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Zhao M, Zhang D, Wang X, Li H, Sun B, Wu Z, Zhu Y, Cao H. Association between lipid profile in early pregnancy and the risk of congenital heart disease in offspring: a prospective cohort study. Sci Rep 2024; 14:3655. [PMID: 38351050 PMCID: PMC10864369 DOI: 10.1038/s41598-024-53876-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 02/06/2024] [Indexed: 02/16/2024] Open
Abstract
This study aimed to investigate the association of lipid profile in early pregnancy and the risk of congenital heart disease (CHD) in offspring. This study was a prospective cohort design based on the Fujian Birth Cohort Study in China. We recruited pregnant women at ≤ 14 weeks of gestation between 2019 and 2022, and all participants in this study filled out the questionnaire about periconceptional exposure. Simultaneously, we collected participants' fasting blood samples to measure their lipid profile by automatic biochemical analyzer. The outcome was defined as offspring with CHD. A multivariable logistic regression model was used to calculate adjusted odds ratio (AOR) risk estimates, which indicate the associations between maternal lipid profiles and CHD in offspring. Restricted cubic splines were used to estimate their nonlinear relationship. A total of 21,425 pregnant women with an average gestational age of 11.3 (± 1.40) weeks were included in the analysis. The higher triglyceride (AOR 1.201, 95% CI [1.036, 1.394]), low-density lipoprotein (AOR 1.216, 95% CI [1.048, 1.410]), apolipoprotein B (Apo B) (AOR 2.107, 95% CI [1.179, 3.763]) levels were correlated with increased odds of CHD in offspring, while high-density lipoprotein (OR 0.672, 95% CI [0.490, 0.920]) related with decreased odds of CHD in offspring. The restricted cubic spline suggested a nonlinear relationship between total cholesterol (TC) levels and the risk of CHD in offspring (P = 0.0048), but no significant nonlinear relationships were found in other lipid profile. Apolipoprotein A was not related to the risk of CHD in offspring as either a continuous variable or a hierarchical variable. Elevated lipid profile in early pregnancy levels are associated with an increased risk of CHD in offspring. Additionally, there is a non-linear relationship between TC levels and the risk of CHD in offspring.
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Affiliation(s)
- Minli Zhao
- College of Clinical Medicine for Obstetrics and Gynecology and Pediatrics, Fujian Medical University, No.18 Daoshan Road, Fuzhou, 350000, China
- Department of Cardiac Surgery, Fujian Children's Hospital (Fujian Branch of Shanghai Children's Medical Center), College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, 350014, China
- NHC Key Laboratory of Technical Evaluation of Fertility Regulation for Non-Human Primate (Fujian Maternity and Child Health Hospital), Fujian Medical University, Fuzhou, 350014, China
| | - Danwei Zhang
- Department of Cardiac Surgery, Fujian Children's Hospital (Fujian Branch of Shanghai Children's Medical Center), College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, 350014, China
| | - Xinrui Wang
- NHC Key Laboratory of Technical Evaluation of Fertility Regulation for Non-Human Primate (Fujian Maternity and Child Health Hospital), Fujian Medical University, Fuzhou, 350014, China
| | - Haibo Li
- Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, 350000, China
| | - Bin Sun
- Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, 350000, China
| | - Zhengqin Wu
- Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, 350000, China
| | - Yibing Zhu
- Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, 350000, China.
| | - Hua Cao
- College of Clinical Medicine for Obstetrics and Gynecology and Pediatrics, Fujian Medical University, No.18 Daoshan Road, Fuzhou, 350000, China.
- Department of Cardiac Surgery, Fujian Children's Hospital (Fujian Branch of Shanghai Children's Medical Center), College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, 350014, China.
- Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, 350000, China.
