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Zhang P, Fu X, Zhao L, Wang L, Wu S, Liu Y, Cheng J, Zhang S. Quantifying fetal heart health in gestational diabetes: a new approach with fetal heart quantification technology. Front Pharmacol 2024; 15:1394885. [PMID: 38863981 PMCID: PMC11165031 DOI: 10.3389/fphar.2024.1394885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2024] [Accepted: 05/13/2024] [Indexed: 06/13/2024] Open
Abstract
Objective This study aimed to assess the impact of gestational diabetes mellitus (GDM) on fetal heart structure and function using a technique called fetal heart quantification (Fetal HQ), with a focus on mitochondrial dynamics, which employs advanced imaging technology for comprehensive analysis. Methods A total of 180 fetuses with normal heart structures, aged 24-40 weeks of gestation, were examined. A 2-3 s cine loop in the standard four-chamber oblique view was captured and analyzed using the speckle-tracking technique with Fetal HQ. Various echocardiographic parameters were evaluated, including four-chamber view (4CV), global spherical index (GSI), global longitudinal strain (GLS), 24-segment spherical index (SI), ventricular fractional area change (FAC), cardiac output (CO), and stroke volume (SV). These parameters were compared between the GDM group and the control group during two gestational periods: 24+0 to 28+0 weeks and 28+1 to 40+1 weeks. Statistical analysis was performed using independent samples t-tests and Mann-Whitney U tests to identify significant differences. Results Twenty fetuses from mothers with GDM and 40 from the control group were recruited at 24+0 to 28+0 weeks. At 28+1 to 40+1 weeks, 40 fetuses from mothers with GDM and 80 from the control group were recruited. The fetal left ventricular global longitudinal function was similar between the GDM and control groups. However, compared to the controls, right ventricular function in the GDM group was lower only at 28+1 to 40+1 weeks. In the GDM group, the global spherical index (GSI) was lower than in the control group at 28+1 to 40+1 weeks (1.175 vs. 1.22; p = 0.001). There were significant decreases in ventricular FAC (38.74% vs. 42.83%; p < 0.0001) and 4CV GLS for the right ventricle (-22.27% vs. -26.31%; p = 0.005) at 28+1 to 40+1 weeks. Conclusion Our findings suggest that GDM is associated with decreased right ventricular function in the fetal heart, particularly during the later stages of pregnancy (28+1 to 40+1 weeks), compared to fetuses from healthy pregnancies. The Fetal HQ technique represents a valuable tool for evaluating the structure and function of fetal hearts affected by GDM during the advanced stages of pregnancy.
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Affiliation(s)
- Pengjie Zhang
- Department of Ultrasound, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Xinghui Fu
- Henan Vocational College of Nursing, Anyang, Henan, China
| | - Lijuan Zhao
- Department of Ultrasound, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Lu Wang
- Department of Ultrasound, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Shuning Wu
- Department of Ultrasound, Xinyang Traditional Chinese Medicine Hospital, Xinyang, Henan, China
| | - Yanyan Liu
- Department of Emergency, The Third People’s Hospital of Zhengzhou, Zhengzhou, Henan, China
| | - Jingliang Cheng
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Shan Zhang
- Department of Ultrasound, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
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Liu H, Zhang L, Cheng H, Chi P, Zhuang Y, Alifu X, Zhou H, Qiu Y, Huang Y, Ainiwan D, Si S, Yu Y. The associations of maternal liver biomarkers in early pregnancy with the risk of gestational diabetes mellitus: a prospective cohort study and Mendelian randomization analysis. Front Endocrinol (Lausanne) 2024; 15:1396347. [PMID: 38836232 PMCID: PMC11148214 DOI: 10.3389/fendo.2024.1396347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 05/06/2024] [Indexed: 06/06/2024] Open
Abstract
Background Associations of liver function with the risk of gestational diabetes mellitus (GDM) remain unclear. This study aimed to examine the relationship and the potential causality between maternal liver biomarkers and the risk of subsequent GDM, as well as to evaluate the interaction between liver biomarkers and lipids on GDM risk. Methods In an ongoing Zhoushan Pregnant Women Cohort, pregnant women who finished the first prenatal follow-up record, underwent liver function tests in early pregnancy, and completed the GDM screening were included in this study. Logistic regression models were used to investigate the association, and the inverse-variance weighted method supplemented with other methods of two-sample Mendelian randomization (MR) analysis was applied to deduce the causality. Results Among 9,148 pregnant women, 1,668 (18.2%) developed GDM. In general, the highest quartile of liver function index (LFI), including ALT, AST, GGT, ALP, and hepatic steatosis index, was significantly associated with an increased risk of GDM (OR ranging from 1.29 to 3.15), especially an elevated risk of abnormal postprandial blood glucose level. Moreover, the causal link between ALT and GDM was confirmed by the MR analysis (OR=1.28, 95%CI:1.05-1.54). A significant interaction between AST/ALT and TG on GDM risk was observed (P interaction = 0.026). Conclusion Elevated levels of LFI in early pregnancy were remarkably associated with an increased risk of GDM in our prospective cohort. Besides, a positive causal link between ALT and GDM was suggested.
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Affiliation(s)
- Hui Liu
- Clinical Research Center, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Libi Zhang
- Department of Public Health and Department of Anesthesiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
- Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, China
| | - Haoyue Cheng
- Department of Public Health and Department of Anesthesiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
- Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, China
| | - Peihan Chi
- Department of Public Health and Department of Anesthesiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
- Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yan Zhuang
- Department of Public Health and Department of Anesthesiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
- Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, China
| | - Xialidan Alifu
- Department of Public Health and Department of Anesthesiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
- Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, China
| | - Haibo Zhou
- Department of Public Health and Department of Anesthesiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
- Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yiwen Qiu
- Department of Public Health and Department of Anesthesiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
- Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, China
| | - Ye Huang
- Department of Public Health and Department of Anesthesiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
- Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, China
| | - Diliyaer Ainiwan
- Department of Public Health and Department of Anesthesiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
- Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, China
| | - Shuting Si
- Yiwu Maternity and Children Hospital (Yiwu Branch of Children's Hospital Zhejiang University School of Medicine), Yiwu, China
| | - Yunxian Yu
- Department of Public Health and Department of Anesthesiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
- Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, China
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Abera D, Larbie C, Abugri J, Ofosu M, Mutocheluh M, Dongsogo J. Prevalence and Predictors of Gestational Diabetes Mellitus in Sub-Saharan Africa: A 10-Year Systematic Review. Endocrinol Diabetes Metab 2024; 7:e00478. [PMID: 38597653 PMCID: PMC11005715 DOI: 10.1002/edm2.478] [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: 11/04/2023] [Revised: 01/18/2024] [Accepted: 02/23/2024] [Indexed: 04/11/2024] Open
Abstract
BACKGROUND Gestational diabetes mellitus (GDM) remains a global public health problem, which affects the well-being of mothers and their children in sub-Saharan Africa (SSA). Studies conducted in different geographical areas provide varied results on its prevalence and predictors. Understanding the extent and predictors of GDM in SSA is important for developing effective interventions and policies. Thus, this review aimed to investigate the prevalence of GDM and its predictive factors in sub-Saharan Africa. METHODS We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards in this review. An extensive search of the PubMed, Web of Sciences and EMBASE databases was carried out covering papers from 2012 to 2022 to assess the prevalence and predictors of GDM. Microsoft Excel 2019 was utilised for study management. GraphPad Prism Version 8.0 and the MedCalc statistical software were employed for data analysis. The findings were analysed using textual descriptions, tables, forest plots and heat maps. RESULTS Using 30 studies with 23,760 participants that satisfied the inclusion criteria, the review found the overall prevalence of GDM in SSA to be 3.05% (1.85%-4.54%). History of preterm delivery, alcohol consumption, family history of diabetes, history of stillbirths, history of macrosomia, overweight or obesity and advanced mother age were all significant predictors of gestational diabetes. Additionally, various biomarkers such as haemoglobin, adiponectin, leptin, resistin, visfatin, vitamin D, triglycerides and dietary intake type were identified as significant predictors of GDM. CONCLUSION In sub-Saharan Africa, there is a high pooled prevalence of gestational diabetes mellitus. In the light of the predictors of GDM identified in this review, it is strongly recommended to implement early screening for women at risk of developing gestational diabetes during their pregnancy. This proactive approach is essential for enhancing the overall well-being of both mothers and children.
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Affiliation(s)
- Daniel Ataanya Abera
- Department of Laboratory Technology, Faculty of Health SciencesKumasi Technical UniversityKumasiGhana
- Department of Biochemistry and Biotechnology, Faculty of Bioscience, College of ScienceKwame Nkrumah University of Science and TechnologyKumasiGhana
| | - Christopher Larbie
- Department of Biochemistry and Biotechnology, Faculty of Bioscience, College of ScienceKwame Nkrumah University of Science and TechnologyKumasiGhana
| | - James Abugri
- Department of Biochemistry and Forensic Sciences, School of Chemical and Biochemical SciencesC. K. Tedam University of Technology and Applied SciencesNavrongoGhana
| | - Mina Ofosu
- Department of Laboratory Technology, Faculty of Health SciencesKumasi Technical UniversityKumasiGhana
| | - Mohamed Mutocheluh
- Department of Clinical Microbiology, School of Medical ScienceKwame Nkrumah University of Science and TechnologyKumasiGhana
| | - Julius Dongsogo
- Department of Biochemistry, Faculty of BiosciencesUniversity for Development StudiesTamaleGhana
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Talebi S, Zeraattalab-Motlagh S, Rahimlou M, Sadeghi E, Rashedi MH, Ghoreishy SM, Mohammadi H. Dietary fat intake with risk of gestational diabetes mellitus and preeclampsia: a systematic review and meta-analysis of prospective cohort studies. Nutr Rev 2024:nuae033. [PMID: 38568994 DOI: 10.1093/nutrit/nuae033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2024] Open
Abstract
CONTEXT Gestational diabetes mellitus (GDM) and preeclampsia (PE) are commonly observed medical complications in pregnancy. Dietary total fat and fatty acids associated with GDM and PE risk have been examined in several epidemiological studies. In some instances, systematic reviews and meta-analyses might provide more accurate dietary recommendations. OBJECTIVES This systematic review and dose-response meta-analysis was conducted to investigate the association between dietary total fat and fatty acids and the risk of GDM and PE. DATA SOURCES Research on dietary fat intake and the risk of GDM and PE was conducted through systematic searches of the PubMed, Scopus, and Web of Science databases for articles published up to August 19, 2023. An investigation of associations between dietary intake of total fat and fatty acids and the risk of GDM and PE was performed using prospective cohort study designs. RESULTS Twenty-one prospective cohort studies were considered eligible. Findings indicated that higher intakes of total fat (relative risk [RR], 1.08; 95% confidence interval [CI], 1.02-1.14), animal fat (RR, 1.56; 95%CI, 1.34-1.89), vegetable fat (RR, 1.23; 95%CI, 1.05-1.45), dietary cholesterol (RR, 1.48; 95%CI, 1.10-2.00), and omega-3 fatty acid (RR, 1.11; 95%CI, 1.02-1.20) are associated with a greater risk of GDM. However, no significant association was found between dietary total fat and fatty acids and the risk of PE. Dose-response meta-analyses suggested every 10% increment in total energy intake from total fat, 5% from animal fat, 5% from vegetable fat, and 100 mg from cholesterol was related to 15%, 12%, 7%, 14%, and 20% higher GDM risk, respectively. CONCLUSIONS Overall, total fat, animal fat, vegetable fat, dietary cholesterol, and omega-3 fatty acid consumption are associated with a small but statistically significant increase in GDM risk. PROTOCOL REGISTRATION PROSPERO (CRD42023466844).
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Affiliation(s)
- Sepide Talebi
- Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Mehran Rahimlou
- Department of Nutrition, School of Public Health, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Erfan Sadeghi
- Department of Biostatistics, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Minoo Hasan Rashedi
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Seyed Mojtaba Ghoreishy
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
- Student Research Committee, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Hamed Mohammadi
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
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Eades CE, Burrows KA, Andreeva R, Stansfield DR, Evans JM. Prevalence of gestational diabetes in the United States and Canada: a systematic review and meta-analysis. BMC Pregnancy Childbirth 2024; 24:204. [PMID: 38491497 PMCID: PMC10941381 DOI: 10.1186/s12884-024-06378-2] [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: 12/16/2022] [Accepted: 02/28/2024] [Indexed: 03/18/2024] Open
Abstract
BACKGROUND An understanding of the prevalence of gestational diabetes mellitus among pregnant women is essential at local, national and international level so that appropriate health care interventions can be planned, financed and delivered. METHODS A systematic review and meta-analysis of primary research reporting the prevalence of gestational diabetes mellitus in Canada or the United States were carried out according to Meta-analysis of Observational Studies in Epidemiology guidelines. Four electronic databases were systematically searched in June 2023 to identify articles that reported gestational diabetes mellitus prevalence using universal screening in pregnant women from eligible general population samples. Estimates were combined using a random effects model, and the effects of moderator variables analysed. RESULTS There were 36 separate samples of women or deliveries (total sample size 1,550,917). Overall mean prevalence of gestational diabetes mellitus was 6.9% (95% CI: 5.7-8.3); 13.7% (95% CI: 10.7-17.3) in studies using a one-step screening strategy, and 5.2% (95% CI: 4.4-6.1) in those using a two-step strategy. Heterogeneity in technical methods between studies produced differences in estimates, as did different diagnostic thresholds used. CONCLUSIONS The meta-analysis suggests a slightly higher prevalence of gestational diabetes mellitus in Canada and the United States, compared to Europe, but highlights the need for standardised protocols for estimating gestational diabetes mellitus prevalence.
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Affiliation(s)
- Claire E Eades
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, FK9 4LA, Scotland, UK.
| | - Katherine A Burrows
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, FK9 4LA, Scotland, UK
| | - Roza Andreeva
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, FK9 4LA, Scotland, UK
| | | | - Josie Mm Evans
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, FK9 4LA, Scotland, UK
- Public Health Scotland, Edinburgh, Scotland
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Mantri N, Goel AD, Patel M, Baskaran P, Dutta G, Gupta MK, Yadav V, Mittal M, Shekhar S, Bhardwaj P. National and regional prevalence of gestational diabetes mellitus in India: a systematic review and Meta-analysis. BMC Public Health 2024; 24:527. [PMID: 38378536 PMCID: PMC10877914 DOI: 10.1186/s12889-024-18024-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 02/06/2024] [Indexed: 02/22/2024] Open
Abstract
BACKGROUND Gestational diabetes mellitus (GDM) is frequently misdiagnosed during pregnancy. There is an abundance of evidence, but little is known regarding the regional prevalence estimates of GDM in India. This systematic review and meta-analysis aims to provide valuable insights into the national and regional prevalence of GDM among pregnant women in India. METHODS We conducted an initial article search on PubMed, Scopus, Google Scholar, and ShodhGanga searches to identify quantitative research papers (database inception till 15th June,2022). This review included prevalence studies that estimated the occurrence of GDM across different states in India. RESULTS Two independent reviewers completed the screening of 2393 articles, resulting in the identification of 110 articles that met the inclusion criteria, which collectively provided 117 prevalence estimates. Using a pooled estimate calculation (with an Inverse square heterogeneity model), the pooled prevalence of GDM in pregnant women was estimated to be 13%, with a 95% confidence interval (CI) ranging from 9 to 16%.. In India, Diabetes in Pregnancy Study of India (DIPSI) was the most common diagnostic criteria used, followed by International Association of Diabetes and Pregnancy Study Groups (IADPSG) and World Health Organization (WHO) 1999. It was observed that the rural population has slightly less prevalence of GDM at 10.0% [6.0-13.0%, I2=96%] when compared to the urban population where the prevalence of GDM was 12.0% [9.0-16.0%, I2 = 99%]. CONCLUSIONS This review emphasizes the lack of consensus in screening and diagnosing gestational diabetes mellitus (GDM), leading to varied prevalence rates across Indian states. It thoroughly examines the controversies regarding GDM screening by analyzing population characteristics, geographic variations, diagnostic criteria agreement, screening timing, fasting vs. non-fasting approaches, cost-effectiveness, and feasibility, offering valuable recommendations for policy makers. By fostering the implementation of state-wise screening programs, it can contribute to improving maternal and neonatal outcomes and promoting healthier pregnancies across the country.
