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Valencia-Ortega J, Solis-Paredes JM, Saucedo R, Estrada-Gutierrez G, Camacho-Arroyo I. Excessive Pregestational Weight and Maternal Obstetric Complications: The Role of Adipokines. Int J Mol Sci 2023; 24:14678. [PMID: 37834125 PMCID: PMC10572963 DOI: 10.3390/ijms241914678] [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: 09/06/2023] [Revised: 09/22/2023] [Accepted: 09/26/2023] [Indexed: 10/15/2023] Open
Abstract
There is a high frequency of overweight and obesity in women of reproductive age. Women who start pregnancy with overweight or obesity have an increased risk of developing maternal obstetric complications such as gestational hypertension, pre-eclampsia, gestational diabetes mellitus, postpartum hemorrhage, and requiring C-section to resolve the pregnancy with a higher risk of C-section surgical site infection. Excessive weight in pregnancy is characterized by dysregulation of adipokines, the functions of which partly explain the predisposition of pregnant women with overweight or obesity to these maternal obstetric complications. This review compiles, organizes, and analyzes the most recent studies on adipokines in pregnant women with excess weight and the potential pathophysiological mechanisms favoring the development of maternal pregnancy complications.
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Affiliation(s)
- Jorge Valencia-Ortega
- Unidad de Investigación en Reproducción Humana, Instituto Nacional de Perinatología-Facultad de Química, Universidad Nacional Autónoma de México, Mexico City 11000, Mexico;
| | - Juan Mario Solis-Paredes
- Department of Reproductive and Perinatal Health Research, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Mexico City 11000, Mexico;
| | - Renata Saucedo
- Unidad de Investigación Médica en Enfermedades Endocrinas, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City 06720, Mexico;
| | | | - Ignacio Camacho-Arroyo
- Unidad de Investigación en Reproducción Humana, Instituto Nacional de Perinatología-Facultad de Química, Universidad Nacional Autónoma de México, Mexico City 11000, Mexico;
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Savard C, Lemieux S, Plante AS, Gagnon M, Leblanc N, Veilleux A, Tchernof A, Morisset AS. Longitudinal changes in circulating concentrations of inflammatory markers throughout pregnancy: are there associations with diet and weight status? Appl Physiol Nutr Metab 2021; 47:287-295. [PMID: 34767478 DOI: 10.1139/apnm-2021-0395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The natural inflammation occurring during pregnancy can, under certain conditions, be associated with adverse pregnancy outcomes. This study aimed to: 1) quantify changes in circulating concentrations of leptin, adiponectin, interleukin-6 (IL-6) and C-reactive protein (CRP) across trimesters of pregnancy, according to pre-pregnancy body mass index (ppBMI); and 2) examine the trimester-specific associations between the inflammatory markers' concentrations, a Mediterranean diet score (MDS) and the dietary inflammatory index (DII). We measured leptin, adiponectin and IL-6 by ELISA, and CRP by high-sensitivity immunonephelometry, in blood samples from 79 pregnant women (age: 32.1 ± 3.7 years; ppBMI: 25.7 ± 5.8 kg/m2). Three web-based 24h recalls were completed at each trimester and used to compute the MDS and the DII. CRP concentrations remained stable across trimesters, whereas concentrations of leptin and IL-6 increased, and adiponectin concentrations decreased (p<0.001). Changes in leptin and adiponectin concentrations also differed according to ppBMI categories (p<0.05). As for the dietary scores, the only significant association was observed in the second trimester between leptin concentrations and the MDS (r=-0.26, p<0.05). In conclusion, ppBMI and the progression of pregnancy itself probably supplant the potential associations between diet and the inflammation occurring during that period. Novelty: • Circulating leptin and IL-6 concentrations increased across trimesters whereas CRP was stable, and adiponectin decreased. • Variations in circulating leptin and adiponectin concentrations differed by ppBMI categories. • Very few associations were observed between dietary scores and inflammatory markers.
