
| | - Dennis O Mook-Kanamori
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands; Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, the Netherlands
| | - Johan W de Fijter
- Department of Nephrology, Leiden University Medical Center, Leiden, the Netherlands
| | - Frits R Rosendaal
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Ton J Rabelink
- Department of Nephrology, Leiden University Medical Center, Leiden, the Netherlands
| | - Roelof A J Smit
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Renée de Mutsert
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Ellen K Hoogeveen
- Department of Nephrology, Leiden University Medical Center, Leiden, the Netherlands; Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands; Department of Nephrology, Jeroen Bosch Hospital, Den Bosch, the Netherlands
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Plank LD, Obolonkin V, Smith M, Savila F, Jalili-Moghaddam S, Tautolo ES, Rush EC. Pacific Islands Families Study: Physical growth to age 14 and metabolic risk. Pediatr Obes 2019; 14:e12497. [PMID: 30653850 DOI: 10.1111/ijpo.12497] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Accepted: 11/21/2018] [Indexed: 12/31/2022]
Abstract
BACKGROUND The relationships between the trajectories of weight gain from early childhood to adolescence and risk for metabolic disease are not well understood. OBJECTIVE The objective of the study is to examine the relationships between weight gain from 2 to 14 years and metabolic risk factors at age 14 years in Pacific Island children. METHODS z scores for weight were calculated at each of the ages 2.5, 4, 6, 9, 11, and 13.5 years in 1053 children. Growth trajectories were determined by estimating the linear trend of z scores with age for each child. In a subgroup of 204 children, biomarkers of metabolic risk were measured and related to linear trend intercepts and slopes. RESULTS More rapid growth (greater slope of z score trajectory) was associated with higher concentrations of insulin, leptin (boys), urate, and markers of liver function, insulin resistance and inflammation. Children with higher weights in early life (greater intercept) showed fewer associations with metabolic markers, but considered together, intercept and slope were independently associated with a range of metabolic risk factors. CONCLUSIONS Both rapid weight gain and a higher body weight in early childhood were associated with higher risk for metabolic disease. Monitoring growth trajectories may help target interventions to optimize nutrition, physical activity, and growth.
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Affiliation(s)
- Lindsay D Plank
- Department of Surgery, University of Auckland, Auckland, New Zealand
| | - Vladimir Obolonkin
- Child Health Research Centre, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Melody Smith
- School of Nursing, University of Auckland, Auckland, New Zealand
| | - Fa'asisila Savila
- Centre for Pacific Health and Development Research, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Shabnam Jalili-Moghaddam
- Child Health Research Centre, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand.,Centre for Pacific Health and Development Research, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand
| | - El-Shadan Tautolo
- Centre for Pacific Health and Development Research, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Elaine C Rush
- Child Health Research Centre, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand.,Centre for Pacific Health and Development Research, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand
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Masalin S, Rönö K, Kautiainen H, Gissler M, Eriksson JG, Laine MK. Body surface area at birth and later risk for gestational diabetes mellitus among primiparous women. Acta Diabetol 2019; 56:397-404. [PMID: 30430243 PMCID: PMC6420481 DOI: 10.1007/s00592-018-1256-2] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Accepted: 11/06/2018] [Indexed: 01/16/2023]
Abstract
AIMS To assess the relationship between body surface area (BSA) at birth and future risk for gestational diabetes mellitus (GDM). METHODS This is an observational cohort study from Vantaa, Finland. The cohort included 1548 Finnish primiparous women, aged 15-28 years, without pre-existing diabetes, who gave birth 2009-2015. All women were born full-term and had complete information about their birth weight and length, from the Finnish Medical Birth Register. Additional data for the study were provided by individual patient health records and Statistics Finland. Study participants were divided into five levels (I-V) according to BSA at birth, based on normal distribution. RESULTS There was an inverse association between BSA at birth and risk for GDM (p = 0.015 for linearity, after adjustments for age, educational attainment, pre-pregnancy BMI and smoking). The odds ratio (OR) for GDM in level V, with the largest BSA at birth, compared with level I, with the smallest BSA at birth, was 0.43 [95% confidence interval (CI) 0.22-0.83]; adjusted for age, educational attainment, pre-pregnancy body mass index and smoking. The OR for GDM was 0.8 (95% CI 0.68-0.95, p = 0.009) for each one standard deviation increase in BSA at birth, adjusted for the same confounders. BSA at birth correlated with adult anthropometry: correlation coefficients were r = 0.16 (95% CI 0.11-0.21) for weight, r = 0.31 (95% CI 0.26-0.35) for height, and r = 0.06 (95% CI 0.01-0.11) for BMI. CONCLUSIONS Body surface area at birth is inversely associated with future risk for GDM in primiparous women.
