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Li DY, Wang L, Li L, Zhou S, Tan J, Tang C, Liao Q, Liu T, Wen L, Qi HB. Maternal vitamin D status and risk of gestational diabetes mellitus in twin pregnancies: a longitudinal twin pregnancies birth cohort study. Nutr J 2024; 23:41. [PMID: 38594739 PMCID: PMC11005156 DOI: 10.1186/s12937-024-00944-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 03/21/2024] [Indexed: 04/11/2024] Open
Abstract
BACKGROUND Gestational diabetes mellitus (GDM) is a common complication of pregnancy, with significant short-term and long-term implications for both mothers and their offspring. Previous studies have indicated the potential benefits of vitamin D in reducing the risk of GDM, yet little is known about this association in twin pregnancies. This study aimed to investigate maternal vitamin D status in the second trimester and examine its association with the risk of GDM in twin pregnancies. METHODS We conducted a prospective cohort study based on data from the Chongqing Longitudinal Twin Study (LoTiS). Peripheral blood serum was collected from the mothers in the second trimester to measure 25(OH)D concentrations. GDM was diagnosed at 23-26 weeks of gestation using a 75-g 2-h oral glucose tolerance test. We used multivariable logistic regression analyses to examine the correlations between vitamin D status and the risk of GDM. RESULTS Of the total participants, 93 (29.9%) women were diagnosed with GDM. The mean serum 25(OH)D concentration in the second trimester was 31.1 ± 11.2 ng/mL, and the rate of vitamin D insufficiency and deficiency were 23.5% and 18.7%, respectively. Compared to women with a 25(OH)D concentration < 30 ng/mL, those with a 25(OH)D concentration ≥ 30 ng/mL had a significantly lower risk of GDM (RR 0.61; 95% CI: 0.43, 0.86), especially those who were overweight before pregnancy (RR 0.32; 95% CI: 0.16, 0.64). The restricted cubic splines model showed an inverted J-shaped relationship between vitamin D concentrations and GDM risk. CONCLUSIONS The risk of GDM was significantly reduced in twin pregnant women with vitamin D concentrations ≥ 30 ng/mL in the second trimester. TRIAL REGISTRATION ChiCTR-OOC-16,008,203. Retrospectively registered on 1 April 2016.
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Affiliation(s)
- Da-Yan Li
- Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
- Department of Obstetrics and Gynecology, Banan Hospital of Chongqing Medical University, Chongqing, 401320, China
- Department of Obstetrics and Gynecology, Women and Children's Hospital of Chongqing Medical University, Longshan Road 120, Yubei District, Chongqing, 401147, China
| | - Lan Wang
- Department of Obstetrics and Gynecology, Women and Children's Hospital of Chongqing Medical University, Longshan Road 120, Yubei District, Chongqing, 401147, China
- Department of Obstetrics and Gynecology, Chongqing Health Center for Women and Children, Chongqing, 401147, China
| | - Li Li
- Department of Obstetrics and Gynecology, Women and Children's Hospital of Chongqing Medical University, Longshan Road 120, Yubei District, Chongqing, 401147, China
- Department of Obstetrics and Gynecology, Chongqing Health Center for Women and Children, Chongqing, 401147, China
| | - Shuwei Zhou
- Department of Obstetrics and Gynecology, Women and Children's Hospital of Chongqing Medical University, Longshan Road 120, Yubei District, Chongqing, 401147, China
- Department of Obstetrics and Gynecology, Chongqing Health Center for Women and Children, Chongqing, 401147, China
| | - Jiangyun Tan
- Department of Obstetrics and Gynecology, Women and Children's Hospital of Chongqing Medical University, Longshan Road 120, Yubei District, Chongqing, 401147, China
- Department of Obstetrics and Gynecology, Chongqing Health Center for Women and Children, Chongqing, 401147, China
| | - Chunyan Tang
- Department of Obstetrics and Gynecology, Women and Children's Hospital of Chongqing Medical University, Longshan Road 120, Yubei District, Chongqing, 401147, China
- Department of Obstetrics and Gynecology, Chongqing Health Center for Women and Children, Chongqing, 401147, China
| | - Qianqian Liao
- Department of Obstetrics and Gynecology, Women and Children's Hospital of Chongqing Medical University, Longshan Road 120, Yubei District, Chongqing, 401147, China
- Department of Obstetrics and Gynecology, Chongqing Health Center for Women and Children, Chongqing, 401147, China
| | - Ting Liu
- Department of Obstetrics and Gynecology, Women and Children's Hospital of Chongqing Medical University, Longshan Road 120, Yubei District, Chongqing, 401147, China
- Department of Obstetrics and Gynecology, Chongqing Health Center for Women and Children, Chongqing, 401147, China
| | - Li Wen
- Department of Obstetrics and Gynecology, Women and Children's Hospital of Chongqing Medical University, Longshan Road 120, Yubei District, Chongqing, 401147, China.