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Affiliation(s)
- Claudia Savard
- Laval University, 4440, School of Nutrition, Quebec, Quebec, Canada;
| | - Simone Lemieux
- Laval University, School of Nutrition, INAF, Pavillon des services, 2440 Boulevard Hochelaga, Quebec, Quebec, Canada, G1V 0A6;
| | | | - Marianne Gagnon
- Laval University, 4440, School of Nutrition, Quebec, Quebec, Canada.,CHU de Québec-Université Laval, 36896, Endocrinology and Nephrology Unit, Quebec, Quebec, Canada.,Laval University, 4440, Institute of Nutrition and Functional Foods, Quebec, Quebec, Canada;
| | - Nadine Leblanc
- Laval University, Department of Food Science and Nutrition, Quebec, Quebec, Canada;
| | - Alain Veilleux
- Laval University, 4440, School of Nutrition, Quebec, Quebec, Canada;
| | - André Tchernof
- Laval University, Laval University Medical Center, Quebec, Quebec, Canada.,Laval University, Institute of Nutrition and Functional Foods (INAF), Quebec, Quebec, Canada;
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He W, Wang L, Zhang Y, Jiang Y, Chen X, Wang Y, Dou Y, Chen H, Yan W. Higher Serum Bilirubin Levels in Response to Higher Carbohydrate Intake During Early Pregnancy and Lower Gestational Diabetes Mellitus Occurrence in Overweight and Obese Gravidae. Front Nutr 2021; 8:701422. [PMID: 34527687 PMCID: PMC8435579 DOI: 10.3389/fnut.2021.701422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 08/11/2021] [Indexed: 11/16/2022] Open
Abstract
Background and Aim: Serum bilirubin levels are recently shown to be a novel protector of gestational diabetes mellitus (GDM), yet whether they could be affected by carbohydrate quality is unclear. We aimed to examine the associations between dietary carbohydrate parameters and serum bilirubin levels during early pregnancy, with further exploration on a potential mediating role of serum bilirubin levels on carbohydrate parameters-GDM pathways. Methods: 260 healthy but overweight or obese gravidae (BMI ≥24 kg/m2) derived from a historical cohort in two hospitals in China were included. The associations between carbohydrate parameters (total carbohydrate intake, glycemic index GI, fiber intake, glycemic load GL) and serum bilirubin levels (total bilirubin, TB and direct bilirubin, DB) and GDM were evaluated by multivariable regression analysis. Generalized structural equation modeling was then applied to perform adjusted mediation analysis. Results: Increased serum bilirubin levels (mmol/L) and decreased GDM occurrence were observed following dietary carbohydrate intake (%E) and GL (g/1,000 kcal) in highest tertile compared to the lowest tertile [carbohydrate: TB: β = 0.926 (95%CI: 0.069, 1.782), DB: β = 0.554 (95%CI: 0.192, 0.916);GL:TB: β = 1.170 (95%CI: 0.339, 2.001); DB: β = 0.369 (95%CI: 0.016, 0.700); carbohydrate: adjusted OR = 0.43 (95%CI:0.19-0.99); GL: adjusted OR = 0.36 (95%CI:0.16, 0.84)]. The mediating effect of carbohydrate intake and GL on GDM through bilirubin levels was evaluated as modest (carbohydrate: 6.2% for TB, 1.3% for DB; GL: 8.7% for TB, 2.3% for DB). No association was observed regarding GI and fiber. Conclusions: Mildly elevated serum bilirubin levels appeared to be in response to higher energies consumed from carbohydrate during early pregnancy in healthy overweight or obese gravidae. However, the mediating effect of bilirubin levels on carbohydrate-GDM pathways is not evident. Larger investigation is further needed for solid evidence.
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Affiliation(s)
- Wennan He
- Department of Clinical Epidemiology & Clinical Trial Unit (CTU), Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
| | - Liping Wang
- International Peace Maternity and Child Health Hospital of China Welfare Institute, Shanghai, China
| | - Yi Zhang
- Department of Clinical Epidemiology & Clinical Trial Unit (CTU), Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
| | - Yuan Jiang
- Department of Clinical Epidemiology & Clinical Trial Unit (CTU), Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
| | - Xiaotian Chen
- Department of Clinical Epidemiology & Clinical Trial Unit (CTU), Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
| | - Yin Wang
- Department of Clinical Epidemiology & Clinical Trial Unit (CTU), Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
| | - Yalan Dou
- Department of Clinical Epidemiology & Clinical Trial Unit (CTU), Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
| | - Hongyan Chen
- Department of Clinical Epidemiology & Clinical Trial Unit (CTU), Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
| | - Weili Yan
- Department of Clinical Epidemiology & Clinical Trial Unit (CTU), Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
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Serapio S, Ahlsson F, Larsson A, Kunovac Kallak T. Second Trimester Maternal Leptin Levels Are Associated with Body Mass Index and Gestational Weight Gain but not Birth Weight of the Infant. Horm Res Paediatr 2020; 92:106-114. [PMID: 31655800 DOI: 10.1159/000503422] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Accepted: 09/16/2019] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Obesity is increasing among the pregnant population. Leptin has an important role in the regulation of energy balance and hunger. The aim of this study was to investigate the association between maternal leptin levels with maternal obesity, gestational weight gain (GWG), single nucleotide polymorphisms (SNPs) within the leptin gene, and the age-adjusted birth weight of the child. MATERIAL AND METHODS Maternal leptin levels (n = 740) and SNPs (n = 504) were analyzed in blood samples taken within the Uppsala Biobank of Pregnant women at pregnancy weeks 16-19. RESULTS Maternal leptin levels differed significantly between body mass index (BMI) groups. Normal weight women had the lowest median leptin levels and levels increased with each BMI group. Leptin SNP genotype was not associated with leptin levels or BMI. There was also no association between maternal leptin levels and age-adjusted birth weight of the child except for a negative association between leptin levels and birth weight in the morbid obese group. DISCUSSION/CONCLUSION Maternal BMI was identified as the best positive explanatory factor for maternal leptin levels. Leptin was a strong positive explanatory factor for GWG. Birth weight of children of uncomplicated pregnancies was, however, dependent on maternal height, BMI, GWG, and parity but not leptin levels, except for in morbid obese women where a negative association between maternal leptin levels and birth weight was found. We speculate that this indicates altered placental function, not manifested in pregnancy complication. We conclude that maternal leptin levels do not affect the birth weight of the child more than BMI, GWG, and parity.