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Zhao R, Cao L, Gu WJ, Li L, Chen ZZ, Xiang J, Zhou ZY, Xu B, Zang WD, Zhou XY, Cao J, Sun K, Zhao JY. Gestational palmitic acid suppresses embryonic GATA-binding protein 4 signaling and causes congenital heart disease. Cell Rep Med 2023; 4:100953. [PMID: 36809766 PMCID: PMC10040382 DOI: 10.1016/j.xcrm.2023.100953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 12/13/2022] [Accepted: 01/31/2023] [Indexed: 02/22/2023]
Abstract
Dysregulated maternal fatty acid metabolism increases the risk of congenital heart disease (CHD) in offspring with an unknown mechanism, and the effect of folic acid fortification in preventing CHD is controversial. Using gas chromatography coupled to either a flame ionization detector or mass spectrometer (GC-FID/MS) analysis, we find that the palmitic acid (PA) concentration increases significantly in serum samples of pregnant women bearing children with CHD. Feeding pregnant mice with PA increased CHD risk in offspring and cannot be rescued by folic acid supplementation. We further find that PA promotes methionyl-tRNA synthetase (MARS) expression and protein lysine homocysteinylation (K-Hcy) of GATA4 and results in GATA4 inhibition and abnormal heart development. Targeting K-Hcy modification by either genetic ablation of Mars or using N-acetyl-L-cysteine (NAC) decreases CHD onset in high-PA-diet-fed mice. In summary, our work links maternal malnutrition and MARS/K-Hcy with the onset of CHD and provides a potential strategy in preventing CHD by targeting K-Hcy other than folic acid supplementation.
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Affiliation(s)
- Rui Zhao
- Institute for Developmental and Regenerative Cardiovascular Medicine, MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
| | - Li Cao
- Obstetrics & Gynecology Hospital of Fudan University, State Key Lab of Genetic Engineering, School of Life Sciences, and Department of Materials Science, Fudan University, Shanghai 200438, China
| | - Wen-Jun Gu
- Obstetrics & Gynecology Hospital of Fudan University, State Key Lab of Genetic Engineering, School of Life Sciences, and Department of Materials Science, Fudan University, Shanghai 200438, China
| | - Lei Li
- Department of Anatomy and Neuroscience Research Institute, School of Basic Medical Sciences, Zhengzhou University, Zhengzhou 450001, China
| | - Zhong-Zhong Chen
- Urogenital Development Research Center, Department of Urology, Shanghai Children's Hospital School of Medicine, Shanghai Jiao Tong University, Shanghai 200062, China
| | - Jie Xiang
- Obstetrics & Gynecology Hospital of Fudan University, State Key Lab of Genetic Engineering, School of Life Sciences, and Department of Materials Science, Fudan University, Shanghai 200438, China
| | - Ze-Yu Zhou
- Obstetrics & Gynecology Hospital of Fudan University, State Key Lab of Genetic Engineering, School of Life Sciences, and Department of Materials Science, Fudan University, Shanghai 200438, China
| | - Bo Xu
- Department of Anesthesiology, General Hospital of Southern Theatre Command of People's Liberation Army, Guangzhou 510030, China
| | - Wei-Dong Zang
- Department of Anatomy and Neuroscience Research Institute, School of Basic Medical Sciences, Zhengzhou University, Zhengzhou 450001, China
| | - Xiang-Yu Zhou
- Obstetrics & Gynecology Hospital of Fudan University, State Key Lab of Genetic Engineering, School of Life Sciences, and Department of Materials Science, Fudan University, Shanghai 200438, China.
| | - Jing Cao
- Department of Anatomy and Neuroscience Research Institute, School of Basic Medical Sciences, Zhengzhou University, Zhengzhou 450001, China.
| | - Kun Sun
- Institute for Developmental and Regenerative Cardiovascular Medicine, MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China.
| | - Jian-Yuan Zhao
- Institute for Developmental and Regenerative Cardiovascular Medicine, MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China; Department of Anatomy and Neuroscience Research Institute, School of Basic Medical Sciences, Zhengzhou University, Zhengzhou 450001, China; International Human Phenome Institutes (Shanghai), Shanghai 200433, China.