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Affiliation(s)
- Senja Masalin
- Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
| | - Kristiina Rönö
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Folkhälsan Research Center, Helsinki, Finland
| | - Hannu Kautiainen
- Folkhälsan Research Center, Helsinki, Finland
- Primary Health Care Unit, Kuopio University Hospital, Kuopio, Finland
| | - Mika Gissler
- Information Department, National Institute for Health and Welfare, Helsinki, Finland
- Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
| | - Johan G Eriksson
- Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Folkhälsan Research Center, Helsinki, Finland
- Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland
| | - Merja K Laine
- Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Vantaa Health Center, Vantaa, Finland
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Ethiopia's high childhood undernutrition explained: analysis of the prevalence and key correlates based on recent nationally representative data. Public Health Nutr 2019; 22:2099-2109. [PMID: 30894232 DOI: 10.1017/s1368980019000569] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To examine the contribution of child, maternal and household factors in stunting, wasting and underweight among children under 5 years in Ethiopia. DESIGN Quantitative cross-sectional design based on nationally representative data. SETTING Urban and rural areas of Ethiopia.ParticipantsYounger (0-24 months; n 4199) and older age groups (25-59 months; n 5497), giving a total of 9696 children. RESULTS Among the younger age group, 29 % were stunted, 14 % were wasted and 19 % were underweight; and among the older age group, the prevalence of stunting, wasting and underweight was 47, 8 and 28 %, respectively. Being female, intake of multiple micronutrients, household having a piped source of drinking-water, high maternal BMI, higher household wealth and higher maternal education were associated with decreased odds of at least one form of undernutrition in both groups. On the other hand, children who were anaemic, had low birth weight, drank from a bottle, and children of stunted or wasted or working mothers were more likely to be stunted, wasted or underweight in both groups (P<0·05). While most predictors and/or risk factors followed a similar pattern across the two age groups, child factors had higher leverage in the younger than the older group across the three forms of undernutrition. CONCLUSIONS Multiple set of factors predicted childhood undernutrition in Ethiopia. The study underscores the importance of intervening in the first 1000 days through promoting maternal education, maternal-child health services, mother's nutrition and improving intrahousehold food distribution.
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Horton DM, Saint DA, Gatford KL, Kind KL, Owens JA. Sex-specific programming of adult insulin resistance in guinea pigs by variable perinatal growth induced by spontaneous variation in litter size. Am J Physiol Regul Integr Comp Physiol 2019; 316:R352-R361. [PMID: 30735437 DOI: 10.1152/ajpregu.00341.2018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Intrauterine growth restriction (IUGR) and subsequent neonatal catch-up growth are implicated in programming of insulin resistance later in life. Spontaneous IUGR in the guinea pig, due to natural variation in litter size, produces offspring with asymmetric IUGR and neonatal catch-up growth. We hypothesized that spontaneous IUGR and/or accelerated neonatal growth would impair insulin sensitivity in adult guinea pigs. Insulin sensitivity of glucose metabolism was determined by hyperinsulinemic-euglycemic clamp (HEC) in 38 (21 male, 17 female) young adult guinea pigs from litters of two-to-four pups. A subset (10 male, 8 female) were infused with d-[3-3H]glucose before and during the HEC to determine rates of basal and insulin-stimulated glucose utilization, storage, glycolysis, and endogenous glucose production. n males, the insulin sensitivity of whole body glucose uptake ( r = 0.657, P = 0.002) and glucose utilization ( r = 0.884, P = 0.004) correlated positively and independently with birth weight, but not with neonatal fractional growth rate (FGR10-28). In females, the insulin sensitivity of whole body and partitioned glucose metabolism was not related to birth weight, but that of endogenous glucose production correlated negatively and independently with FGR10-28 ( r = -0.815, P = 0.025). Thus, perinatal growth programs insulin sensitivity of glucose metabolism in the young adult guinea pig and in a sex-specific manner; impaired insulin sensitivity, including glucose utilization, occurs after IUGR in males and impaired hepatic insulin sensitivity after rapid neonatal growth in females.