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Affiliation(s)
- Solveig Serapio
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Fredrik Ahlsson
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Anders Larsson
- Department of Medical Sciences, Clinical Chemistry, Uppsala University, Uppsala, Sweden
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Xiao WQ, He JR, Shen SY, Lu JH, Kuang YS, Wei XL, Qiu X. Maternal circulating leptin profile during pregnancy and gestational diabetes mellitus. Diabetes Res Clin Pract 2020; 161:108041. [PMID: 32006645 DOI: 10.1016/j.diabres.2020.108041] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 01/15/2020] [Accepted: 01/27/2020] [Indexed: 12/13/2022]
Abstract
AIMS To evaluate the difference in maternal circulating leptin profile between pregnant women with and without gestational diabetes mellitus (GDM). METHODS This is a nested case-control study embedded in the Born in Guangzhou Cohort Study in Guangzhou Women and Children's Medical Center, with 198 GDM cases and 192 controls included. Maternal plasma leptin profile was defined as leptin concentrations measured at early (baseline) and late pregnancy, as well as a ratio of concentration at late to that at early pregnancy (RL1L0). General linear regression was used to assess the associations between GDM and log-transformed leptin measurements. RESULTS Women with GDM had a higher baseline leptin concentration and lower RL1L0 compared to those without GDM. The log leptin concentration at baseline (β: 0.19, 95%CI: 0.04, 0.34) and the log RL1L0 (β: -0.22, 95%CI: -0.41, -0.03) were associated with GDM status. The RL1L0 decreased significantly along with the increase of 1-hour glucose and the difference between 1-hour and fasting glucose levels in both GDM and non-GDM women. CONCLUSIONS Women with GDM had a certain profile of circulating leptin, with higher baseline concentration but less increase during pregnancy, suggesting an impaired compensatory response to increasing insulin resistance along with the progress of pregnancy.
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Affiliation(s)
- Wan-Qing Xiao
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 510623 Guangzhou, China; Department of Woman and Child Health Care, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 510623 Guangzhou, China; Department of Obstetrics and Gynecology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 510623 Guangzhou, China
| | - Jian-Rong He
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 510623 Guangzhou, China; Department of Woman and Child Health Care, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 510623 Guangzhou, China
| | - Song-Ying Shen
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 510623 Guangzhou, China
| | - Jin-Hua Lu
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 510623 Guangzhou, China; Department of Woman and Child Health Care, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 510623 Guangzhou, China
| | - Ya-Shu Kuang
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 510623 Guangzhou, China
| | - Xue-Ling Wei
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 510623 Guangzhou, China; Department of Woman and Child Health Care, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 510623 Guangzhou, China
| | - Xiu Qiu
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 510623 Guangzhou, China; Department of Woman and Child Health Care, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 510623 Guangzhou, China; Department of Obstetrics and Gynecology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 510623 Guangzhou, China.
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Brooks VL, Fu Q, Shi Z, Heesch CM. Adaptations in autonomic nervous system regulation in normal and hypertensive pregnancy. HANDBOOK OF CLINICAL NEUROLOGY 2020; 171:57-84. [PMID: 32736759 DOI: 10.1016/b978-0-444-64239-4.00003-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
There is an increase in basal sympathetic nerve activity (SNA) during normal pregnancy; this counteracts profound primary vasodilation. However, pregnancy also impairs baroreflex control of heart rate and SNA, contributing to increased mortality secondary to peripartum hemorrhage. Pregnancy-induced hypertensive disorders evoke even greater elevations in SNA, which likely contribute to the hypertension. Information concerning mechanisms is limited. In normal pregnancy, increased angiotensin II acts centrally to support elevated SNA. Hypothalamic sites, including the subfornical organ, paraventricular nucleus, and arcuate nucleus, are likely (but unproven) targets. Moreover, no definitive mechanisms for exaggerated sympathoexcitation in hypertensive pregnancy have been identified. In addition, normal pregnancy increases gamma aminobutyric acid inhibition of the rostral ventrolateral medulla (RVLM), a key brainstem site that transmits excitatory inputs to spinal sympathetic preganglionic neurons. Accumulated evidence supports a major role for locally increased production and actions of the neurosteroid allopregnanolone as one mechanism. A consequence is suppression of baroreflex function, but increased basal SNA indicates that excitatory influences predominate in the RVLM. However, many questions remain regarding other sites and factors that support increased SNA during normal pregnancy and, more importantly, the mechanisms underlying excessive sympathoexcitation in life-threatening hypertensive pregnancy disorders such as preeclampsia.
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Affiliation(s)
- Virginia L Brooks
- Department of Physiology and Pharmacology, Oregon Health & Science University, Portland, OR, United States.