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3
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Cao L, Du Y, Zhang M, Wang F, Zhao JY, Ren YY, Gui YH. High maternal blood lipid levels during early pregnancy are associated with increased risk of congenital heart disease in offspring. Acta Obstet Gynecol Scand 2021; 100:1806-1813. [PMID: 34346055 PMCID: PMC8518762 DOI: 10.1111/aogs.14225] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 06/02/2021] [Accepted: 06/30/2021] [Indexed: 12/28/2022]
Abstract
Introduction This study aimed to investigate whether maternal blood lipid levels during early pregnancy are associated with the occurrence of congenital heart disease (CHD) in their offspring. Material and methods In this single‐center case–control study, mothers of offspring with CHD (n = 230) and without CHD (n = 381) were included. Maternal lipid levels were determined on fasting blood samples taken in the first trimester. Relevant demographic and clinical data were extracted from the medical records. Maternal lipid profile was compared between the two groups, and regression analysis was performed to evaluate the association between lipid profile and CHD risk in offspring. Results Compared with the control group, levels of triglyceride, apolipoprotein‐A1, and apolipoprotein‐B in early pregnancy were significantly higher in the CHD group. Multivariate analyses showed that triglyceride (odds ratio [OR] 2.46, 95% CI 1.62–3.73, p < 0.01), total/high‐density lipoprotein cholesterol (OR 2.10, 95% CI 1.07–4.13, p = 0.03), and apolipoprotein‐A1 (OR 2.73, 95% CI 1.16–6.40, p = 0.02) were positively associated with CHD risk in offspring. Conclusions Elevated maternal lipid profile was associated with increased risk of CHD in offspring.
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Affiliation(s)
- Li Cao
- Cardiovascular Center, Children's Hospital of Fudan University, Shanghai, China.,Ultrasound Department, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Yan Du
- Office of Clinical Epidemiology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Mo Zhang
- Office of Clinical Epidemiology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Feng Wang
- Cardiovascular Center, Children's Hospital of Fudan University, Shanghai, China
| | - Jian-Yuan Zhao
- State Key Lab of Genetic Engineering and School of Life Sciences, Fudan University, Shanghai, China
| | - Yun-Yun Ren
- Ultrasound Department, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Yong-Hao Gui
- Cardiovascular Center, Children's Hospital of Fudan University, Shanghai, China
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Taylor K, Elhakeem A, Thorbjørnsrud Nader JL, Yang TC, Isaevska E, Richiardi L, Vrijkotte T, Pinot de Moira A, Murray DM, Finn D, Mason D, Wright J, Oddie S, Roeleveld N, Harris JR, Andersen AN, Caputo M, Lawlor DA. Effect of Maternal Prepregnancy/Early-Pregnancy Body Mass Index and Pregnancy Smoking and Alcohol on Congenital Heart Diseases: A Parental Negative Control Study. J Am Heart Assoc 2021; 10:e020051. [PMID: 34039012 PMCID: PMC8483540 DOI: 10.1161/jaha.120.020051] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 03/29/2021] [Indexed: 11/29/2022]
Abstract
Background Congenital heart diseases (CHDs) are the most common congenital anomaly. The causes of CHDs are largely unknown. Higher prenatal body mass index (BMI), smoking, and alcohol consumption are associated with increased risk of CHDs. Whether these are causal is unclear. Methods and Results Seven European birth cohorts, including 232 390 offspring (2469 CHD cases [1.1%]), were included. We applied negative exposure paternal control analyses to explore the intrauterine effects of maternal BMI, smoking, and alcohol consumption during pregnancy, on offspring CHDs and CHD severity. We used logistic regression, adjusting for confounders and the other parent's exposure and combined estimates using a fixed-effects meta-analysis. In adjusted analyses, maternal overweight (odds ratio [OR], 1.15 [95% CI, 1.01-1.31]) and obesity (OR, 1.12 [95% CI, 0.93-1.36]), compared with normal weight, were associated with higher odds of CHD, but there was no clear evidence of a linear increase in odds across the whole BMI distribution. Associations of paternal overweight, obesity, and mean BMI were similar to the maternal associations. Maternal pregnancy smoking was associated with higher odds of CHD (OR, 1.11 [95% CI, 0.97-1.25]) but paternal smoking was not (OR, 0.96 [95% CI, 0.85-1.07]). The positive association with maternal smoking appeared to be driven by nonsevere CHD cases (OR, 1.22 [95% CI, 1.04-1.44]). Associations with maternal moderate/heavy pregnancy alcohol consumption were imprecisely estimated (OR, 1.16 [95% CI, 0.52-2.58]) and similar to those for paternal consumption. Conclusions We found evidence of an intrauterine effect for maternal smoking on offspring CHDs, but no evidence for higher maternal BMI or alcohol consumption. Our findings provide further support for the importance of smoking cessation during pregnancy.
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Affiliation(s)
- Kurt Taylor
- Population Health ScienceBristol Medical SchoolBristolUnited Kingdom
- Medical Research Council Integrative Epidemiology Unit at the University of BristolUnited Kingdom
| | - Ahmed Elhakeem
- Population Health ScienceBristol Medical SchoolBristolUnited Kingdom
- Medical Research Council Integrative Epidemiology Unit at the University of BristolUnited Kingdom
| | | | - Tiffany C. Yang
- Bradford Institute for Health ResearchBradford Teaching Hospitals National Health Service Foundation TrustBradfordUnited Kingdom
| | - Elena Isaevska
- Cancer Epidemiology UnitDepartment of Medical SciencesUniversity of Turin and CPO PiemonteTurinItaly
| | - Lorenzo Richiardi
- Cancer Epidemiology UnitDepartment of Medical SciencesUniversity of Turin and CPO PiemonteTurinItaly
| | - Tanja Vrijkotte
- Department of Public and Occupational HealthAmsterdam Public Health Research InstituteAmsterdam University Medical CenterUniversity of Amsterdamthe Netherlands
| | | | - Deirdre M. Murray
- The Irish Centre for Fetal and Neonatal Translational ResearchUniversity College CorkCorkIreland
- Department of Paediatrics and Child HealthUniversity College CorkCorkIreland
| | - Daragh Finn
- The Irish Centre for Fetal and Neonatal Translational ResearchUniversity College CorkCorkIreland
- Department of Paediatrics and Child HealthUniversity College CorkCorkIreland
| | - Dan Mason
- Bradford Institute for Health ResearchBradford Teaching Hospitals National Health Service Foundation TrustBradfordUnited Kingdom
| | - John Wright
- Bradford Institute for Health ResearchBradford Teaching Hospitals National Health Service Foundation TrustBradfordUnited Kingdom
| | - Sam Oddie
- Centre for Reviews and DisseminationUniversity of YorkHeslingtonYorkUnited Kingdom
| | - Nel Roeleveld
- Department for Health EvidenceRadboud Institute for Health SciencesRadboud University Medical CenterNijmegenthe Netherlands
| | - Jennifer R. Harris
- Division of Health Data and DigitalisationNorwegian Institute of Public HealthOsloNorway
- Centre for Fertility and HealthNorwegian Institute of Public HealthOsloNorway
| | | | - Massimo Caputo
- Translational ScienceBristol Medical SchoolBristolUnited Kingdom
- Bristol National Institute for Health Research Biomedical Research CenterBristolUnited Kingdom
| | - Deborah A. Lawlor
- Population Health ScienceBristol Medical SchoolBristolUnited Kingdom
- Medical Research Council Integrative Epidemiology Unit at the University of BristolUnited Kingdom
- Bristol National Institute for Health Research Biomedical Research CenterBristolUnited Kingdom
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5
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Vrijkotte TGM, Smeets J, de Rooij SR, Bosch JA. Maternal long-chain polyunsaturated fatty acid status during early pregnancy: Association with child behavioral problems and the role of autonomic nervous system activity. Clin Nutr 2020; 40:3338-3345. [PMID: 33218766 DOI: 10.1016/j.clnu.2020.11.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 10/06/2020] [Accepted: 11/01/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND & AIMS The prenatal environment, including availability of critical nutrients, has a profound impact on offspring development. The present study examined the association between maternal long-chain polyunsaturated fatty acid (LC-PUFA) status during pregnancy and later child behavioral problems at the age of 5-6 years. In light of evidence of autonomic nervous system (ANS) dysregulation in some behavioral problems, study further tested if the above association is statistically mediated by cardiac ANS activity. METHODS Data was collected as part of the Amsterdam Born Children and their Development-study and complete data were available for 1717 mothers and their offspring. Maternal LC-PUFA status was assessed during early pregnancy (mean gestation = 12.7, SD = 2.5 weeks) and quantified as levels of docosahexenoic acid (DHA), arachidonic acid (AA), eicosapentaenoic acid (EPA), as well as the ratio of n-6:n-3 fatty acids. Child emotional problems and peer problems (internalizing problems), as well as conduct problems and inattention/hyperactivity (externalizing problems), were assessed using the Strengths and Difficulties Questionnaire as rated by the mother and teacher at 5-6 years. Child cardiac respiratory sinus arrhythmia (RSA), pre-ejection period (PEP), and heart rate (HR) were utilized as measures of ANS activity at 5-6 years. RESULTS The results confirmed an association between maternal LC-PUFA status and internalizing behavioral problems as rated by the mother, as shown for DHA (β = -0.11;p < 0.01), EPA (β = -0.22;p < 0.05), and n-6:n-3 LC-PUFA (β = 0.17;p < 0.01). Statistical mediation was only demonstrated for HR. No associations were observed between LC-PUFA status and externalizing behavioral problems. CONCLUSIONS The present results are consistent with a role of maternal LC-PUFA status in internalizing behavioral problems as rated by the mother. These results were not observed when problem behavior was rated by the teacher. Analyses did not yield strong evidence supporting ANS activity as a possible mediator in this relationship.
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Affiliation(s)
- T G M Vrijkotte
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.
| | - J Smeets
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands; Department of Medical Psychology, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - S R de Rooij
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands; Department of Epidemiology and Data Science, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - J A Bosch
- Department of Medical Psychology, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands; Department of Psychology, University of Amsterdam, Amsterdam, the Netherlands
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Xue RH, Lin XH, Wu DD, Huang HF. Monitoring maternal triglyceride concentrations during pregnancy could be useful in reducing perinatal mortality. Acta Obstet Gynecol Scand 2020; 99:1262. [PMID: 32232828 DOI: 10.1111/aogs.13854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Revised: 03/21/2020] [Accepted: 03/23/2020] [Indexed: 11/27/2022]
Affiliation(s)
- Rui-Hong Xue
- Department of Obstetrics and Gynecology, International Peace Maternity and Child, Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Xian-Hua Lin
- Center of Reproductive Medicine, International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Dan-Dan Wu
- Center of Reproductive Medicine, International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,Institute of Embryo-Fetal Original Adult Disease Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - He-Feng Huang
- Center of Reproductive Medicine, International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,Institute of Embryo-Fetal Original Adult Disease Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China.,Shanghai Municipal Key Clinical Specialty, Shanghai, China
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Harreiter J, Simmons D, Desoye G, Corcoy R, Adelantado JM, Devlieger R, Galjaard S, Damm P, Mathiesen ER, Jensen DM, Andersen LLT, Dunne F, Lapolla A, Dalfra MG, Bertolotto A, Wender-Ozegowska E, Zawiejska A, Mantaj U, Hill D, Jelsma JGM, Snoek FJ, Leutner M, Lackinger C, Worda C, Bancher-Todesca D, Scharnagl H, van Poppel MNM, Kautzky-Willer A. Nutritional Lifestyle Intervention in Obese Pregnant Women, Including Lower Carbohydrate Intake, Is Associated With Increased Maternal Free Fatty Acids, 3-β-Hydroxybutyrate, and Fasting Glucose Concentrations: A Secondary Factorial Analysis of the European Multicenter, Randomized Controlled DALI Lifestyle Intervention Trial. Diabetes Care 2019; 42:1380-1389. [PMID: 31182492 DOI: 10.2337/dc19-0418] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 05/12/2019] [Indexed: 02/03/2023]
Abstract
OBJECTIVE In our randomized controlled trial, we investigated the impact of healthy eating (HE) aiming for restricted gestational weight gain (GWG) and physical activity (PA) interventions on maternal and neonatal lipid metabolism. RESEARCH DESIGN AND METHODS Obese pregnant women (n = 436) were included before 20 weeks' gestation and underwent glucose testing (oral glucose tolerance test) and lipid profiling at baseline and 24-28 and 35-37 gestational weeks after an at least 10-h overnight fast. This secondary analysis had a factorial design with comparison of HE (n = 221) versus no HE (n = 215) and PA (n = 218) versus no PA (n = 218). Maternal changes in triglycerides (TG), LDL cholesterol, HDL cholesterol, free fatty acids (FFAs), and leptin from baseline to end of pregnancy and neonatal outcomes were analyzed using general linear models with adjustment for relevant parameters. RESULTS At 24-28 weeks' gestation, FFAs (mean ± SD, 0.60 ± 0.19 vs. 0.55 ± 0.17 mmol/L, P < 0.01) were increased after adjustment for FFA at baseline, maternal age, BMI at time of examination, gestational week, insulin resistance, self-reported food intake, self-reported physical activity, and maternal smoking, and GWG was lower (3.3 ± 2.6 vs. 4.3 ± 2.8 kg, P < 0.001, adjusted mean differences -1.0 [95% CI -1.5; -0.5]) in HE versus no HE. Fasting glucose levels (4.7 ± 0.4 vs. 4.6 ± 0.4 mmol/L, P < 0.05) and 3-β-hydroxybutyrate (3BHB) (0.082 ± 0.065 vs. 