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Affiliation(s)
- Neha Mantri
- School of Public Health, AIIMS, Jodhpur, India
| | - Akhil Dhanesh Goel
- Department of Community Medicine & Family Medicine, AIIMS, Jodhpur, India.
| | - Mamta Patel
- School of Public Health, AIIMS, Jodhpur, India
| | - Pritish Baskaran
- Department of Community Medicine & Family Medicine, AIIMS, Jodhpur, India
| | - Gitashree Dutta
- Department of Community Medicine & Family Medicine, AIIMS, Jodhpur, India
| | - Manoj Kumar Gupta
- Department of Community Medicine & Family Medicine, AIIMS, Jodhpur, India
| | | | - Madhukar Mittal
- Department of Endocrinology and Metabolism, AIIMS, Jodhpur, India
| | | | - Pankaj Bhardwaj
- Department of Community Medicine & Family Medicine, Academic Head, School of Public Health, AIIMS, Jodhpur, India
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van der Pligt PF, Kuswara K, McNaughton SA, Abbott G, Islam SMS, Huynh K, Meikle PJ, Mousa A, Ellery SJ. Maternal diet quality and associations with plasma lipid profiles and pregnancy-related cardiometabolic health. Eur J Nutr 2023; 62:3369-3381. [PMID: 37646831 PMCID: PMC10611854 DOI: 10.1007/s00394-023-03244-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 08/21/2023] [Indexed: 09/01/2023]
Abstract
PURPOSE To assess the relationship of early pregnancy maternal diet quality (DQ) with maternal plasma lipids and indicators of cardiometabolic health, including blood pressure (BP), gestational diabetes mellitus (GDM) and gestational weight gain (GWG). METHODS Women (n = 215) aged 18-40 years with singleton pregnancies were recruited at 10-20 weeks gestation. Diet quality was assessed by the Dietary Guideline Index, calculated at early ([mean ± SD]) (15 ± 3 weeks) and late (35 ± 2 weeks) pregnancy. Lipidomic analysis was performed, and 698 species across 37 lipid classes were measured from plasma blood samples collected at early (15 ± 3 weeks) and mid (27 ± 3 weeks)-pregnancy. Clinical measures (BP, GDM diagnosis, weight) and blood samples were collected across pregnancy. Multiple linear and logistic regression models assessed associations of early pregnancy DQ with plasma lipids at early and mid-pregnancy, BP at three antenatal visits, GDM diagnosis and total GWG. RESULTS Maternal DQ scores ([mean ± SD]) decreased significantly from early (70.7 ± 11.4) to late pregnancy (66.5 ± 12.6) (p < 0.0005). At a false discovery rate of 0.2, early pregnancy DQ was significantly associated with 13 plasma lipids at mid-pregnancy, including negative associations with six triglycerides (TGs); TG(54:0)[NL-18:0] (neutral loss), TG(50:1)[NL-14:0], TG(48:0)[NL-18:0], TG(52:1)[NL-18:0], TG(54:1)[NL-18:1], TG(50:0)[NL-18:0]. No statistically significant associations were found between early pregnancy DQ and BP, GDM or GWG. CONCLUSION Maternal diet did not adhere to Australian Dietary Guidelines. Diet quality was inversely associated with multiple plasma TGs. This study provides novel insights into the relationship between DQ, lipid biomarkers and cardiometabolic health during pregnancy.
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Affiliation(s)
- Paige F van der Pligt
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, 3220, Australia.
- Department of Nutrition and Dietetics, Western Health, Footscray, Australia.
| | - Konsita Kuswara
- School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, 3220, Australia
| | - Sarah A McNaughton
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, 3220, Australia
| | - Gavin Abbott
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, 3220, Australia
| | - Sheikh Mohammed Shariful Islam
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, 3220, Australia
| | - Kevin Huynh
- Baker Heart and Diabetes Institute, 75 Commercial Road, Melbourne, VIC, 3004, Australia
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - Peter J Meikle
- Baker Heart and Diabetes Institute, 75 Commercial Road, Melbourne, VIC, 3004, Australia
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - Aya Mousa
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, Clayton, VIC, 3168, Australia
| | - Stacey J Ellery
- The Ritchie Centre, Hudson Institute of Medical Research, Clayton, VIC, Australia
- Department of Obstetrics and Gynaecology, Monash University, Clayton, VIC, Australia
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Singh D, Mittal P, Bachani S, Mukherjee B, Mittal MK, Suri J. Ultrasonographic Assessment of Body Fat Index for Prediction of Gestational Diabetes Mellitus and Neonatal Complications. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2023; 45:102177. [PMID: 37437777 DOI: 10.1016/j.jogc.2023.04.026] [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: 01/18/2023] [Revised: 04/27/2023] [Accepted: 04/28/2023] [Indexed: 07/14/2023]
Abstract
OBJECTIVES To assess maternal pre-peritoneal fat and subcutaneous fat at 16-20 weeks gestation by ultrasound. Thus, calculate body fat index (BFI) and determine its cut-off value for prediction of gestational diabetes mellitus (GDM) and neonatal subcutaneous adiposity. METHODS A cohort study was conducted in 200 pregnant women with singleton fetus during anomaly scan using BFI where they were screened for GDM at 24-28 weeks gestation by oral glucose tolerance test. Labour and neonatal outcomes were recorded. The receiver operating characteristic curve was used to determine the cut-offs for BFI, pre-peritoneal fat thickness, and subcutaneous fat thickness in order to predict GDM. RESULTS The area under receiver operating characteristic curve for BFI was 0.967 (95% CI 0.932-0.987) with a sensitivity of 97.3%, specificity of 89.57%, negative predictive value of 99.3%, and diagnostic accuracy of 91% at a BFI cut-off of 0.88. The study analysis demonstrated BFI to be statistically superior to BMI > 22.9 kg/m2 for prediction of GDM. BFI > 0.88 was a risk factor for developing neonatal subcutaneous adiposity. CONCLUSIONS BFI is a practical and convenient non-invasive screening tool to predict GDM and neonatal subcutaneous adiposity.
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Affiliation(s)
- Deepanjali Singh
- Department of Obstetrics and Gynaecology, VMMC and Safdarjung Hospital, New Delhi, India
| | - Pratima Mittal
- Department of Obstetrics and Gynaecology, VMMC and Safdarjung Hospital, New Delhi, India; Department of Obstetrics and Gynaecology, Amrita Institute of Medical Sciences, Faridabad, India
| | - Sumitra Bachani
- Department of Obstetrics and Gynaecology, VMMC and Safdarjung Hospital, New Delhi, India
| | - Bijoya Mukherjee
- Department of Obstetrics and Gynaecology, VMMC and Safdarjung Hospital, New Delhi, India.
| | | | - Jyotsna Suri
- Department of Obstetrics and Gynaecology, VMMC and Safdarjung Hospital, New Delhi, India
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Liu PJ, Ma L, Li R, Liu Y. The Association Between the Imbalance of Single-Carbon Nutrients in Early Pregnancy and Gestational Diabetes Mellitus Risk is Influenced by Serum Selenium Status: A Cohort Study. Diabetes Metab Syndr Obes 2023; 16:3275-3283. [PMID: 37881350 PMCID: PMC10596188 DOI: 10.2147/dmso.s428286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 10/10/2023] [Indexed: 10/27/2023] Open
Abstract
Purpose The role of imbalanced one-carbon nutrients in gestational diabetes mellitus (GDM) risk has garnered significant interest, yet existing studies yield inconsistent results. Our objective was to assess whether the association between an unbalanced ratio of folate to vitamin B12 and GDM risk is influenced by the status of other micronutrients. Methods This cohort study included 366 singleton-pregnancy Han women enrolled at the Shunyi District Maternal and Child Health Hospital in Beijing, China. During the first trimester of pregnancy, we measured red blood cell (RBC) folate, serum levels of vitamin B12, vitamin D, and selenium. We examined the association between the imbalanced status of RBC folate and vitamin B12 and GDM risk using logistic regression, stratified by serum selenium or vitamin D status. Results Among the 366 women, 67 (18.3%) were diagnosed with GDM, 201 (54.9%) had vitamin D deficiency, and 245 (66.9%) had selenium deficiency. Overall, women with higher RBC folate/vitamin B12 ratios did not exhibit a significantly higher risk of GDM compared to those in reference tertile (all P > 0.05). Subsequently, we divided women into deficient and non-deficient groups based on serum selenium or vitamin D levels. In women with selenium deficiency, those in the highest tertile of the RBC folate/vitamin B12 ratio had the highest odds of GDM [OR: 3.40 (1.16-9.97), P=0.026] after adjusting for covariates. However, similar findings were not observed in pregnancies with normal selenium status. Irrespective of vitamin D status, women with higher RBC folate/vitamin B12 ratios did not exhibit a significantly increased risk of GDM. Conclusion Micronutrient deficiencies are common in early pregnancy. Women with a higher folate/vitamin B12 ratio coupled with selenium deficiency in early pregnancy have a higher GDM risk. These findings underscore the importance of micronutrient assessment in early pregnancy and subsequent interventions for micronutrient deficiencies.
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Affiliation(s)
- Peng Ju Liu
- Department of Clinical Nutrition, Peking Union Medical College Hospital, China Academic Medical Science and Peking Union Medical College, Beijing, People’s Republic of China
| | - Liangkun Ma
- Department of Gynaecology and Obstetrics, Peking Union Medical College Hospital, China Academic Medical Science and Peking Union Medical College, Beijing, People’s Republic of China
| | - Rui Li
- Department of Clinical Nutrition, Peking Union Medical College Hospital, China Academic Medical Science and Peking Union Medical College, Beijing, People’s Republic of China
| | - Yanping Liu
- Department of Clinical Nutrition, Peking Union Medical College Hospital, China Academic Medical Science and Peking Union Medical College, Beijing, People’s Republic of China
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Ringvoll H, Kolberg M, Rangul V, Hafskjold I, Haug EB, Blomhoff R, Henriksen HB, Horn J. Postpartum lifestyle behaviour among women with prior gestational diabetes mellitus: evidence from the HUNT study. BMJ Nutr Prev Health 2023; 6:173-181. [PMID: 38618544 PMCID: PMC11009551 DOI: 10.1136/bmjnph-2022-000612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 09/19/2023] [Indexed: 04/16/2024] Open
Abstract
Introduction Women with a history of gestational diabetes mellitus (GDM) are at increased risk of type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD). Recommendations for postpartum follow-up include targeted lifestyle advice to lower the risk.The aim of this study was to compare postpartum lifestyle behaviours and perceptions among women with and without a history of GDM. In addition, we examined whether lifestyle behaviours of women with a history of GDM participating in a lifestyle intervention study differed from lifestyle behaviours of women with a history of GDM in the general population. Research design and methods We linked data from the fourth survey of the population-based Trøndelag Health Study (HUNT4) to information from the Medical Birth Registry of Norway for women with registered births between 2000 and 2019. Using logistic regression, we compared lifestyle behaviours in women with and without GDM. In secondary analyses, lifestyle behaviours in women with GDM participating in a postpartum lifestyle intervention study were compared with HUNT participants with GDM using Fisher's exact tests/t-tests. Results A high proportion of the women in our population, regardless of GDM history, reported several unhealthy lifestyle behaviours. We found no significant association between history of GDM and lifestyle behaviours. The lifestyle intervention study for women with a history of GDM appeared to recruit women with more favourable lifestyle behaviours. Conclusions Women, regardless of GDM history, could potentially benefit from further support for lifestyle improvement, but it may be especially important in women with a history of GDM given their increased risk of T2DM and CVD. Interventions targeting women with GDM might not reach the women with the unhealthiest lifestyle behaviours, and measures to reach out to all women should be further investigated.
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Affiliation(s)
- Hanne Ringvoll
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Faculty of Medicine and Health Sciences, Trondheim, Norway
| | - Marit Kolberg
- Center for Oral Health Services and Research, Trondheim, Norway
| | - Vegar Rangul
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Faculty of Medicine and Health Sciences, Trondheim, Norway
- Nord University, Levanger, Norway
- Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Ingrid Hafskjold
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Faculty of Medicine and Health Sciences, Trondheim, Norway
| | - Eirin Beate Haug
- K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
| | - Rune Blomhoff
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
- Department of Clinic Service, Division of Cancer Medicine, Oslo University Hospital, Oslo, Norway
| | - Hege Berg Henriksen
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Julie Horn
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Faculty of Medicine and Health Sciences, Trondheim, Norway
- Department of Obstetrics and Gynecology, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
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11
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Sabir MS, Hassan MM, Malik M, Saleem R, Tariq Z, Zohaib K, Javaid M, Malik AY, Saleem A. Diagnostic Accuracy of Fetal Anterior Abdominal Wall Thickness as an Early Sonographic Sign for Diagnosing Gestational Diabetes. Cureus 2023; 15:e46538. [PMID: 37927742 PMCID: PMC10625453 DOI: 10.7759/cureus.46538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/05/2023] [Indexed: 11/07/2023] Open
Abstract
Introduction Traditionally, different fetal variable measurements are used in ultrasound to assess fetal growth. Ultrasound can detect abnormal fetal growth. Gestational diabetes mellitus (GDM) is linked to higher fetal obesity as early as 20 weeks of pregnancy. The amount of fetal adipose tissue may be measured by measuring the thickness of the anterior abdominal wall. Measuring the thickness of the fetus's anterior abdominal wall (AAWT) is a straightforward procedure that may be performed alongside standard abdominal circumference measurements. Objectives To check the diagnostic accuracy of fetal AAWT as an early sonographic sign for diagnosing GDM, keeping oral glucose tolerance test as the gold standard. Study design This research was conducted using a cross-sectional analysis. Study place and duration The study was conducted in the Radiology Department at Rawalpindi Medical University and Allied Hospitals from July 10, 2019 to January 9, 2020. Materials and methods Women between the ages of 18 and 45 who had a family history of type 2 diabetes and were at risk for developing GDM were recruited. Exclusions were made for diabetic women, those carrying multiples, and those with autoimmune diseases. The AAWT measurement of the fetus, which included the skin and subcutaneous tissue, was acquired using the traditional anterior cranial view, 2-3 cm lateral to cord insertion. Pregnant patients at risk for GDM underwent screening using an oral glucose tolerance test. Those exhibiting any two abnormal values were diagnosed with GDM. Results The overall sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of fetal AAWT as an early sonographic sign for diagnosing GDM, with the oral glucose tolerance test as the gold standard, were 93.14%, 82.65%, 84.82%, 92.05%, and 88.0%, respectively. Conclusion The study concludes that the diagnostic accuracy of fetal AAWT as an early sonographic indicator for identifying gestational diabetes is notably high.
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Affiliation(s)
| | | | - Moeena Malik
- Internal Medicine, Rawalpindi Medical University, Rawalpindi, PAK
| | - Rabia Saleem
- Obstetrics and Gynecology, Rawalpindi Medical University, Rawalpindi, PAK
| | - Zartasha Tariq
- General Medicine, Holy Family Hospital Rawalpindi, Rawalpindi, PAK
| | - Khurram Zohaib
- Internal Medicine, Benazir Bhutto Hospital, Rawalpindi, PAK
| | - Maham Javaid
- Internal Medicine, Allama Iqbal Medical College, Lahore, PAK
| | - Adnan Younas Malik
- Internal Medicine and Nephrology, District Headquarter Hospital, Rawalpindi, PAK
| | - Amna Saleem
- Pediatrics and Child Health, Islamic International Medical College Trust (IIMCT)Pakistan Railways Hospital, Rawalpindi, PAK
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12
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Sohmaran C, Bte Mohamed Rahim A, Chua JYX, Shorey S. Perceptions of primiparous women diagnosed with gestational diabetes mellitus: A descriptive qualitative study. Midwifery 2023; 125:103802. [PMID: 37657131 DOI: 10.1016/j.midw.2023.103802] [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: 02/17/2023] [Revised: 08/13/2023] [Accepted: 08/25/2023] [Indexed: 09/03/2023]
Abstract
OBJECTIVE To understand the perceptions of primiparous women recently diagnosed with Gestational Diabetes Mellitus (GDM) in Singapore. DESIGN A descriptive qualitative study design. SETTING An outpatient women's health clinic in a tertiary hospital in Singapore. PARTICIPANTS Twelve English-speaking primiparous women (aged 27-44 years old) who were diagnosed with GDM were recruited via purposive sampling to participate in this study. METHODS Face-to-face interviews were carried out with study participants in a private room at the outpatient clinic from December 2019 to May 2021. All interviews were audio-recorded and transcribed verbatim on the same day. Data analysis was guided by Braun and Clarke's thematic analysis framework. FINDINGS Four main themes were identified from this study's findings: (1) Life leading to GDM: A 'hint' that something was wrong, (2) Reactions to diagnosis: Shock or acceptance, (3) Learning to cope: Facing internal and external challenges, and (4) Living with GDM: A way forward. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE Primiparous women with GDM require comprehensive informational, practical, and emotional support to help them manage and accept their condition. Healthcare providers are encouraged to provide individualised and holistic care to these women using a humanistic approach. Accessible online educational resources and peer support services could be considered. Public campaigns to increase the general public's awareness of GDM would also allow future women and their families to be more familiar with the condition and hence more prepared to cope with it.
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Affiliation(s)
- Chithrra Sohmaran
- Nursing Division, KK Women's and Children's Hospital, 100 Bukit Timah Road, 229899, Singapore
| | - Asmira Bte Mohamed Rahim
- Nursing Division, Obstetric Day Assessment Centre, KK Women's and Children's Hospital, 100 Bukit Timah Road, 229899, Singapore
| | - Joelle Yan Xin Chua
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Shefaly Shorey
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
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13
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Chan ES, Chadha R, de Koning L. Maternal Hemoglobin A1c in the Third-Trimester May Underestimate Maternal Hyperglycemia and Its Impact on Offspring in Perinatal Demise Associated With Gestational Diabetes Mellitus: An Autopsy Case Series. Pediatr Dev Pathol 2023; 26:472-481. [PMID: 37672690 PMCID: PMC10685682 DOI: 10.1177/10935266231194697] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/08/2023]
Abstract
INTRODUCTION Gestational diabetes mellitus (GDM) is a common metabolic disorder linked to adverse pregnancy outcomes. Recent research indicates that HbA1c is reliable in detecting maternal glycemia during the first trimester but may underestimate glucose intolerance in the late second to third trimesters. Therefore, it is reasonable to hypothesize that mothers with GDM, despite apparently normal HbA1c levels in the third trimester, may give birth to infants displaying characteristic features often seen in infants of diabetic mothers with suboptimal glycemic control. This study aimed to describe a case series of autopsy cases involving stillborn or deceased neonates delivered in the third trimester to mothers diagnosed with GDM and having normal HbA1c levels at or around the time of delivery. The primary focus was on identifying and documenting the characteristic features commonly associated with "infants of diabetic mothers" with suboptimal glycemic control in this series of cases. MATERIALS AND METHODS We conducted a retrospective review of autopsy reports from our institution spanning 7.5 years. The study included cases that met the following criteria: (1) stillborn or infants who died in the early neonatal period, delivered in the third trimester; (2) mothers diagnosed with GDM; (3) normal maternal HbA1c levels of ≤6.1% at or around the time of delivery; (4) birthweight or femoral length exceeding the 90th percentile for gestational age; and (5) absence of genetic aberrations. We also examined these cases for other characteristic features associated with "infants of diabetic mothers." RESULTS Ten autopsy cases met our inclusion criteria, including 9 stillbirths and 1 neonatal death. Gestational age at delivery ranged from 32 to 39 weeks (mean: 35.7 weeks). Femoral length exceeded the 90th percentile in all cases, and 6 cases had birthweights above the 90th percentile. Puffy facies were observed in 6 cases. Among the 9 cases with complete autopsies including internal examination, 6 exhibited excess adipose tissue, 4 had cardiomegaly, and 3 showed pancreatic islet hyperplasia. Hypoxic-ischemic encephalopathy was detected in 7 cases. No structural abnormalities were noted. DISCUSSION Our findings demonstrated that fetuses and neonates born to mothers with apparently normal HbA1c levels in the third trimester could still display characteristic features commonly observed in infants of diabetic mothers with poor glycemic control, also known as "infants of diabetic mothers." This study underscores the potential of third-trimester maternal HbA1c measurements to underestimate maternal glycemia and its consequential impact on fetal development, as well as the subsequent manifestation of features of "infants of diabetic mothers."
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Affiliation(s)
- Elaine S Chan
- Department of Pathology and Laboratory Medicine, University of Calgary Cumming School of Medicine, Calgary, AB, Canada
- Alberta Children’s Hospital, Calgary, AB, Canada
- Alberta Precision Laboratories, Calgary, AB, Canada
| | - Rati Chadha
- Department of Obstetrics and Gynaecology, University of Calgary Cumming School of Medicine, Calgary, AB, Canada
| | - Lawrence de Koning
- Department of Pathology and Laboratory Medicine, University of Calgary Cumming School of Medicine, Calgary, AB, Canada
- Alberta Children’s Hospital, Calgary, AB, Canada
- Alberta Precision Laboratories, Calgary, AB, Canada
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14
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唐 芳, 白 怀, 关 林, 刘 兴, 范 平, 周 密, 吴 玉, 刘 思, 王 玉, 李 德. [Association Between Apolipoprotein C-3 SstⅠ Polymorphism and Serum Lipids in Patients With Gestational Diabetes Mellitus]. SICHUAN DA XUE XUE BAO. YI XUE BAN = JOURNAL OF SICHUAN UNIVERSITY. MEDICAL SCIENCE EDITION 2023; 54:994-999. [PMID: 37866958 PMCID: PMC10579069 DOI: 10.12182/20230960505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Indexed: 10/24/2023]
Abstract
Objective To investigate the apolipoprotein C-3 (APOC3) gene Sst Ⅰ polymorphism and its relationship with changes in serum lipids in patients with gestational diabetes mellitus (GDM). Methods A total of 630 pregnant women with GDM and 1027 normal pregnant controls were covered in the study. The genotype and allele frequencies of APOC3 Sst Ⅰ polymorphism were analyzed by polymerase chain reaction and restriction fragment length polymorphism (PCR-RFLP). Total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and glucose (Glu) were measured by enzymatic methods. Plasma insulin (INS) was measured by chemiluminescence. Apolipoproteins A 1 (apoA1) and B (apoB) levels were measured by turbidimetric immunoassay. Results The allele frequencies of S1 and S2 of the APOC3 polymorphism at the SstⅠ locus were 0.704 and 0.296 in the GDM group and 0.721 and 0.279 in the control group, respectively. There was no significant difference in genotype frequency and allele frequency of APOC3 Sst Ⅰ polymorphism between the GDM and the control groups ( P>0.05). In the GDM group, those with S2S2 and S1S2 genotypes had higher plasma HDL-C levels and lower atherogenic index (AI) values than those with S1S1 genotype did, with the differences being statistically significant (all P<0.05). GDM patients were then divided into obesity and non-obesity subgroups. Further subgroup analysis showed that the association of APOC3 genotype with changes in HDL-C levels was observed only in obese GDM patients, while the association of APOC3 genotype with changes in AI values was observed in both obese and nonobese patients. In addition, in obese GDM patients, those with S2S2 genotype had significantly higher plasma TG levels than those with S1S1 and S1S2 genotypes did ( P<0.05 and P<0.01, respectively). In non-obese GDM patients, those with S2S2 genotype had significantly lower apoB/apoA1 ratio than S2S2 carriers did ( P<0.05). No genotype-related effect on lipid and apolipoprotein variations was evident in the normal controls. Conclusion APOC3 Sst Ⅰ polymorphism in GDM patients is associated with HDL-C and TG levels as well as AI value and apoB/apoA1 ratio. The changes in lipid levels and apolipoprotein ratio showed BMI-dependent features. However, association between polymorphism at the locus and the development of GDM was not observed.
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Affiliation(s)
- 芳梅 唐
- 四川大学华西护理学院 /四川大学华西第二医院 质量控制办公室 (成都 610041)West China School of Nursing, Sichuan University/Quality Control Department, West China Second University Hospital, Sichuan University, Chengdu 610041, China
| | - 怀 白
- 四川大学华西护理学院 /四川大学华西第二医院 质量控制办公室 (成都 610041)West China School of Nursing, Sichuan University/Quality Control Department, West China Second University Hospital, Sichuan University, Chengdu 610041, China
| | - 林波 关
- 四川大学华西护理学院 /四川大学华西第二医院 质量控制办公室 (成都 610041)West China School of Nursing, Sichuan University/Quality Control Department, West China Second University Hospital, Sichuan University, Chengdu 610041, China
| | - 兴会 刘
- 四川大学华西护理学院 /四川大学华西第二医院 质量控制办公室 (成都 610041)West China School of Nursing, Sichuan University/Quality Control Department, West China Second University Hospital, Sichuan University, Chengdu 610041, China
| | - 平 范
- 四川大学华西护理学院 /四川大学华西第二医院 质量控制办公室 (成都 610041)West China School of Nursing, Sichuan University/Quality Control Department, West China Second University Hospital, Sichuan University, Chengdu 610041, China
| | - 密 周
- 四川大学华西护理学院 /四川大学华西第二医院 质量控制办公室 (成都 610041)West China School of Nursing, Sichuan University/Quality Control Department, West China Second University Hospital, Sichuan University, Chengdu 610041, China
| | - 玉洁 吴
- 四川大学华西护理学院 /四川大学华西第二医院 质量控制办公室 (成都 610041)West China School of Nursing, Sichuan University/Quality Control Department, West China Second University Hospital, Sichuan University, Chengdu 610041, China
| | - 思旭 刘
- 四川大学华西护理学院 /四川大学华西第二医院 质量控制办公室 (成都 610041)West China School of Nursing, Sichuan University/Quality Control Department, West China Second University Hospital, Sichuan University, Chengdu 610041, China
| | - 玉峰 王
- 四川大学华西护理学院 /四川大学华西第二医院 质量控制办公室 (成都 610041)West China School of Nursing, Sichuan University/Quality Control Department, West China Second University Hospital, Sichuan University, Chengdu 610041, China
| | - 德华 李
- 四川大学华西护理学院 /四川大学华西第二医院 质量控制办公室 (成都 610041)West China School of Nursing, Sichuan University/Quality Control Department, West China Second University Hospital, Sichuan University, Chengdu 610041, China
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15
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Asadi M, Zahedi F, Ebrahimpur M, Larijani B. Ethical challenges in gestational diabetes. J Med Ethics Hist Med 2023; 16:6. [PMID: 37753523 PMCID: PMC10518638 DOI: 10.18502/jmehm.v16i6.13470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 08/01/2023] [Indexed: 09/28/2023] Open
Abstract
The Article Abstract is not available.
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Affiliation(s)
- Mojgan Asadi
- Associate Professor, Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - Farzaneh Zahedi
- Researcher, Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - Mahbube Ebrahimpur
- Associate Professor, Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - Bagher Larijani
- professor, Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran; Medical Ethics and History of Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran.
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16
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Kang BS, Lee SU, Hong S, Choi SK, Shin JE, Wie JH, Jo YS, Kim YH, Kil K, Chung YH, Jung K, Hong H, Park IY, Ko HS. Prediction of gestational diabetes mellitus in Asian women using machine learning algorithms. Sci Rep 2023; 13:13356. [PMID: 37587201 PMCID: PMC10432552 DOI: 10.1038/s41598-023-39680-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 07/28/2023] [Indexed: 08/18/2023] Open
Abstract
This study developed a machine learning algorithm to predict gestational diabetes mellitus (GDM) using retrospective data from 34,387 pregnancies in multi-centers of South Korea. Variables were collected at baseline, E0 (until 10 weeks' gestation), E1 (11-13 weeks' gestation) and M1 (14-24 weeks' gestation). The data set was randomly divided into training and test sets (7:3 ratio) to compare the performances of light gradient boosting machine (LGBM) and extreme gradient boosting (XGBoost) algorithms, with a full set of variables (original). A prediction model with the whole cohort achieved area under the receiver operating characteristics curve (AUC) and area under the precision-recall curve (AUPR) values of 0.711 and 0.246 at baseline, 0.720 and 0.256 at E0, 0.721 and 0.262 at E1, and 0.804 and 0.442 at M1, respectively. Then comparison of three models with different variable sets were performed: [a] variables from clinical guidelines; [b] selected variables from Shapley additive explanations (SHAP) values; and [c] Boruta algorithms. Based on model [c] with the least variables and similar or better performance than the other models, simple questionnaires were developed. The combined use of maternal factors and laboratory data could effectively predict individual risk of GDM using a machine learning model.
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Affiliation(s)
- Byung Soo Kang
- Department of Obstetrics and Gynecology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Seon Ui Lee
- Department of Obstetrics and Gynecology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Subeen Hong
- Department of Obstetrics and Gynecology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sae Kyung Choi
- Department of Obstetrics and Gynecology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jae Eun Shin
- Department of Obstetrics and Gynecology, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jeong Ha Wie
- Department of Obstetrics and Gynecology, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yun Sung Jo
- Department of Obstetrics and Gynecology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yeon Hee Kim
- Department of Obstetrics and Gynecology, Uijeongbu St. Mary's Hospital,, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Kicheol Kil
- Department of Obstetrics and Gynecology, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yoo Hyun Chung
- Department of Obstetrics and Gynecology, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | | | | | - In Yang Park
- Department of Obstetrics and Gynecology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hyun Sun Ko
- Department of Obstetrics and Gynecology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
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Okami H, Kawaharada R, Yoshizaki H, Toriumi A, Tsutsumi S, Nakamura A. Maternal n-7 Unsaturated Fatty Acids Protect the Fetal Brain from Neuronal Degeneration in an Intrauterine Hyperglycemic Animal Model. Nutrients 2023; 15:3434. [PMID: 37571372 PMCID: PMC10421171 DOI: 10.3390/nu15153434] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 07/29/2023] [Accepted: 07/31/2023] [Indexed: 08/13/2023] Open
Abstract
We previously reported that glycation induces insulin resistance in the hearts of newborn pups from a gestational diabetes mellitus (GDM) rat model. Administration of n-3 unsaturated fatty acids suppressed glycation and improved signaling in GDM rat pups. In this study, we investigated their effects on cranial neurons using the GDM rat model and PC12 cells derived from rat adrenal pheochromocytomas. Additionally, we examined whether n-3 and n-7 unsaturated fatty acids (cis-palmitoleic acid [CPA] and trans-palmitoleic acid [TPA]) ameliorate the detrimental effects of high glucose exposure on rats. In the neonatal cerebrum of GDM rats, increased levels of advanced glycation end products (AGEs) inhibited Akt phosphorylation; however, CPA and TPA intake during pregnancy ameliorated these abnormalities. Furthermore, exposure to high-glucose-induced apoptosis in PC12 cells compared to the cells cultured in control glucose. PC12 cells exposed to high-glucose with fatty acids exhibited reduced AGE production and apoptosis induction compared to the high-glucose group. These findings suggest that a hyperglycemic environment during pregnancy promotes AGE formation in brain neuronal proteins and induces apoptosis. Both TPA and CPA mitigated these abnormalities; however, CPA is cytotoxic, highlighting its safety in pregnant women.
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Affiliation(s)
- Haruka Okami
- Department of General Surgical Science, Graduate School of Medicine, Gunma University, Maebashi 371-8511, Japan;
| | - Ritsuko Kawaharada
- Department of Health and Nutrition, Takasaki University of Health and Welfare, Takasaki 370-0033, Japan;
| | - Hitomi Yoshizaki
- Department of Bioregulatory Science (Physiology), Nippon Medical School, Tokyo 113-8602, Japan;
| | - Akiyo Toriumi
- Department of Public Health, Graduate School of Medicine, Gunma University, Maebashi 371-8511, Japan;
| | - Saki Tsutsumi
- Department of Neurophysiology & Neural Repair, Graduate School of Medicine, Gunma University, Maebashi 371-8511, Japan;
| | - Akio Nakamura
- Department of Molecular Nutrition, Faculty of Human Life Sciences, Jissen Women’s University, Hino 191-8510, Japan
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Nadeem A, Saeed M, Sadiqa A, Moin H, Khan QU. The Effect of Vitamin D3 Intervention on the Association Among Vitamin D3, Adiponectin, and Body Mass Index in Pregnant Women With Gestational Diabetes. Cureus 2023; 15:e43506. [PMID: 37719527 PMCID: PMC10500543 DOI: 10.7759/cureus.43506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/15/2023] [Indexed: 09/19/2023] Open
Abstract
INTRODUCTION Vitamin D3 (VD3) deficiency is a strong predictor of gestational diabetes. Therefore, VD3 supplementation during the antenatal period could prevent the development of gestational diabetes via its effects on insulin secretion, insulin sensitivity, body mass index (BMI), and adiponectin production. OBJECTIVES To observe the effect of VD3 supplementation on adiponectin and BMI and to explore the effect of VD3 supplementation on the association among VD3, adiponectin, and BMI in pregnant women with gestational diabetes. METHODS A randomized control trial was performed after receiving consent at Postgraduate Medical Institute, Lahore. Subjects at 20-26 weeks of gestation with gestational diabetes and with a deficiency/insufficiency of VD3 were included. The study excluded those who were smokers, had multiple pregnancies, or had other gestational complications. Subjects were categorized into interventional (VD3 supplementation) and control groups. The institutional ethical committee approved the study. Serum samples were used for enzyme-linked immunosorbent assay estimation of VD3 and adiponectin levels. Statistical Product and Service Solutions (SPSS) (IBM SPSS Statistics for Windows, Version 21.0, Armonk, NY) software was used to analyze data. Student t-tests were applied to compare quantitative variables, and Chi-square tests were utilized to compare qualitative variables. Pearson's correlation and linear regressions were performed to explore the association. At a 95% confidence interval, a p-value of ≤0.05 was taken as significant. RESULTS With an increase in serum VD3 levels, a decrease in serum adiponectin level was observed in pregnant women with gestational diabetes (interventional group: r = -0.088, p = 0.74); however, after the intervention of VD3 supplementation in the same subjects, an increase in serum adiponectin level was noted with an increase in VD3 (interventional group: r = 0.273, p = 0.28). A significant direct relationship was found between BMI and adiponectin in the same study population (interventional group: r = 0.7, p = 0.001). Interestingly, after the intervention, BMI tends to be less likely to increase adiponectin levels (interventional group: r = 0.09, p = 0.73). Moreover, an inverse association was exhibited between BMI and VD3 levels in all the study groups before intervention (control group: r = -0.07, p = 0.78; interventional group: r = -0.035, p = 0.89) and after intervention (interventional group: r = -0.12, p = 0.65), except in the control group after the intervention span, where BMI mildly raises the VD3 levels (r = -0.12, p = 0.65). CONCLUSION BMI increases with an increase in serum adiponectin levels in gestational diabetic women, but after VD3 supplementation, BMI was less likely to influence adiponectin. Also, with an increase in BMI, a decrease in the VD3 in all study groups was observed except in the control group after VD3 supplementation.