| | - Qi Fu
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, TX, United States; Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Zhigang Shi
- Department of Physiology and Pharmacology, Oregon Health & Science University, Portland, OR, United States
| | - Cheryl M Heesch
- Department of Biomedical Sciences and Dalton Cardiovascular Research Center, University of Missouri, Columbia, MO, United States
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Pregestational excess weight and adverse maternal outcomes: a systematic review of previous studies in Brazil. NUTR HOSP 2020; 37:384-395. [DOI: 10.20960/nh.02851] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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Stefaniak M, Dmoch-Gajzlerska E, Mazurkiewicz B, Gajzlerska-Majewska W. Maternal serum and cord blood leptin concentrations at delivery. PLoS One 2019; 14:e0224863. [PMID: 31697751 PMCID: PMC6837318 DOI: 10.1371/journal.pone.0224863] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 10/23/2019] [Indexed: 12/28/2022] Open
Abstract
Introduction Studies have demonstrated leptin involvement in the physiology and pathophysiology of pregnancy and suggest that leptin may be a prognostic marker for some complications of pregnancy although the association remains unclear. To date no studies have reported leptin reference intervals established in normal pregnancy, which could be used for interpreting the differences in leptin levels found in normal and pathological pregnancies. Objective To determine leptin concentrations at delivery, in maternal serum in normal pregnancy and in cord blood and to establish reference intervals for leptin. Material and methods The study was performed in 194 pregnant women without any comorbid health conditions. Leptin concentrations in maternal serum and in cord blood were measured by ELISA and subsequently analyzed by gestational age (weeks), maternal Body Mass Index (BMI), mode of delivery and infant gender and birth weight. For comparative analyses of normally distributed variables, parametric tests such as the Student–t were used to test the assumption of homogeneity or non-homogeneity of variance and a One-Way ANOVA when more than two groups were compared. The Pearson correlation coefficient was calculated to assess the correlation between normally distributed variables (p<0.05). The reference intervals for leptin were obtained by referring to the central 95% of laboratory test values. Results In normal pregnant women, the mean serum leptin concentration at delivery was 37.17 ± 28.07 ng/mL and the established reference interval was 33.19–41.14 ng/mL. The mean leptin concentration in cord blood was 14.78 ± 15.97 ng/mL and the established reference interval was 12.32–17.67 ng/mL. There was a statistically significant positive correlation between maternal serum and cord blood leptin concentrations (r = 0.37; p = 0.00). Mean leptin concentrations in cord blood increased with gestational age (p = 0.00). No statistically significant differences in maternal serum and cord blood leptin concentrations were found in regard to mode of delivery and neonatal gender. A statistically significant correlation was found between maternal serum leptin and third-trimester BMI (r = 0.22; p = 0.00), but there was no association between maternal BMI and cord blood leptin concentration. There was a statistically significant positive correlation between cord blood leptin concentration and birth weight (r = 0.23; p = 0.00). Conclusions Reference intervals for leptin in maternal serum and in cord blood established in normal pregnancy could be used in clinical practice for interpreting the differences in leptin concentrations found in normal pregnancy and in complications of pregnancy. The results indicate a strong association between maternal serum leptin levels and obesity and between cord blood leptin levels and birth weight.
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Affiliation(s)
- Małgorzata Stefaniak
- Department of Obstetrics and Gynecology Didactics, Faculty of Health Sciences, Medical University of Warsaw, Warsaw, Poland
- * E-mail:
| | - Ewa Dmoch-Gajzlerska
- Department of Obstetrics and Gynecology Didactics, Faculty of Health Sciences, Medical University of Warsaw, Warsaw, Poland
| | - Barbara Mazurkiewicz
- Department of Obstetrics and Gynecology Didactics, Faculty of Health Sciences, Medical University of Warsaw, Warsaw, Poland
| | - Wanda Gajzlerska-Majewska
- Department of Obstetrics and Gynecology, First Faculty of Medicine, Medical University of Warsaw, Warsaw, Poland
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Farias DR, Alves-Santos NH, Eshriqui I, Martins MC, Struchiner CJ, Lepsch J, Costa N, Kac G. Leptin gene polymorphism (rs7799039; G2548A) is associated with changes in serum lipid concentrations during pregnancy: a prospective cohort study. Eur J Nutr 2019; 59:1999-2009. [PMID: 31292750 DOI: 10.1007/s00394-019-02049-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Accepted: 07/05/2019] [Indexed: 12/20/2022]
Abstract
PURPOSE Little is known about the effects of leptin and leptin receptor polymorphisms on lipid changes during pregnancy. The aims of this study were to evaluate the associations between the single nucleotide polymorphisms (SNPs) of leptin and leptin receptor genes and the lipid concentrations during pregnancy; and to test whether dietary intake is a mediator in these associations. METHODS A prospective cohort of 154 pregnant women was followed up in Rio de Janeiro, Brazil during the following gestational periods: 5-13th, 20-26th and 30-36th weeks. HDL-C, total cholesterol (TC) and triglyceride (TG) were measured by the enzymatic colorimetric method, and LDL-C was calculated. DNA was extracted by the phenol-chloroform method, and leptin (G2548A, rs7799039) and leptin receptor SNPs (Q223R; rs1137101 and K109R; rs1137100) were genotyped using real-time PCR. Statistical analyses included linear mixed-effect models. RESULTS Women with the AA genotype of G2548A polymorphism reported a higher fat and total energy intake and had a higher increase in TG concentration during pregnancy than women with AG or GG genotype. The association between G2548A SNP and TG concentrations was not attenuated by adjusting for total lipid (g) and energy (kcal) intake. We did not observe significant associations between the Q223R and K109R SNPs and the lipid concentrations. CONCLUSIONS Women homozygous for the A allele of the leptin SNP (G2548A) had a higher increase in TG concentrations per gestational week compared with women with the AG or GG genotype. This is an exploratory and hypothesis-generating study, and the results need confirmation in studies with larger sample sizes.'
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Affiliation(s)
- Dayana Rodrigues Farias
- Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Institute of Nutrition Josué de Castro, Federal University of Rio de Janeiro, Avenida Carlos Chagas Filho, 373, CCS, Bloco, J2-sala 29, Cidade Universitária-Ilha Do Fundão, Rio de Janeiro, RJ, 21941-902, Brazil
| | - Nadya Helena Alves-Santos
- Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Institute of Nutrition Josué de Castro, Federal University of Rio de Janeiro, Avenida Carlos Chagas Filho, 373, CCS, Bloco, J2-sala 29, Cidade Universitária-Ilha Do Fundão, Rio de Janeiro, RJ, 21941-902, Brazil
| | - Ilana Eshriqui
- Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Institute of Nutrition Josué de Castro, Federal University of Rio de Janeiro, Avenida Carlos Chagas Filho, 373, CCS, Bloco, J2-sala 29, Cidade Universitária-Ilha Do Fundão, Rio de Janeiro, RJ, 21941-902, Brazil
| | - Maisa Cruz Martins
- Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Institute of Nutrition Josué de Castro, Federal University of Rio de Janeiro, Avenida Carlos Chagas Filho, 373, CCS, Bloco, J2-sala 29, Cidade Universitária-Ilha Do Fundão, Rio de Janeiro, RJ, 21941-902, Brazil
| | - Cláudio J Struchiner
- Escola de Matemática Aplicada, Fundação Getúlio Vargas, Praia de Botafogo 190, Rio de Janeiro, RJ, 22250-900, Brazil
| | - Jaqueline Lepsch
- Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Institute of Nutrition Josué de Castro, Federal University of Rio de Janeiro, Avenida Carlos Chagas Filho, 373, CCS, Bloco, J2-sala 29, Cidade Universitária-Ilha Do Fundão, Rio de Janeiro, RJ, 21941-902, Brazil
| | - Nathalia Costa
- Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Institute of Nutrition Josué de Castro, Federal University of Rio de Janeiro, Avenida Carlos Chagas Filho, 373, CCS, Bloco, J2-sala 29, Cidade Universitária-Ilha Do Fundão, Rio de Janeiro, RJ, 21941-902, Brazil
| | - Gilberto Kac
- Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Institute of Nutrition Josué de Castro, Federal University of Rio de Janeiro, Avenida Carlos Chagas Filho, 373, CCS, Bloco, J2-sala 29, Cidade Universitária-Ilha Do Fundão, Rio de Janeiro, RJ, 21941-902, Brazil.
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Carlhäll S, Källén K, Thorsell A, Blomberg M. Maternal plasma leptin levels in relation to the duration of the active phase of labor. Acta Obstet Gynecol Scand 2018; 97:1248-1256. [PMID: 29772056 DOI: 10.1111/aogs.13380] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 05/09/2018] [Indexed: 12/21/2022]
Abstract
INTRODUCTION Obese women have increased leptin levels and longer duration of labor compared with normal-weight women. Leptin has an inhibitory effect on myometrial contractility in vitro. Our purpose was to examine whether maternal leptin levels in active labor were associated with the duration of the active phase of labor. MATERIAL AND METHODS This prospective cohort study included 914 women. Maternal blood samples were collected in active labor. The plasma-leptin concentration was obtained using a direct sandwich-based ELISA. Bivariate and multiple linear regression analyses were used to study the association between leptin levels and the duration of labor. RESULTS A 1 ng/mL increase in maternal plasma leptin was associated with a 0.015 hour increase in duration of labor (P < .007). This association was not statistically significant in the adjusted analyses nor when analyzing nulliparous and multiparous women separately. In women with spontaneous labor (n = 766) leptin levels were not associated with an increase in duration of labor in the adjusted analyses. CONCLUSIONS There was no significant association between leptin levels and duration of the active phase of labor. Leptin in vivo might display a similar dose-response effect on myometrial contractility as demonstrated in in vitro studies. Future studies need to explore the association between leptin levels and time in labor in obese women with high leptin levels to evaluate a possible dose-response effect.
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Affiliation(s)
- Sara Carlhäll
- Department of Obstetrics and Gynecology and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Karin Källén
- Institution of Clinical Sciences Lund, Center for Reproductive Epidemiology, Tornblad Institute, Lund University, Lund, Sweden
| | - Annika Thorsell
- Center for Social and Affective Neuroscience, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, Sweden
| | - Marie Blomberg
- Department of Obstetrics and Gynecology and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
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Maternal lipids and leptin concentrations are associated with large-for-gestational-age births: a prospective cohort study. Sci Rep 2017; 7:804. [PMID: 28400574 PMCID: PMC5429770 DOI: 10.1038/s41598-017-00941-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Accepted: 03/20/2017] [Indexed: 11/22/2022] Open
Abstract
The change in maternal lipid, leptin and adiponectin concentrations during pregnancy and infant birth weight (BW) is still poorly characterized. Thus, the aim of the study was to evaluate the association of maternal lipids, leptin and adiponectin throughout pregnancy with large-for-gestational-age (LGA) births and BW z-score. A prospective cohort of 199 mothers was followed during pregnancy in Rio de Janeiro, Brazil. The statistical analyses comprised multiple logistic and linear regression. Women delivered 36 LGA and 11 small-for-gestational-age newborns. HDL-c rate of change throughout pregnancy was negatively associated with BW z-score (β = −1.99; p = 0.003) and the delivery of a LGA newborn (OR = 0.02; p = 0.043). Pregnancy baseline concentration of log leptin was positively associated (OR = 3.92; p = 0.025) with LGA births. LDL-c rate of change throughout pregnancy was positively associated with BW z-score (β = 0.31; p = 0.004). Log triglycerides and log adiponectin were not significantly associated with BW z-score or LGA birth. In conclusion, a higher log leptin pregnancy baseline concentration and a lower HDL-c rate of change during pregnancy were associated with higher odds of having a LGA newborn. These maternal biomarkers are important to foetal growth and could be used in prenatal care as an additional strategy to screen women at risk of inadequate BW.