0.068 ± 0.067 mmol/L, P < 0.05) were higher in HE. Significant negative associations between carbohydrate intake and FFA, 3BHB, and fasting glucose at 24-28 weeks' gestation were observed. No differences between groups were found in oral glucose tolerance test or leptin or TG levels at any time. Furthermore, in PA versus no PA, no similar changes were found. In cord blood, elevated FFA levels were found in HE after full adjustment (0.34 ± 0.22 vs. 0.29 ± 0.16 mmol/L, P = 0.01). CONCLUSIONS HE intervention was associated with reduced GWG, higher FFAs, higher 3BHB, and higher fasting glucose at 24-28 weeks of gestation, suggesting induction of lipolysis. Increased FFA was negatively associated with carbohydrate intake and was also observed in cord blood. These findings support the hypothesis that maternal antenatal dietary restriction including carbohydrates is associated with increased FFA mobilization.
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Affiliation(s)
- Jürgen Harreiter
- Gender Medicine Unit, Division of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Vienna, Austria
| | - David Simmons
- Institute of Metabolic Science, Addenbrookes Hospital, Cambridge, England.,Macarthur Clinical School, Western Sydney University, Sydney, New South Wales, Australia
| | - Gernot Desoye
- Department of Obstetrics and Gynecology, Medical University of Graz, Graz, Austria
| | - Rosa Corcoy
- Institut de Recerca de l'Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.,Biomaterials and Nanotechnology, CIBER Bioengineering, Instituto de Salud Carlos III, Madrid, Spain
| | - Juan M Adelantado
- Institut de Recerca de l'Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Roland Devlieger
- Department of Development and Regeneration, KU Leuven, University Leuven, Leuven, Belgium.,Department of Obstetrics and Gynecology, University Hospitals Leuven, Leuven, Belgium.,Department of Obstetrics, Gynecology, and Fertility, GZA Sint-Augustinus Wilrijk, Antwerpen, Belgium
| | - Sander Galjaard
- Department of Development and Regeneration, KU Leuven, University Leuven, Leuven, Belgium.,Department of Obstetrics and Gynecology, University Hospitals Leuven, Leuven, Belgium.,Department of Obstetrics and Gynaecology, Division of Obstetrics and Prenatal Medicine, Erasmus University Medical Centre Rotterdam, Rotterdam, the Netherlands
| | - Peter Damm
- Center for Pregnant Women with Diabetes, Departments of Endocrinology and Obstetrics, Rigshospitalet, Copenhagen, Denmark.,The Clinical Institute of Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Elisabeth R Mathiesen
- Center for Pregnant Women with Diabetes, Departments of Endocrinology and Obstetrics, Rigshospitalet, Copenhagen, Denmark.,The Clinical Institute of Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Dorte M Jensen
- Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark.,Department of Gynaecology and Obstetrics, Odense University Hospital, Odense, Denmark.,Department of Clinical Research, Faculty of Health, University of Southern Denmark, Sønderborg, Denmark
| | - Lise Lotte T Andersen
- Department of Gynaecology and Obstetrics, Odense University Hospital, Odense, Denmark.,Department of Clinical Research, Faculty of Health, University of Southern Denmark, Sønderborg, Denmark
| | - Fidelma Dunne
- Galway Diabetes Research Centre and National University of Ireland, Galway, Ireland
| | | | | | | | - Ewa Wender-Ozegowska
- Division of Reproduction, Medical Faculty I, Poznan University of Medical Sciences, Poznan, Poland
| | - Agnieszka Zawiejska
- Division of Reproduction, Medical Faculty I, Poznan University of Medical Sciences, Poznan, Poland
| | - Urszula Mantaj
- Division of Reproduction, Medical Faculty I, Poznan University of Medical Sciences, Poznan, Poland
| | - David Hill
- Recherche en Santé Lawson SA, St. Gallen, Switzerland
| | - Judith G M Jelsma
- Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.,Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Frank J Snoek
- Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.,Department of Medical Psychology, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Michael Leutner
