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Lis-Kuberka J, Pupek M, Orczyk-Pawiłowicz M. The Mother-Child Dyad Adipokine Pattern: A Review of Current Knowledge. Nutrients 2023; 15:4059. [PMID: 37764842 PMCID: PMC10535905 DOI: 10.3390/nu15184059] [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] [Received: 08/21/2023] [Revised: 09/11/2023] [Accepted: 09/13/2023] [Indexed: 09/29/2023] Open
Abstract
An important role in the network of interconnections between the mother and child is played by adipokines, which are adipose tissue hormones engaged in the regulation of metabolism. Alternations of maternal adipokines translate to the worsening of maternal insulin resistance as well as metabolic stress, altered placenta functions, and fetal development, which finally contribute to long-term metabolic unfavorable conditions. This paper is the first to summarize the current state of knowledge concerning the concentrations of individual adipokines in different biological fluids of maternal and cord plasma, newborn/infant plasma, milk, and the placenta, where it highlights the impact of adverse perinatal risk factors, including gestational diabetes mellitus, preeclampsia, intrauterine growth restriction, preterm delivery, and maternal obesity on the adipokine patterns in maternal-infant dyads. The importance of adipokine measurement and relationships in biological fluids during pregnancy and lactation is crucial for public health in the area of prevention of most diet-related metabolic diseases. The review highlights the huge knowledge gap in the field of hormones participating in the energy homeostasis and metabolic pathways during perinatal and postnatal periods in the mother-child dyad. An in-depth characterization is needed to confirm if the adverse outcomes of early developmental programming might be modulated via maternal lifestyle intervention.
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Affiliation(s)
- Jolanta Lis-Kuberka
- Department of Biochemistry and Immunochemistry, Division of Chemistry and Immunochemistry, Wroclaw Medical University, M. Skłodowskiej-Curie 48/50, 50-369 Wroclaw, Poland
| | | | - Magdalena Orczyk-Pawiłowicz
- Department of Biochemistry and Immunochemistry, Division of Chemistry and Immunochemistry, Wroclaw Medical University, M. Skłodowskiej-Curie 48/50, 50-369 Wroclaw, Poland
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Antoniou MC, Quansah DY, Mühlberg S, Gilbert L, Arhab A, Schenk S, Lacroix A, Stuijfzand B, Horsch A, Puder JJ. Maternal and fetal predictors of anthropometry in the first year of life in offspring of women with GDM. Front Endocrinol (Lausanne) 2023; 14:1144195. [PMID: 37056671 PMCID: PMC10086315 DOI: 10.3389/fendo.2023.1144195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 03/13/2023] [Indexed: 03/30/2023] Open
Abstract
INTRODUCTION Gestational Diabetes Mellitus (GDM) carries an increased risk for adverse perinatal and longer-term cardiometabolic consequences in offspring. This study evaluated the utility of maternal anthropometric, metabolic and fetal (cord blood) parameters to predict offspring anthropometry up to 1 year in pregnancies with GDM. MATERIALS AND METHODS In this prospective analysis of the MySweetheart study, we included 193/211 women with GDM that were followed up to 1 year postpartum. Maternal predictors included anthropometric (pre-pregnancy BMI, gestational weight gain (GWG), weight and fat mass at the 1st GDM visit), and metabolic parameters (fasting insulin and glucose, Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), Quantitative insulin-sensitivity check index (QUICKI), HbA1c, triglycerides, and high-density lipoprotein (HDL) at the 1st visit and HbA1c at the end of pregnancy). Fetal predictors (N=46) comprised cord blood glucose and insulin, C-Peptide, HOMA-IR, triglycerides and HDL. Offspring outcomes were anthropometry at birth (weight/weight z-score, BMI, small and large for gestational age (SGA,LGA)), 6-8 weeks and 1 year (weight z-score, BMI/BMI z-score, and the sum of 4 skinfolds). RESULTS In multivariate analyses, birth anthropometry (weight, weight z-score, BMI and/or LGA), was positively associated with cord blood HDL and HbA1c at the 1st GDM visit, and negatively with maternal QUICKI and HDL at the 1st GDM visit (all p ≤ 0.045). At 6-8 weeks, offspring BMI was positively associated with GWG and cord blood insulin, whereas the sum of skinfolds was negatively associated with HDL at the 1st GDM visit (all p ≤0.023). At 1 year, weight z-score, BMI, BMI z-score, and/or the sum of skinfolds were positively associated with pre-pregnancy BMI, maternal weight, and fat mass at the 1st GDM visit and 3rd trimester HbA1c (all p ≤ 0.043). BMI z-score and/or the sum of skinfolds were negatively associated with cord blood C-peptide, insulin and HOMA-IR (all p ≤0.041). DISCUSSION Maternal anthropometric, metabolic, and fetal metabolic parameters independently affected offspring anthropometry during the 1st year of life in an age-dependent manner. These results show the complexity of pathophysiological mechanism for the developing offspring and could represent a base for future personalized follow-up of women with GDM and their offspring.
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Affiliation(s)
- Maria-Christina Antoniou
- Unit of Pediatric Endocrinology and Diabetology, Pediatric Service, Woman-Mother-Child Department, Lausanne University Hospital, Lausanne, Switzerland
| | - Dan Yedu Quansah
- Obstetric Service, Woman-Mother-Child Department, Lausanne University Hospital, Lausanne, Switzerland
| | - Suzanne Mühlberg
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Leah Gilbert
- Obstetric Service, Woman-Mother-Child Department, Lausanne University Hospital, Lausanne, Switzerland
| | - Amar Arhab
- Obstetric Service, Woman-Mother-Child Department, Lausanne University Hospital, Lausanne, Switzerland
| | - Sybille Schenk
- Obstetric Service, Woman-Mother-Child Department, Lausanne University Hospital, Lausanne, Switzerland
| | - Alain Lacroix
- Obstetric Service, Woman-Mother-Child Department, Lausanne University Hospital, Lausanne, Switzerland
| | - Bobby Stuijfzand
- Obstetric Service, Woman-Mother-Child Department, Lausanne University Hospital, Lausanne, Switzerland
| | - Antje Horsch
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne, Lausanne, Switzerland
- Neonatology Service, Woman-Mother-Child Department, Lausanne University Hospital, Lausanne, Switzerland
| | - Jardena Jacqueline Puder
- Obstetric Service, Woman-Mother-Child Department, Lausanne University Hospital, Lausanne, Switzerland
- *Correspondence: Jardena Jacqueline Puder,
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Niknam A, Ramezani Tehrani F, Behboudi-Gandevani S, Rahmati M, Hedayati M, Abedini M, Firouzi F, Torkestani F, Zokaee M, Azizi F. Umbilical cord blood concentration of connecting peptide (C-peptide) and pregnancy outcomes. BMC Pregnancy Childbirth 2022; 22:764. [PMID: 36224521 PMCID: PMC9559016 DOI: 10.1186/s12884-022-05081-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 09/24/2022] [Accepted: 09/27/2022] [Indexed: 11/10/2022] Open
Abstract
Background C-peptide offers potential as a marker to indicate childhood metabolic outcomes. Measuring C-peptide concentration might have better future utility in the risk stratification of neonates born to overweight or diabetic mothers. Prior research has tried to bring this matter into the light; however, the clinical significance of these associations is still far from reach. Here we sought to investigate the associations between fetomaternal metabolic variables and umbilical cord blood C-peptide concentration. Methods For the present study, 858 pregnant women were randomly selected from among a sub-group of 35,430 Iranian pregnant women who participated in a randomized community non-inferiority trial of gestational diabetes mellitus (GDM) screening. Their umbilical cord (UC) blood C-peptide concentrations were measured, and the pregnancy variables of macrosomia/large for gestational age (LGA) and primary cesarean section (CS) delivery were assessed. The variation of C-peptide concentrations among GDM and macrosomia status was plotted. Due to the skewed distribution of C-peptide concentration in the sample, median regression analysis was used to identify potential factors related to UC C-peptide concentration. Results In the univariate model, positive GDM status was associated with a 0.3 (95% CI: 0.06 − 0.54, p = 0.01) increase in the median coefficient of UC blood C-peptide concentration. Moreover, one unit (kg) increase in the birth weight was associated with a 0.25 (95% CI: 0.03 − 0.47, p = 0.03) increase in the median coefficient of UC blood C-peptide concentration. In the multivariate model, after adjusting for maternal age, maternal BMI, and macrosomia status, the positive status of GDM and macrosomia were significantly associated with an increase in the median coefficient of UC blood C-peptide concentration (Coef.= 0.27, 95% CI: 0.13 − 0.42, p < 0.001; and Coef.= 0.34, 95% CI: 0.06 − 0.63, p = 0.02, respectively). Conclusion UC blood concentration of C-peptide is significantly associated with the incidence of maternal GDM and neonatal macrosomia. Using stratification for maternal BMI and gestational weight gain (GWG) and investigating molecular markers like Leptin and IGF-1 in the future might lay the ground to better understand the link between metabolic disturbances of pregnancy and UC blood C-peptide concentration. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-022-05081-4.
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Affiliation(s)
- Atrin Niknam
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fahimeh Ramezani Tehrani
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | | | - Maryam Rahmati
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mehdi Hedayati
- Cellular and Molecular Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mehrandokht Abedini
- Infertility and cell therapy office, Transplant & Disease Treatment Center, Ministry of Health and Medical Education, Tehran, Iran
| | - Faegheh Firouzi
- Tehran Medical Branch, Islamic Azad University, Tehran, Iran
| | | | - Mehdi Zokaee
- Senior Executive of Public Health, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Suwaydi MA, Zhou X, Perrella SL, Wlodek ME, Lai CT, Gridneva Z, Geddes DT. The Impact of Gestational Diabetes Mellitus on Human Milk Metabolic Hormones: A Systematic Review. Nutrients 2022; 14:nu14173620. [PMID: 36079876 PMCID: PMC9460195 DOI: 10.3390/nu14173620] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 08/29/2022] [Accepted: 08/29/2022] [Indexed: 02/07/2023] Open
Abstract
Gestational diabetes mellitus (GDM) is a common pregnancy complication with short- and long-term health consequences for the infant and mother. Breastfeeding is the recommended mode of feeding as it offers an opportunity to reduce the risk of GDM consequences, likely partially mediated through changes in human milk (HM) composition. This review systematically reviewed 12 identified studies that investigated the impact of GDM on concentrations of HM metabolic hormones. Meta-analysis was not possible due to significant heterogeneity in study designs and hormone measurement techniques. The risk of bias was assessed using the National Institute for Clinical Excellence (NICE) tool. The methodological qualities were medium in half of the studies, while 25% (3/12) of studies carried a high risk of bias. Significant relationships were reported between GDM and concentrations of HM ghrelin (3/3 studies), insulin (2/4), and adiponectin (2/6), which may play an integral role in infant growth and development. In conclusion, preliminary evidence suggests that GDM may alter HM metabolic hormone concentrations; however, these relationships may be limited to the early lactation stage.
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Affiliation(s)
- Majed A. Suwaydi
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia or
- Department of Medical Laboratory Technology, College of Applied Medical Sciences, Jazan University, Jazan 54142, Saudi Arabia
| | - Xiaojie Zhou
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia or
| | - Sharon L. Perrella
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia or
| | - Mary E. Wlodek
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia or
- Population Health, Murdoch Children’s Research Institute (MCRI), Parkville, VI 3052, Australia
| | - Ching Tat Lai
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia or
| | - Zoya Gridneva
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia or
- Correspondence: ; Tel.: +61-8-6488-4467
| | - Donna T. Geddes
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia or
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Neven ACH, Mousa A, Boyle JA, Teede HJ. Endocrine and metabolic interactions in healthy pregnancies and hyperinsulinemic pregnancies affected by polycystic ovary syndrome, diabetes and obesity. Front Endocrinol (Lausanne) 2022; 13:993619. [PMID: 36733795 PMCID: PMC9886898 DOI: 10.3389/fendo.2022.993619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 12/06/2022] [Indexed: 01/18/2023] Open
Abstract
During pregnancy, the fetoplacental unit is key in the pronounced physiological endocrine changes which support pregnancy, fetal development and survival, birth and lactation. In healthy women, pregnancy is characterized by changes in insulin sensitivity and increased maternal androgen levels. These are accompanied by a suite of mechanisms that support fetal growth, maintain glucose homeostasis and protect both mother and fetus from adverse effects of pregnancy induced insulin and androgen excess. In pregnancies affected by endocrine, metabolic disorders such as polycystic ovary syndrome (PCOS), diabetes and obesity, there is an imbalance of beneficial and adverse impacts of pregnancy induced endocrine changes. These inter-related conditions are characterized by an interplay of hyperinsulinemia and hyperandrogenism which influence fetoplacental function and are associated with adverse pregnancy outcomes including hypertensive disorders of pregnancy, macrosomia, preterm delivery and caesarean section. However, the exact underlying mechanisms and relationships of the endocrine and metabolic milieu in these disorders and the impact they have on the prenatal endocrine environment and developing fetus remain poorly understood. Here we aim to review the complex endocrine and metabolic interactions in healthy women during normal pregnancies and those in pregnancies complicated by hyperinsulinemic disorders (PCOS, diabetes and obesity). We also explore the relationships between these endocrine and metabolic differences and the fetoplacental unit, pregnancy outcomes and the developing fetus.
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Affiliation(s)
- Adriana C. H. Neven
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, Clayton, VIC, Australia
| | - Aya Mousa
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, Clayton, VIC, Australia
| | - Jacqueline A. Boyle
- Monash Department of Obstetrics and Gynaecology, Monash Health, Clayton, VIC, Australia
- Eastern Health Clinical School, Monash University, Box Hill, VIC, Australia
- *Correspondence: Jacqueline A. Boyle,
| | - Helena J. Teede
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, Clayton, VIC, Australia
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Li C, Cai Y, Li Y, Peng B, Liu Y, Wang Z, Yang T, Hu Y, Fu Y, Shi T, Peng H, Zhang Y, Chen J, Li T, Chen L. Well-controlled gestational diabetes mellitus without pharmacologic therapy decelerates weight gain in infancy. Front Endocrinol (Lausanne) 2022; 13:1063989. [PMID: 36601002 PMCID: PMC9807162 DOI: 10.3389/fendo.2022.1063989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 11/29/2022] [Indexed: 12/23/2022] Open
Abstract
AIM There are no prospective longitudinal studies on the association between well-controlled gestational diabetes mellitus (GDM) without pharmacologic therapy and the physical growth of offspring in infancy. We aimed to identify the trajectories in physical growth (from 0-12 months of age) in the offspring of mothers with well-controlled GDM without pharmacologic therapy in a prospective cohort in China. METHODS This study included 236 offspring of mothers with GDM and 369 offspring of mothers without GDM. Mothers with GDM were not on pharmacologic therapy. The length and weight of infants were measured at 0, 1, 3, 6, and 12 months. Linear mixed-effect models and linear mixed-effect models were applied. RESULTS The fully adjusted model showed that the weight-for-age z-score (WAZ), length-for-age z-score (LAZ), and BMI-for-age z-score (BMIZ) were similar at birth for the GDM and control groups. However, subsequent increases in WAZ and BMIZ for the GDM group lagged the increases for the control group at the subsequent periods of observation, 0-1, 0-6, and 0-12 months. CONCLUSIONS Well-controlled GDM without pharmacologic therapy may normalize physical growth of offspring at birth and decelerate their weight gain in infancy. Whether glycemic control can mitigate the long-term effects of GDM on the growth trajectory in offspring remains unclear.
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Affiliation(s)
- Chao Li
- Ministry of Education Key Laboratory of Child Development and Disorders, Department of Growth, Development, and Mental Health of Children and Adolescence Center, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China; Chongqing Key Laboratory of Child Health and Nutrition, Chongqing, China
- Chongqing Key Laboratory of Child Health and Nutrition, Chongqing, China
- Department of Child Health Care, The First People's Hospital of Chongqing Liangjiang New Area, Chongqing, China
| | - Yixi Cai
- Department of Child Health Care, The First People's Hospital of Chongqing Liangjiang New Area, Chongqing, China
| | - Yinying Li
- Department of Child Health Care, The First People's Hospital of Chongqing Liangjiang New Area, Chongqing, China
| | - Bin Peng
- School of Public Health and Management, Department of Health Statistics, Chongqing Medical University, Chongqing, China
| | - Yongfang Liu
- Ministry of Education Key Laboratory of Child Development and Disorders, Department of Growth, Development, and Mental Health of Children and Adolescence Center, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China; Chongqing Key Laboratory of Child Health and Nutrition, Chongqing, China
- Chongqing Key Laboratory of Child Health and Nutrition, Chongqing, China
| | - Zhenming Wang
- Department of Child Health Care, The First People's Hospital of Chongqing Liangjiang New Area, Chongqing, China
| | - Ting Yang
- Ministry of Education Key Laboratory of Child Development and Disorders, Department of Growth, Development, and Mental Health of Children and Adolescence Center, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China; Chongqing Key Laboratory of Child Health and Nutrition, Chongqing, China
- Chongqing Key Laboratory of Child Health and Nutrition, Chongqing, China
| | - Yirong Hu
- Department of Child Health Care, The First People's Hospital of Chongqing Liangjiang New Area, Chongqing, China
| | - Yajun Fu
- Department of Child Health Care, The First People's Hospital of Chongqing Liangjiang New Area, Chongqing, China
| | - Tingmei Shi
- Department of Child Health Care, The First People's Hospital of Chongqing Liangjiang New Area, Chongqing, China
| | - Hong Peng
- Department of Child Health Care, The First People's Hospital of Chongqing Liangjiang New Area, Chongqing, China
| | - Yue Zhang
- Department of Child Health Care, The First People's Hospital of Chongqing Liangjiang New Area, Chongqing, China
| | - Jie Chen
- Ministry of Education Key Laboratory of Child Development and Disorders, Department of Growth, Development, and Mental Health of Children and Adolescence Center, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China; Chongqing Key Laboratory of Child Health and Nutrition, Chongqing, China
- Chongqing Key Laboratory of Child Health and Nutrition, Chongqing, China
| | - Tingyu Li
- Ministry of Education Key Laboratory of Child Development and Disorders, Department of Growth, Development, and Mental Health of Children and Adolescence Center, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China; Chongqing Key Laboratory of Child Health and Nutrition, Chongqing, China
- Chongqing Key Laboratory of Child Health and Nutrition, Chongqing, China
| | - Li Chen
- Ministry of Education Key Laboratory of Child Development and Disorders, Department of Growth, Development, and Mental Health of Children and Adolescence Center, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China; Chongqing Key Laboratory of Child Health and Nutrition, Chongqing, China
- Chongqing Key Laboratory of Child Health and Nutrition, Chongqing, China
- *Correspondence: Li Chen, ;;
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Lackovic M, Milicic B, Mihajlovic S, Filimonovic D, Jurisic A, Filipovic I, Rovcanin M, Prodanovic M, Nikolic D. Gestational Diabetes and Risk Assessment of Adverse Perinatal Outcomes and Newborns Early Motoric Development. MEDICINA (KAUNAS, LITHUANIA) 2021; 57:741. [PMID: 34440947 PMCID: PMC8401518 DOI: 10.3390/medicina57080741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 07/18/2021] [Accepted: 07/20/2021] [Indexed: 11/21/2022]
Abstract
Background and Objectives: The aim of this study was to analyze the presence of gestational diabetes mellitus (GDM) on maternal and fetal perinatal parameters, as well to evaluate the influence of GDM on neonatal early motoric development. Materials and Methods: In this prospective study, we evaluated 203 eligible participants that were admitted to obstetrics department for a labor. GDM was assessed by evaluation of maternal parameters, fetal parameters, as well its impact on infants early motoric development (Alberta Infant Motor Scale-AIMS). Results: Presence of GDM was significantly positively associated with: pre-pregnancy weight, obesity degree, weight at delivery, gestational weight gain (GWG), body mass index (BMI) at delivery, GWG and increased pre-pregnancy BMI, glucose levels in mother's venous blood after the delivery, positive family history for cardiovascular disease, pregnancy-related hypertension, congenital thrombophilia, drug use in pregnancy, large for gestational age (LGA), mode of delivery (Cesarean section and instrumental delivery). Likewise, GDM association was detected for tested ultrasound parameters (biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC), femoral length (FL)), length at birth, birth weight, newborn's head circumference, newborn's chest circumference, AIMS supination and pronation at three months, AIMS supination, pronation, sitting and standing at six months. Only Amniotic Fluid Index and AIMS supination at three months of infant's age remained significantly associated in multivariate regression model. Conclusions: The presence of significant positive association of numerous tested parameters in our study on perinatal outcomes and early motoric development, points to the necessity of establishing appropriate clinical decision-making strategies for all pregnant woman at risk and emphasize the importance of providing adequate glycaemia control options and further regular follow ups during the pregnancy.
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Affiliation(s)
- Milan Lackovic
- Clinical Hospital Center “Dr. Dragiša Mišović”, 11000 Belgrade, Serbia; (M.L.); (S.M.); (I.F.)
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (D.F.); (A.J.); (M.R.)
| | - Biljana Milicic
- Faculty of Dental Medicine, University of Belgrade, 11000 Belgrade, Serbia;
| | - Sladjana Mihajlovic
- Clinical Hospital Center “Dr. Dragiša Mišović”, 11000 Belgrade, Serbia; (M.L.); (S.M.); (I.F.)
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (D.F.); (A.J.); (M.R.)
| | - Dejan Filimonovic
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (D.F.); (A.J.); (M.R.)
- Obstetrics/Gynecology Clinic “Narodni Front”, 11000 Belgrade, Serbia
| | - Aleksandar Jurisic
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (D.F.); (A.J.); (M.R.)
- Obstetrics/Gynecology Clinic “Narodni Front”, 11000 Belgrade, Serbia
| | - Ivana Filipovic
- Clinical Hospital Center “Dr. Dragiša Mišović”, 11000 Belgrade, Serbia; (M.L.); (S.M.); (I.F.)
| | - Marija Rovcanin
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (D.F.); (A.J.); (M.R.)
- Obstetrics/Gynecology Clinic “Narodni Front”, 11000 Belgrade, Serbia
| | - Maja Prodanovic
- Cardiology Clinic, Emergency Center, University Clinical Center of Serbia, 11000 Belgrade, Serbia;
| | - Dejan Nikolic
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (D.F.); (A.J.); (M.R.)
- Physical Medicine and Rehabilitation Department, University Children’s Hospital, Tirsova 10, 11000 Belgrade, Serbia
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Herath MP, Beckett JM, Hills AP, Byrne NM, Ahuja KDK. Gestational Diabetes Mellitus and Infant Adiposity at Birth: A Systematic Review and Meta-Analysis of Therapeutic Interventions. J Clin Med 2021; 10:jcm10040835. [PMID: 33670645 PMCID: PMC7922793 DOI: 10.3390/jcm10040835] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 02/03/2021] [Accepted: 02/16/2021] [Indexed: 12/16/2022] Open
Abstract
Exposure to untreated gestational diabetes mellitus (GDM) in utero increases the risk of obesity and type 2 diabetes in adulthood, and increased adiposity in GDM-exposed infants is suggested as a plausible mediator of this increased risk of later-life metabolic disorders. Evidence is equivocal regarding the impact of good glycaemic control in GDM mothers on infant adiposity at birth. We systematically reviewed studies reporting fat mass (FM), percent fat mass (%FM) and skinfold thicknesses (SFT) at birth in infants of mothers with GDM controlled with therapeutic interventions (IGDMtr). While treating GDM lowered FM in newborns compared to no treatment, there was no difference in FM and SFT according to the type of treatment (insulin, metformin, glyburide). IGDMtr had higher overall adiposity (mean difference, 95% confidence interval) measured with FM (68.46 g, 29.91 to 107.01) and %FM (1.98%, 0.54 to 3.42) but similar subcutaneous adiposity measured with SFT, compared to infants exposed to normal glucose tolerance (INGT). This suggests that IGDMtr may be characterised by excess fat accrual in internal adipose tissue. Given that intra-abdominal adiposity is a major risk factor for metabolic disorders, future studies should distinguish adipose tissue distribution of IGDMtr and INGT.
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Yang MN, Chiu HC, Wang WJ, Fang F, Zhang GH, Zhu H, Zhang L, Zhang DL, Du Q, He H, Huang R, Liu X, Li F, Zhang J, Ouyang F, Hua X, Luo ZC. Sex dimorphism in the associations of gestational diabetes with cord blood adiponectin and retinol-binding protein 4. BMJ Open Diabetes Res Care 2020; 8:8/1/e001310. [PMID: 32973071 PMCID: PMC7517565 DOI: 10.1136/bmjdrc-2020-001310] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 07/09/2020] [Accepted: 07/25/2020] [Indexed: 02/03/2023] Open
Abstract
INTRODUCTION Gestational diabetes (GD) is associated with impaired insulin sensitivity in newborns. Adiponectin and retinol-binding protein 4 (RBP-4) are involved in regulating insulin sensitivity. Females are more likely to develop diabetes at young ages than males. We tested the hypothesis that GD may affect RBP-4 and adiponectin levels in early life, and there may be sex-dimorphic associations. RESEARCH DESIGN AND METHODS In a nested case-control study of 153 matched pairs of neonates of mothers with GD and euglycemic pregnancies in the Shanghai Birth Cohort, we evaluated cord plasma leptin, high molecular weight (HMW) and total adiponectin and RBP-4 concentrations. RESULTS Comparing GD versus euglycemic pregnancies adjusted for maternal and neonatal characteristics in female newborns, cord plasma total adiponectin (mean±SD: 30.8±14.3 vs 37.1±16.1 µg/mL, p=0.048) and HMW adiponectin (14.6±7.7 vs 19.3±8.3 µg/mL, p=0.004) concentrations were lower, while RBP-4 concentrations were higher (21.7±5.4 vs 20.0±4.8 µg/mL, p=0.007). In contrast, there were no differences in male newborns (all p>0.2). RBP-4 concentrations were higher in female versus male newborns (21.7±5.4 vs 18.8±4.5 µg/mL, p<0.001) in GD pregnancies only. HMW adiponectin concentrations were significantly higher in female versus male newborns in euglycemic pregnancies only (19.3±8.3 vs 16.1±7.4 µg/mL, p=0.014). CONCLUSIONS GD was associated with lower cord plasma HMW adiponectin and higher RBP-4 concentrations in female newborns only. The study is the first to reveal a sex-dimorphic early life impact of GD on metabolic health biomarkers in the offspring. GD may alter the normal presence (HMW adiponectin) or absence (RBP-4) of sex dimorphism in some insulin sensitivity regulation-relevant adipokines in early life.
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Affiliation(s)
- Meng-Nan Yang
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, and Department of Pediatrics, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
- Department of Obstetrics and Gynecology, Lunenfeld-Tanenbaum Research Institute, Prosserman Centre for Population Health Research, Mount Sinai Hospital, Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Huei-Chen Chiu
- Department of Obstetrics and Gynecology, Lunenfeld-Tanenbaum Research Institute, Prosserman Centre for Population Health Research, Mount Sinai Hospital, Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Wen-Juan Wang
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
- Department of Obstetrics and Gynecology, Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Fang Fang
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, and Department of Pediatrics, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Guang-Hui Zhang
- Department of Clinical Assay Laboratory, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Hong Zhu
- Department of Obstetrics and Gynecology, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Lin Zhang
- Obstetrics and Gynecology, International Peace Maternity and Child Health Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China
| | - Dan-Li Zhang
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, and Department of Pediatrics, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Qinwen Du
- Department of Obstetrics and Gynecology, Ruijin Hospital Affiliated to Shanghai Jiao Tong University Medical School, Shanghai, China
| | - Hua He
- Department of Pediatrics, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Rong Huang
- Department of Obstetrics and Gynecology, Lunenfeld-Tanenbaum Research Institute, Prosserman Centre for Population Health Research, Mount Sinai Hospital, Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Xin Liu
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, and Department of Pediatrics, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Fei Li
- Department of Pediatrics, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Jun Zhang
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Fengxiu Ouyang
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Xiaolin Hua
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
- Obstetrics and Gynecology, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China
| | - Zhong-Cheng Luo
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, and Department of Pediatrics, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
- Department of Obstetrics and Gynecology, Lunenfeld-Tanenbaum Research Institute, Prosserman Centre for Population Health Research, Mount Sinai Hospital, Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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10
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Chee C, Hibbert EJ, Lam P, Nanan R, Liu A. Sonographic and other nonglycemic factors can predict large-for-gestational-age infants in diet-managed gestational diabetes mellitus: A retrospective cohort study. J Diabetes 2020; 12:562-572. [PMID: 32250016 DOI: 10.1111/1753-0407.13042] [Citation(s) in RCA: 4] [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] [Received: 12/01/2019] [Revised: 03/01/2020] [Accepted: 03/27/2020] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Gestational diabetes mellitus (GDM) is one of the most common complications of pregnancy. Left untreated or poorly controlled, GDM results in adverse infant outcomes such as large for gestational age (LGA). This study aims to identify nonglycemic maternal and fetal factors predictive of LGA outcomes in pregnancies complicated by diet-managed GDM. METHODS This was a retrospective cohort study of singleton pregnancies complicated by diet-managed GDM from 2004 to 2015. Multiple logistic regression analysis was performed on maternal and perinatal factors to identify risk factors for LGA. In addition, a subset univariate analysis was conducted for pregnancies in which fetal ultrasound abdominal circumference measurements were available at gestational weeks 18 to 22, 24 to 28, and 29 to 33. RESULTS A total of 1064 women were included, delivering 123 LGA infants. Women with higher parity (odds ratio [OR] 1.44; CI, 1.23-1.68; P < .001) and higher prepregnancy body mass index (BMI) (OR 1.09; CI, 1.06-1.12; P < .001) were more likely to have LGA infants. Maternal smoking (OR 0.30; CI, 0.14-0.62; P = .001) and higher gestational age at birth (OR 0.91; CI, 0.84-0.99; P = .018) were associated with reduced risk. Subset univariate analysis showed that fetal abdominal circumference measurements at weeks 24 to 28 and 29 to 33 beyond the 75th percentile (OR 5.92 and 13.74, respectively) and 90th percentile (OR 4.57 and 15.89, respectively) were highly predictive of LGA. CONCLUSIONS Parity, smoking status, maternal BMI, gestational age, and ultrasound fetal abdominal circumference measurements were identified as useful predictors of LGA. Presence of these predictors may prompt closer monitoring of pregnancy and early therapeutic intervention to improve management and reduce the risk of adverse fetal and maternal outcomes.
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Affiliation(s)
- Chermaine Chee
- Discipline of Paediatrics, The University of Sydney Nepean Clinical School, Faculty of Medicine and Health, The University of Sydney, Penrith, New South Wales, Australia
| | - Emily Jane Hibbert
- Department of Endocrinology and Diabetes, Division of Medicine, The University of Sydney Nepean Clinical School, Faculty of Medicine and Health, The University of Sydney, Penrith, New South Wales, Australia
| | - Penny Lam
- Department of Perinatal Ultrasound, Nepean Hospital, Penrith, New South Wales, Australia
| | - Ralph Nanan
- Discipline of Paediatrics, The University of Sydney Nepean Clinical School, Faculty of Medicine and Health, The University of Sydney, Penrith, New South Wales, Australia
- Charles Perkins Centre Nepean, The University of Sydney, Penrith, New South Wales, Australia
| | - Anthony Liu
- Discipline of Paediatrics, The University of Sydney Nepean Clinical School, Faculty of Medicine and Health, The University of Sydney, Penrith, New South Wales, Australia
- Charles Perkins Centre Nepean, The University of Sydney, Penrith, New South Wales, Australia
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Talton OO, Bates K, Salazar SR, Ji T, Schulz LC. Lean maternal hyperglycemia alters offspring lipid metabolism and susceptibility to diet-induced obesity in mice†. Biol Reprod 2020; 100:1356-1369. [PMID: 30698664 DOI: 10.1093/biolre/ioz009] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 12/20/2018] [Accepted: 01/28/2019] [Indexed: 01/06/2023] Open
Abstract
We previously developed a model of gestational diabetes mellitus (GDM) in which dams exhibit glucose intolerance, insulin resistance, and reduced insulin response to glucose challenge only during pregnancy, without accompanying obesity. Here, we aimed to determine how lean gestational glucose intolerance affects offspring risk of metabolic dysfunction. One cohort of offspring was sacrificed at 19 weeks, and one at 31 weeks, with half of the second cohort placed on a high-fat, high-sucrose diet (HFHS) at 23 weeks. Exposure to maternal glucose intolerance increased weights of HFHS-fed offspring. Chow-fed offspring of GDM dams exhibited higher body fat percentages at 4, 12, and 20 weeks of age. At 28 weeks, offspring of GDM dams fed the HFHS but not the chow diet (CD) also had higher body fat percentages than offspring of controls (CON). Exposure to GDM increased the respiratory quotient (Vol CO2/Vol O2) in offspring. Maternal GDM increased adipose mRNA levels of peroxisome proliferator-activated receptor gamma (Pparg) and adiponectin (Adipoq) in 31-week-old CD-fed male offspring, and increased mRNA levels of insulin receptor (Insr) and lipoprotein lipase (Lpl) in 31-week-old male offspring on both diets. In liver at 31 weeks, mRNA levels of peroxisome proliferator-activated receptor alpha (Ppara) were elevated in CD-fed male offspring of GDM dams, and male offspring of GDM dams exhibited higher mRNA levels of Insr on both diets. Neither fasting insulin nor glucose tolerance was affected by exposure to GDM. Our findings show that GDM comprising glucose intolerance only during pregnancy programs increased adiposity in offspring, and suggests increased insulin sensitivity of subcutaneous adipose tissue.
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Affiliation(s)
- Omonseigho O Talton
- Department of Obstetrics, Gynecology, and Women's Health, University of Missouri, Columbia, Missouri, USA.,Division of Biological Sciences, University of Missouri, Columbia, Missouri, USA
| | - Keenan Bates
- Department of Obstetrics, Gynecology, and Women's Health, University of Missouri, Columbia, Missouri, USA.,Division of Biological Sciences, University of Missouri, Columbia, Missouri, USA
| | | | - Tieming Ji
- Department of Statistics, University of Missouri, Columbia, Missouri, USA
| | - Laura Clamon Schulz
- Department of Obstetrics, Gynecology, and Women's Health, University of Missouri, Columbia, Missouri, USA.,Division of Biological Sciences, University of Missouri, Columbia, Missouri, USA
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Gestational Diabetes Mellitus Is Associated with Age-Specific Alterations in Markers of Adiposity in Offspring: A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17093187. [PMID: 32375312 PMCID: PMC7246521 DOI: 10.3390/ijerph17093187] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Revised: 04/24/2020] [Accepted: 04/27/2020] [Indexed: 12/14/2022]
Abstract
Maternal hyperglycemia alters an offspring’s metabolic health outcomes, as demonstrated by the increased risk for obesity, impaired glucose handling and diabetes from early childhood onwards. Infant growth patterns are associated with childhood adiposity and metabolic health outcomes and, as such, can be used as potential markers to detect suboptimal metabolic development at an early age. Hence, we aimed to assess whether gestational diabetes mellitus (GDM) has an impact on offspring growth trajectories. Outcomes included weight gain (WG), body mass index (BMI), and skin fold thickness (SFT) measured at least at two time points from birth to later childhood. In addition, we explored the role of early life pre- and post-natal nutritional modifiable factors on longitudinal growth in infants of mother with GDM (GDM–F1). Despite the large heterogeneity of the studies, we can still conclude that GDM seems to be associated with altered growth outcomes in the offspring. More specifically, these alterations in growth outcomes seem to be rather time-specific. Increased SFT were reported particularly at birth, with limited information on reporting SFT between 2–5 y, and increased adiposity, measured via SFT and BMI, appeared mainly in later childhood (5–10 y). Studies evaluating longitudinal growth outcomes suggested a potential role of early life nutritional modifiable factors including maternal nutrition and breastfeeding. These may impact the cycle of adverse metabolic health by attenuating growth outcome alterations among GDM–F1. Conclusions: Timely diagnoses of growth deviations in infancy are crucial for early identification of GDM–F1 who are at risk for childhood overweight and metabolic disease development.
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Sena ASS, Souza ASRD, Barros VDO, Lima MDCP, Melo ASO, Amorim MMRD. Prenatal factors associated with fetal visceral adiposity. JORNAL DE PEDIATRIA (VERSÃO EM PORTUGUÊS) 2020. [DOI: 10.1016/j.jpedp.2018.11.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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14
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Prenatal factors associated with fetal visceral adiposity. J Pediatr (Rio J) 2020; 96:341-349. [PMID: 30742798 PMCID: PMC9432064 DOI: 10.1016/j.jped.2018.11.013] [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: 07/24/2018] [Revised: 10/29/2018] [Accepted: 11/01/2018] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To assess fetal visceral adiposity and associated factors during pregnancy. METHODS Secondary analysis of prospective cohort data with 172 pairs (pregnant woman/fetus) treated at public health units. Anthropometric data, metabolic (glucose, glycated hemoglobin, insulin, insulin resistance, total cholesterol and fractions, triglycerides) measures, fetal biometry, and visceral and subcutaneous adiposity in the binomial (pregnant woman/fetus) were evaluated at the 16th, 28th and 36th gestational weeks by ultrasonography. Pearson's correlation coefficient and multiple linear regression were used, with a significance level of 5%. RESULTS At the 16th week, the mean age of the pregnant women was 26.6±5.8 years and mean weight was 62.7±11.5kg; 47.0% had normal weight, 28.3% were overweight, 13.3% were underweight, and 11.2% were obese. At 36 weeks, 44.1% had inadequate gestational weight gain, 32.5% had adequate gestational weight gain, and 23.3% had excessive gestational weight gain. Fetal visceral adiposity at week 36 showed a positive correlation with maternal variables: weight (r=0.15) and body mass index (r=0.21) at the 16th; with weight (r=0.19), body mass index (r=0.24), and gestational weight gain (r=0.21) at the 28th; and with weight (r=0.22), body mass index (r=0.26), and gestational weight gain (r=0.21) at the 36th week. After multiple linear regression, adiposity at the 28th week remained associated with fetal variables: abdominal circumference (p<0.0001), head circumference (p=0.01), area (p<0.0001), and thigh circumference (p<0.001). At the 36th week, adiposity remained associated with the abdominal circumference of the 28th (p=0.02) and 36th weeks (p<0.001). CONCLUSION Adiposity was positively correlated with the measurements of the pregnant woman. After the multivariate analysis, the persistence of the association occurred with the abdominal circumference, a central adiposity measurement with a higher metabolic risk.
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15
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Maternal gestational diabetes and infant feeding, nutrition and growth: a systematic review and meta-analysis. Br J Nutr 2020; 123:1201-1215. [PMID: 31964432 DOI: 10.1017/s0007114520000264] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Gestational diabetes mellitus (GDM) is a major health problem, with increased risks of obesity and diabetes in offspring. However, little is known about the effect of GDM on infant feeding, nutrition and growth, and whether these factors play a role in mediating these risks. We systematically reviewed evidence for the effect of GDM on infant feeding, nutrition and growth. We searched MEDLINE, Web-of-Science, Embase, CINAHL and CENTRAL for studies that reported outcomes in infants <2 years who were and were not exposed to GDM. Studies of pre-gestational diabetes were excluded. Meta-analysis was performed for three epochs (1–6, 7–12, 13–24 months), using inverse-variance, fixed-effects methods. Primary outcomes were energy intake (kJ) and BMI (kg/m2). Twenty-five studies and 308 455 infants were included. Infants exposed to GDM, compared with those not exposed, had similar BMI at age 1–6 months (standardised mean difference (SMD) = 0·01, 95 % CI −0·04, 0·06; P = 0·69) and 7–12 months (SMD = 0·04, 95 % CI −0·01, 0·10; P = 0·09), reduced length at 1–6 and 7–12 months, increased whole-body fat at 1–6 months, higher rates of formula supplementation in hospital, shorter duration of breast-feeding and decreased rates of continued breast-feeding at 12 months. Breast milk of women with GDM had lower protein content. There was no association between GDM and infant weight and skinfold thickness. No data were available for nutritional intake and outcomes at 13–24 months. Low- or very low-quality evidence suggests GDM is not associated with altered BMI in infancy, but is associated with increased fat mass, high rates of formula use and decreased duration of breast-feeding.
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Arroyo-Jousse V, Jaramillo A, Castaño-Moreno E, Lépez M, Carrasco-Negüe K, Casanello P. Adipokines underlie the early origins of obesity and associated metabolic comorbidities in the offspring of women with pregestational obesity. Biochim Biophys Acta Mol Basis Dis 2019; 1866:165558. [PMID: 31654701 DOI: 10.1016/j.bbadis.2019.165558] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Revised: 09/10/2019] [Accepted: 09/12/2019] [Indexed: 02/07/2023]
Abstract
Maternal pregestational obesity is a well-known risk factor for offspring obesity, metabolic syndrome, cardiovascular disease and type 2 diabetes. The mechanisms by which maternal obesity can induce alterations in fetal and later neonatal metabolism are not fully elucidated due to its complexity and multifactorial causes. Two adipokines, leptin and adiponectin, are involved in fetal and postnatal growth trajectories, and both are altered in women with pregestational obesity. The placenta synthesizes leptin, which goes mainly to the maternal circulation and in lesser amount to the developing fetus. Maternal pregestational obesity and hyperleptinemia are associated with placental dysfunction and changes in nutrient transporters which directly affect fetal growth and development. By the other side, the embryo can produce its own leptin from early in development, which is associated to fetal weight and adiposity. Adiponectin, an insulin-sensitizing adipokine, is downregulated in maternal obesity. High molecular weight (HMW) adiponectin is the most abundant form and with most biological actions. In maternal obesity lower total and HMW adiponectin levels have been described in the mother, paralleled with high levels in the umbilical cord. Several studies have found that cord blood adiponectin levels are related with postnatal growth trajectories, and it has been suggested that low adiponectin levels in women with pregestational obesity enhance placental insulin sensitivity and activation of placental amino acid transport systems, supporting fetal overgrowth. The possible mechanisms by which maternal pregestational obesity, focusing in the actions of leptin and adiponectin, affects the fetal development and postnatal growth trajectories in their offspring are discussed.
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Affiliation(s)
| | | | | | - M Lépez
- School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - K Carrasco-Negüe
- Department of Obstetrics, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - P Casanello
- Department of Obstetrics, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile; Department of Neonatology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
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17
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Abreu LRS, Shirley MK, Castro NP, Euclydes VV, Bergamaschi DP, Luzia LA, Cruz AM, Rondó PHC. Gestational diabetes mellitus, pre-pregnancy body mass index, and gestational weight gain as risk factors for increased fat mass in Brazilian newborns. PLoS One 2019; 14:e0221971. [PMID: 31465493 PMCID: PMC6715169 DOI: 10.1371/journal.pone.0221971] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Accepted: 08/15/2019] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Gestational diabetes mellitus (GDM) is a common complication of pregnancy. It may predispose offspring to increased fat mass (FM) and the development of obesity, however few data from Latin America exist. OBJECTIVE To investigate the influence of GDM on newborn FM in mother-newborn pairs recruited from a public maternity care center in São Paulo, Brazil. METHODS Data were collected cross-sectionally in 2013-2014 from 72 mothers diagnosed with GDM, and 211 mothers with normal glucose tolerance (NGT). Newborn FM was evaluated by air-displacement plethysmography (PEA POD), and relevant demographic and obstetric data were collected from hospital records. Associations between maternal GDM status and newborn FM were investigated by multiple linear regression analysis, with adjustment for maternal age, pre-pregnancy BMI, gestational weight gain, type of delivery, sex of the child, and gestational age. RESULTS FM was greater in GDM versus NGT newborns in a bivariable model (Median (IQR), GDM: 0.35 (0.3) kg vs. NGT: 0.27 (0.2) kg, p = 0.02), however GDM status was not a significant predictor of FM with adjustment for other variables. Rather, pre-pregnancy BMI (coefficient (β) 1.46; 95% confidence interval (CI) 0.66, 2.27), gestational weight gain (β 1.32; 95% CI 0.49, 2.15), and male sex (β -17.8; 95% CI -27.2, -8.29) predicted newborn FM. Analyzing GDM and NGT groups separately, pre-pregnancy BMI (β 6.75; 95% CI 2.36, 11.1) and gestational weight gain (β 5.64; 95% CI 1.16, 10.1) predicted FM in the GDM group, while male sex alone predicted FM in the NGT group (β -12.3; 95% CI -18.3, -6.34). CONCLUSIONS Combined model results suggest that in our cohort, pre-pregnancy BMI and gestational weight gain are more important risk factors for increased neonatal FM than GDM. However, group-specific model results suggest that GDM status may contribute to variation in the relationship between maternal/offspring factors and FM. Our use of a binary GDM variable in the combined model may have precluded clearer results on this point. Prospective cohort studies including data on maternal pre-pregnancy BMI, GWG, and glycemic profile are needed to better understand associations among these variables and their relative influence on offspring FM.
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Affiliation(s)
- Laísa R. S. Abreu
- Nutrition Department, School of Public Health, University of São Paulo, São Paulo, SP, Brazil
| | - Meghan K. Shirley
- Nutrition Department, School of Public Health, University of São Paulo, São Paulo, SP, Brazil
- * E-mail:
| | - Natália P. Castro
- Nutrition Department, School of Public Health, University of São Paulo, São Paulo, SP, Brazil
| | - Verônica V. Euclydes
- Nutrition Department, School of Public Health, University of São Paulo, São Paulo, SP, Brazil
| | - Denise P. Bergamaschi
- Epidemiology Department, School of Public Health, University of São Paulo, São Paulo, SP, Brazil
| | - Liania A. Luzia
- Nutrition Department, School of Public Health, University of São Paulo, São Paulo, SP, Brazil
| | - Ana M. Cruz
- Geraldo de Paula Souza Health Center, School of Public Health, University of São Paulo, São Paulo, SP, Brazil
| | - Patrícia H. C. Rondó
- Nutrition Department, School of Public Health, University of São Paulo, São Paulo, SP, Brazil
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Chen L, Merkhan MM, Forsyth NR, Wu P. Chorionic and amniotic membrane-derived stem cells have distinct, and gestational diabetes mellitus independent, proliferative, differentiation, and immunomodulatory capacities. Stem Cell Res 2019; 40:101537. [PMID: 31422237 DOI: 10.1016/j.scr.2019.101537] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 06/25/2019] [Accepted: 08/12/2019] [Indexed: 12/19/2022] Open
Abstract
Placental membrane-derived mesenchymal stem cells (MSCs), with the advantages of being non-invasive and having fewer ethical issues, are a promising source for cell therapy. Gestational diabetes (GDM) alters the uterine environment and may affect the therapeutic potential of MSCs derived from placenta. Therefore, we evaluated the biological properties of amniotic (AMSCs) and chorionic membrane MSCs (CMSCs) from human GDM placenta in order to explore their therapeutic potential. In comparison of GDM-/Healthy- CMSCs and AMSCs, the immunophenotypes and typical stellate morphology of MSC were similar in CMSCs irrespective of disease state while the MSC morphology in GDM-AMSCs was less evident. GDM- and Healthy- CMSCs displayed an enhanced proliferation rate and tri-lineage differentiation capacity compared with AMSCs. Notably, GDM-CMSCs had a significantly increased adipogenic ability than Healthy-CMSCs accompanied by increased transcriptional responsiveness of PPARγ and ADIPOQ induction. The secretome effect of Healthy- and GDM- CMSCs/AMSCs by using conditioned media and coculture experiments, suggests that GDM- and Healthy- CMSCs provided an equivalent immunoregulatory effect on suppressing T-cells activation but a reduced effect of GDM-CMSCs on macrophage regulation. However, Healthy- and GDM- CMSCs displayed a superior immunomodulatory capacity in regulation of both T-cells and macrophages than AMSCs. In summary, we highlight the importance of the maternal GDM intrauterine environment during pregnancy and its impact on CMSCs/AMSCs proliferation ability, CMSCs adipogenic potential, and macrophage regulatory capacity.
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Affiliation(s)
- Liyun Chen
- Guy Hilton Research Centre, School of Pharmacy and Bioengineering, Keele University, Stoke-on-Trent, UK.
| | - Marwan M Merkhan
- Guy Hilton Research Centre, School of Pharmacy and Bioengineering, Keele University, Stoke-on-Trent, UK; College of Pharmacy, University of Mosul, Mosul, Iraq
| | - Nicholas R Forsyth
- Guy Hilton Research Centre, School of Pharmacy and Bioengineering, Keele University, Stoke-on-Trent, UK.
| | - Pensee Wu
- Guy Hilton Research Centre, School of Pharmacy and Bioengineering, Keele University, Stoke-on-Trent, UK; Academic Unit of Obstetrics and Gynaecology, University Hospital of North Midlands, Stoke-on-Trent, UK; Keele Cardiovascular Research Group, Institute for Applied Clinical Sciences and Centre for Prognosis Research, Institute of Primary Care and Health Sciences, Keele University, Stoke-on-Trent, UK.
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de Brito Alves JL, de Oliveira Y, Carvalho NNC, Cavalcante RGS, Pereira Lira MM, Nascimento LCPD, Magnani M, Vidal H, Braga VDA, de Souza EL. Gut microbiota and probiotic intervention as a promising therapeutic for pregnant women with cardiometabolic disorders: Present and future directions. Pharmacol Res 2019; 145:104252. [PMID: 31054952 DOI: 10.1016/j.phrs.2019.104252] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 04/10/2019] [Accepted: 04/30/2019] [Indexed: 12/12/2022]
Abstract
Maternal cardiometabolic disorders, such as gestational diabetes mellitus, pre-eclampsia, obesity, and dyslipidemia, are the most common conditions that predispose offspring to risk for future cardiometabolic diseases, needing appropriate therapeutic approach. The implications of microbiota in the pathophysiology of maternal cardiometabolic disorders are progressively emerging and probiotics may be a simple and safe therapeutic strategy for maternal cardiometabolic management. In this review, we argue the importance of cardiometabolic dysfunction during pregnancy and/or lactation on the offspring risk for cardiometabolic disease in later life. In addition, we comprehensively discuss the microbial diversity observed in maternal cardiometabolic disorders and we present the main findings on probiotic intervention as a potential strategy for management of maternal cardiometabolic disorders. Current data reveal that gut microbiota may be transmitted from mother to offspring. Whether targeting microbiota with probiotic intervention during the periconceptional period prevents or delays the onset of cardiometabolic disorders in adult offspring should be tested in future clinical trials.
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Affiliation(s)
- José Luiz de Brito Alves
- Department of Nutrition, Health Sciences Center, Federal University of Paraíba, João Pessoa, Brazil.
| | - Yohanna de Oliveira
- Department of Nutrition, Health Sciences Center, Federal University of Paraíba, João Pessoa, Brazil
| | | | | | | | | | - Marciane Magnani
- Department of Food Engineering, Technology Center, Federal University of Paraiba, Joao Pessoa, Brazil
| | - Hubert Vidal
- Univ-Lyon, CarMeN(Cardio, Metabolism,Diabetes and Nutrition) Laboratory, INSERM U1060, INRA U1397, Université Claude Bernard Lyon 1, INSA Lyon, Oullins, France
| | - Valdir de Andrade Braga
- Department of Biotechnology, Biotechnology Center, Federal University of Paraíba, João Pessoa, PB, Brazil
| | - Evandro Leite de Souza
- Department of Nutrition, Health Sciences Center, Federal University of Paraíba, João Pessoa, Brazil
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20
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Telschow A, Ferrari N, Deibert C, Flöck A, Merz WM, Gembruch U, Ehrhardt C, Dötsch J, Graf C. High Maternal and Low Cord Blood Leptin Are Associated with BMI-SDS Gain in the First Year of Life. Obes Facts 2019; 12:575-585. [PMID: 31593957 PMCID: PMC6876596 DOI: 10.1159/000502421] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Accepted: 07/29/2019] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Early infant weight development influences metabolic regulation later in life. For the prevention of obesity and metabolic diseases, it is important to understand the underlying mechanisms in detail. OBJECTIVES This study aims to examine the effects of maternal anthropometric, sociodemographic, and lifestyle factors on maternal and cord blood leptin levels at birth and on the development of body mass index (BMI) standard deviation scores (SDS) in offspring up to 1 year of age. METHODS Seventy-six mother-child pairs were enrolled in this follow-up analysis in a cross-sectional design. Standardized questionnaires were used to collect information regarding maternal anthropometrics, lifestyle habits, and sociodemographic conditions, and newborn weight, or, rather, BMI-SDS, development during the first year of life. RESULTS Cord blood leptin (β = -0.222, p = 0.074), maternal leptin (β = 0.414, p = 0.001), and female sex of the offspring (β = 0.385, p = 0.003) explained 29.0% of the variance in BMI-SDS changes in the first year of life. Cord blood leptin was influenced by newborn sex (male; β = -0.220, p = 0.025) and maternal moderate-intensity physical activity in the third trimester (β = 0.265, p = 0.007, corr. R2 = 9.2%); maternal leptin was influenced by maternal prepregnancy BMI (β = 0.602, p < 0.001) and weight gain during pregnancy (β = 0.247, p = 0.004, corr. R2 = 35.5%). CONCLUSIONS Higher maternal and lower cord blood leptin levels are associated with a higher BMI-SDS increase during the first year of life. Maternal leptin is influenced by maternal BMI and weight gain during pregnancy, and cord blood leptin is influenced by maternal physical activity; therefore, it can be suggested that an active and healthy maternal lifestyle may play a pivotal and beneficial role in the offspring's weight development.
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Affiliation(s)
| | - Nina Ferrari
- Cologne Center for Prevention in Childhood and Youth/Heart Center Cologne, University Hospital of Cologne, Cologne, Germany
- Department for Physical Activity in Public Health, Institute of Movement and Neurosciences, German Sport University Cologne, Cologne, Germany
| | | | - Anne Flöck
- Department of Obstetrics and Prenatal Medicine, University of Bonn Medical School, Bonn, Germany
| | - Waltraut M Merz
- Department of Obstetrics and Prenatal Medicine, University of Bonn Medical School, Bonn, Germany
| | - Ulrich Gembruch
- Department of Obstetrics and Prenatal Medicine, University of Bonn Medical School, Bonn, Germany
| | - Christina Ehrhardt
- Department for Physical Activity in Public Health, Institute of Movement and Neurosciences, German Sport University Cologne, Cologne, Germany
| | - Jörg Dötsch
- Department of Pediatrics and Adolescent Medicine, University Hospital of Cologne, Cologne, Germany
| | - Christine Graf
- Department for Physical Activity in Public Health, Institute of Movement and Neurosciences, German Sport University Cologne, Cologne, Germany
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21
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Zhao BH, Jiang Y, Zhu H, Xi FF, Chen Y, Xu YT, Liu F, Wang YY, Hu WS, Lv WG, Luo Q. Placental Delta-Like 1 Gene DNA Methylation Levels Are Related to Mothers' Blood Glucose Concentration. J Diabetes Res 2019; 2019:9521510. [PMID: 31886292 PMCID: PMC6927055 DOI: 10.1155/2019/9521510] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Accepted: 11/04/2019] [Indexed: 12/20/2022] Open
Abstract
PURPOSE We aim to identify the methylation status of delta-like 1 (DLK1) in the placenta and the correlation between DLK1 methylation and maternal serum glucose level and fetal birth weight. METHODS We analyzed the gene expression of DLK1 gene in both maternal and fetal sides of the placenta in a GDM group (n = 15) and a control group (n = 15) using real-time polymerase chain reaction. With MethylTargetTM technique, we detected the methylation status of DLK1 promotor in the placenta. Furthermore, Pearson's correlation was used to confirm the association of methylation alteration of DLK1 promoter and maternal 2 h OGTT glucose level and fetal birth weight. RESULTS In our study, we found that DLK1 expression in both maternal and fetal sides of the placenta decreased significantly in GDM group compared with control group, and it was caused by hypermethylation of DLK1 promoter region. Additionally, the methylation status of DLK1 gene in the maternal side of the placenta highly correlated with maternal 2 h OGTT glucose level (coefficient = 0.7968, P < 0.0001), while the methylation status in the fetal side of the placenta was closely related to fetal birth weight (coefficient = 0.6233, P < 0.0001). CONCLUSIONS Our results demonstrated that altered expression of DLK1 was caused by the hypermethylation of DLK1 promoter region in the placenta, and intrauterine exposure to GDM has long-lasting effects on the epigenome of the offspring.
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Affiliation(s)
- Bai-Hui Zhao
- Department of Obstetrics, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Ying Jiang
- Department of Obstetrics, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Hong Zhu
- Department of Obstetrics and Gynecology, The International Peace Maternity and Child Health Hospital of China Welfare institute, Shanghai, China
| | - Fang-Fang Xi
- Department of Obstetrics, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yuan Chen
- Department of Obstetrics, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Ye-Tao Xu
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Fang Liu
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Ya-Yun Wang
- Department of Obstetrics, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Wen-Sheng Hu
- Department of Obstetrics, Maternal and Child Health Care Hospital, Hangzhou, China
| | - Wei-Guo Lv
- Department of Obstetrics, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Qiong Luo
- Department of Obstetrics, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China
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22
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Brei C, Much D, Brunner S, Stecher L, Hauner H. Longitudinal sonographic assessment of abdominal fat distribution from 2 to 5 years of age. Pediatr Res 2018; 84:677-683. [PMID: 30135594 DOI: 10.1038/s41390-018-0147-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 07/06/2018] [Accepted: 07/09/2018] [Indexed: 01/02/2023]
Abstract
BACKGROUND To better understand children's adipose tissue (AT) development and distribution, longitudinal data from direct assessment methods are valuable. Previously, we reported sonographic data on abdominal subcutaneous and preperitoneal fat areas ≤1 year of age. METHODS Sonographic measurements were annually pursued to assess the development of fat compartments in 2-5 year-old children. The effect of sex and correlations with comprehensive anthropometry (e.g., BMI percentiles, skinfold thickness (SFT) measurements, and waist circumference) are presented. RESULTS Subcutaneous fat areas increased modestly and were significantly greater in females at each time point investigated. Preperitoneal fat area increased significantly over time (all P values < 0.001) with greater area in females from 3 years onward (e.g., at 3 years estimated mean difference -4.8 mm2; 95% CI: -8.6, -0.9; P = 0.016). The strongest correlations for subcutaneous fat area were consistently observed for SFT measurements. Preperitoneal fat area showed rather weak to moderate correlations, with greater correlation coefficients for SFT measurements compared to waist circumference. CONCLUSION For the first time, longitudinal ultrasound data on abdominal body fat covering preschool age are presented. Evaluation revealed a differential development of fat compartments, depending on children's age and sex with SFT measurements as the best predictor for both fat depots.
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Affiliation(s)
- Christina Brei
- Else Kröner-Fresenius-Center for Nutritional Medicine, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Daniela Much
- Else Kröner-Fresenius-Center for Nutritional Medicine, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Stefanie Brunner
- Else Kröner-Fresenius-Center for Nutritional Medicine, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Lynne Stecher
- Else Kröner-Fresenius-Center for Nutritional Medicine, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Hans Hauner
- Else Kröner-Fresenius-Center for Nutritional Medicine, Klinikum rechts der Isar, Technische Universität München, Munich, Germany. .,ZIEL, Institute for Food and Health, Nutritional Medicine Unit, Technische Universität München, Freising, Germany.
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23
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Meyer DM, Brei C, Stecher L, Brunner S, Hauner H. Maternal insulin resistance, triglycerides and cord blood insulin are not determinants of offspring growth and adiposity up to 5 years: a follow-up study. Diabet Med 2018; 35:1399-1403. [PMID: 29938825 DOI: 10.1111/dme.13765] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/20/2018] [Indexed: 12/14/2022]
Abstract
AIMS Metabolic dysregulation in utero may influence fetal metabolism and early growth. We previously investigated relationships between maternal indices of glucose homeostasis and triglycerides as well as cord blood insulin with offspring anthropometry up to 2 years. The aim of this analysis was to follow these relationships up to the age of 5 years. METHODS Associations between maternal metabolic variables of glucose and lipid metabolism measured at 32 weeks' gestation and cord blood insulin with growth and body composition of 162 offspring aged 3-5 years were explored. Both indirect (i.e. body weight, BMI percentiles, sum of four skinfold thicknesses) and direct (i.e. ultrasonography, magnetic resonance imaging in a subgroup) measurement techniques were employed. RESULTS Maternal metabolic indices were largely unrelated to child body composition. Cord blood insulin was negatively associated with fat mass and lean body mass at 3 years in unadjusted analyses, and the sum of four skinfold thicknesses and body fat percentage in adjusted analyses, whereas the association with lean body mass was no longer observed. An inverse relationship between cord blood insulin and weight gain up to 5 years was observed in girls only with small effect sizes. CONCLUSIONS Results from this follow-up do not provide convincing evidence that these markers are independently related to offspring growth and adiposity in early childhood. Although cord blood insulin was weakly inversely related to weight gain in girls at 5 years, we cannot conclude that the observed changes in outcomes are clinically meaningful. (Clinical Trials Registry No: NCT00362089).
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Affiliation(s)
- D M Meyer
- Else Kröner-Fresenius-Center for Nutritional Medicine, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - C Brei
- Else Kröner-Fresenius-Center for Nutritional Medicine, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - L Stecher
- Else Kröner-Fresenius-Center for Nutritional Medicine, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - S Brunner
- Else Kröner-Fresenius-Center for Nutritional Medicine, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - H Hauner
- Else Kröner-Fresenius-Center for Nutritional Medicine, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
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24
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Houshmand-Oeregaard A, Hansen NS, Hjort L, Kelstrup L, Broholm C, Mathiesen ER, Clausen TD, Damm P, Vaag A. Differential adipokine DNA methylation and gene expression in subcutaneous adipose tissue from adult offspring of women with diabetes in pregnancy. Clin Epigenetics 2017; 9:37. [PMID: 28413567 PMCID: PMC5390345 DOI: 10.1186/s13148-017-0338-2] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2016] [Accepted: 03/31/2017] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Offspring of women with diabetes in pregnancy are at increased risk of type 2 diabetes mellitus (T2DM), potentially mediated by epigenetic mechanisms. The adipokines leptin, adiponectin, and resistin (genes: LEP, ADIPOQ, RETN) play key roles in the pathophysiology of T2DM. We hypothesized that offspring exposed to maternal diabetes exhibit alterations in epigenetic regulation of subcutaneous adipose tissue (SAT) adipokine transcription. We studied adipokine plasma levels, SAT gene expression, and DNA methylation of LEP, ADIPOQ, and RETN in adult offspring of women with gestational diabetes (O-GDM, N = 82) or type 1 diabetes (O-T1DM, N = 67) in pregnancy, compared to offspring of women from the background population (O-BP, N = 57). RESULTS Compared to O-BP, we found elevated plasma leptin and resistin levels in O-T1DM, decreased gene expression of all adipokines in O-GDM, decreased RETN expression in O-T1DM, and increased LEP and ADIPOQ methylation in O-GDM. In multivariate regression analysis, O-GDM remained associated with increased ADIPOQ methylation and decreased ADIPOQ and RETN gene expression and O-T1DM remained associated with decreased RETN expression after adjustment for potential confounders and mediators. CONCLUSIONS In conclusion, offspring of women with diabetes in pregnancy exhibit increased ADIPOQ DNA methylation and decreased ADIPOQ and RETN gene expression in SAT. However, altered methylation and expression levels were not reflected in plasma protein levels, and the functional implications of these findings remain uncertain.
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Affiliation(s)
- Azadeh Houshmand-Oeregaard
- Center for Pregnant Women with Diabetes, Department of Obstetrics, Rigshospitalet, Dept. 7821, Blegdamsvej 9, 2100 Copenhagen, Denmark.,Diabetes and Metabolism, Department of Endocrinology, Rigshospitalet, Copenhagen, Denmark.,Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Ninna S Hansen
- Diabetes and Metabolism, Department of Endocrinology, Rigshospitalet, Copenhagen, Denmark.,Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Danish Diabetes Academy/Danish PhD School of Molecular Metabolism, Odense, Denmark
| | - Line Hjort
- Diabetes and Metabolism, Department of Endocrinology, Rigshospitalet, Copenhagen, Denmark.,Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Danish Diabetes Academy/Danish PhD School of Molecular Metabolism, Odense, Denmark
| | - Louise Kelstrup
- Center for Pregnant Women with Diabetes, Department of Obstetrics, Rigshospitalet, Dept. 7821, Blegdamsvej 9, 2100 Copenhagen, Denmark.,Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Christa Broholm
- Diabetes and Metabolism, Department of Endocrinology, Rigshospitalet, Copenhagen, Denmark
| | - Elisabeth R Mathiesen
- Center for Pregnant Women with Diabetes, Department of Obstetrics, Rigshospitalet, Dept. 7821, Blegdamsvej 9, 2100 Copenhagen, Denmark.,Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Center for Pregnant Women with Diabetes, Department of Endocrinology, Rigshospitalet, Copenhagen, Denmark
| | - Tine D Clausen
- Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Department of Gynecology and Obstetrics, Nordsjaellands Hospital, University of Copenhagen, Hilleroed, Denmark
| | - Peter Damm
- Center for Pregnant Women with Diabetes, Department of Obstetrics, Rigshospitalet, Dept. 7821, Blegdamsvej 9, 2100 Copenhagen, Denmark.,Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Allan Vaag
- Diabetes and Metabolism, Department of Endocrinology, Rigshospitalet, Copenhagen, Denmark.,Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,AstraZeneca, Mölndal, Sweden
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25
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Musial B, Vaughan OR, Fernandez-Twinn DS, Voshol P, Ozanne SE, Fowden AL, Sferruzzi-Perri AN. A Western-style obesogenic diet alters maternal metabolic physiology with consequences for fetal nutrient acquisition in mice. J Physiol 2017; 595:4875-4892. [PMID: 28382681 PMCID: PMC5509867 DOI: 10.1113/jp273684] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 03/03/2017] [Indexed: 12/19/2022] Open
Abstract
KEY POINTS In the Western world, obesogenic diets containing high fat and high sugar (HFHS) are commonly consumed during pregnancy, although their effects on the metabolism of the mother, in relation to feto-placental glucose utilization and growth, are unknown. In the present study, the consumption of an obesogenic HFHS diet compromised maternal glucose tolerance and insulin sensitivity in late pregnancy in association with dysregulated lipid and glucose handling by the dam. These maternal metabolic changes induced by HFHS feeding were related to altered feto-placental glucose metabolism and growth. A HFHS diet during pregnancy therefore causes maternal metabolic dysfunction with consequences for maternal nutrient allocation for fetal growth. These findings have implications for the health of women and their infants, who consume obesogenic diets during pregnancy. ABSTRACT In the Western world, obesogenic diets containing high fat and high sugar (HFHS) are commonly consumed during pregnancy. However, the impacts of a HFHS diet during pregnancy on maternal insulin sensitivity and signalling in relation to feto-placental growth and glucose utilization are unknown. The present study examined the effects of a HFHS diet during mouse pregnancy on maternal glucose tolerance and insulin resistance, as well as, on feto-placental glucose metabolism. Female mice were fed a control or HFHS diet from day (D) 1 of pregnancy (term = D20.5). At D16 or D19, dams were assessed for body composition, metabolite and hormone concentrations, tissue abundance of growth and metabolic signalling pathways, glucose tolerance and utilization and insulin sensitivity. HFHS feeding perturbed maternal insulin sensitivity in late pregnancy; hepatic insulin sensitivity was higher, whereas sensitivity of the skeletal muscle and white adipose tissue was lower in HFHS than control dams. These changes were accompanied by increased adiposity and reduced glucose production and glucose tolerance of HFHS dams. The HFHS diet also disturbed the hormone and metabolite milieu and altered expression of growth and metabolic signalling pathways in maternal tissues. Furthermore, HFHS feeding was associated with impaired feto-placental glucose metabolism and growth. A HFHS diet during pregnancy therefore causes maternal metabolic dysfunction with consequences for maternal nutrient allocation for fetal growth. These findings have implications for the health of women and their infants, who consume HFHS diets during pregnancy.
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Affiliation(s)
- Barbara Musial
- Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge, UK
| | - Owen R Vaughan
- Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge, UK
| | - Denise S Fernandez-Twinn
- University of Cambridge Metabolic Research Laboratories, and MRC Metabolic Disease Unit, Wellcome Trust-MRC Institute of Metabolic Science, Addenbrooke's Hospital, Cambridge, UK
| | - Peter Voshol
- University of Cambridge Metabolic Research Laboratories, and MRC Metabolic Disease Unit, Wellcome Trust-MRC Institute of Metabolic Science, Addenbrooke's Hospital, Cambridge, UK
| | - Susan E Ozanne
- University of Cambridge Metabolic Research Laboratories, and MRC Metabolic Disease Unit, Wellcome Trust-MRC Institute of Metabolic Science, Addenbrooke's Hospital, Cambridge, UK
| | - Abigail L Fowden
- Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge, UK
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26
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Cauble JS, Dewi M, Hull HR. Validity of anthropometric equations to estimate infant fat mass at birth and in early infancy. BMC Pediatr 2017; 17:88. [PMID: 28347278 PMCID: PMC5368988 DOI: 10.1186/s12887-017-0844-6] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Accepted: 03/21/2017] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND In newborns and children, body fat estimation equations are often used at different ages than the age used to develop the equations. Limited validation studies exist for newborn body fat estimation equations at birth or later in infancy. The study purpose was to validate 4 newborn fat mass (FM) estimation equations in comparison to FM measured by air displacement plethysmography (ADP; the Pea Pod) at birth and 3 months. METHODS Ninety-five newborns (1-3 days) had their body composition measured by ADP and anthropometrics assessed by skinfolds. Sixty-three infants had repeat measures taken (3 months). FM measured by ADP was compared to FM from the skinfold estimation equations (Deierlein, Catalano, Lingwood, and Aris). Paired t-tests assessed mean differences, linear regression assessed accuracy, precision was assessed by R2 and standard error of the estimate (SEE), and bias was assessed by Bland-Altman plots. RESULTS At birth, FM measured by ADP differed from FM estimated by Deierlein, Lingwood and Aris equations, but did not differ from the Catalano equation. At 3 months, FM measured by ADP was different from all equations. At both time points, poor precision and accuracy was detected. Bias was detected in most all equations. CONCLUSIONS Poor agreement, precision, and accuracy were found between prediction equations and the criterion at birth and 3 months.
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Affiliation(s)
- Jennifer S Cauble
- Department of Dietetics and Nutrition, School of Health Professions, University of Kansas Medical Center, 3901 Rainbow BLVD, Mail Stop 4013, Kansas City, KS, 66160, USA
| | - Mira Dewi
- Department of Dietetics and Nutrition, School of Health Professions, University of Kansas Medical Center, 3901 Rainbow BLVD, Mail Stop 4013, Kansas City, KS, 66160, USA
| | - Holly R Hull
- Department of Dietetics and Nutrition, School of Health Professions, University of Kansas Medical Center, 3901 Rainbow BLVD, Mail Stop 4013, Kansas City, KS, 66160, USA.
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27
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O'brien CM, Poprzeczny A, Dodd JM. Implications of maternal obesity on fetal growth and the role of ultrasound. Expert Rev Endocrinol Metab 2017; 12:45-58. [PMID: 30058877 DOI: 10.1080/17446651.2017.1271707] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Over fifty percent of women entering pregnancy are overweight or obese. This has a significant impact on short and long term maternal and infant health outcomes, and the intergenerational effects of obesity are now a major public health problem globally. Areas covered: There are two major pathways contributing to fetal growth. Glucose and insulin directly affect growth, while other substrates such as leptin, adiponectin and insulin-like growth factors indirectly influence growth through structural and morphological effects on the placenta, uteroplacental blood flow, and regulation of placental transporters. Advances in ultrasonography over the past decade have led to interest in the prediction of the fetus at risk of overgrowth and adiposity utilizing both standard ultrasound biometry and fetal body composition measurements. However, to date there is no consensus regarding the definition of fetal overgrowth, its reporting, and clinical management. Expert commentary: Maternal dietary intervention targeting the antenatal period appear to be too late to sufficiently affect fetal growth. The peri-conceptual period and early pregnancy are being evaluated to determine if the intergenerational effects of maternal obesity can be altered to improve newborn, infant and child health.
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Affiliation(s)
- Cecelia M O'brien
- a School of Paediatrics and Reproductive Health, and Robinson Research Institute , University of Adelaide , Adelaide , Australia
- b Maternal Fetal Medicine Unit , John Hunter Hospital , Newcastle , Australia
| | - Amanda Poprzeczny
- a School of Paediatrics and Reproductive Health, and Robinson Research Institute , University of Adelaide , Adelaide , Australia
- c Department of Obstetrics and Gynaecology , Lyell McEwin Hospital , Adelaide , Australia
| | - Jodie M Dodd
- a School of Paediatrics and Reproductive Health, and Robinson Research Institute , University of Adelaide , Adelaide , Australia
- d Department of Perinatal Medicine, Women's and Babies Division , Women's and Children's Hospital , Adelaide , Australia
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28
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Guzmán-Bárcenas J, Hernández JA, Arias-Martínez J, Baptista-González H, Ceballos-Reyes G, Irles C. Estimation of umbilical cord blood leptin and insulin based on anthropometric data by means of artificial neural network approach: identifying key maternal and neonatal factors. BMC Pregnancy Childbirth 2016; 16:179. [PMID: 27440187 PMCID: PMC4955136 DOI: 10.1186/s12884-016-0967-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Accepted: 07/12/2016] [Indexed: 01/07/2023] Open
Abstract
Background Leptin and insulin levels are key factors regulating fetal and neonatal energy homeostasis, development and growth. Both biomarkers are used as predictors of weight gain and obesity during infancy. There are currently no prediction algorithms for cord blood (UCB) hormone levels using Artificial Neural Networks (ANN) that have been directly trained with anthropometric maternal and neonatal data, from neonates exposed to distinct metabolic environments during pregnancy (obese with or without gestational diabetes mellitus or lean women). The aims were: 1) to develop ANN models that simulate leptin and insulin concentrations in UCB based on maternal and neonatal data (ANN perinatal model) or from only maternal data during early gestation (ANN prenatal model); 2) To evaluate the biological relevance of each parameter (maternal and neonatal anthropometric variables). Methods We collected maternal and neonatal anthropometric data (n = 49) in normoglycemic healthy lean, obese or obese with gestational diabetes mellitus women, as well as determined UCB leptin and insulin concentrations by ELISA. The ANN perinatal model consisted of an input layer of 12 variables (maternal and neonatal anthropometric and biochemical data from early gestation and at term) while the ANN prenatal model used only 6 variables (maternal anthropometric from early gestation) in the input layer. For both networks, the output layer contained 1 variable to UCB leptin or to UCB insulin concentration. Results The best architectures for the ANN perinatal models estimating leptin and insulin were 12-5-1 while for the ANN prenatal models, 6-5-1 and 6-4-1 were found for leptin and insulin, respectively. ANN models presented an excellent agreement between experimental and simulated values. Interestingly, the use of only prenatal maternal anthropometric data was sufficient to estimate UCB leptin and insulin values. Maternal BMI, weight and age as well as neonatal birth were the most influential parameters for leptin while maternal morbidity was the most significant factor for insulin prediction. Conclusions Low error percentage and short computing time makes these ANN models interesting in a translational research setting, to be applied for the prediction of neonatal leptin and insulin values from maternal anthropometric data, and possibly the on-line estimation during pregnancy. Electronic supplementary material The online version of this article (doi:10.1186/s12884-016-0967-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- José Guzmán-Bárcenas
- Department of Physiology and Cellular Development, Instituto Nacional de Perinatología Isidro Espinoza de los Reyes (INPerIER), Montes Urales 800, Lomas de Virreyes, Mexico city, C.P. 11000, Mexico
| | - José Alfredo Hernández
- Centro de Investigación en Ingeniería y Ciencias Aplicadas (CIICAp)-Universidad Autónoma del Estado de Morelos (UAEM), Cuernavaca, Morelos, Mexico
| | - Joel Arias-Martínez
- Departmento de Ciencias de la Salud-Universidad de Sonora, Campus Cajeme, Sonora, Mexico
| | - Héctor Baptista-González
- Department of Physiology and Cellular Development, Instituto Nacional de Perinatología Isidro Espinoza de los Reyes (INPerIER), Montes Urales 800, Lomas de Virreyes, Mexico city, C.P. 11000, Mexico
| | - Guillermo Ceballos-Reyes
- Laboratorio Multidisciplinario y Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Mexico City, Mexico
| | - Claudine Irles
- Department of Physiology and Cellular Development, Instituto Nacional de Perinatología Isidro Espinoza de los Reyes (INPerIER), Montes Urales 800, Lomas de Virreyes, Mexico city, C.P. 11000, Mexico.
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Garcia-Flores J, Cruceyra M, Cañamares M, Garicano A, Nieto O, Espada M, Lopez A, Tamarit I, Sainz De La Cuesta R. Weight-related and analytical maternal factors in gestational diabetes to predict birth weight and cord markers of diabetic fetopathy. Gynecol Endocrinol 2016; 32:548-52. [PMID: 26829514 DOI: 10.3109/09513590.2016.1138461] [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: 11/13/2022] Open
Abstract
OBJECTIVE The objective was to determine the value of clinical and analytical maternal factors to predict birth weight and umbilical cord biochemical markers of diabetic fetopathy. METHODS Prospective evaluation of gestational diabetes pregnancies (n = 50). Maternal weight-related clinical and analytical factors were collected during pregnancy. After birth, an umbilical cord sample was taken. RESULTS Univariate linear regression analysis showed relationship between maternal weight, glycated hemoglobin (HbA1c) and insulin-like growth factor 1 (IGF1) with birth weight percentile. A significant association was found between maternal weight and cord insulin and C-peptide. Maternal HbA1c, leptin and insulin during pregnancy showed a positive linear association to cord leptin, insulin and C-peptide. In multivariate analysis models, final maternal BMI showed an independent positive association with cord C-peptide. CONCLUSIONS Maternal weight-related and analytical parameters show diagnostic value to birth weight and cord markers.
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Affiliation(s)
- Jose Garcia-Flores
- a High-Risk Pregnancy Unit, Obstetrics & Gynecology Department, Hospital Universitario Quiron Madrid , Spain and
| | - Mireia Cruceyra
- a High-Risk Pregnancy Unit, Obstetrics & Gynecology Department, Hospital Universitario Quiron Madrid , Spain and
| | - Marina Cañamares
- a High-Risk Pregnancy Unit, Obstetrics & Gynecology Department, Hospital Universitario Quiron Madrid , Spain and
| | - Ainhoa Garicano
- a High-Risk Pregnancy Unit, Obstetrics & Gynecology Department, Hospital Universitario Quiron Madrid , Spain and
| | - Olga Nieto
- a High-Risk Pregnancy Unit, Obstetrics & Gynecology Department, Hospital Universitario Quiron Madrid , Spain and
| | - Mercedes Espada
- a High-Risk Pregnancy Unit, Obstetrics & Gynecology Department, Hospital Universitario Quiron Madrid , Spain and
| | - Ana Lopez
- b Clinical Analysis Department, Hospital Universitario Quiron Madrid , Pozuelo de Alarcon , Spain
| | - Ines Tamarit
- a High-Risk Pregnancy Unit, Obstetrics & Gynecology Department, Hospital Universitario Quiron Madrid , Spain and
| | - Ricardo Sainz De La Cuesta
- a High-Risk Pregnancy Unit, Obstetrics & Gynecology Department, Hospital Universitario Quiron Madrid , Spain and
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El-Mazary AAM, Nasif KA, Abdel-Hakeem GL, Sherif T, Farouk E, El-Gezawy EM. Adiponectin, leptin and insulin levels at birth and in early postnatal life in neonates with hypoxic ischemic encephalopathy. J Diabetes Metab Disord 2015; 14:87. [PMID: 26629481 PMCID: PMC4666056 DOI: 10.1186/s40200-015-0219-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Accepted: 11/30/2015] [Indexed: 01/05/2023]
Abstract
Background Hypoxic ischemic encephalopathy (HIE) occurs in one to three per 1000 live full-term births. Fifteen to twenty percent will die in the postnatal period, and an additional 25 % will develop severe and permanent neuropsychological sequalae. The control of growth and nutritional status in the fetus and neonate is a complex mechanism, in which also hormones produced by adipose tissue, such as adiponectin and leptin are involved. The aim of this study was to measure the levels of adiponectin, leptin and insulin in neonates with HIE at birth and in early postnatal life and comparing them with normal healthy AGA and SGA neonates Methods This study carried out on 80 full-term neonates born in Minia university hospital during the period from May 2013 to December 2014. They were divided into group I included 25 neonates with HIE and group II included 55 normal healthy neonates (30 appropriate for gestational age (AGA) and 25 small for gestational age (SGA)). Weight, length, head circumference, body mass index (BMI), glucose, adiponectin, leptin and insulin levels were measured for all neonates. Adiponectin, leptin and insulin levels were compared between neonates with HIE and normal healthy neonates as well as between AGA and SGA neonates at birth, 2nd and 6th days of life. Results Adiponectin and leptin levels were significantly higher at birth then began to decrease during the first postnatal week in all neonates while insulin level increased during the same period. Serum adiponectin levels were significantly lower while serum leptin and insulin levels were significantly higher in neonates with HIE than healthy neonates. In all neonates, the serum adiponectin level was positively correlated at birth with weight, length, BMI and leptin levels but not with insulin level. In neonates with HIE, serum adiponectin level was not correlated with weight, BMI, leptin level or insulin level. In all neonates, the serum leptin level was positively correlated at birth with body weight, height and BMI. In neonates with HIE serum leptin levels were not correlated with weight, BMI or insulin level after birth. There were no correlations between either leptin or adiponectin serum levels or any of the studied parameters in neonates with HIE Conclusions Neonates who are suffering from HIE had lower serum levels of adiponectin and higher serum levels of leptin and insulin than normal healthy neonates at birth and during the early postnatal period. The decline of leptin and increased the insulin levels after birth in all neonates may be important for the stimulation of feeding behavior and the acquisition of energy homeostasis during the early postnatal life. Positive significant correlations between adiponectin, leptin, body weight and body mass indices were present in normal healthy neonates but not in neonates with HIE reflecting the effect of hypoxia on the regulatory mechanisms controlling the adipose tissue functions.
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Affiliation(s)
| | - Khalid A Nasif
- Biochemistry Department, Faculty of Medicine, Minia University, Minya, Egypt
| | | | - Tahra Sherif
- