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Zulueta M, Gallardo-Rincón H, Martinez-Juarez LA, Lomelin-Gascon J, Ortega-Montiel J, Montoya A, Mendizabal L, Arregi M, Martinez-Martinez MDLA, Camarillo Romero EDS, Mendieta Zerón H, Garduño García JDJ, Simón L, Tapia-Conyer R. Development and validation of a multivariable genotype-informed gestational diabetes prediction algorithm for clinical use in the Mexican population: insights into susceptibility mechanisms. BMJ Open Diabetes Res Care 2023; 11:11/2/e003046. [PMID: 37085278 PMCID: PMC10124192 DOI: 10.1136/bmjdrc-2022-003046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 04/01/2023] [Indexed: 04/23/2023] Open
Abstract
INTRODUCTION Gestational diabetes mellitus (GDM) is underdiagnosed in Mexico. Early GDM risk stratification through prediction modeling is expected to improve preventative care. We developed a GDM risk assessment model that integrates both genetic and clinical variables. RESEARCH DESIGN AND METHODS Data from pregnant Mexican women enrolled in the 'Cuido mi Embarazo' (CME) cohort were used for development (107 cases, 469 controls) and data from the 'Mónica Pretelini Sáenz' Maternal Perinatal Hospital (HMPMPS) cohort were used for external validation (32 cases, 199 controls). A 2-hour oral glucose tolerance test (OGTT) with 75 g glucose performed at 24-28 gestational weeks was used to diagnose GDM. A total of 114 single-nucleotide polymorphisms (SNPs) with reported predictive power were selected for evaluation. Blood samples collected during the OGTT were used for SNP analysis. The CME cohort was randomly divided into training (70% of the cohort) and testing datasets (30% of the cohort). The training dataset was divided into 10 groups, 9 to build the predictive model and 1 for validation. The model was further validated using the testing dataset and the HMPMPS cohort. RESULTS Nineteen attributes (14 SNPs and 5 clinical variables) were significantly associated with the outcome; 11 SNPs and 4 clinical variables were included in the GDM prediction regression model and applied to the training dataset. The algorithm was highly predictive, with an area under the curve (AUC) of 0.7507, 79% sensitivity, and 71% specificity and adequately powered to discriminate between cases and controls. On further validation, the training dataset and HMPMPS cohort had AUCs of 0.8256 and 0.8001, respectively. CONCLUSIONS We developed a predictive model using both genetic and clinical factors to identify Mexican women at risk of developing GDM. These findings may contribute to a greater understanding of metabolic functions that underlie elevated GDM risk and support personalized patient recommendations.
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Affiliation(s)
- Mirella Zulueta
- Research and Development Department, Patia Europe, San Sebastian, Spain
| | - Héctor Gallardo-Rincón
- Health Sciences University Center, University of Guadalajara, Guadalajara, Mexico
- Operative Solutions, Carlos Slim Foundation, Mexico City, Mexico
| | | | | | | | | | - Leire Mendizabal
- Research and Development Department, Patia Europe, San Sebastian, Spain
| | - Maddi Arregi
- Research and Development Department, Patia Europe, San Sebastian, Spain
| | | | | | - Hugo Mendieta Zerón
- Faculty of Medicine, Autonomous University of the State of Mexico, Toluca, Mexico
| | | | - Laureano Simón
- Research and Development Department, Patia Europe, San Sebastian, Spain
| | - Roberto Tapia-Conyer
- Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico
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Xu X, Wang Y, Han N, Yang X, Ji Y, Liu J, Jin C, Lin L, Zhou S, Luo S, Bao H, Liu Z, Wang B, Yan L, Wang HJ, Ma X. Early Pregnancy Exposure to Rare Earth Elements and Risk of Gestational Diabetes Mellitus: A Nested Case-Control Study. Front Endocrinol (Lausanne) 2021; 12:774142. [PMID: 34987477 PMCID: PMC8721846 DOI: 10.3389/fendo.2021.774142] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Accepted: 12/03/2021] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVE The extensive use of rare earth elements (REEs) in many technologies was found to have effects on human health, but the association between early pregnancy exposure to REEs and gestational diabetes mellitus (GDM) is still unknown. METHODS This nested case-control study involved 200 pregnant women with GDM and 200 healthy pregnant women from the Peking University Birth Cohort in Tongzhou. We examined the serum concentrations of 14 REEs during early pregnancy and analyzed their associations with the risk of GDM. RESULTS When the elements were considered individually in the logistic regression model, no significant associations were found between REEs and GDM, after adjusting for confounding variables (P > 0.05). In weighted quantile sum (WQS) regression, each quartile decrease in the mixture index for REEs resulted in a 1.67-fold (95% CI: 1.12-2.49) increased risk of GDM. Neodymium (Nd), Praseodymium (Pr), and Lanthanum (La) were the most important contributors in the mixture. CONCLUSION The study findings indicated that early pregnancy exposure to lower levels of REE mixture was associated with an increased risk of GDM, and Nd, Pr, and La exhibited the strongest effects in the mixture.
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Affiliation(s)
- Xiangrong Xu
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China
- Environmental and Spatial Epidemiology Research Center, National Human Genetic Resources Center, Beijing, China
| | - Yuanyuan Wang
- Environmental and Spatial Epidemiology Research Center, National Human Genetic Resources Center, Beijing, China
- Human Genetic Resources Center, National Research Institute for Family Planning, Beijing, China
| | - Na Han
- Obstetrical Department, Tongzhou Maternal and Child Health Hospital of Beijing, Beijing, China
| | - Xiangming Yang
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China
| | - Yuelong Ji
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China
| | - Jue Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Chuyao Jin
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China
| | - Lizi Lin
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China
| | - Shuang Zhou
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China
| | - Shusheng Luo
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China
| | - Heling Bao
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China
| | - Zheng Liu
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China
| | - Bin Wang
- Institute of Reproductive and Child Health, Peking University/Key Laboratory of Reproductive Health, National Health and Family Planning Commission of the People’s Republic of China, Beijing, China
| | - Lailai Yan
- Department of Laboratorial Science and Technology, School of Public Health, Peking University, Beijing, China
- *Correspondence: Hai-Jun Wang, ; Lailai Yan, ; Xu Ma,
| | - Hai-Jun Wang
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China
- Environmental and Spatial Epidemiology Research Center, National Human Genetic Resources Center, Beijing, China
- *Correspondence: Hai-Jun Wang, ; Lailai Yan, ; Xu Ma,
| | - Xu Ma
- Environmental and Spatial Epidemiology Research Center, National Human Genetic Resources Center, Beijing, China
- Human Genetic Resources Center, National Research Institute for Family Planning, Beijing, China
- *Correspondence: Hai-Jun Wang, ; Lailai Yan, ; Xu Ma,
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