- Gender Medicine Unit, Division of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Vienna, Austria
| | | | - Christof Worda
- Division of Obstetrics and Feto-Maternal Medicine, Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria
| | - Dagmar Bancher-Todesca
- Division of Obstetrics and Feto-Maternal Medicine, Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria
| | - Hubert Scharnagl
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - Mireille N M van Poppel
- Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.,Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands.,Institute of Sport Science, University of Graz, Graz, Austria
| | - Alexandra Kautzky-Willer
- Gender Medicine Unit, Division of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Vienna, Austria
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Li Y, He J, Zeng X, Zhao S, Wang X, Yuan H. Non-fasting lipids detection and their significance in pregnant women. Lipids Health Dis 2019; 18:96. [PMID: 30975209 PMCID: PMC6458631 DOI: 10.1186/s12944-019-1038-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Accepted: 03/29/2019] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND The majority of pregnant women present an increase in lipids. To investigate the influence of the non-fasting state in the lipid and lipoprotein profile in pregnancy, we have aimed to assess the dynamic change of serum lipid and lipoprotein profile with serum glucose in pregnancy to contrast the differences between fasting and non-fasting state. METHODS Forty-five pregnant women and 41 controls were included in our study. All serum samples were assayed for TC, TG, HDL-C, LDL-C, ApoB, ApoA-1, Lp(a), sdLDL, and Glu concentrations. The comparison between pregnant women and controls (fasting and 2 h after breakfast), differences of these measurement results at three point-in-time, the associations between the concentrations of serum lipid and some maternal and fetus characteristics was conducted with statistical analysis. RESULTS Except Glu (p < 0.001), there were no significant differences of all lipids between three point-in-time in pregnant women (p > 0.1). The statistically higher levels were found in fasting TC (p = 0.003), TG (p = 0.019), LDL-C (p = 0.002), ApoB (p = 0.001), ApoA1 (p = 0.013) and sdLDL (p < 0.001) of pregnant women compared with controls. Besides, the statistically significances were also found in 2-h TC (p = 0.001), LDL-C (p = 0.001), ApoB (p < 0.001), Glu (p = 0.013), ApoA-1 (p = 0.009) and sdLDL (p < 0.001) of pregnant women compared with controls. Otherwise, in non-fasting status (2 h after breakfast), pregnancy complication was relevant to TC (p = 0.041), HDL-C (p = 0.014), Glu (p = 0.004). Delivery mode was relevant to TC (p = 0.012), HDL-C (p = 0.013), LDL-C (p = 0.026), ApoA-1 (p = 0.012), and sdLDL (p = 0.044). BMI was relevant to TG (p = 0.027). CONCLUSION We have suggested the non-fasting lipids detection can be used for estimate lipid metabolism in pregnant women.
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Affiliation(s)
- Yulong Li
- Department of Clinical Laboratory, Beijing Anzhen Hospital, Capital Medical University, Anzhen Road No. 2, Chaoyang District, Beijing, People’s Republic of China
| | - Jianxun He
- Department of Clinical Laboratory, Beijing Anzhen Hospital, Capital Medical University, Anzhen Road No. 2, Chaoyang District, Beijing, People’s Republic of China
| | - Xiaoli Zeng
- Department of Clinical Laboratory, Beijing Anzhen Hospital, Capital Medical University, Anzhen Road No. 2, Chaoyang District, Beijing, People’s Republic of China
| | - Song Zhao
- Department of Clinical Laboratory, Beijing Anzhen Hospital, Capital Medical University, Anzhen Road No. 2, Chaoyang District, Beijing, People’s Republic of China
| | - Xuebing Wang
- Department of Clinical Laboratory, Beijing Anzhen Hospital, Capital Medical University, Anzhen Road No. 2, Chaoyang District, Beijing, People’s Republic of China
| | - Hui Yuan
- Department of Clinical Laboratory, Beijing Anzhen Hospital, Capital Medical University, Anzhen Road No. 2, Chaoyang District, Beijing, People’s Republic of China
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