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Affiliation(s)
- Amna Nadeem
- Physiology, CMH Lahore Medical College and Institute of Dentistry, Lahore, PAK
- Medicine and Surgery, National University of Medical Sciences (NUMS), Rawalpindi, PAK
| | - Muniza Saeed
- Physiology, Ameer-ud-Din Medical College, Lahore, PAK
| | - Ayesha Sadiqa
- Physiology, CMH Lahore Medical College and Institute of Dentistry, Lahore, PAK
- Medicine and Surgery, National University of Medical Sciences (NUMS), Rawalpindi, PAK
| | - Hira Moin
- Physiology, National University of Sciences and Technology (NUST), Islamabad, PAK
| | - Qudsia U Khan
- Physiology, CMH Lahore Medical and Dental College, Lahore, PAK
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Yang N, Zhang W, Ji C, Ge J, Zhang X, Li M, Wang M, Zhang T, He J, Zhu H. Metabolic alteration of circulating steroid hormones in women with gestational diabetes mellitus and the related risk factors. Front Endocrinol (Lausanne) 2023; 14:1196935. [PMID: 37396163 PMCID: PMC10310992 DOI: 10.3389/fendo.2023.1196935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 06/02/2023] [Indexed: 07/04/2023] Open
Abstract
Background Abnormally changed steroid hormones during pregnancy are closely related to the pathological process of gestational diabetes mellitus (GDM). Our aim was to systematically profile the metabolic alteration of circulating steroid hormones in GDM women and screen for risk factors. Methods This study was a case-control study with data measured from 40 GDM women and 70 healthy pregnant women during their 24-28 gestational weeks. 36 kinds of steroid hormones, including 3 kinds of corticosteroids, 2 kinds of progestins, 5 kinds of androgens and 26 kinds of downstream estrogens in serum were systematically measured using a combined sensitive UPLC-MS/MS method. The flux of different metabolic pathways of steroid hormones was analyzed. Logistic regression and ROC curve model analyses were performed to identify potential steroid markers closely associated with GDM development. Results Serum corticosteroids, progestins and almost all the estrogen metabolites via 16-pathway from parent estrogens were higher in GDM women compared with healthy controls. Most of the estrogen metabolites via 4-pathway and more than half of the metabolites via 2-pathway were not significantly different. 16α-hydroxyestrone (16OHE1), estrone-glucuronide/sulfate (E1-G/S) and the ratio of total 2-pathway estrogens to total estrogens were screened as three indicators closely related to the risk of GDM development. The adjusted odds ratios of GDM for the highest quartile compared with the lowest were 72.22 (95% CI 11.27-462.71, P trend <0.001) for 16OHE1 and 6.28 (95% CI 1.74-22.71, P trend <0.05) for E1-G/S. The ratio of 2-pathway estrogens to total estrogens was negatively associated with the risk of GDM. Conclusion The whole metabolic flux from cholesterol to downstream steroid hormones increased in GDM condition. The most significant changes were observed in the 16-pathway metabolism of estrogens, rather than the 2- or 4-pathway or other types of steroid hormones. 16OHE1 may be a strong marker associated with the risk for GDM.
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Affiliation(s)
- Na Yang
- Department of Pharmacy, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
- Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Wei Zhang
- Nanjing Qlife Medical Technology Co., Ltd, Nanjing, Jiangsu, China
| | - Cheng Ji
- Department of Pharmacy, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
| | - Jiajia Ge
- Department of Pharmacy, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
| | - Xiaoli Zhang
- Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Meijuan Li
- Nanjing Qlife Medical Technology Co., Ltd, Nanjing, Jiangsu, China
| | - Min Wang
- Department of Pharmacy, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
| | - Tianqi Zhang
- Department of Pharmacy, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
| | - Jun He
- Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Huaijun Zhu
- Department of Pharmacy, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
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Sulhariza HZ, Zalilah MS, Geeta A. Maternal hemoglobin change from early pregnancy to second trimester is associated with risk of gestational diabetes mellitus: a retrospective cohort study. Front Nutr 2023; 10:1197485. [PMID: 37396129 PMCID: PMC10308040 DOI: 10.3389/fnut.2023.1197485] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 05/26/2023] [Indexed: 07/04/2023] Open
Abstract
Introduction The accrual of iron that is reflected in high maternal hemoglobin (Hb) status is increasingly recognized as a risk factor for gestational diabetes mellitus (GDM). Changes in maternal Hb level could also implicate glycemic status in pregnancy. This study aimed to determine the associations between maternal Hb levels and their changes with GDM. Methods In this retrospective cohort study, a total of 1,315 antenatal records of mothers with singleton pregnancies from eight health clinics of a district in the northern region of Peninsular Malaysia who delivered between 1st January 2016-31st December 2017 were analyzed. Data extracted from the records were socio-demographic, anthropometric, obstetrical, and clinical data. Hb levels were extracted at booking (<14 weeks) and second trimester (14-28 weeks). Change in Hb was determined by subtracting the Hb level in the second trimester from the booking Hb level and was categorized as decreased, unchanged, and increased Hb. The associations between maternal Hb levels and their changes with GDM risk were analyzed using multiple regression, adjusting for covariates in four different models. Model 1: maternal age and height. Model 2: covariates of Model 1 added with parity, history of GDM, and family history of diabetes. Model 3: covariates of Model 2 added with iron supplementation at booking. Model 4: covariates of Model 3 added with Hb level at booking. Results and Discussions Unchanged Hb level from booking to second trimester was significantly associated with GDM risk in Model 1 (AOR: 2.55; 95% CI: 1.20, 5.44; p < 0.05), Model 2 (AOR: 2.45, 95% CI: 1.13, 5.34; p < 0.05) Model 3 (AOR: 2.42; 95% CI: 1.11, 5.27; p < 0.05), and Model 4 (AOR: 2.51; 95% CI: 1.15, 5.49; p < 0.05). No significant associations were observed between maternal Hb levels and GDM in the study. Conclusion Unchanged Hb levels from the booking (<14 weeks of gestation) to the second trimester (14-28 weeks) increased GDM risk. Further investigation is warranted to evaluate the associations between changes in maternal Hb and GDM risk and to identify potential factors influencing this relationship.
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Affiliation(s)
- Husni Zain Sulhariza
- Department of Nutrition, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
- Institute of Public Health, National Institute of Health, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia
| | - Mohd Shariff Zalilah
- Department of Nutrition, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Appannah Geeta
- Department of Nutrition, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
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Li X, Zhang B, Ding W, Jia X, Han Z, Zhang L, Hu Y, Shen B, Wang H. Serum Proteomic Signatures in Umbilical Cord Blood of Preterm Neonates Delivered by Women with Gestational Diabetes. Diabetes Metab Syndr Obes 2023; 16:1525-1539. [PMID: 37260850 PMCID: PMC10228520 DOI: 10.2147/dmso.s406297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 05/19/2023] [Indexed: 06/02/2023] Open
Abstract
Background Women who develop diabetes during pregnancy are at higher risk of preterm birth. Here, we identified differentially expressed proteins (DEPs) in the serum of umbilical cord blood samples obtained from preterm neonates delivered by women with gestational diabetes to provide therapeutic targets for clinical drug development. Materials and Methods Umbilical cord blood was collected after delivery of preterm neonates by women with gestational diabetes and after delivery of healthy neonates by women without diabetes. DEPs in the serum samples were identified using liquid chromatography-tandem mass spectrometry. Gene Ontology (GO), cluster analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) were used to determine the biological functions associated with these DEPs. Enzyme linked immunosorbent assay was used to confirm the key DEPs. Results We found that 21 proteins were significantly upregulated, and 51 proteins were significantly downregulated in 72 DEPs in serum samples. GO analyses showed that the DEPs were mainly associated with the GO terms cellular process, biological regulation, cellular anatomical entity, and binding. KEGG signaling pathway analysis indicated that most of the upregulated DEPs were associated with the complement and coagulation cascades, Staphylococcus aureus infection, pertussis, HIF-1 signaling pathway and PPAR signaling pathway and that most of the downregulated DEPs were associated with the complement and coagulation cascades, dilated cardiomyopathy, pathways in cancer, Chagas disease, and hypertrophic cardiomyopathy. The results of KEGG pathway annotation and enrichment analyses indicated that changes in the complement and coagulation cascades may be importantly associated with preterm delivery of neonates by women with gestational diabetes. The key DEPs were confirmed by enzyme linked immunosorbent assay. Conclusion Our proteomics and bioinformatics analyses identified several key proteins and the complement and coagulation cascades pathway that warrant further investigation as potential novel therapeutic targets in preterm delivery among women with gestational diabetes.
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Affiliation(s)
- Xiaoyan Li
- Department of Pediatrics, Anhui Province Maternity and Child Health Hospital, Hefei, Anhui, 230001, People’s Republic of China
| | - Bin Zhang
- Department of Pediatrics, Anhui Province Maternity and Child Health Hospital, Hefei, Anhui, 230001, People’s Republic of China
| | - Wen Ding
- School of Basic Medicine, Anhui Medical University, Hefei, Anhui, 230032, People’s Republic of China
| | - Xianfen Jia
- Department of Pediatrics, Anhui Province Maternity and Child Health Hospital, Hefei, Anhui, 230001, People’s Republic of China
| | - Zhen Han
- Department of Pediatrics, Anhui Province Maternity and Child Health Hospital, Hefei, Anhui, 230001, People’s Republic of China
| | - Lin Zhang
- School of Basic Medicine, Anhui Medical University, Hefei, Anhui, 230032, People’s Republic of China
| | - Yifeng Hu
- School of Basic Medicine, Anhui Medical University, Hefei, Anhui, 230032, People’s Republic of China
| | - Bing Shen
- School of Basic Medicine, Anhui Medical University, Hefei, Anhui, 230032, People’s Republic of China
| | - Huiqin Wang
- Department of Pediatrics, Anhui Province Maternity and Child Health Hospital, Hefei, Anhui, 230001, People’s Republic of China
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Salami A, El Karim I, Lundy F, Loney T, Donaldson M, O'Neill C. An exploratory study of maternal diabetes and offspring use of dental services-Northern Ireland national cohort study. BDJ Open 2023; 9:14. [PMID: 37037830 PMCID: PMC10085974 DOI: 10.1038/s41405-023-00140-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 03/05/2023] [Accepted: 03/06/2023] [Indexed: 04/12/2023] Open
Abstract
INTRODUCTION A small number of literature has posited a link between prenatal exposure to gestational diabetes mellitus and an increased risk of developmental defects in the enamel of offspring. However, the evidence remains inconclusive. AIMS This study examined the relationship between the diabetes status of mothers and the use of dental services by offspring to that pregnancy. MATERIAL AND METHODS Anonymised data from a cohort of mothers who carried a child to term in Northern Ireland between 2012 and 2017 and service use by the child were taken from administrative databases from March 2015 to September 2021. Descriptive statistics, differences in means and regression analyses were used to examine the relationship between service use and maternal diabetes status, controlling for covariates. RESULTS In multivariate analyses that controlled inter alia for age and deprivation, diabetes status was negatively related to restoration, extraction, prevention, and total service use. In the analysis of the COVID period, pre-COVID prevention was negatively related to extractions, restorations, prevention and services in general. CONCLUSION The relationship between maternal diabetic status and aspects of offspring use of dental services was contrary to that suggested in previous studies and warrants more detailed investigation using this valuable data resource.
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Affiliation(s)
- Anas Salami
- School of Medicine Dentistry and Biomedical Science, Queen's University Belfast, Belfast, UK.
- Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates.
| | - Ikhlas El Karim
- School of Medicine Dentistry and Biomedical Science, Queen's University Belfast, Belfast, UK
| | - Fionnuala Lundy
- School of Medicine Dentistry and Biomedical Science, Queen's University Belfast, Belfast, UK
| | - Tom Loney
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Michael Donaldson
- Department of Health, Strategic Planning and Performance Group, London, UK
| | - Ciaran O'Neill
- Centre for Public Health, Queen's University Belfast, Belfast, UK
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Motahari-Tabari NS, Nasiri-Amiri F, Faramarzi M, Shirvani MA, Bakhtiari A, Omidvar S. The Effectiveness of Information-Motivation-Behavioral Skills Model on Self-Care Practices in Early Pregnancy to Prevent Gestational Diabetes Mellitus in Iranian Overweight and Obese Women: A Randomized Controlled Trial. COMMUNITY HEALTH EQUITY RESEARCH & POLICY 2023; 43:257-264. [PMID: 34056987 DOI: 10.1177/0272684x211020300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Gestational diabetes mellitus (GDM) is one of the most common metabolic dysfunction in pregnancy and as overweight and obesity are of the major risk factors. The aim of this study was to determine the effect of Information-Motivation and Behavioral skills (IMB) model-based counseling on preventing GDM in overweight and obese pregnant women. METHODS This randomized controlled trial study was conducted on 137 pregnant women in two groups; education and counseling IMB model-based for four sessions (n = 70), and antenatal usual care (AUC) (n = 67). This study was conducted on overweight and obese pregnant women, at the 12 to 16 weeks' gestation and recruited from the Prenatal Clinic of Rohani Hospital in north of Iran. Blood glucose was measured before and 8 weeks after the intervention. Descriptive and inferential statistics including mean, frequency, t-test, chi-square and ANCOVA were used. RESULTS The prevalence of GDM was lower in the intervention group than the control group (10% and 29.9%, respectively, RR = 0.33, CI 95% (0.15- 0.74) p = .004) as well as mean fasting blood glucose (Cohen's d = 0.28, p = .07), and glucose tolerance test at the first and second hour (d = 0.41 and Cohen's d = 0.73, respectively, p < .01). CONCLUSIONS A lifestyle intervention in early pregnancy by IMB counseling in overweight and obese pregnant women can be effective in decrease GDM.
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Affiliation(s)
| | - F Nasiri-Amiri
- Department of Midwifery and Reproductive Health, Faculty of Nursing & Midwifery, Babol University of Medical Sciences, Babol, I.R Iran
| | - Mahbobeh Faramarzi
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Marjan Ahmad Shirvani
- Sexual and Reproductive Health Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Afsaneh Bakhtiari
- Mobility Impairment Research Babol, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Shabnam Omidvar
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.,Department of Reproductive Health, School of Nursing & Midwifery, Babol University of Medical Sciences, Babol, Iran
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Kan KW, Wan Mohd MA, Nik-Ahmad-Zuky NL, Shatriah I. Central Corneal Thickness and Intraocular Pressure in Women With Gestational Diabetes Mellitus. Cureus 2023; 15:e35996. [PMID: 37041894 PMCID: PMC10083123 DOI: 10.7759/cureus.35996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/09/2023] [Indexed: 03/12/2023] Open
Abstract
INTRODUCTION Pregnancy causes an increase in central corneal thickness (CCT) and a reduction in intraocular pressure (IOP), especially in the third trimester. However, there is very limited published data regarding CCT and IOP in gestational diabetes mellitus (GDM) on diet control. This study is aimed to compare the means of CCT and IOP between pregnant women with GDM on diet control, healthy pregnant women, and healthy non-pregnant women. METHODS This is a comparative cross-sectional study. A total of 184 women were recruited and divided into the following three groups: 61 pregnant women with GDM on diet control, 63 healthy pregnant women, and 60 healthy non-pregnant women as control. All subjects have undergone ocular examination during their 36-40 weeks of gestation. CCT measurement was done using a specular microscope and IOP measurement using a non-contact tonometer. Data from the right eye were analyzed. RESULTS The mean age was 32 (4.0) years in GDM on diet control, 29 (3.0) years in healthy pregnant women, and 27 (5.4) years in healthy non-pregnant women. The number of gravidas was 2.5 (0.8) in women with GDM on diet control and 2.3 (0.8) in healthy pregnant women. There was a significant difference (p<0.05) in the mean CCT in women with GDM on diet control compared to healthy pregnant and healthy non-pregnant women. The mean IOP is significantly lower in both pregnant women with GDM on diet control and healthy pregnant groups, compared to the healthy non-pregnant women group. CONCLUSION Women with GDM showed significantly thicker mean CCT than healthy pregnant and non-pregnant women. The mean IOP is significantly lower in both pregnant women with GDM on diet control and healthy pregnant groups, compared to the healthy non-pregnant women group.