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Pendeloski KPT, Ono E, Torloni MR, Mattar R, Daher S. Maternal obesity and inflammatory mediators: A controversial association. Am J Reprod Immunol 2017; 77. [PMID: 28328066 DOI: 10.1111/aji.12674] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Accepted: 02/22/2017] [Indexed: 12/11/2022] Open
Abstract
The link between maternal obesity and inflammatory mediators is still unclear. Our aim was to summarize the main findings of recently published studies on this topic. We performed a search in Medline for studies published in the last years on obesity, human pregnancy, and inflammatory mediators. We report the findings of 30 studies. The characteristics and number of participants, study design, gestational age at sample collection, and type of sample varied widely. Approximately two-thirds of them investigated more than one mediator, and 50% included participants in only one trimester of pregnancy. The most frequently investigated mediators were leptin, tumour necrosis factor-alpha (TNF-α), and interleukin (IL)-6. Almost all studies reported an association between maternal obesity, leptin, and C-reactive protein (CRP) serum levels but not with IL-1β and IL-10. The association of IL-6, TNF-α, monocyte chemo-attractant protein-1 (MCP-1), adiponectin, and resistin with maternal obesity is still controversial. To clarify the physiopathological link between maternal obesity and inflammation, more high-quality studies are needed.
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Affiliation(s)
| | - Erika Ono
- Department of Obstetrics, Universidade Federal de São Paulo, São Paulo, Sao Paulo, Brazil
| | - Maria Regina Torloni
- Department of Obstetrics, Universidade Federal de São Paulo, São Paulo, Sao Paulo, Brazil
| | - Rosiane Mattar
- Department of Obstetrics, Universidade Federal de São Paulo, São Paulo, Sao Paulo, Brazil
| | - Silvia Daher
- Department of Obstetrics, Universidade Federal de São Paulo, São Paulo, Sao Paulo, Brazil
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Carlhäll S, Bladh M, Brynhildsen J, Claesson IM, Josefsson A, Sydsjö G, Thorsell A, Blomberg M. Maternal obesity (Class I-III), gestational weight gain and maternal leptin levels during and after pregnancy: a prospective cohort study. BMC OBESITY 2016; 3:28. [PMID: 27257506 PMCID: PMC4875677 DOI: 10.1186/s40608-016-0108-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Accepted: 05/12/2016] [Indexed: 11/10/2022]
Abstract
BACKGROUND Maternal obesity is accompanied by maternal and fetal complications during and after pregnancy. The risks seem to increase with degree of obesity. Leptin has been suggested to play a role in the development of obesity related complications. Whether maternal leptin levels differ between obese and morbidly obese women, during and after pregnancy, have to our knowledge not been previously described. Neither has the association between maternal leptin levels and gestational weight gain in obese women. The aim was to evaluate if maternal plasma leptin levels were associated with different degrees of maternal obesity and gestational weight gain. METHODS Prospective cohort study including women categorized as obesity class I-III (n = 343) and divided into three gestational weight gain groups (n = 304). Maternal plasma leptin was measured at gestational week 15, 29 and 10 weeks postpartum. Maternal Body Mass Index (BMI) was calculated from early pregnancy weight. Gestational weight gain was calculated using maternal weight in delivery week minus early pregnancy weight. The mean value and confidence interval of plasma-leptin were analysed with a two-way ANOVA model. Interaction effect between BMI and gestational weight gain group was tested with a two-way ANOVA model. RESULTS The mean maternal leptin concentrations were significantly higher in women with obesity class III compared to women in obesity class I, at all times when plasma leptin were measured. The mean leptin concentrations were also significantly higher in women with obesity class II compared to women in obesity class I, except in gestational week 29. There was no difference in mean levels of plasma leptin between the gestational weight gain groups. No significant interaction between BMI and gestational weight gain group was found. CONCLUSIONS Plasma leptin levels during and after pregnancy were associated with obesity class but not with degree of gestational weight gain. These results are in concordance with epidemiological findings where the risk of obstetric complications increases with increased maternal obesity class. The effect on obstetric outcome by degree of gestational weight gain is less pronounced than the adverse effects associated with maternal obesity.