- Department of Obstetrics and Gynecology, Chongqing Health Center for Women and Children, Chongqing, 401147, China.
| | - Hong-Bo Qi
- Department of Obstetrics and Gynecology, Women and Children's Hospital of Chongqing Medical University, Longshan Road 120, Yubei District, Chongqing, 401147, China.
- Department of Obstetrics and Gynecology, Chongqing Health Center for Women and Children, Chongqing, 401147, China.
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Li L, Li K, Zhou X, Knowles RL. Maximising the potential of Chinese birth cohort studies: a systematic review of mother-baby cohorts in mainland China. Public Health 2024; 227:119-130. [PMID: 38168592 DOI: 10.1016/j.puhe.2023.11.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 11/21/2023] [Accepted: 11/23/2023] [Indexed: 01/05/2024]
Abstract
OBJECTIVES There is now a growing interest in early-life influences on adult diseases in China. A number of birth cohorts have been established. This systematic review provided a better understanding of the development of mother-baby cohorts in China. STUDY DESIGN Systematic review. METHODS We conducted a systematic review for research or profile papers in English/Chinese that reported data from mother-baby cohorts in mainland China, with ≥1y follow-up after birth. We identified 315 papers, corresponding to 31 cohorts from 19 provinces/megacities. RESULTS All cohorts started in 1999-2017 (21 after 2010) and were set up with broad objectives or specific scientific focus. The baseline sample size varied, from <500 to >300,000 mothers. A majority of cohorts were initiated during pregnancy and followed children to <10y, only six to adolescence and none into adulthood. These cohorts mostly collected samples from mothers and babies, in addition to using interviews/questionnaires to collect information about pregnancy, birth and child health. Most cohorts were recruited from a single province/city. The large western region was understudied. CONCLUSIONS Mother-baby cohorts have developed rapidly in China, but usually with a short follow-up duration. Extending the follow-up of children and developing cross-cohort collaboration will increase the diversity, size and coverage of the sample, allow studying early influences on life-course health and identify targets for early intervention in the Chinese population.
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Affiliation(s)
- L Li
- Population, Policy and Practice Research and Teaching Department, University College London Great Ormond Street Institute of Child Health, UK.
| | - K Li
- UCL Institute of Epidemiology and Health Care, UK.
| | - X Zhou
- Institute of Social Medicine, Zhejiang University School of Medicine, China; Second Affiliated Hospital, Zhejiang University School of Medicine, China.
| | - R L Knowles
- Population, Policy and Practice Research and Teaching Department, University College London Great Ormond Street Institute of Child Health, UK.
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Jiang H, Han TL, Yang J, Yang Y, Wang F, Chen Y, Huang N, Mansell T, Craig JM, Scurrah KJ, Novakovic B, Baker PN, Zhang H, Wei Y, Wang L, Saffery R. Evidence for ethnicity and location as regulators of the newborn blood metabolome: a monozygous twin study. Front Nutr 2024; 10:1259777. [PMID: 38239842 PMCID: PMC10794553 DOI: 10.3389/fnut.2023.1259777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 12/07/2023] [Indexed: 01/22/2024] Open
Abstract
Introduction Monochorionic, diamniotic (MCDA) monozygotic twins share nearly all genetic variation and a common placenta in utero. Despite this, MCDA twins are often discordant for a range of common phenotypes, including early growth and birth weight. As such, MCDA twins represent a unique model to explore variation in early growth attributable primarily to in utero environmental factors. Methods MCDA twins with a range of within-pair birth weight discordance were sampled from the peri/postnatal epigenetic twin study (PETS, Melbourne; n = 26 pairs), Beijing twin study (BTS, Beijing; n = 25), and the Chongqing longitudinal twin study (LoTiS, Chongqing; n = 22). All PETS participants were of European-Australian ancestry, while all Chinese participants had Han ancestry. The average of the birth weight difference between the larger and smaller co-twins for all twin pairs was determined and metabolomic profiles of amino acids, TCA cycle intermediates, fatty acids, organic acids, and their derivatives generated from cord blood plasma by gas chromatograph mass spectrometry. Within and between co-twin pair analyses were performed to identify metabolites specifically associated with discordance in birth weight. Multivariable regression and pathway enrichment analyses between different regions were performed to evaluate the geographical effects on the metabolism of MCDA twin pairs. Results PETS twins showed a markedly different metabolic profile at birth compared to the two Chinese samples. Within-pair analysis revealed an association of glutathione, creatinine, and levulinic acid with birth weight discordance. Caffeine, phenylalanine, and several saturated fatty acid levels were uniquely elevated in PETS twins and were associated with maternal BMI and average within pair birth weight, in addition to birth weight discordance. LoTiS twins had higher levels of glutathione, tyrosine, and gamma-linolenic acid relative to PETS and BTS twins, potentially associated with eating habits. Conclusion This study highlights the potential role of underlying genetic variation (shared by MZ twins), in utero (non-shared by MZ twins) and location-specific (shared by MZ twins) environmental factors, in regulating the cord blood metabolome of uncomplicated MCDA twins. Future research is needed to unravel these complex relationships that may play a key role in phenotypic metabolic alterations of twins independent of genetic diversity.