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25
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Yu W, Liu X, Wu N. Association between fasting plasma glucose variability and maternal and infant outcomes in patients with hyperglycemia during pregnancy: a retrospective cohort study. ANNALS OF TRANSLATIONAL MEDICINE 2023; 11:92. [PMID: 36819594 PMCID: PMC9929746 DOI: 10.21037/atm-22-6476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 01/11/2023] [Indexed: 02/03/2023]
Abstract
Background Blood glucose variability (GV) is believed to be closely related to the occurrence of adverse obstetric outcomes. However, few studies have investigated how the change in fasting plasma glucose (FPG) influenced on the adverse obstetric outcomes. This study mainly evaluated the relationship between FPG coefficient of variation (FPG-CV) and adverse outcomes in patients with gestational hyperglycemia and determine the ideal FPG-CV threshold for predicting maternal and infant outcomes. Methods We retrospective analyzed the data of 608 pregnant hyperglycemic patients in the Obstetrics Department of Shengjing Hospital Affiliated to China Medical University between June 2019 and December 2021 and followed up inpatients through the Hospital Information System (HIS). We collected the venous FPG from 24-28 weeks of pregnancy to delivery. Maternal and infant outcomes were based on the latest definitions. The chi-square test and logistic regression analysis were performed to evaluate the correlation between FPG-CV and adverse outcomes. Two multivariate binary logistic regression models were used to adjust for confounding factors. Stratified analysis was performed according to hemoglobin A1c (HbA1c) levels (<5.9% and ≥5.9%) and insulin injection (not used and used) in the third trimester of pregnancy. The receiver operating characteristic (ROC) curve was used to evaluate the prediction of FPG-CV on adverse outcomes. Results All patients were divided into four groups based on the quartile of FPG-CV. The proportion of FPG-SD and insulin injections differed among the groups (P<0.05). Among the outcomes, the highest incidence rate was 26.3% for large for gestational age (LGA), 8.7% for premature delivery. FPG-CV remains independently associated with low birth weight [odds ratio (OR) =1.086, P=0.007], preterm birth (OR =1.069, P=0.012), and preeclampsia (OR =1.180, P<0.001). FPG-CV can predict preeclampsia, with an area under the curve (AUC) of 0.725. Conclusions Our results suggest that patients with gestational hyperglycemia should undergo routine FPG monitoring from diagnosis to delivery. Also, the impact of blood glucose fluctuations on adverse outcomes should be considered in the clinical treatment. The rational application of hypoglycemic treatment can stabilize blood glucose levels, however, the effects of different regimens on GV and outcomes should be studied further.
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Affiliation(s)
- Wenshu Yu
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, China;,Department of Endocrinology, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Xiuyan Liu
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Na Wu
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, China;,Medical Department, Shengjing Hospital of China Medical University, Shenyang, China
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Zhong Q, Chen Y, Luo M, Lin Q, Tan J, Xiao S, Willey JA, Chen JL, Whittemore R, Guo J. The 18-month efficacy of an Intensive LifeStyle Modification Program (ILSM) to reduce type 2 diabetes risk among rural women: a cluster randomized controlled trial. Global Health 2023; 19:6. [PMID: 36703168 PMCID: PMC9881320 DOI: 10.1186/s12992-023-00910-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 01/20/2023] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Many lifestyle interventions have demonstrated efficacy up to one-year follow-up, yet maintaining improvements at longer-term follow-up is a well-recognized worldwide challenge, especially in underserved areas. The purpose of this study is to compare the 18-month efficacy of an Intensive LifeStyle Modification Program to usual care in reducing the risk for type 2 diabetes (T2D) among women with a history of gestational diabetes mellitus (GDM). METHODS We conducted a two-arm, cluster randomized controlled trial among women with a history of GDM in China. A total of 16 towns (clusters) in two distinct rural areas in south-central China were randomly selected (8 towns per area) and assigned (1:1) to the intervention (Intensive LifeStyle Modification Program) or control (usual care) group with stratification in the two rural areas. The strategies for maintaining intervention effects were used (including setting recursive goals and providing a supportive environment, etc.) under the guidance of social cognitive theory. The primary outcome was a change in T2D risk; secondary outcomes included glycemic, weight-related, behavioral, and psychological variables. All outcomes were collected at baseline, 6, and 18 months. All participants entered the intention-to-treat analysis. Data were analyzed via generalized estimation equation models (accounting for clusters) at the individual level, with subgroup analysis included in the model. RESULTS The sample included 320 women from 16 clusters (20 women per cluster). At 18 months, the intervention group demonstrated a significant improvement in T2D risk score, fasting blood glucose, body mass index (BMI), waist circumference, intention to eat low glycemic index food, perceived stress, quality of life in psychological and environmental domains, and social support over time (p < 0.05) based on the intention-to-treat analysis set. Subgroup analysis showed a significant interaction effect on T2D risk score in subgroups of different BMI, waist circumference, and blood glucose (p < 0.05). CONCLUSIONS Over 18 months, the Intensive LifeStyle Modification Program reduced T2D risk among rural women with a history of GDM in China. Women who were overweight, had high abdominal adiposity, or had blood glucose intolerance benefited more from this intervention. This program serves as a potential diabetes prevention model for women with a history of GDM in low-resource settings worldwide. TRIAL REGISTRATION Registered on Chinese Clinical Trial Registry (ChiCTR1800015023) on 1st March 2018, http://www.chictr.org.cn/showproj.aspx?proj=25569.
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Affiliation(s)
- Qinyi Zhong
- grid.216417.70000 0001 0379 7164Xiangya School of Nursing, Central South University, 172 Tongzipo Road, Changsha, 410013 Hunan China
- grid.5379.80000000121662407Manchester Centre for Health Psychology, School of Health Science, University of Manchester, Manchester, Greater Manchester M13 9PL UK
| | - Yao Chen
- grid.216417.70000 0001 0379 7164Xiangya School of Nursing, Central South University, 172 Tongzipo Road, Changsha, 410013 Hunan China
| | - Mengchun Luo
- Maternal and Child Health Hospital of Yongding, Zhangjiajie, Hunan 427000 People’s Republic of China
| | - Qian Lin
- grid.216417.70000 0001 0379 7164Xiangya School of Public Health, Central South University, Changsha, Hunan 410013 People’s Republic of China
| | - Jianghong Tan
- grid.501248.aZhuzhou Central Hospital, Zhuzhou, Hunan 412000 People’s Republic of China
| | - Shuiyuan Xiao
- grid.216417.70000 0001 0379 7164Xiangya School of Public Health, Central South University, Changsha, Hunan 410013 People’s Republic of China
| | - James Allen Willey
- grid.266102.10000 0001 2297 6811Department of Family and Community Medicine, University of California, San Francisco, CA 94118 USA
| | - Jyu-Lin Chen
- grid.266102.10000 0001 2297 6811School of Nursing, University of California, San Francisco, CA 94118 USA
| | - Robin Whittemore
- grid.47100.320000000419368710School of Nursing, Yale University, New Haven, CT 06520 USA
| | - Jia Guo
- grid.216417.70000 0001 0379 7164Xiangya School of Nursing, Central South University, 172 Tongzipo Road, Changsha, 410013 Hunan China
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Feng Y, Lv Y, Feng Q, Song X, Li X, Wang Y. Improvement of stress adaptation and insulin resistance in women with GDM by WeChat group management during novel coronavirus pneumonia. Front Nutr 2023; 9:1017472. [PMID: 36698457 PMCID: PMC9868617 DOI: 10.3389/fnut.2022.1017472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 12/12/2022] [Indexed: 01/11/2023] Open
Abstract
Aim To evaluate the improvement of glycemic control and stress adaptation in patients with GDM by mobile phone WeChat management during novel coronavirus pneumonia. Methods In this study, 75 women with GDM were included, of whom 35 were included in mobile WeChat group management as the GDM-M group and 40 as the GDM group. Results After mobile WeChat group management for 4 weeks, E and NE were lower. MDA was lower, and SOD was higher. HOMA-IR was lower. E, NE, and cortisol were related to HOMA-IR positively, MDA was positively related to HOMA-IR, and SOD was negatively related to HOMA-IR. E and cortisol were positively related to MDA but negatively related to SOD. Conclusion The stress adaptation disorder and insulin resistance in patients with GDM who have completed mobile WeChat group management can be improved during novel coronavirus pneumonia. Mobile WeChat management played a positive role in improving the insulin resistance of women with GDM under special circumstances, which may reduce the risk of maternal and fetal complications.
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Affiliation(s)
- Yan Feng
- Department of Clinical Nutrition, Yuhuangding Hospital Affiliated to Qingdao University, Yantai, China,*Correspondence: Yan Feng ✉
| | - Yuping Lv
- Department of Medical Oncology, Yan Tai Zhifu Hospital, Yantai, China
| | - Qi Feng
- Department of General Surgery, Xi'an, China
| | - Xinna Song
- Department of Clinical Nutrition, Yuhuangding Hospital Affiliated to Qingdao University, Yantai, China
| | - Xiaoyan Li
- Department of Obstetrics, Yuhuangding Hospital Affiliated to Qingdao University, Yantai, China
| | - Yongjun Wang
- Department of Clinical Nutrition, The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Shandong, China,Yongjun Wang ✉
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Liu W, Zhang Q, Liu W, Qiu C. Association between air pollution exposure and gestational diabetes mellitus in pregnant women: a retrospective cohort study. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:2891-2903. [PMID: 35941503 DOI: 10.1007/s11356-022-22379-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 07/31/2022] [Indexed: 06/15/2023]
Abstract
The global prevalence of gestational diabetes mellitus (GDM) is increasing annually, and previous research reports on the relationship between exposure to air pollutants and GDM are not completely consistent. We investigated the association between air pollutant exposure and GDM in pregnant women in a retrospective cohort study in Guangzhou. We found that in the first trimester, exposure to PM2.5 and CO showed a significant association with GDM. In the second trimester, exposure to PM10 was significantly associated with GDM. In the third trimester, exposure to PM2.5, PM10, NO2, SO2, and CO at IQR4 (odds ratio [OR] = 1.271, 95% confidence interval [CI]: 1.179-1.370; OR = 1.283, 95% CI: 1.191-1.383; OR = 1.230, 95% CI: 1.145-1.322; OR = 1.408, 95% CI: 1.303-1.522; OR = 1.150, 95% CI: 1.067-1.240, respectively) compared with IQR1 was positively associated with GDM. However, exposure to NO2 was negatively associated with GDM in the first and second trimesters, and O3 was negatively associated with GDM in the second and third trimesters. We found that the correlation between air pollutants and GDM in different trimesters of pregnancy was not completely consistent in this retrospective cohort study. During pregnancy, there may be an interaction between air pollutant exposure and other factors, such as pregnant women's age, occupation, anemia status, pregnancy-induced hypertension status, and pregnancy season.
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Affiliation(s)
- Weiqi Liu
- Department of Clinical Laboratory, The Maternal and Children Health Care Hospital (Huzhong Hospital) of Huadu, Guangzhou, Guangdong, 510800, People's Republic of China.
| | - Qingui Zhang
- Department of Clinical Laboratory, Foshan Fosun Chancheng Hospital, Foshan, Guangdong, 528000, People's Republic of China
| | - Weiling Liu
- Department of Clinical Laboratory, Foshan Fosun Chancheng Hospital, Foshan, Guangdong, 528000, People's Republic of China
| | - Cuiqing Qiu
- Medical Information Office, The Maternal and Children Health Care Hospital (Huzhong Hospital) of Huadu, Guangzhou, Guangdong, 510800, People's Republic of China
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Kozica-Olenski SL, Soldatos G, Marlow L, Cooray SD, Boyle JA. Exploring the acceptability and experience of receiving diabetes and pregnancy care via telehealth during the COVID-19 pandemic: a qualitative study. BMC Pregnancy Childbirth 2022; 22:932. [PMID: 36514010 PMCID: PMC9745277 DOI: 10.1186/s12884-022-05175-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 11/01/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has significantly impacted the delivery of diabetes in pregnancy care and general maternity care. This study aimed to explore the experiences and acceptability of telehealth use in diabetes in pregnancy care during the COVID-19 pandemic, from the perspectives of pregnant women and their clinicians. The secondary aim was to explore the experiences of pregnant women receiving general maternity care via telehealth during the COVID-19 pandemic. METHODS In-depth qualitative semi-structured interviews were undertaken and analysed via thematic inductive approaches. The Nonadoption, Abandonment, and Challenges to the Scale-Up, Spread, and Sustainability of Health and Care Technologies Framework (NASSS) was applied. RESULTS Eigthteen interviews were conducted with culturally and linguistically diverse pregnant women and 4 clinicians (endocrinologists and dietitians). All interviewees were satisfied with telehealth as a positive alternative to face-to-face consultations for diabetes care during the COVID-19 pandemic. Numerous benefits of delivering diabetes care via telehealth were discussed and themes centred around greater access to care, economic benefits and improved safety. Most barriers concerned the adopters (clinicians), yet, feasible and realistic suggestions to overcome barriers were voiced. The scope for technology adaptation and ongoing embedment into routine diabetes care was described. Overall, a hybrid flexible delivery model, predominantly consisting of telephone consultations, with some face-to-face consultations for initial diabetes appointments was recommended for future care. The use of telehealth in replacement of face-to-face appointments for general maternity care was perceived as reducing care quality. CONCLUSION In this study, telehealth was viewed as acceptable to women and clinicians for diabetes in pregnancy care, supporting the ongoing delivery of a hybrid service model of telehealth and face-to-face care. These findings provide valuable information to improve diabetes in pregnancy services to meet the needs of women during the COVID-19 pandemic and beyond.
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Affiliation(s)
- S. L. Kozica-Olenski
- grid.1002.30000 0004 1936 7857Monash Centre for Health Research and Implementation, Monash University, Melbourne, Locked Bag 29, Clayton, Victoria 3168 Australia
| | - G. Soldatos
- grid.1002.30000 0004 1936 7857Monash Centre for Health Research and Implementation, Monash University, Melbourne, Locked Bag 29, Clayton, Victoria 3168 Australia ,grid.419789.a0000 0000 9295 3933Diabetes and Vascular Medicine Unit, Monash Health, Melbourne, Victoria Australia
| | - L. Marlow
- grid.1002.30000 0004 1936 7857Monash Centre for Health Research and Implementation, Monash University, Melbourne, Locked Bag 29, Clayton, Victoria 3168 Australia
| | - S. D. Cooray
- grid.1002.30000 0004 1936 7857Monash Centre for Health Research and Implementation, Monash University, Melbourne, Locked Bag 29, Clayton, Victoria 3168 Australia ,grid.419789.a0000 0000 9295 3933Diabetes and Vascular Medicine Unit, Monash Health, Melbourne, Victoria Australia
| | - J. A. Boyle
- grid.419789.a0000 0000 9295 3933Department of Obstetrics and Gynaecology, Monash Health, Melbourne, Victoria Australia ,grid.1002.30000 0004 1936 7857Eastern Health Clinical School, Monash University, Box Hill, Melbourne, Australia
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Abd Latif R, Yusof NA, Yahya R, Muda Z, Tengku Lih TB, Mohamed K, Lah D, Abd Kadir R, Hassan M, Wan Sulaiman WR, Akbar Merican SA, Mohd Hanafi MSI. The prevalence of gestational diabetes, associated factors and feto-maternal outcome among antenatal women attending health clinics in Terengganu. MALAYSIAN FAMILY PHYSICIAN : THE OFFICIAL JOURNAL OF THE ACADEMY OF FAMILY PHYSICIANS OF MALAYSIA 2022; 17:43-52. [PMID: 36606162 PMCID: PMC9809446 DOI: 10.51866/oal302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
INTRODUCTION Gestational diabetes mellitus (GDM) is a known risk factor for diabetes mellitus (DM). The rising prevalence of GDM in the Asian population (11.7%) may explain the increasing incidence of DM in women. This study examined the prevalence of GDM, its associated factors and the foeto-maternal outcomes of women with GDM in Terengganu. METHOD A cross-sectional study was conducted between April and September 2019 using secondary data from antenatal records in 40 health clinics in Terengganu for 2018. All pregnant women aged 25 years and above with or without risk factors for GDM were included in the study. Those with pre-existing type 1 or 2 DM were excluded. A total of 270 respondents were included. The prevalence of GDM and its associated factors were determined using descriptive statistics followed by multiple logistic regression. RESULTS The prevalence of GDM in Terengganu was 27.3% (n=72). Logistic regression analysis found that BMI at booking (adjusted OR=4.51, 95% CI 2.13-9.55, p<0.001), history of GDM (adjusted OR=5.31, 95% CI 2.17-12.99, p<0.001) and family history of DM (adjusted OR=4.24, 95% CI 2.23-8.05, p<0.001) were the significant associated risk factors. Of women with GDM, 17.7% (n=11) had postpartum pre-diabetes based on modified oral glucose tolerance at 6 weeks postpartum. Univariate analysis using chi-square tests showed a significant association of neonatal jaundice and hypoglycaemia with GDM. CONCLUSION Because the prevalence of GDM in Terengganu is high, surveillance of GDM in highrisk pregnancies and effective glycaemic management should be emphasised to prevent adverse foeto-maternal outcomes.
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Affiliation(s)
- Rozimah Abd Latif
- MMBS (Adelaide), MMed (Family Medicine) USM, Klinik Kesihatan Merchang, Marang, Terengganu, Malaysia
| | - Nurul Azreen Yusof
- MD (UKM), MMed (Family Medicine) USM, Faculty of Medicine, Universiti Sultan, Zainal Abidin, Kuala Terengganu, Terengganu, Malaysia.
| | - Ranimah Yahya
- MD (UKM), MMed (Family Medicine) USM, Klinik Kesihatan Rahmat, Chalok, Setiu, Terengganu, Malaysia
| | - Zahrni Muda
- MD (USM), MMed (Family Medicine) USM, Klinik Kesihatan Al-Muktafi Billah, Shah, Jengai, Dungun, Terengganu, Malaysia
| | - Tengku Bahiah Tengku Lih
- MD (UKM), MMed (Family Medicine) UKM, Klinik Kesihatan Padang Luas, Jerteh, Besut, Terengganu, Malaysia
| | - Kamilah Mohamed
- MD (UKM), MMed (Family Medicine) UKM, Klinik Kesihatan Batu Rakit, Kuala, Nerus, Terengganu, Malaysia
| | - Darisah Lah
- MD (UKM), MMed (Family Medicine), UKM, Klinik Kesihatan Bukit Tunggal, Kuala, Nerus, Terengganu, Malaysia
| | - Rohaiza Abd Kadir
- MD (UKM), MMed (Family Medicine) UKM, Klinik Kesihatan Seberang Takir, Kuala Nerus, Terengganu, Malaysia
| | - Maira Hassan
- MBBS (Banglaore), MMed (Family Medicine) USM, Klinik Kesihatan Manir, Kuala, Terengganu, Terengganu, Malaysia
| | - Wan Ruzilasalwa Wan Sulaiman
- MD (UKM), MMed (Family Medicine) UKM, Klinik Kesihatan Kuala, Dungun, Kg Alor Tembese, Kuala Dungun, Dungun, Terengganu, Malaysia
| | - Siti Aminah Akbar Merican
- MD (USM), MMed (Family Medicine) UKM, Klinik Kesihatan Kuala, Berang, Kuala Berang, Terengganu, Malaysia
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Effects of a smartphone-based nursing counseling and feedback system for women with gestational diabetes on compliance, glycemic control, and satisfaction: a randomized controlled study. Int J Diabetes Dev Ctries 2022. [DOI: 10.1007/s13410-022-01142-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Ramirez Zegarra R, Dall’Asta A, Revelli A, Ghi T. COVID-19 and Gestational Diabetes: The Role of Nutrition and Pharmacological Intervention in Preventing Adverse Outcomes. Nutrients 2022; 14:nu14173562. [PMID: 36079820 PMCID: PMC9460671 DOI: 10.3390/nu14173562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 08/14/2022] [Accepted: 08/23/2022] [Indexed: 12/15/2022] Open
Abstract
Pregnant women with GDM affected by COVID-19 seem to be at higher risk of adverse maternal and neonatal outcomes, especially those with overweight or obesity. Good glycemic control seems to be the most effective measure in reducing the risk of GDM and severe COVID-19. For such purposes, the Mediterranean diet, micronutrient supplementation, and physical activity are considered the first line of treatment. Failure to achieve glycemic control leads to the use of insulin, and this clinical scenario has been shown to be associated with an increased risk of adverse maternal and neonatal outcomes. In this review, we explore the current evidence pertaining to the pathogenesis of SARS-CoV-2 leading to the main complications caused by COVID-19 in patients with GDM. We also discuss the incidence of complications caused by COVID-19 in pregnant women with GDM according to their treatment.
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Affiliation(s)
- Ruben Ramirez Zegarra
- Obstetrics and Gynaecology Unit, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
- Department of Obstetrics and Gynaecology, University Hospital Rechts der Isar, Technical University of Munich, 81675 Munich, Germany
| | - Andrea Dall’Asta
- Obstetrics and Gynaecology Unit, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
| | - Alberto Revelli
- Sant’Anna Hospital, Department of Surgical Sciences, University of Turin, 10126 Turin, Italy
| | - Tullio Ghi
- Obstetrics and Gynaecology Unit, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
- Correspondence:
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Zheng MM, Lu Y, Cai YS, Li MX, Fei Y, Zheng D. Preventive effect of one-day outpatient health management on adverse pregnancy outcomes in patients with gestational diabetes mellitus: a retrospective cohort study. Transl Pediatr 2022; 11:1362-1373. [PMID: 36072537 PMCID: PMC9442207 DOI: 10.21037/tp-22-324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 08/05/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND One-day outpatient health management has been applied to treat gestational diabetes mellitus (GDM) and prevent further complications. However, the relationships between one-day outpatient health management and adverse pregnancy outcomes remain ambiguous, because of limited evidence. We analyzed the effects of one-day outpatient health management on premature birth, macrosomia and low-birth-weight infants in patients with GDM. METHODS We retrospectively enrolled pregnant women with GDM who delivered at Guiyang Maternal and Child Health Hospital between 2019 and 2021. Patients could voluntarily choose to participate in either the general outpatient health education or a one-day outpatient health management. Data on demographic and clinical characteristics were collected and pregnancy outcomes ascertained. Logistic regression analysis was used to detect the potential relationship between one-day outpatient health management and adverse pregnancy outcomes including preterm birth, macrosomia, and low-birth-weight infants. GDM, preterm birth, low birth weight and macrosomia was diagnosed according to the criteria established by Obstetrics and Gynecology (9th edition). RESULTS A total of 3,249 patients with GDM were included, and 798 (24.56%) patients participated in the one-day outpatient health management. Statistically significant differences were observed in the maternal age (P<0.05) and gravidity (P<0.001) between the study and control groups. The incidences of premature birth, low-birth-weight infant, and macrosomia in patients attending the one-day outpatient service were 9.6%, 8.1%, and 4.5%, while the incidences of those who did not attend the one-day outpatient service were 12.4%, 11.1%, and 7.5%. After adjusting for maternal age, ethnic groups, body mass index (BMI) before pregnancy, family history of diabetes, history of abnormal pregnancy, history of polycystic ovary syndrome, gravidity, hyperthyroidism and hypothyroidism, multivariate logistic regression analyses showed that this one-day outpatient health management was a protective factor for premature birth [odds ratio (OR) 0.751, 95% confidence interval (CI): 0.576-0.981], macrosomia (OR 0.567, 95% CI: 0.385-0.834) and low-birth-weight infants (OR 0.699, 95% CI: 0.522-0.937). CONCLUSIONS The degree of acceptance of patients with GDM to a one-day outpatient health management is still low. This one-day outpatient health management may reduce the incidence of adverse pregnancy outcomes in women with GDM to a certain extent.
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Affiliation(s)
- Meng-Mou Zheng
- Department of Preventive Medicine, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Yang Lu
- Department of Women Healthcare, Guiyang Maternal and Child Health Hospital, Guiyang, China
| | - Yu-Shu Cai
- Department of Women Healthcare, Guiyang Maternal and Child Health Hospital, Guiyang, China
| | - Ming-Xuan Li
- Department of Women Healthcare, Guiyang Maternal and Child Health Hospital, Guiyang, China
| | - Yu Fei
- Department of Preventive Medicine, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Dan Zheng
- Department of Women Healthcare, Guiyang Maternal and Child Health Hospital, Guiyang, China
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Zhou G, Chen C, Han G, Jiang H, Cao M. Relationship between different hepatitis B virus infection status and gestational diabetes mellitus prevalence among pregnant women with chronic HBV infection: A retrospective study. J Viral Hepat 2022; 29:596-603. [PMID: 35582862 DOI: 10.1111/jvh.13700] [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: 11/24/2021] [Accepted: 03/18/2022] [Indexed: 12/09/2022]
Abstract
To investigate the relationships between different hepatitis B virus (HBV) infection status and gestational diabetes mellitus (GDM) and analyse the potential risk factors, we conducted an observational retrospective study in HBV-infected pregnant women to compare the differences of GDM prevalence and clinical outcomes between groups divided by HBV infection status. Spearman's correlation coefficient was used to evaluate the correlations among hepatitis B e antigen (HBeAg), HBV DNA and liver function. Logistic regression model was used to analyse the risk factors. In all, 1390 HBsAg-positive pregnant women were enrolled. HBeAg titre and HBV DNA, ALT and AST were correlated (r = 0.743, p < 0.001; r = 0.813, p < 0.001). Overall GDM prevalence was 21%. GDM prevalence of HBV-infected women with abnormal liver function was higher than those with normal liver function (26.8% vs. 20%, p = 0.027). Age over 35 years and abnormal liver function over 5 times ULN and 1-2 times ULN were independent risk factors for GDM prevalence with odds ratio (OR) of 1.858 (95% CI 1.227-2.815), 1.589 (95% CI 1.023-2.468) and 2.203 (95% CI 1.029-4.718), respectively. GDM prevalence in HBV-infected pregnancies with abnormal liver function was higher than those with normal liver function. Age over 35 years and abnormal liver function were independent risk factors for GDM in HBV-infected women.
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Affiliation(s)
- Guanlun Zhou
- Department of Obstetrics and Gynecology, The Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing, China
| | - Chao Chen
- Department of Obstetrics and Gynecology, The Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing, China
| | - Guorong Han
- Department of Obstetrics and Gynecology, The Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing, China
| | - Hongxiu Jiang
- Department of Obstetrics and Gynecology, The Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing, China
| | - Minkai Cao
- Department of Obstetrics and Gynecology, The Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing, China
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Yap PPH, Papachristou Nadal I, Rysinova V, Basri NI, Samsudin IN, Forbes A, Noor NM, Supian ZA, Hassan H, Paimin F, Zakaria R, Mohamed Alias SR, Ismail Bukhary NB, Benton M, Ismail K, Chew BH. Study protocol on risk factors for the diagnosis of gestational diabetes mellitus in different trimesters and their relation to maternal and neonatal outcomes (GDM-RIDMAN). BMJ Open 2022; 12:e052554. [PMID: 35882454 PMCID: PMC9330332 DOI: 10.1136/bmjopen-2021-052554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION Gestational diabetes mellitus (GDM) is often associated with adverse pregnancy outcomes. However, the association of risk factors with GDM diagnosis, maternal and neonatal health outcomes is less established when compared with women without GDM. We aim to examine the diagnostic accuracy of the conventional and novel risk factors for a GDM diagnosis and their impact on maternal and neonatal health outcomes. METHODS AND ANALYSIS This retrospective cohort and nested case-control study at six public health clinics is based on medical records and questionnaire survey of women between 2 and 12 months postpartum. The estimated required sample size is 876 complete records (292 cases, 584 control, at a ratio of 1:2). Oral glucose tolerance test results will be used to identify glucose dysregulation, and maternal and neonatal outcomes include maternal weight gain, pre-eclampsia, polyhydramnios, mode of delivery, preterm or postdate birth, complications in labour, birth weight, gestational age at birth, Apgar score, congenital anomaly, congenital hypothyroidism, neonatal death or stillbirth, hypoglycaemia and hyperbilirubinaemia. Psychosocial measures include the WHO Quality of Life: brief, mother-infant bonding (14-item Postpartum Bonding Questionnaire and 19-item Maternal Postnatal Attachment Scale), anxiety (7-item Generalised Anxiety Disorder), depression (9-item Patient Health Questionnaire) and stress (Perceived Stress Scale symptoms) questionnaires. The comparative incidences of maternal and neonatal health outcomes, the comparative prevalence of the psychosocial outcomes between women with GDM and without GDM, specificity, sensitivity, positive and negative predictive values of the risk factors, separately and combined, will be reported. All GDM risk factors and outcomes will be modelled using multivariable regression analysis and the receiver operating characteristics curve will be reported. ETHICS AND DISSEMINATION This study was approved by the Malaysia Research and Ethics Committee, Ministry of Health Malaysia. Informed consent will be obtained from all participants. Findings will be submitted for publications in scientific journals.
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Affiliation(s)
- Pamela Phui Har Yap
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Iliatha Papachristou Nadal
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
- Department of Psychological Medicine, King's College London Institute of Psychiatry Psychology and Neuroscience, London, UK
| | - Veronika Rysinova
- Department of Psychological Medicine, King's College London Institute of Psychiatry Psychology and Neuroscience, London, UK
| | - Nurul Iftida Basri
- Department of Obstetrics and Gynaecology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Intan Nureslyna Samsudin
- Department of Pathology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Angus Forbes
- Division of Care in Long-term Conditions, King's College London, London, UK
| | - Nurain Mohd Noor
- Clinical Research Centre (CRC), Hospital Putrajaya Malaysia, Putrajaya, Malaysia
| | - Ziti Akthar Supian
- Klinik Kesihatan Seri Kembangan, Ministry of Health Malaysia, Seri Kembangan, Selangor, Malaysia
| | - Haslinda Hassan
- Klinik Kesihatan Puchong, Ministry of Health Malaysia, Puchong, Selangor, Malaysia
| | - Fuziah Paimin
- Klinik Kesihatan Putrajaya Presint 9, Ministry of Health Malaysia, Putrajaya, Malaysia
| | - Rozita Zakaria
- Klinik Kesihatan Putrajaya Presint 18, Ministry of Health Malaysia, Putrajaya, Malaysia
| | | | | | - Madeleine Benton
- Department of Psychological Medicine, King's College London Institute of Psychiatry Psychology and Neuroscience, London, UK
| | - Khalida Ismail
- Department of Psychological Medicine, King's College London Institute of Psychiatry Psychology and Neuroscience, London, UK
| | - Boon How Chew
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
- Department of Psychological Medicine, King's College London Institute of Psychiatry Psychology and Neuroscience, London, UK
- Clinical Research Unit, Hospital Pengajar Universiti Putra Malaysia, Serdang, Selangor, Malaysia
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Effects of Probiotic Supplementation during Pregnancy on the Future Maternal Risk of Metabolic Syndrome. Int J Mol Sci 2022; 23:ijms23158253. [PMID: 35897822 PMCID: PMC9330652 DOI: 10.3390/ijms23158253] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 07/21/2022] [Accepted: 07/23/2022] [Indexed: 12/12/2022] Open
Abstract
Probiotics are live microorganisms that induce health benefits in the host. Taking probiotics is generally safe and well tolerated by pregnant women and their children. Consumption of probiotics can result in both prophylactic and therapeutic effects. In healthy adult humans, the gut microbiome is stable at the level of the dominant taxa: Bacteroidetes, Firmicutes and Actinobacteria, and has a higher presence of Verrucomicrobia. During pregnancy, an increase in the number of Proteobacteria and Actinobacteria phyla and a decrease in the beneficial species Roseburia intestinalis and Faecalibacterium prausnitzii are observed. Pregnancy is a "window" to the mother's future health. The aim of this paper is to review studies assessing the potentially beneficial effects of probiotics in preventing the development of diseases that appear during pregnancy, which are currently considered as risk factors for the development of metabolic syndrome, and consequently, reducing the risk of developing maternal metabolic syndrome in the future. The use of probiotics in gestational diabetes mellitus, preeclampsia and excessive gestational weight gain is reviewed. Probiotics are a relatively new intervention that can prevent the development of these disorders during pregnancy, and thus, would reduce the risk of metabolic syndrome resulting from these disorders in the mother's future.
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Wang Y, Lu S, Xu X, Zhang L, Yang J, Hu W. The interactive effects of pre-pregnancy body mass index, thyroid function, and blood lipid levels on the risk of gestational diabetes mellitus: a crossover analysis. BMC Pregnancy Childbirth 2022; 22:580. [PMID: 35858832 PMCID: PMC9301852 DOI: 10.1186/s12884-022-04908-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 07/12/2022] [Indexed: 11/13/2022] Open
Abstract
Background Studies have demonstrated the associations between pre-pregnancy obesity, thyroid dysfunction, dyslipidemia, and increased risk of gestational diabetes mellitus (GDM) in pregnant women. This study was designed to investigate whether and to what extent, the interactions between these factors contribute to the risk of GDM. Methods A case–control study of 232 GDM cases and 696 controls was conducted among pregnant women from Hangzhou, China. Multiple logistic regression analysis was applied to identify independent risk factors of GDM. Crossover analysis was performed to assess the interactive effects of pre-pregnancy body mass index (pBMI), thyroid hormones, and blood lipid profiles on the risk of GDM. The indexes including attributable proportion (AP) to the interaction and the relative excess risk due to interaction (RERI) were calculated. Results Chinese pregnant women with pBMI > 23 kg/m2 (adjusted: OR = 4.162, p < 0.001), high triglyceride levels (> 2.30 mmol/L) (adjusted: OR = 1.735, p < 0.001), and the free triiodothyronine/free thyroxine (FT3/FT4) ratio ≥ 0.502 (OR = 4.162, p < 0.001) have significantly increased risk of GDM. Crossover analysis indicated that there were significant interactions between pre-pregnancy overweight/obesity and FT3/FT4 ≥ 0.502 (AP = 0.550, p < 0.001; RERI = 7.586, p = 0.009), high TG levels and FT3/FT4 ≥ 0.502 (AP = 0.348, 95%CI = 0.081–0.614, P = 0.010; RERI = 2.021, 95%CI = 0.064–3.978, p = 0.043) on the risk of GDM. Conclusion The interactions between pBMI and FT3/FT4 ratio, TG level and FT3/FT4 ratio may have significant impacts on the risk of GDM in pregnant women. Such findings may help improve our understanding of the pathogenesis of GDM as well as develop comprehensive strategies for the management of GDM.
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Affiliation(s)
- Ying Wang
- Department of Nutrition and Toxicology, Hangzhou Normal University School of Public Health, Hangzhou, China.,Department of Obstetrics, The Affiliated Hangzhou Women's Hospital, Hangzhou Normal University, Hangzhou, China
| | - Sha Lu
- Department of Obstetrics, The Affiliated Hangzhou Women's Hospital, Hangzhou Normal University, Hangzhou, China
| | - Xianrong Xu
- Department of Nutrition and Toxicology, Hangzhou Normal University School of Public Health, Hangzhou, China
| | - Lijun Zhang
- Department of Nutrition and Toxicology, Hangzhou Normal University School of Public Health, Hangzhou, China
| | - Jun Yang
- Department of Nutrition and Toxicology, Hangzhou Normal University School of Public Health, Hangzhou, China. .,Zhejiang Provincial Research Center for the Diagnosis and Treatment of Uterine Cancer, The Affiliated Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China.
| | - Wensheng Hu
- Department of Obstetrics, The Affiliated Hangzhou Women's Hospital, Hangzhou Normal University, Hangzhou, China.
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Shen L, Sahota DS, Chaemsaithong P, Tse WT, CHUNG MY, Ip JKH, Leung TY, Poon LC. First trimester screening for gestational diabetes mellitus with maternal factors and biomarkers. Fetal Diagn Ther 2022; 49:256-264. [DOI: 10.1159/000525384] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 05/20/2022] [Indexed: 11/19/2022]
Abstract
Introduction: This study aimed to identify risk factors among maternal characteristics, obstetric history and first trimester preeclampsia-specific biomarkers that were associated with subsequent development of gestational diabetes mellitus (GDM) and evaluate the performance of the prediction models.
Methods: Secondary analysis of a prospective cohort study. The performance of the prediction models was assessed by area under receiver operating characteristic curve (AUROC).
Results: A total of 837 (8.9%) cases of GDM and 8535 (91.1%) unaffected cases were included. The AUROC of the prediction model combining maternal characteristics and obstetric history (0.735) was better than that of the model utilizing maternal characteristics (AUROC 0.708) and preeclampsia-specific biomarkers (AUROC 0.566). Amongst the preeclampsia-specific biomarkers, the mean arterial pressure (MAP) contributed to the increasing risk of GDM, however, its addition did not improve the AUROC of the model combining maternal characteristics and obstetric history (0.738).
Conclusion: The first trimester prediction model for GDM with maternal characteristics and obstetric history achieves moderate predictability. The inclusion of MAP in the model combining maternal characteristics and obstetric history does not improve the screening performance for GDM. Future studies are needed to explore the effect of blood pressure control from early pregnancy on preventing GDM.
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Begum R, Roy S, Banik S. The prevalence of gestational diabetes mellitus in Bangladesh: a systematic review and meta-analysis. Int J Diabetes Dev Ctries 2022. [DOI: 10.1007/s13410-022-01091-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Malhotra S, Kant S, Kumar R, Ahamed F, Mandal S, M C A, Misra P, Gupta Y. Gestational Diabetes Mellitus Among Pregnant Women Attending Ante-natal Clinic at a Secondary Care Health Facility in Haryana, India. Cureus 2022; 14:e25452. [PMID: 35774711 PMCID: PMC9239524 DOI: 10.7759/cureus.25452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/29/2022] [Indexed: 11/15/2022] Open
Abstract
Introduction: Gestational diabetes has serious health effects during pregnancy and childbirth. We estimated the occurrence of gestational diabetes mellitus (GDM) among pregnant women in a secondary care hospital in Haryana. Methods: It was a hospital-based cross-sectional study, done in an ante-natal clinic (ANC) at a sub-district hospital (SDH), Faridabad district of Haryana, India. Eligible pregnant women attending the ANC clinic were recruited. An oral glucose tolerance test (OGTT) with 75 g of glucose was done with a collection of blood for fasting blood sugar (FBS) and two-hour post-OGTT blood glucose. A pre-tested semi-structured interview schedule was administered. Both the modified International Association of the Diabetes and Pregnancy Study Groups criteria (IADPSGC) and the Diabetes in Pregnancy Study Group of India (DIPSI) criteria were used. Data were presented as percentages, means, standard deviation, and 95% confidence interval (CI). Bi-variable and multi-variable logistic regressions were done. The level of significance was set at 0.05. Results: Of the 623 eligible participants, 66.1% were within the 20-25 age group. The GDM was found in 14.1% (95%CI: 11.5-17.1) participants as per modified IADPSG criteria and 6.7% (95%CI: 4.9-9.0) participants as per DIPSI criteria, respectively. Increasing age [adjusted odds ratio (AOR): 1.24 (95% CI: 1.05-1.47), p=0.008] and increasing years of schooling [AOR: 1.19 (1.01-1.41), p=0.032] were significantly associated with GDM by DIPSI criteria. Family history of DM was also found to have an increased odds with GDM using modified IADPSG criteria [AOR 2.87 (95% CI: 1.09-7.54), p=0.032]. Conclusion: Considerable proportion of pregnant women were found to have GDM in a Sub-district hospital at Ballabgarh in north India. The study highlighted the need and generated evidence about the feasibility of GDM screening utilizing routine staff in a secondary care facility.
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Parveen N, Hassan SUN, Zahra A, Iqbal N, Batool A. Early-Onset of Gestational Diabetes vs. Late-Onset: Can We Revamp Pregnancy Outcomes? IRANIAN JOURNAL OF PUBLIC HEALTH 2022; 51:1030-1039. [PMID: 36407740 PMCID: PMC9643226 DOI: 10.18502/ijph.v51i5.9418] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 11/06/2021] [Indexed: 06/16/2023]
Abstract
BACKGROUND We assessed risk factors, antenatal and intrapartum complications associated with early-onset Gestational diabetes mellitus (GDM) in comparison with late-onset GDM. METHODS This retrospective study included 161 GDM women having singleton pregnancies, without previous medical disorder and delivered at a tertiary care Hospital in Ha'il City, KSA from Dec 2020 till Jun 2021. Women diagnosed at < 24 weeks of pregnancy were grouped as early-onset GDM (n=71) and those diagnosed at ≥ 24 weeks as late-onset GDM (n=90). Both groups were matched for background variables. Chi-square and binary logistic regression analysis were applied with P-value significance at 0.05. RESULTS Past history of GDM, macrosomia and stillbirth were significant predictors for early-onset GDM (P value 0.000, 0.002 and 0.040 respectively). Regression analysis showed early-onset GDM significantly increases the risk for recurrent urinary tract infections (AOR 2.35), polyhydramnios (AOR 2.81), reduced fetal movements (AOR 2.13), intrauterine fetal demise (AOR 8.06), macrosomia (AOR 2.16), fetal birth trauma (2.58), low APGAR score at birth (AOR 8.06), and neonatal ICU admissions (AOR 2.65). Rate of preterm birth, hypertensive disorders, labor onset (natural vs. induced) and cesarean section and intrapartum maternal complications were same in both groups. CONCLUSION Early-onset GDM significantly increases certain maternal (recurrent urinary tract infections, polyhydramnios and reduced fetal movements) and fetal complications (intrauterine fetal demise, macrosomia fetal birth trauma, low APGAR score at birth and neonatal ICU admissions). Most of these adverse pregnancy outcomes can be prevented through early registration and screening, close follow up, growth ultrasounds, and provision of efficient emergency and neonatal care services.
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Affiliation(s)
- Nuzhat Parveen
- Department of Obstetrics and Gynecology, College of Medicine, University of Ha’il, Ha’il-81451, Saudi Arabia
| | - Sehar-un-Nisa Hassan
- Department of Public Health, College of Public Health and Health Informatics, University of Ha’il, Ha’il-81451, Saudi Arabia
| | - Aqeela Zahra
- Department of Family and Community Medicine, College of Medicine, University of Ha’il, Ha’il-81451, Saudi Arabia
| | - Naveed Iqbal
- Department of Obstetrics and Gynecology, College of Medicine, University of Ha’il, Ha’il-81451, Saudi Arabia
| | - Asma Batool
- Maternity and Children Hospital Ha’il, Ha’il, Saudi Arabia
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Sex-specific mediating effect of gestational weight gain between pre-pregnancy body mass index and gestational diabetes mellitus. Nutr Diabetes 2022; 12:25. [PMID: 35468888 PMCID: PMC9039078 DOI: 10.1038/s41387-022-00203-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 03/29/2022] [Accepted: 04/12/2022] [Indexed: 11/08/2022] Open
Abstract
Background Inappropriate weight gain may increase the risk of gestational diabetes mellitus (GDM). However, the relationship between pre-pregnancy body mass index (BMI), weight gain, and GDM has not been precisely quantified. This study aimed to explore whether gestational weight gain played a mediating role between pre-pregnancy BMI and GDM and whether the mediating effect was sex specific. Methods This study established a population-based observational cohort to assess weight gain in pregnant women. Mediation analyses were performed to quantify whether weight gain mediated the association between pre-pregnancy BMI and GDM. Results A total of 67,777 pregnant women were included in the final analysis, among whom 6751 (10.0%) were diagnosed with GDM. We verified that both pre-pregnancy BMI and weight gain were associated with GDM, and that BMI negatively contributed to weight gain. We also found that weight gain had a significant mediating effect on the relationship between pre-pregnancy BMI and GDM (Za × Zb confidence intervals [CIs] 0.00234–0.00618). Furthermore, the effect was sex-specific, in that it was only significant in overweight women carrying female fetuses (Za × Zb CIs 0.00422–0.01977), but not male fetuses (Za × Zb CIs −0.00085 to 0.01236). Conclusions Weight gain during pregnancy had a fetal sex-specific mediating effect between pre-pregnancy BMI and GDM.
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Adverse Pregnancy Outcomes and Maternal Chronic Diseases in the Future: A Cross-Sectional Study Using KoGES-HEXA Data. J Clin Med 2022; 11:jcm11051457. [PMID: 35268548 PMCID: PMC8911450 DOI: 10.3390/jcm11051457] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 03/02/2022] [Accepted: 03/06/2022] [Indexed: 01/27/2023] Open
Abstract
Adverse pregnancy outcomes (APOs) are associated with an increased risk of chronic diseases, including cardiovascular disease (CVD) and metabolic syndrome (MS), in the future. We designed a large-scale cohort study to evaluate the influence of APOs (preeclampsia, gestational diabetes mellitus (GDM), stillbirth, macrosomia, and low birth weight) on the incidence of chronic diseases, body measurements, and serum biochemistry in the future and investigate whether combinations of APOs had additive effects on chronic diseases. We used health examinee data from the Korean Genome and Epidemiology Study (KoGES-HEXA) and extracted data of parous women (n = 30,174; mean age, 53.02 years) for the analysis. Women with APOs were more frequently diagnosed with chronic diseases and had a family history of chronic diseases compared with women without APOs. Composite APOs were associated with an increased risk of hypertension, diabetes mellitus, hyperlipidemia, angina pectoris, stroke, and MS (adjusted odds ratio: 1.093, 1.379, 1.269, 1.351, 1.414, and 1.104, respectively) after adjustment for family history and social behaviors. Preeclampsia and GDM were associated with an increased risk of some chronic diseases; however, the combination of preeclampsia and GDM did not have an additive effect on the risk. APOs moderately influenced the future development of maternal CVD and metabolic derangements, independent of family history and social behaviors.
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Wang L, Yao H, Shen W, Wang X, Huang C, Yu X, Liu C. Gestational diabetes mellitus is associated with blood inflammatory indicators in a Chinese pregnant women population. Gynecol Endocrinol 2022; 38:153-157. [PMID: 34907826 DOI: 10.1080/09513590.2021.2015762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVE This study aimed to investigate relationships between blood inflammatory and metabolic biomarkers in pregnant Chinese women with gestational diabetes mellitus (GDM) in Southwest China and to compare the contributions of blood inflammatory indicators to GDM identification. SUBJECTS AND METHODS In total, 1,347 pregnant women were divided by gestational week into early-, middle- and late-pregnancy groups. Fasting samples were collected for complete blood count (CBC) and biochemical indicator measurements. Receiver operating characteristic (ROC) curves were used to predict GDM. Multivariate logistic regression was used to examine the associations between blood inflammatory indicators and GDM prevalence in pregnant women. RESULTS Significant differences were found in blood inflammatory indicators and metabolic markers in different pregnancy trimesters. For the pregnant women with GDM, FPG, 1 h-PG, 2 h-PG levels, NLR and PLR, WBC and neutrophil counts were statistically differences when compared with non-GDM groups. ROC curve analysis indicated that the NLR, PLR, WBC and neutrophil counts have predictive value for GDM from 24-28 gestational weeks. The FPG levels in 24th-28th weeks of pregnant women were positively correlated with the NLR, PLR, 1 h-PG, 2 h-PG levels and negatively correlated with lymphocyte count. Following adjustment for the age, PLR, and FPG level, multivariate logistic regression showed that the NLR was an independent factor predicting GDM in the 24th-28th weeks of pregnancy. CONCLUSION The blood inflammatory indicators NLR, PLR, and WBC and neutrophil counts were higher in GDM women than in healthy pregnant women, suggesting that blood inflammatory indicators are associated with GDM.
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Affiliation(s)
- Li Wang
- Department of Clinical Laboratory, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Haibo Yao
- Department of Medical Records, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Wei Shen
- Department of Clinical Laboratory, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Xuemei Wang
- Department of Clinical Laboratory, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Cheng Huang
- Department of Clinical Laboratory, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Xia Yu
- Department of Clinical Laboratory, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Chenggui Liu
- Department of Clinical Laboratory, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
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Faal Siahkal S, Javadifar N, Najafian M, Iravani M, Zakerkish M, Heshmati R. The psychosocial challenges associated with gestational diabetes mellitus: A systematic review of qualitative studies. Prim Care Diabetes 2022; 16:11-26. [PMID: 34538572 DOI: 10.1016/j.pcd.2021.09.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 08/30/2021] [Accepted: 09/06/2021] [Indexed: 12/25/2022]
Abstract
BACKGROUND Gestational diabetes is a disease with complex management that requires multidisciplinary collaboration. To achieve treatment goals, in addition to using medications and paying attention to exercise and diet, it is also important to take into account the mental health and psychosocial aspects of diabetes management. This study aimed to highlight these challenges associated with gestational diabetes. METHOD This qualitative systematic review involved a search of the following databases: CINAHL, EMBASE, MEDLINE, and PsycINFO. Title, abstract, and full-text screening was done using Covidence software, and quality assessment of the included papers was conducted using the Critical Appraisal Skills Programme Checklist. Enhancing transparency in reporting the synthesis of the qualitative research statement (ENTREQ) was used in the design of this paper. Data synthesis was done using meta-aggregation method. RESULTS Out of the 2440 articles searched, 24 were qualitatively analyzed. The CASP score of the included papers was optimal. The 514 findings extracted from the 24 studies were aggregated into five broad conceptual categories: psychological challenges, socio-cultural challenges, information-communication challenges, challenges associated with a lifestyle change, and challenges related to health care. CONCLUSION Recognizing the psychosocial challenges associated with gestational diabetes and developing support packages tailored to psychosocial needs can help improve the management of these patients.
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Affiliation(s)
- Shahla Faal Siahkal
- Midwifery Department, Nursing & Midwifery School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Nahid Javadifar
- Reproductive Health Promotion Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Mahin Najafian
- Department of Obstetrics and Gynecology, School of Medicine, Fertility, Infertility and Perinatology Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Mina Iravani
- Reproductive Health Promotion Research Center, Midwifery and Reproductive Health Department, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Mehrnoosh Zakerkish
- Department of Endocrinology and Metabolism, Faculty of Medicine, Diabetes Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Rasoul Heshmati
- Department of Psychology, Faculty of Education and Psychology, University of Tabriz, Tabriz, Iran.
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Amin USM, Parvez N, Rahman TA, Hasan MR, Das KC, Jahan S, Hasanat MA, Seraj ZI, Salimullah M. CDKAL1 gene rs7756992 A/G and rs7754840 G/C polymorphisms are associated with gestational diabetes mellitus in a sample of Bangladeshi population: implication for future T2DM prophylaxis. Diabetol Metab Syndr 2022; 14:18. [PMID: 35090536 PMCID: PMC8796445 DOI: 10.1186/s13098-021-00782-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 12/30/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Association of single nucleotide polymorphisms (SNP) rs7756992 A/G and rs7754840 G/C of cyclin-dependent kinase 5 regulatory subunit-associated protein 1-like 1 (CDKAL1) gene with the susceptibility of gestational diabetes mellitus (GDM) has been studied in a group of Bangladeshi women. METHODS In this case-control study, 212 GDM patients and 256 control subjects were genotyped for rs7756992 and rs7754840 by PCR-RFLP and TaqMan™ allelic discrimination assay method respectively. Genotyping results were confirmed by DNA sequencing and replicated TaqMan™ assay. The odds ratios and their 95% confidence interval were calculated by logistic regression to determine the associations between genotypes and GDM. RESULTS The genotype frequencies of rs7756992-AA/AG/GG in the GDM group and the control group were 37%/48%, 53%/45%, 10%/7% and those of rs7754840-CC/CG/GG were 51%/55%, 40.1%/39.8%, 9%/5% respectively. Under dominant and log additive models rs7756992 was revealed significantly associated with GDM after being adjusted for family history of diabetes (FHD) and gravidity. Conversely, rs7754840 was significantly associated (P = 0.047) with GDM only under the recessive model after the same adjustment. The risk allele frequency of both SNPs was higher in the GDM group but significantly (P = 0.029) increased prevalence was observed in the rs7756992 G allele. When positive FHD and risk alleles of these SNPs were synergistically present in any pregnant woman, the chance of developing GDM was augmented by many folds. The codominant model revealed 2.5 and 2.1 folds increase in odds by AG (rs7756992) and GC (rs7754840) genotypes and 3.7 and 4.5 folds by GG (rs7756992) and CC (rs7754840) genotypes respectively. A significant 2.7 folds (P = 0.038) increase in odds of GDM resulted from the interaction of rs7756992 and family history of diabetes under the dominant model. The cumulative effect of multigravidity and risk alleles of these SNPs increased the odds of GDM more than 1.5 folds in different genotypes. CONCLUSION This study not only revealed a significant association between rs7756992 and rs7754840 with GDM but also provided the possibility as potential markers for foretelling about GDM and type 2 diabetes mellitus in Bangladeshi women.
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Affiliation(s)
- U S Mahzabin Amin
- Molecular Biotechnology Division, National Institute of Biotechnology (NIB), Ganakbari, Ashulia, Savar, Dhaka, 1349, Bangladesh
| | - Nahid Parvez
- Molecular Biotechnology Division, National Institute of Biotechnology (NIB), Ganakbari, Ashulia, Savar, Dhaka, 1349, Bangladesh
| | - Tahia Anan Rahman
- Molecular Biotechnology Division, National Institute of Biotechnology (NIB), Ganakbari, Ashulia, Savar, Dhaka, 1349, Bangladesh
| | - Md Rakibul Hasan
- Department of Endocrinology and Metabolism, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh
| | - Keshob Chandra Das
- Molecular Biotechnology Division, National Institute of Biotechnology (NIB), Ganakbari, Ashulia, Savar, Dhaka, 1349, Bangladesh
| | - Sharmin Jahan
- Department of Endocrinology and Metabolism, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh
| | - Muhammad Abul Hasanat
- Department of Endocrinology and Metabolism, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh
| | - Zeba I Seraj
- Department of Biochemistry and Molecular Biology, University of Dhaka, Dhaka, Bangladesh
| | - Md Salimullah
- Molecular Biotechnology Division, National Institute of Biotechnology (NIB), Ganakbari, Ashulia, Savar, Dhaka, 1349, Bangladesh.
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Masuko N, Tanimura K, Kojima N, Imafuku H, Deguchi M, Okada Y, Hirota Y, Ogawa W, Yamada H. Predictive factors for postpartum glucose intolerance in women with gestational diabetes mellitus. J Obstet Gynaecol Res 2022; 48:640-646. [PMID: 35052019 DOI: 10.1111/jog.15155] [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: 08/18/2021] [Revised: 12/18/2021] [Accepted: 01/06/2022] [Indexed: 11/28/2022]
Abstract
AIM The aim of this prospective cohort study was to evaluate the risk factors for postpartum glucose intolerance (GI) in women with gestational diabetes mellitus (GDM). METHOD A total of 140 women with GDM were enrolled. Of these, 115 underwent a 75-g oral glucose tolerance test (OGTT) at 12 weeks after delivery. Clinical factors and parameters in the antepartum 75-g OGTT associated with postpartum GI were evaluated by logistic regression analyses. RESULTS Twenty-two (19.1%) of the 115 women with GDM developed postpartum GI. The univariate and multivariable logistic regression analyses revealed that low oral disposition index (DI) was a risk factor for postpartum GI (OR, 0.2; 95% CI, 0.04-0.7; p < 0.05), and that no clinical factors were associated with postpartum GI. CONCLUSIONS Lower oral DI on the antepartum 75-g OGTT may be a useful marker for identifying GDM women who are at high risk for postpartum GI.
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Affiliation(s)
- Naohisa Masuko
- Department of Obstetrics and Gynecology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Kenji Tanimura
- Department of Obstetrics and Gynecology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Nobue Kojima
- Department of Obstetrics and Gynecology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hitomi Imafuku
- Department of Obstetrics and Gynecology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Masashi Deguchi
- Department of Obstetrics and Gynecology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yuko Okada
- Division of Diabetes and Endocrinology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yushi Hirota
- Division of Diabetes and Endocrinology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Wataru Ogawa
- Division of Diabetes and Endocrinology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hideto Yamada
- Department of Obstetrics and Gynecology, Kobe University Graduate School of Medicine, Kobe, Japan.,Center for Recurrent Pregnancy Loss, Teine Keijinkai Hospital, Sapporo, Japan
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Wu Y, Shi J, Su Q, Yang Z, Qin L. Correlation Between Circulating PCSK9 Levels and Gestational Diabetes Mellitus in a Chinese Population. Front Endocrinol (Lausanne) 2022; 13:826757. [PMID: 35498417 PMCID: PMC9043651 DOI: 10.3389/fendo.2022.826757] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 03/11/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Previous studies reported that proprotein convertase subtilisin/kexin type 9 (PCSK9) was a key player in the regulations of lipid metabolism and glucose homeostasis. The current study aimed to detect the expression of PCSK9 in pregnant women with gestational diabetes mellitus (GDM) and investigate the possible relationships between PCSK9 and related metabolic phenotypes in GDM. METHODS Circulating PCSK9 levels were determined by ELISA kit in a cohort of subjects with GDM (n = 170) and normal glucose tolerance (NGT; n = 130). We collected blood samples from all participants for the biochemical index determinations. Diagnosis of GDM was made according to the International Association of the Diabetes and Pregnancy Study Groups Consensus Panel. Correlation analysis and logistic regression analysis were used to study the potential associations between PCSK9 and GDM. RESULTS GDM women presented significantly higher circulating PCSK9 levels than those in NGT pregnant subjects (268.07 ± 77.17 vs. 254.24 ± 74.22 ng/ml, P < 0.05). In the GDM group, serum PCSK9 levels were positively correlated with fasting plasma glucose (FPG) (R = 0.251, P = 0.015), glycated hemoglobin (HbA1c) (R = 0.275, P = 0.009), total cholesterol (TC) (R = 0.273, P = 0.010), and low-density lipoprotein cholesterol (LDL-C) (R = 0.326, P = 0.002) after adjustment of age and gestational age. Logistic regression found that age [odds ratio (OR) = 5.412, P = 0.02] and serum PCSK9 levels (OR = 4.696, P = 0.03) were independently associated with GDM. Compared with the lowest serum PCSK9 level quartile group, the prevalence of GDM was significantly higher in the highest quartile group, the ORs of GDM were 3.485 (95% CI 1.408-8.627, P < 0.05 for the trend), after adjusting for potential confounders. CONCLUSIONS Circulating PCSK9 levels were associated with dyslipidemia, pathoglycemia, and the risk of incident GDM, indicating a potential link between PCSK9 and GDM.
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Affiliation(s)
- Yiming Wu
- Department of Endocrinology, Xinhua Hospital Chongming Branch, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Jie Shi
- Department of Endocrinology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Qing Su
- Department of Endocrinology, Xinhua Hospital Chongming Branch, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Department of Endocrinology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Zhen Yang
- Department of Endocrinology, Xinhua Hospital Chongming Branch, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Department of Endocrinology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- *Correspondence: Zhen Yang, ; Li Qin,
| | - Li Qin
- Department of Endocrinology, Xinhua Hospital Chongming Branch, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Department of Endocrinology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- *Correspondence: Zhen Yang, ; Li Qin,
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Cao YM, Ma M, Wang W, Cai NN. The therapeutic effects of attending a one-day outpatient service on patients with gestational diabetes and different pre-pregnancy body mass indices. Front Public Health 2022; 10:1051582. [PMID: 36960096 PMCID: PMC10027732 DOI: 10.3389/fpubh.2022.1051582] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 11/29/2022] [Indexed: 03/09/2023] Open
Abstract
Purpose This study investigated the effects of attending a one-day outpatient service on the outcomes of patients with gestational diabetes mellitus (GDM) and different pre-pregnancy body mass indices (BMIs). Methods The study recruited 311 pregnant women with GDM into a one-day outpatient service at The Fourth Hospital of Shijiazhuang from September 2019 to December 2021. They were randomly assigned to three groups, based on their pre-pregnancy BMI as follows: group A, BMI < 18.5 kg/m2; group B, 18.5 ≥ BMI > 25.0 kg/m2; group C, BMI ≥25 kg/m2. The following information was collected from all the participants: fasting blood glucose, hemoglobin A1c (HbA1C), insulin dose, gestational weight gain, weight gain after the one-day outpatient service, and perinatal outcomes. Results The three groups showed significant differences in fasting blood glucose and HbA1C, insulin treatment rate, and the incidence of pregnancy hypertension/preeclampsia and neonatal jaundice (all P < 0.05). The rate of excessive gestational weight gain in all of the groups also reflected significant differences (P < 0.05). Group A showed the lowest weight gain, while group C gained the most weight. There is no significant difference in the incidences of hypertension/preeclampsia, neonatal jaundice, or premature birth between patients with weight loss/no weight gain and those with positive weight gain. Conclusion One-day diabetes outpatient integrated management may effectively help to manage weight gain and blood glucose in patients with GDM and different pre-pregnancy BMIs. Dietary control after a GDM diagnosis may have helped to avoid weight gain entirely, as well as negative weight gain, but did not increase the risk of maternal and infant-related complications.
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Prüst JT, Brummaier T, Wah M, Yee HH, Win NN, Pimanpanarak M, Min AM, Gilder ME, Tun NW, Ilozumba O, Kabeer BSA, Terranegra A, Nosten F, Lee SJ, McGready R. Risk factor-based screening compared to universal screening for gestational diabetes mellitus in marginalized Burman and Karen populations on the Thailand-Myanmar border: An observational cohort. Wellcome Open Res 2022; 7:132. [PMID: 36874585 PMCID: PMC9976631.2 DOI: 10.12688/wellcomeopenres.17743.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/06/2023] [Indexed: 01/19/2023] Open
Abstract
Background: Gestational diabetes mellitus (GDM) contributes to maternal and neonatal morbidity. As data from marginalized populations remains scarce, this study compares risk-factor-based to universal GDM screening in a low resource setting. Methods: This is a secondary analysis of data from a prospective preterm birth cohort. Pregnant women were enrolled in the first trimester and completed a 75g oral glucose tolerance test (OGTT) at 24-32 weeks' gestation. To define GDM cases, Hyperglycaemia and Adverse Pregnancy Outcomes (HAPO trial) criteria were used. All GDM positive cases were treated. Sensitivity and specificity of risk-factor-based selection for screening (criteria: age ≥30y, obesity (Body mass index (BMI) ≥27.5kg/m 2), previous GDM, 1 st degree relative with diabetes, previous macrosomia (≥4kg), previous stillbirth, or symphysis-fundal height ≥90th percentile) was compared to universal screening using the OGTT as the gold standard. Adverse maternal and neonatal outcomes were compared by GDM status. Results: GDM prevalence was 13.4% (50/374) (95% CI: 10.3-17.2). Three quarters of women had at least one risk factor (n=271 women), with 37/50 OGTT positive cases correctly identified: sensitivity 74.0% (59.7-85.4) and specificity 27.8% (3.0-33.0). Burman women (self-identified) accounted for 29.1% of the cohort population, but 38.0% of GDM cases. Percentiles for birthweight (p=0.004), head circumference (p=0.002), and weight-length ratio (p=0.030) were higher in newborns of GDM positive compared with non-GDM mothers. 21.7% (75/346) of newborns in the cohort were small-for-gestational age (≤10 th percentile). In Burman women, overweight/obese BMI was associated with a significantly increased adjusted odds ratio 5.03 (95% CI: 1.43-17.64) for GDM compared with normal weight, whereas in Karen women, the trend in association was similar but not significant (OR 2.36; 95% CI 0.95-5.89). Conclusions: Risk-factor-based screening missed one in four GDM positive women. Considering the benefits of early detection of GDM and the limited additional cost of universal screening, a two-step screening program was implemented.
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Affiliation(s)
- Janna T Prüst
- Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, 10400, Thailand
- Department of Health Sciences, Vrije Universiteit Amsterdam, Amsterdam, 1081, The Netherlands
| | - Tobias Brummaier
- Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, 10400, Thailand
- Swiss Tropical and Public Health Institute, Allschwill, 4123, Switzerland
- University of Basel, Basel, 4001, Switzerland
| | - Mu Wah
- Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, 10400, Thailand
| | - Htay Htay Yee
- Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, 10400, Thailand
| | - Nyo Nyo Win
- Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, 10400, Thailand
| | - Mupawjay Pimanpanarak
- Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, 10400, Thailand
| | - Aung Myat Min
- Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, 10400, Thailand
| | - Mary Ellen Gilder
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Nay Win Tun
- Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, 10400, Thailand
| | - Onaedo Ilozumba
- Department of Health Sciences, Vrije Universiteit Amsterdam, Amsterdam, 1081, The Netherlands
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | | | | | - Francois Nosten
- Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, 10400, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, OX3 7LG, UK
| | - Sue J Lee
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, OX3 7LG, UK
- Mahidol-Oxford Tropical Medicine Research Unit, Mahidol University, Bangkok, 10400, Thailand
| | - Rose McGready
- Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, 10400, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, OX3 7LG, UK
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