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Affiliation(s)
- Sara Carlhäll
- Department of Obstetrics and Gynaecology and Department of Clinical and Experimental Medicine, Linköping University, 58185 Linköping, Sweden
| | - Marie Bladh
- Department of Obstetrics and Gynaecology and Department of Clinical and Experimental Medicine, Linköping University, 58185 Linköping, Sweden
| | - Jan Brynhildsen
- Department of Obstetrics and Gynaecology and Department of Clinical and Experimental Medicine, Linköping University, 58185 Linköping, Sweden
| | - Ing-Marie Claesson
- Department of Obstetrics and Gynaecology and Department of Clinical and Experimental Medicine, Linköping University, 58185 Linköping, Sweden
| | - Ann Josefsson
- Department of Obstetrics and Gynaecology and Department of Clinical and Experimental Medicine, Linköping University, 58185 Linköping, Sweden
| | - Gunilla Sydsjö
- Department of Obstetrics and Gynaecology and Department of Clinical and Experimental Medicine, Linköping University, 58185 Linköping, Sweden
| | - Annika Thorsell
- Division of Cell Biology, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, 58185 Linköping, Sweden
| | - Marie Blomberg
- Department of Obstetrics and Gynaecology and Department of Clinical and Experimental Medicine, Linköping University, 58185 Linköping, Sweden
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Lepsch J, Farias DR, Vaz JDS, de Jesus Pereira Pinto T, da Silva Lima N, Freitas Vilela AA, Cunha M, Factor-Litvak P, Kac G. Serum saturated fatty acid decreases plasma adiponectin and increases leptin throughout pregnancy independently of BMI. Nutrition 2016; 32:740-7. [PMID: 27036610 DOI: 10.1016/j.nut.2016.01.016] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Revised: 01/06/2016] [Accepted: 01/20/2016] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The aim of this study was to investigate whether serum concentrations of total saturated fatty acids (SFAs), polyunsaturated fatty acids (PUFAs), and their fractions are associated with plasma adiponectin and leptin concentrations throughout pregnancy. METHODS A prospective cohort of 201 pregnant women was followed from gestational weeks 5 to 13, 20 to 26, and 30 to 36. Blood samples were collected at the three visits after 12 h of fasting. Fatty acid concentrations were determined using fast gas-liquid chromatography. Plasma adiponectin (μg/mL) and leptin (ng/dL) concentrations were evaluated using enzyme-linked immunosorbent assay kits. Statistical analyses included median adipokine concentrations according to the tertiles of fatty acid distribution and multiple linear mixed-effect models adjusted for body mass index, gestational age, total energy intake, alcohol consumption, and smoking. RESULTS Women classified in the third SFA concentration tertile had lower median values of adiponectin compared with those in the first tertile ([first trimester: first tertile = 5.36; third tertile = 5.00]; [second trimester: first tertile = 6.39; third tertile = 4.47]; [third trimester: first tertile = 6.46; third tertile = 4.60]). Similar trends were observed for the 14:0, 16:0 and 18:0 fractions. In the multiple longitudinal models, total SFA (β = -41.039; P = 0.008) and 16:0 were negatively associated with plasma adiponectin (16:0, β = -0.511; P = 0.001). Total PUFA ω-6 (β = 28.961; P = 0.002) and 18:2 ω-6 (β = 0.259, P = 0.006) were positively associated with the adiponectin. Total SFA (β = 0.110, P = 0.007), 14:0 (β = 0.072, P = 0.011), and 20:3 ω-6 (β = 0.039; P = 0.035) were positively associated with plasma leptin. CONCLUSIONS Total serum SFA and the 16:0 fraction were negatively associated with plasma adiponectin and positively associated with leptin concentrations. Total ω-6 PUFA was positively associated only with plasma adiponectin concentrations throughout pregnancy.
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Affiliation(s)
- Jaqueline Lepsch
- Nutritional Epidemiology Observatory, Josué de Castro Nutrition Institute, Rio de Janeiro Federal University, Rio de Janeiro, Brazil
| | - Dayana Rodrigues Farias
- Nutritional Epidemiology Observatory, Josué de Castro Nutrition Institute, Rio de Janeiro Federal University, Rio de Janeiro, Brazil
| | | | - Thatiana de Jesus Pereira Pinto
- Nutritional Epidemiology Observatory, Josué de Castro Nutrition Institute, Rio de Janeiro Federal University, Rio de Janeiro, Brazil
| | - Natália da Silva Lima
- Nutritional Epidemiology Observatory, Josué de Castro Nutrition Institute, Rio de Janeiro Federal University, Rio de Janeiro, Brazil
| | - Ana Amélia Freitas Vilela
- Nutritional Epidemiology Observatory, Josué de Castro Nutrition Institute, Rio de Janeiro Federal University, Rio de Janeiro, Brazil
| | - Marcelo Cunha
- National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Pam Factor-Litvak
- Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Gilberto Kac
- Rio de Janeiro Federal University, Josué de Castro Nutrition Institute, Department of Social and Applied Nutrition, Rio de Janeiro, Brazil.
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Franco-Sena AB, Rebelo F, Pinto TJP, Farias DR, Silveira GE, Mendes RH, Henriques VT, Kac G. The effect of leptin concentrations and other maternal characteristics on gestational weight gain is different according to pre-gestational BMI: results from a prospective cohort. BJOG 2015; 123:1804-13. [DOI: 10.1111/1471-0528.13826] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/20/2015] [Indexed: 12/01/2022]
Affiliation(s)
- AB Franco-Sena
- Nutritional Epidemiology Observatory; Department of Social and Applied Nutrition; Institute of Nutrition Josué de Castro; Rio de Janeiro Federal University; Rio de Janeiro Brazil
- Graduate Program in Nutrition; Institute of Nutrition Josué de Castro; Rio de Janeiro Federal University; Rio de Janeiro Brazil
| | - F Rebelo
- Nutritional Epidemiology Observatory; Department of Social and Applied Nutrition; Institute of Nutrition Josué de Castro; Rio de Janeiro Federal University; Rio de Janeiro Brazil
| | - TJP Pinto
- Nutritional Epidemiology Observatory; Department of Social and Applied Nutrition; Institute of Nutrition Josué de Castro; Rio de Janeiro Federal University; Rio de Janeiro Brazil
- Graduate Program in Nutrition; Institute of Nutrition Josué de Castro; Rio de Janeiro Federal University; Rio de Janeiro Brazil
| | - DR Farias
- Nutritional Epidemiology Observatory; Department of Social and Applied Nutrition; Institute of Nutrition Josué de Castro; Rio de Janeiro Federal University; Rio de Janeiro Brazil
- Graduate Program in Nutrition; Institute of Nutrition Josué de Castro; Rio de Janeiro Federal University; Rio de Janeiro Brazil
| | - GE Silveira
- Nutritional Epidemiology Observatory; Department of Social and Applied Nutrition; Institute of Nutrition Josué de Castro; Rio de Janeiro Federal University; Rio de Janeiro Brazil
| | - RH Mendes
- Nutritional Epidemiology Observatory; Department of Social and Applied Nutrition; Institute of Nutrition Josué de Castro; Rio de Janeiro Federal University; Rio de Janeiro Brazil
| | - VT Henriques
- Nutritional Epidemiology Observatory; Department of Social and Applied Nutrition; Institute of Nutrition Josué de Castro; Rio de Janeiro Federal University; Rio de Janeiro Brazil
| | - G Kac
- Nutritional Epidemiology Observatory; Department of Social and Applied Nutrition; Institute of Nutrition Josué de Castro; Rio de Janeiro Federal University; Rio de Janeiro Brazil
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Farias DR, Franco-Sena AB, Vilela A, Lepsch J, Mendes RH, Kac G. Lipid changes throughout pregnancy according to pre-pregnancy BMI: results from a prospective cohort. BJOG 2015; 123:570-8. [PMID: 25639335 DOI: 10.1111/1471-0528.13293] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/12/2014] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To evaluate the rate of change in serum lipids and the factors associated with their variations, stratifying for pre-pregnancy body mass index (BMI) categories. DESIGN Prospective cohort. SETTING Public Health centre, Rio de Janeiro, Brazil. POPULATION Two hundred and twenty-five healthy pregnant women recruited between 2009 and 2011. METHODS Women were evaluated during the three trimesters of pregnancy (5th-13th, 20th-26th and 30th-36th gestational weeks). Pre-pregnancy BMI (kg/m²) was classified as normal weight (NW = 18.5-24.9), overweight (OW = 25.0-29.9) or obese (OB ≥ 30.0). The independent variables included maternal socioeconomic, demographic, biochemical and lifestyle factors. We performed linear mixed-effects models adjusted for gestational age and body weight, reporting coefficient (β) and 95% confidence interval (95% CI). MAIN OUTCOME MEASURES Longitudinal total cholesterol (TC), high-density lipoprotein (HDL-c), low-density lipoprotein (LDL-c) and triglyceride (TG) measurements. RESULTS OW and OB women presented higher mean TG, TC and LDL-c compared with their NW counterparts (P < 0.05). The mean HDL-c concentrations were higher in NW than in OB women (P = 0.03). OW and OB women presented lower serum TC (βOW = -0.014; 95% CI = -0.026 to -0.002; P = 0.022; βOB = -0.015; 95% CI -0.015 to 0.001; P = 0.066) and LDL-c (βOW = -0.012; 95% CI = -0.021 to -0.002; P = 0.017; βOB = -0.018; 95% CI = -0.031 to -0.005; P = 0.005) rates of change (mmol/l per gestational week) compared with the NW. Pre-gestational BMI was the main factor associated with the rate of changes in TC and LDL-c concentrations. CONCLUSION Pre-pregnancy BMI was the main factor associated with the rate of change in TC and LDL-c throughout pregnancy, and OW and OB women presented lower rates of change compared with NW controls.
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Affiliation(s)
- D R Farias
- Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Institute of Nutrition Josué de Castro, Rio de Janeiro Federal University, Rio de Janeiro, Brazil.,Graduate Program in Nutrition, Institute of Nutrition Josué de Castro, Rio de Janeiro Federal University, Rio de Janeiro, Brazil
| | - A B Franco-Sena
- Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Institute of Nutrition Josué de Castro, Rio de Janeiro Federal University, Rio de Janeiro, Brazil.,Graduate Program in Nutrition, Institute of Nutrition Josué de Castro, Rio de Janeiro Federal University, Rio de Janeiro, Brazil
| | - Aaf Vilela
- Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Institute of Nutrition Josué de Castro, Rio de Janeiro Federal University, Rio de Janeiro, Brazil.,Graduate Program in Nutrition, Institute of Nutrition Josué de Castro, Rio de Janeiro Federal University, Rio de Janeiro, Brazil
| | - J Lepsch
- Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Institute of Nutrition Josué de Castro, Rio de Janeiro Federal University, Rio de Janeiro, Brazil.,Graduate Program in Nutrition, Institute of Nutrition Josué de Castro, Rio de Janeiro Federal University, Rio de Janeiro, Brazil
| | - R H Mendes
- Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Institute of Nutrition Josué de Castro, Rio de Janeiro Federal University, Rio de Janeiro, Brazil
| | - G Kac
- Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Institute of Nutrition Josué de Castro, Rio de Janeiro Federal University, Rio de Janeiro, Brazil
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