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Affiliation(s)
- Huimin Jiang
- Department of Reproductive Medicine Center, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Ting-Li Han
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jing Yang
- Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
| | - Yang Yang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Maternal and Fetal Medicine, Chongqing Medical University, Chongqing, China
- Mass Spectrometry Centre of Maternal-Fetal Medicine, Life Science Institution, Chongqing Medical University, Chongqing, China
| | - Fengdi Wang
- Department of Reproductive Medicine Center, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yuelu Chen
- Department of Reproductive Medicine Center, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Nana Huang
- Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
| | - Toby Mansell
- Murdoch Children’s Research Institute, and Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia
| | - Jeffrey M. Craig
- Murdoch Children’s Research Institute, and Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia
- The Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine, Deakin University, Melbourne, VIC, Australia
| | - Katrina J. Scurrah
- Twins Research Australia and Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Boris Novakovic
- Murdoch Children’s Research Institute, and Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia
| | - Philip N. Baker
- College of Life Sciences, University of Leicester, Leicester, United Kingdom
| | - Hua Zhang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Maternal and Fetal Medicine, Chongqing Medical University, Chongqing, China
| | - Yuan Wei
- Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
| | - Lianlian Wang
- Department of Reproductive Medicine Center, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Richard Saffery
- Murdoch Children’s Research Institute, and Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia
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Wen L, Fu H, Saffery R, Tong C, Liu Y, Kilby MD, Qi H, Baker PN. Cord blood adiponectin and leptin concentrations in monochorionic twins with selective intrauterine growth restriction and their associations with childhood growth trajectories. Pediatr Obes 2023:e13034. [PMID: 37019852 DOI: 10.1111/ijpo.13034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 02/12/2023] [Accepted: 03/06/2023] [Indexed: 04/07/2023]
Abstract
BACKGROUND Being born with intrauterine growth restriction (IUGR) was associated with subsequent health issues later in life. However, the underlying role of adipokines in IUGR is unknown. OBJECTIVES To measure the adiponectin and leptin concentrations in the cord blood of monochorionic (MC) twins with selective IUGR (sIUGR) and evaluate their associations with childhood growth trajectories. METHODS Cord blood samples were collected from 22 pairs of MC twins with sIUGR and 20 pairs of normal MC twins. Adiponectin and leptin concentrations in cord blood were determined by ELISA. Data regarding perinatal outcomes and infantile growth trajectories from birth to 24 months were obtained. RESULTS Only cord blood adiponectin concentrations were associated with IUGR (β -1.51, 95% CI -2.45, -0.57, p = 0.002), and cord blood leptin concentrations were significantly lower in sIUGR twins compared to normal twins (2.8 ± 1.6 vs. 6.4 ± 3.0, p < 0.001). Adiponectin concentrations were negatively associated with height increments from birth to 6 months (β -0.28, 95% CI -0.51, -0.06, p = 0.015). Leptin concentrations were negatively associated with weight at 6 and 24 months (β -0.12 95% CI -0.22, -0.02, p = 0.002; β -0.18 95% CI -0.33, -0.03, p = 0.019) and weight and height increments from birth to 6 months (β -0.17 95% CI -0.29, -0.06, p = 0.020; β -0.40 95% CI -0.81, -0.01, p = 0.037). CONCLUSION Cord blood adiponectin concentrations were negatively associated with IUGR but did not predict childhood growth. Cord blood leptin concentrations were inversely associated with weight and height increments in the first 6 months.
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Affiliation(s)
- Li Wen
- State Key Laboratory of Maternal and Fetal Medicine of Chongqing Municipality, The First Affiliated Hospital of Chongqing Medical University, 400016, Chongqing, China
- Department of Obstetrics, Women and Children's Hospital of Chongqing Medical University, 401147, Chongqing, China
| | - Huijia Fu
- Reproductive Medicine Center, The First Affiliated Hospital of Chongqing Medical University, 400016, Chongqing, China
| | - Richard Saffery
- Molecular Immunity, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Victoria, Australia
- Department of Pediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Chao Tong
- State Key Laboratory of Maternal and Fetal Medicine of Chongqing Municipality, The First Affiliated Hospital of Chongqing Medical University, 400016, Chongqing, China
| | - Yamin Liu
- Department of Obstetrics, Women and Children's Hospital of Chongqing Medical University, 401147, Chongqing, China
| | - Mark D Kilby
- Fetal Medicine Centre, Birmingham Women's & Children's Foundation Trust, B15 2TG, Birmingham, UK
- Institute of Metabolism & Systems Research, College of Medical & Dental Sciences, University of Birmingham, B15 2TT, Birmingham, UK
| | - Hongbo Qi
- State Key Laboratory of Maternal and Fetal Medicine of Chongqing Municipality, The First Affiliated Hospital of Chongqing Medical University, 400016, Chongqing, China
- Department of Obstetrics, Women and Children's Hospital of Chongqing Medical University, 401147, Chongqing, China
| | - Philip N Baker
- College of Life Sciences, University of Leicester, LE1 7RH, Leicester, UK
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Li S, Qiu Y, Yuan X, Zhang Q, Kilby MD, Saffery R, Baker PN, Wen L, Tong C, Qi H. Impact of maternal gestational weight gain in twin pregnancies on early childhood obesity risk: A longitudinal birth cohort study. Front Pediatr 2022; 10:906086. [PMID: 35983080 PMCID: PMC9378839 DOI: 10.3389/fped.2022.906086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 07/13/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES To investigate the impact of gestational weight gain (GWG) on the body mass index-for-age z score (BAZ) and obesity risk among twin offspring. METHODS This study included 263 women who were pregnant with twins and their offspring. Maternal GWG was measured in each trimester, and infant weight and length were measured at 6, 12, and 24 months. RESULTS Total GWG was positively correlated with offspring birthweight and BAZ at 6, 12 and 24 months [adjusted β 0.013 (95% CI: 0.008-0.019), 0.028 (95% CI: 0.005-0.050), 0.033 (95% CI: 0.010-0.056) and 0.025 (95% CI: 0.004-0.047), respectively]. Excessive total GWG was related to an increased relative risk (RR) of large for gestational age (LGA) and overweight at 6 and 12 months. Only the second trimester gestational weight gain rate (GWGR) was positively correlated with birthweight (adjusted β 0.380, 95% CI: 0.256-0.504), and RRs of 6.818 (95% CI: 1.568-29.642) and 2.852 (95% CI: 1.466-5.548) were found for LGA and overweight at 12 months, respectively. CONCLUSIONS Total GWG and the second trimester GWGR were correlated with BAZ and overweight/obesity risk in twin offspring; the impact was obvious in the first year of life and gradually disappeared over time. CLINICAL TRIAL REGISTRATION ChiCTR-OOC-16008203, Registered on 1 April 2016 at the Chinese Clinical Trial Registry.
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Affiliation(s)
- Sisi Li
- State Key Laboratory of Maternal and Fetal Medicine of Chongqing Municipality, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yuhan Qiu
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xi Yuan
- State Key Laboratory of Maternal and Fetal Medicine of Chongqing Municipality, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qin Zhang
- State Key Laboratory of Maternal and Fetal Medicine of Chongqing Municipality, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Mark D Kilby
- Birmingham Women's and Children's Foundation Trust, Fetal Medicine Centre, Birmingham, United Kingdom.,Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Richard Saffery
- Molecular Immunity, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, VIC, Australia.,Department of Pediatrics, University of Melbourne, Parkville, VIC, Australia
| | - Philip N Baker
- College of Life Sciences, University of Leicester, Leicester, United Kingdom
| | - Li Wen
- State Key Laboratory of Maternal and Fetal Medicine of Chongqing Municipality, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Chao Tong
- State Key Laboratory of Maternal and Fetal Medicine of Chongqing Municipality, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Hongbo Qi
- State Key Laboratory of Maternal and Fetal Medicine of Chongqing Municipality, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.,Chongqing Women and Children's Health Center, Chongqing, China
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