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Affiliation(s)
- Dane M Horton
- Robinson Research Institute, The University of Adelaide , Adelaide, South Australia , Australia.,Adelaide Medical School, The University of Adelaide , Adelaide, South Australia , Australia
| | - David A Saint
- Adelaide Medical School, The University of Adelaide , Adelaide, South Australia , Australia
| | - Kathryn L Gatford
- Robinson Research Institute, The University of Adelaide , Adelaide, South Australia , Australia.,Adelaide Medical School, The University of Adelaide , Adelaide, South Australia , Australia
| | - Karen L Kind
- Robinson Research Institute, The University of Adelaide , Adelaide, South Australia , Australia.,School of Animal and Veterinary Sciences, The University of Adelaide , Adelaide, South Australia , Australia
| | - Julie A Owens
- Robinson Research Institute, The University of Adelaide , Adelaide, South Australia , Australia.,Adelaide Medical School, The University of Adelaide , Adelaide, South Australia , Australia.,Office of the Deputy Vice-Chancellor Research, Deakin University, Waurn Ponds, Geelong, Victoria , Australia
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Meertens L, Smits L, van Kuijk S, Aardenburg R, van Dooren I, Langenveld J, Zwaan IM, Spaanderman M, Scheepers H. External validation and clinical usefulness of first-trimester prediction models for small- and large-for-gestational-age infants: a prospective cohort study. BJOG 2019; 126:472-484. [PMID: 30358080 PMCID: PMC6590121 DOI: 10.1111/1471-0528.15516] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/12/2018] [Indexed: 12/19/2022]
Abstract
Objective To assess the external validity of all published first‐trimester prediction models based on routinely collected maternal predictors for the risk of small‐ and large‐for‐gestational‐age (SGA and LGA) infants. Furthermore, the clinical potential of the best‐performing models was evaluated. Design Multicentre prospective cohort. Setting Thirty‐six midwifery practices and six hospitals (in the Netherlands). Population Pregnant women were recruited at <16 weeks of gestation between 1 July 2013 and 31 December 2015. Methods Prediction models were systematically selected from the literature. Information on predictors was obtained by a web‐based questionnaire. Birthweight centiles were corrected for gestational age, parity, fetal sex, and ethnicity. Main outcome measures Predictive performance was assessed by means of discrimination (C‐statistic) and calibration. Results The validation cohort consisted of 2582 pregnant women. The outcomes of SGA <10th percentile and LGA >90th percentile occurred in 203 and 224 women, respectively. The C‐statistics of the included models ranged from 0.52 to 0.64 for SGA (n = 6), and from 0.60 to 0.69 for LGA (n = 6). All models yielded higher C‐statistics for more severe cases of SGA (<5th percentile) and LGA (>95th percentile). Initial calibration showed poor‐to‐moderate agreement between the predicted probabilities and the observed outcomes, but this improved substantially after recalibration. Conclusion The clinical relevance of the models is limited because of their moderate predictive performance, and because the definitions of SGA and LGA do not exclude constitutionally small or large infants. As most clinically relevant fetal growth deviations are related to ‘vascular’ or ‘metabolic’ factors, models predicting hypertensive disorders and gestational diabetes are likely to be more specific. Tweetable abstract The clinical relevance of prediction models for the risk of small‐ and large‐for‐gestational‐age is limited. The clinical relevance of prediction models for the risk of small‐ and large‐for‐gestational‐age is limited.
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Affiliation(s)
- Lje Meertens
- Department of Epidemiology, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands
| | - Ljm Smits
- Department of Epidemiology, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands
| | - Smj van Kuijk
- Department of Clinical Epidemiology and Medical Technology Assessment (KEMTA), Maastricht University Medical Centre, Maastricht, the Netherlands
| | - R Aardenburg
- Department of Obstetrics and Gynaecology, Zuyderland Medical Centre, Heerlen, the Netherlands
| | - Ima van Dooren
- Department of Obstetrics and Gynaecology, Sint Jans Gasthuis Weert, Weert, the Netherlands
| | - J Langenveld
- Department of Obstetrics and Gynaecology, Zuyderland Medical Centre, Heerlen, the Netherlands
| | - I M Zwaan
- Department of Obstetrics and Gynaecology, Laurentius Hospital, Roermond, the Netherlands
| | - Mea Spaanderman
- Department of Obstetrics and Gynaecology, School for Oncology and Developmental Biology (GROW), Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Hcj Scheepers
- Department of Obstetrics and Gynaecology, School for Oncology and Developmental Biology (GROW), Maastricht University Medical Centre, Maastricht, the Netherlands
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Cocucci SE, Santacruz Silvero MG, Losada MO, Touzón MS, RudaVega H, Vazquez Blanco M, Provenzano SL, Vay CA, Famiglietti ÁMR, Perazzi BE. [Microbiological analysis of the maternal genital tract and umbilical cord blood and its association with neonatal damage]. Rev Argent Microbiol 2018; 51:157-163. [PMID: 30541666 DOI: 10.1016/j.ram.2017.09.005] [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: 04/24/2017] [Revised: 08/03/2017] [Accepted: 09/19/2017] [Indexed: 11/15/2022] Open
Abstract
The etiology leading to neonatal damage is multifactorial, being genital infections one of the causes. The objective of the study was to identify microorganisms of the maternal genital tract that are associated with neonatal damage, in order to prevent future perinatal complications. Seven hundred and eleven pregnant patients attended their prenatal control during the period January 2010-July 2013. Ureaplasma urealyticum and Mycoplasma hominis presence was investigated in umbilical cord blood by metabolic substrates (Micofast-Biomerieux) and that of T.vaginalis, by PCR using specific primers. The microbiological study of the vaginal contents of 288 pregnant patients at weeks 35 to 37 was performed by conventional methods, adding the modified thioglycolate culture for T.vaginalis. GroupB streptococcus (GBS) was investigated in anorectal and vaginal introitus swabs, using selective broth enrichment and subsequent isolation in chromogenic medium. The χ2 Yates test and Fisher's test were used for independent samples. A p value <0.05 was considered statistically significant. The pathogens significantly related to neonatal damage were M.hominis (p=0.03), T.vaginalis (p=0.03), and BV (p=0.02). Main complications were preterm birth, premature rupture of membranes (PRM), low weight and Apgar score ≤7. U.urealyticum (p=0.35), Candidaspp. (p=0.94) and GBS (p=0.18) were not related to neonatal damage. Since different microorganisms of the maternal genital tract were related to neonatal damage, it is very important to perform the microbiological study of vaginal contents during pregnancy to prevent possible maternal and perinatal complications.
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Affiliation(s)
- Silvina E Cocucci
- Laboratorio de Bacteriología Clínica, Departamento de Bioquímica Clínica, Facultad de Farmacia y Bioquímica, Hospital de Clínicas José de San Martín, Universidad de Buenos Aires, Córdoba, CABA, Argentina
| | - Mirtha G Santacruz Silvero
- Laboratorio de Bacteriología Clínica, Departamento de Bioquímica Clínica, Facultad de Farmacia y Bioquímica, Hospital de Clínicas José de San Martín, Universidad de Buenos Aires, Córdoba, CABA, Argentina
| | - Mirta O Losada
- Laboratorio de Bacteriología Clínica, Departamento de Bioquímica Clínica, Facultad de Farmacia y Bioquímica, Hospital de Clínicas José de San Martín, Universidad de Buenos Aires, Córdoba, CABA, Argentina
| | - María S Touzón
- Laboratorio de Bacteriología Clínica, Departamento de Bioquímica Clínica, Facultad de Farmacia y Bioquímica, Hospital de Clínicas José de San Martín, Universidad de Buenos Aires, Córdoba, CABA, Argentina
| | - Hilda RudaVega
- División de Obstetricia, Hospital de Clínicas José de San Martín, Universidad de Buenos Aires, Córdoba, CABA, Argentina
| | - Manuel Vazquez Blanco
- División de Cardiología, Hospital de Clínicas José de San Martín, Universidad de Buenos Aires, Córdoba, CABA, Argentina
| | - Sergio L Provenzano
- División de Neonatología, Hospital de Clínicas José de San Martín, Universidad de Buenos Aires, Córdoba, CABA, Argentina
| | - Carlos A Vay
- Laboratorio de Bacteriología Clínica, Departamento de Bioquímica Clínica, Facultad de Farmacia y Bioquímica, Hospital de Clínicas José de San Martín, Universidad de Buenos Aires, Córdoba, CABA, Argentina
| | - Ángela M R Famiglietti
- Laboratorio de Bacteriología Clínica, Departamento de Bioquímica Clínica, Facultad de Farmacia y Bioquímica, Hospital de Clínicas José de San Martín, Universidad de Buenos Aires, Córdoba, CABA, Argentina
| | - Beatriz E Perazzi
- Laboratorio de Bacteriología Clínica, Departamento de Bioquímica Clínica, Facultad de Farmacia y Bioquímica, Hospital de Clínicas José de San Martín, Universidad de Buenos Aires, Córdoba, CABA, Argentina.
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Van Hulst A, Paradis G, Benedetti A, Barnett TA, Henderson M. Pathways Linking Birth Weight and Insulin Sensitivity in Early Adolescence: A Double Mediation Analysis. J Clin Endocrinol Metab 2018; 103:4524-4532. [PMID: 30137396 PMCID: PMC6220441 DOI: 10.1210/jc.2018-00525] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Accepted: 08/15/2018] [Indexed: 01/02/2023]
Abstract
PURPOSE We examined pathways linking birth weight, weight gain from 0 to 2 years, and adiposity during childhood with insulin sensitivity in early adolescence. METHODS Data were from a longitudinal cohort of 630 Quebec white children with a parental history of obesity (Quebec Adipose and Lifestyle Investigation in Youth study). In a subsample of children born at term (n = 395), weight-for-length z score (zWFL) from 0 to 2 years were computed. At 8 to 10 years, the percentage of body fat was assessed using dual energy X-ray absorptiometry. At 10 to 12 years, the Matsuda insulin sensitivity index (ISI) and the homeostasis model assessment for insulin resistance were determined. A linear regression-based approach for mediation analysis was used to estimate the distinct pathways linking zWFL at 0 to 2 years to insulin sensitivity. RESULTS Every additional unit in zWFL at birth was associated with a 10% (95% CI, 5.26% to 14.85%) increase in the Matsuda ISI in early adolescence, independently of the weight at 0 to 2 years and in childhood. An indirect effect of zWFL at birth on the Matsuda ISI was also observed but in the opposite direction (-4.44; 95% CI, -7.91 to -1.05). This relation was mediated by childhood adiposity but not by weight gain from 0 to 2 years. The indirect effect of weight gain from 0 to 2 years, via childhood adiposity, also led to lower insulin sensitivity (-4.83%, 95% CI, -7.34 to -2.53). The findings were similar for the homeostasis model assessment for insulin resistance or when restricted to children with appropriate-for-gestational-age birth weights. CONCLUSIONS A greater birth weight-for-length resulted in improved insulin sensitivity in early adolescence. However, in the presence of excess childhood adiposity, both a greater birth weight and a faster rate of weight gain from 0 to 2 years resulted in lower insulin sensitivity.
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Affiliation(s)
- Andraea Van Hulst
- Ingram School of Nursing, McGill University, Montreal, Quebec, Canada
- Centre de Recherche du CHU Sainte-Justine, Montreal, Quebec, Canada
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Gilles Paradis
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Andrea Benedetti
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada
- Department of Medicine, McGill University, Montreal, Quebec, Canada
- Respiratory Epidemiology and Clinical Research Unit, McGill University Health Centre, Montreal, Quebec, Canada
| | - Tracie A Barnett
- Centre de Recherche du CHU Sainte-Justine, Montreal, Quebec, Canada
- INRS-Armand-Frappier Institute, Laval, Quebec, Canada
| | - Mélanie Henderson
- Centre de Recherche du CHU Sainte-Justine, Montreal, Quebec, Canada
- Department of Pediatrics, University of Montreal, Montreal, Quebec, Canada
- Correspondence and Reprint Requests: Mélanie Henderson, MD, PhD, Division of Endocrinology, Centre Hospitalier Universitaire Sainte-Justine, 3175 Chemin Côte Sainte-Catherine, Montreal, Quebec H3T 1C5, Canada. E-mail:
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White PC. Alterations of Cortisol Metabolism in Human Disorders. Horm Res Paediatr 2018; 89:320-330. [PMID: 29843121 DOI: 10.1159/000485508] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Accepted: 11/21/2017] [Indexed: 11/19/2022] Open
Abstract
The interconversion of active and inactive corticosteroids - cortisol and cortisone, respectively, in humans - is modulated by isozymes of 11β-hydroxysteroid dehydrogenase (11-HSD). Studies of this process have provided crucial insights into glucocorticoid effects in a wide variety of tissues. The 11-HSD1 isozyme functions mainly as an oxoreductase (cortisone to cortisol) and is expressed at high levels in the liver and other glucocorticoid target tissues. Because it is required for full physiological effects of cortisol, it has emerged as a drug target for metabolic syndrome and type 2 diabetes. Mutations in the corresponding HSD11B1 gene, or in the H6PD gene encoding hexose-6-phosphate dehydrogenase (which supplies the NADPH required for the oxoreductase activity of 11-HSD1), cause apparent cortisone reductase deficiency, a rare syndrome of adrenocortical hyperactivity and hyperandrogenism. In contrast, the 11-HSD2 isozyme functions as a dehydrogenase (cortisol to cortisone) and is expressed mainly in mineralocorticoid target tissues, where it bars access of cortisol to the mineralocorticoid receptor. Mutations in the HSD11B2 gene encoding 11-HSD2 cause the syndrome of apparent mineralocorticoid excess, a severe form of familial hypertension. The role of this enzyme in the pathogenesis of common forms of low-renin hypertension remains uncertain.
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Chiu YH, Williams PL, Gillman MW, Hauser R, Rifas-Shiman SL, Bellavia A, Fleisch AF, Oken E, Chavarro JE. Maternal intake of pesticide residues from fruits and vegetables in relation to fetal growth. ENVIRONMENT INTERNATIONAL 2018; 119:421-428. [PMID: 30029096 PMCID: PMC6169789 DOI: 10.1016/j.envint.2018.07.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 05/31/2018] [Accepted: 07/06/2018] [Indexed: 05/21/2023]
Abstract
OBJECTIVES To examine the associations of maternal intake of fruits and vegetables (FVs), considering pesticide residue levels, with fetal growth. METHODS We studied 1777 mothers (1275 white, 502 non-white) and their infants from Project Viva, a prospective pre-birth cohort (1999-2002). We categorized FVs as containing high or low pesticide residues using data from the US Department of Agriculture. We then used a food frequency questionnaire to estimate each participant's intake of high and low pesticide residue FVs in the first and second trimester. The primary outcomes were small-for-gestational-age (SGA; <10th percentile in birth-weight-for-gestational-age), large-for-gestational-age (LGA; ≥10th percentile in birth-weight-for-gestational-age) and preterm birth (gestational age <37 weeks). We also evaluated whether the associations between high pesticide residue FV intake and birth outcomes were modified by race/ethnicity. RESULTS 5.5% of newborns were SGA, 13.7% were LGA, and 7.3% were preterm. Intakes of high or low pesticide residue FVs, regardless of pregnancy trimester, were not associated with risks of SGA, LGA, or preterm birth. In addition, the associations of high pesticide FV intake with SGA and LGA were not modified by race/ethnicity. However, we observed heterogeneity in the relationship between first trimester high pesticide FV intake and risk of preterm birth by race/ethnicity (P value for interaction = 0.01), although this relationship did not persist after correction for multiple comparisons (Bonferroni corrected level of significance: P < 2.8 × 10-3). CONCLUSIONS There were no clear associations between high or low pesticide FV intake during pregnancy with SGA, LGA or preterm birth.
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Affiliation(s)
- Yu-Han Chiu
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA.
| | - Paige L Williams
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA; Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Matthew W Gillman
- Division of Chronic Disease Research Across the Lifecourse (CoRAL), Department of Population Medicine, Harvard Medical School, Boston, MA 02215, USA; Harvard Pilgrim Health Care Institute, Boston, MA 02215, USA
| | - Russ Hauser
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA; Vincent Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Sheryl L Rifas-Shiman
- Division of Chronic Disease Research Across the Lifecourse (CoRAL), Department of Population Medicine, Harvard Medical School, Boston, MA 02215, USA; Harvard Pilgrim Health Care Institute, Boston, MA 02215, USA
| | - Andrea Bellavia
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Abby F Fleisch
- Pediatric Endocrinology and Diabetes, Maine Medical Center, Portland, ME 04101, USA; Center for Outcomes Research and Evaluation, Maine Medical Center Research Institute, Portland, ME 04101, USA
| | - Emily Oken
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA; Division of Chronic Disease Research Across the Lifecourse (CoRAL), Department of Population Medicine, Harvard Medical School, Boston, MA 02215, USA; Harvard Pilgrim Health Care Institute, Boston, MA 02215, USA
| | - Jorge E Chavarro
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA; Harvard Medical School, Boston, MA 02115, USA.
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Victims of Chinese famine in early life have increased risk of metabolic syndrome in adulthood. Nutrition 2018; 53:20-25. [DOI: 10.1016/j.nut.2017.12.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Revised: 12/14/2017] [Accepted: 12/22/2017] [Indexed: 10/18/2022]
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Mohan R, Baumann D, Alejandro EU. Fetal undernutrition, placental insufficiency, and pancreatic β-cell development programming in utero. Am J Physiol Regul Integr Comp Physiol 2018; 315:R867-R878. [PMID: 30110175 DOI: 10.1152/ajpregu.00072.2018] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The prevalence of obesity and type 2 (T2D) diabetes is a major health concern in the United States and around the world. T2D is a complex disease characterized by pancreatic β-cell failure in association with obesity and insulin resistance in peripheral tissues. Although several genes associated with T2D have been identified, it is speculated that genetic variants account for only <10% of the risk for this disease. A strong body of data from both human epidemiological and animal studies shows that fetal nutrient factors in utero confer significant susceptibility to T2D. Numerous studies done in animals have shown that suboptimal maternal environment or placental insufficiency causes intrauterine growth restriction (IUGR) in the fetus, a critical factor known to predispose offspring to obesity and T2D, in part by causing permanent consequences in total functional β-cell mass. This review will focus on the potential contribution of the placenta in fetal programming of obesity and TD and its likely impact on pancreatic β-cell development and growth.
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Affiliation(s)
- Ramkumar Mohan
- Department of Integrative Biology and Physiology, University of Minnesota , Minneapolis, Minnesota
| | - Daniel Baumann
- Department of Integrative Biology and Physiology, University of Minnesota , Minneapolis, Minnesota
| | - Emilyn Uy Alejandro
- Department of Integrative Biology and Physiology, University of Minnesota , Minneapolis, Minnesota
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Yates DT, Petersen JL, Schmidt TB, Cadaret CN, Barnes TL, Posont RJ, Beede KA. ASAS-SSR Triennnial Reproduction Symposium: Looking Back and Moving Forward-How Reproductive Physiology has Evolved: Fetal origins of impaired muscle growth and metabolic dysfunction: Lessons from the heat-stressed pregnant ewe. J Anim Sci 2018; 96:2987-3002. [PMID: 29701769 PMCID: PMC6095381 DOI: 10.1093/jas/sky164] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 04/24/2018] [Indexed: 12/11/2022] Open
Abstract
Intrauterine growth restriction (IUGR) is the second leading cause of perinatal mortality and predisposes offspring to metabolic disorders at all stages of life. Muscle-centric fetal adaptations reduce growth and yield metabolic parsimony, beneficial for IUGR fetal survival but detrimental to metabolic health after birth. Epidemiological studies have reported that IUGR-born children experience greater prevalence of insulin resistance and obesity, which progresses to diabetes, hypertension, and other metabolic disorders in adulthood that reduce quality of life. Similar adaptive programming in livestock results in decreased birth weights, reduced and inefficient growth, decreased carcass merit, and substantially greater mortality rates prior to maturation. High rates of glucose consumption and metabolic plasticity make skeletal muscle a primary target for nutrient-sparing adaptations in the IUGR fetus, but at the cost of its contribution to proper glucose homeostasis after birth. Identifying the mechanisms underlying IUGR pathophysiology is a fundamental step in developing treatments and interventions to improve outcomes in IUGR-born humans and livestock. In this review, we outline the current knowledge regarding the adaptive restriction of muscle growth and alteration of glucose metabolism that develops in response to progressively exacerbating intrauterine conditions. In addition, we discuss the evidence implicating developmental changes in β adrenergic and inflammatory systems as key mechanisms for dysregulation of these processes. Lastly, we highlight the utility and importance of sheep models in developing this knowledge.
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Affiliation(s)
- Dustin T Yates
- Department of Animal Science, University of Nebraska-Lincoln, Lincoln, NE
| | - Jessica L Petersen
- Department of Animal Science, University of Nebraska-Lincoln, Lincoln, NE
| | - Ty B Schmidt
- Department of Animal Science, University of Nebraska-Lincoln, Lincoln, NE
| | - Caitlin N Cadaret
- Department of Animal Science, University of Nebraska-Lincoln, Lincoln, NE
| | - Taylor L Barnes
- Department of Animal Science, University of Nebraska-Lincoln, Lincoln, NE
| | - Robert J Posont
- Department of Animal Science, University of Nebraska-Lincoln, Lincoln, NE
| | - Kristin A Beede
- Department of Animal Science, University of Nebraska-Lincoln, Lincoln, NE
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Prenatal caffeine ingestion induces long-term alterations in scavenger receptor class B type I expression and glucocorticoid synthesis in adult male offspring rat adrenals. Food Chem Toxicol 2018; 120:24-31. [PMID: 29958987 DOI: 10.1016/j.fct.2018.06.056] [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: 07/19/2017] [Revised: 06/07/2018] [Accepted: 06/25/2018] [Indexed: 11/21/2022]
Abstract
Caffeine is contained within many drinks and food that are consumed daily. Prenatal caffeine ingestion (PCI) is a risk factor for intrauterine growth retardation (IUGR). We previously observed that PCI inhibits scavenger receptor class B type I (SR-BI)-mediated cholesterol uptake in fetal adrenals, subsequently decreasing glucocorticoid synthesis and inducing IUGR. In the present study, we aimed to investigate the long-term effects of PCI on adrenal glucocorticoid synthesis in adult male offspring rats. After establishing the PCI-induced IUGR, adult male offspring was injected intraperitoneally with 5 mg/kg·d lipopolysaccharide (LPS) for 2 days to induce acute stress. We observed persistent inhibition of SR-BI expression in PCI adrenals before and after stress. Compared with the controls, the PCI offspring had higher corticosterone concentrations after stress. The serum cholesterol concentration was stable without intergroup differences before and after stress. The cholesterol concentration in PCI adrenals showed a higher decrease rate than that of the control after stress. In summary, PCI induced long-term alterations in SR-BI expression and glucocorticoid synthesis in adult male offspring rat adrenals. Cholesterol has to be over-consumed in PCI adrenals against acute stress. This study provides an experimental basis to explain the susceptibility of IUGR offspring to metabolic diseases in adults.
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Soo JY, Wiese MD, Berry MJ, Morrison JL. Does poor fetal growth influence the extent of fetal exposure to maternal medications? Pharmacol Res 2018; 130:74-84. [DOI: 10.1016/j.phrs.2018.02.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Revised: 12/18/2017] [Accepted: 02/01/2018] [Indexed: 10/18/2022]
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Huang YT, Lin HY, Wang CH, Su BH, Lin CC. Association of preterm birth and small for gestational age with metabolic outcomes in children and adolescents: A population-based cohort study from Taiwan. Pediatr Neonatol 2018; 59:147-153. [PMID: 28789832 DOI: 10.1016/j.pedneo.2017.07.007] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2017] [Revised: 06/21/2017] [Accepted: 07/18/2017] [Indexed: 10/19/2022] Open
Abstract
BACKGROUND Previous studies have identified preterm birth and/or small for gestational age (SGA) as risk factors for features of the metabolic syndrome, including high blood pressure, insulin sensitivity and atherosclerosis, occurring later in life, with controversial results. We conducted this population-based cohort study to investigate metabolic outcomes in those with former preterm birth and/or SGA status in Taiwan. METHODS Data were obtained from Taiwan's universal National Health Insurance Research Database. From 1996 to 2004, 37,119 preterm infants, 3386 SGA infants, and 162,020 matched controls were included. We investigated the risk of the metabolic disease, including hypertension, diabetes, and hyperlipidemia, which had been recorded by the end of 2008. RESULTS The preterm and SGA cohort, combined into one, had a significantly increased risk of developing metabolic disorders when compared with the comparison cohort (HR = 2.46, 95% CI = 2.02-3.01). We observed that children with former preterm and SGA status in Taiwan had a higher risk of developing hypertension (HR = 3.24, 95% CI = 1.58-6.67), Type 1 diabetes mellitus (HR = 1.80, 95% CI = 1.05-3.07), Type 2 diabetes mellitus (HR = 2.49, 95% CI = 1.98-3.14), and hyperlipidemia (HR = 2.14, 95% CI = 1.29-3.52). CONCLUSION Our study revealed the risk of metabolic disease in those with preterm birth and/or SGA. Further studies with a longer duration of follow-up are required to confirm if there is a tendency for the metabolic syndrome to develop in this study cohort.
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Affiliation(s)
- Yu-Ting Huang
- Department of Neonatology, China Medical University Children's Hospital, Taichung, Taiwan; School of Medicine, China Medical University, Taichung, Taiwan
| | - Hsiang-Yu Lin
- Department of Neonatology, China Medical University Children's Hospital, Taichung, Taiwan; School of Medicine, China Medical University, Taichung, Taiwan
| | - Chung-Hsing Wang
- Department of Genetics and Metabolism, China Medical University Children's Hospital, Taichung, Taiwan; School of Medicine, China Medical University, Taichung, Taiwan
| | - Bai-Horng Su
- Department of Neonatology, China Medical University Children's Hospital, Taichung, Taiwan; School of Medicine, China Medical University, Taichung, Taiwan.
| | - Che-Chen Lin
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
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Morakinyo AO, Samuel TA, Awobajo FO, Oludare GO, Mofolorunso A. High-Dose Perinatal Folic-Acid Supplementation Alters Insulin Sensitivity in Sprague-Dawley Rats and Diminishes the Expression of Adiponectin. J Diet Suppl 2018; 16:14-26. [PMID: 29451831 DOI: 10.1080/19390211.2018.1426076] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The possible intake of folate in excess of the recommended upper levels is a matter of critical importance. This study was conducted to investigate the effects of prenatal and postnatal high folic acid supplementation (FAS) on glucose tolerance, insulin sensitivity, lipid metabolism, and expression of adiponectin in rats. The study included 20 female rats divided into two groups: control group and FAS group (receiving high folic acid supplemented diet). Both groups of female rats were mated and pregnancy confirmed. At parturition, the diet of 5 dams that were fed with control diet during gestation and their litters was changed to FAS diet and continued throughout lactation. Similarly, half of the dams that were previously fed with FAS diet during gestation and their litters were also changed to control diet. The remaining 5 dams in each group continued on their respective diets throughout lactation with their litters. Other dams remained on their respective diets throughout lactation. Food and water intake, body weight, lipid concentrations, insulin, and the expression of adiponectin were determined. Glucose tolerance and insulin sensitivity were also measured to evaluate glucose homeostasis. FAS significantly increased the postweaning food, water intake, triglyceride, and insulin levels but diminished insulin sensitivity in adult offspring. The expression of adiponectin in insulin-sensitive tissues was also significantly decreased and these were consistent with insulin resistance of FAS offspring. High-dose FAS may promote insulin resistance and dyslipidemia and disrupt glucose metabolism possibly by depressing adiponectin expression. Although this is an animal model and the effects of the diets cannot be directly transposed to humans, this study provides indications of the possible adverse effects of FAS maternal diet on glucose metabolism in the offspring.
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Affiliation(s)
- Ayodele Olufemi Morakinyo
- a Physiology Department , College of Medicine of the University of Lagos, University of Lagos , Idi-Araba , Lagos , Nigeria
| | - Titilola Aderonke Samuel
- b Biochemistry Department , College of Medicine of the University of Lagos, University of Lagos , Idi-Araba , Lagos , Nigeria
| | - Funmileyi Olubajo Awobajo
- a Physiology Department , College of Medicine of the University of Lagos, University of Lagos , Idi-Araba , Lagos , Nigeria
| | - Gabriel Olorunleke Oludare
- a Physiology Department , College of Medicine of the University of Lagos, University of Lagos , Idi-Araba , Lagos , Nigeria
| | - Adekunle Mofolorunso
- a Physiology Department , College of Medicine of the University of Lagos, University of Lagos , Idi-Araba , Lagos , Nigeria
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Figueras F, Caradeux J, Crispi F, Eixarch E, Peguero A, Gratacos E. Diagnosis and surveillance of late-onset fetal growth restriction. Am J Obstet Gynecol 2018; 218:S790-S802.e1. [PMID: 29422212 DOI: 10.1016/j.ajog.2017.12.003] [Citation(s) in RCA: 161] [Impact Index Per Article: 26.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Revised: 11/16/2017] [Accepted: 12/01/2017] [Indexed: 11/18/2022]
Abstract
By consensus, late fetal growth restriction is that diagnosed >32 weeks. This condition is mildly associated with a higher risk of perinatal hypoxic events and suboptimal neurodevelopment. Histologically, it is characterized by the presence of uteroplacental vascular lesions (especially infarcts), although the incidence of such lesions is lower than in preterm fetal growth restriction. Screening procedures for fetal growth restriction need to identify small babies and then differentiate between those who are healthy and those who are pathologically small. First- or second-trimester screening strategies provide detection rates for late smallness for gestational age <50% for 10% of false positives. Compared to clinically indicated ultrasonography in the third trimester, universal screening triples the detection rate of late smallness for gestational age. As opposed to early third-trimester ultrasound, scanning late in pregnancy (around 37 weeks) increases the detection rate for birthweight <3rd centile. Contrary to early fetal growth restriction, umbilical artery Doppler velocimetry alone does not provide good differentiation between late smallness for gestational age and fetal growth restriction. A combination of biometric parameters (with severe smallness usually defined as estimated fetal weight or abdominal circumference <3rd centile) with Doppler criteria of placental insufficiency (either in the maternal [uterine Doppler] or fetal [cerebroplacental ratio] compartments) offers a classification tool that correlates with the risk for adverse perinatal outcome. There is no evidence that induction of late fetal growth restriction at term improves perinatal outcomes nor is it a cost-effective strategy, and it may increase neonatal admission when performed <38 weeks.
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Affiliation(s)
- Francesc Figueras
- Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu), Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona; and Center for Biomedical Research on Rare Diseases, Madrid, Spain.
| | - Javier Caradeux
- Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu), Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona; and Center for Biomedical Research on Rare Diseases, Madrid, Spain
| | - Fatima Crispi
- Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu), Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona; and Center for Biomedical Research on Rare Diseases, Madrid, Spain
| | - Elisenda Eixarch
- Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu), Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona; and Center for Biomedical Research on Rare Diseases, Madrid, Spain
| | - Anna Peguero
- Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu), Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona; and Center for Biomedical Research on Rare Diseases, Madrid, Spain
| | - Eduard Gratacos
- Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu), Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona; and Center for Biomedical Research on Rare Diseases, Madrid, Spain
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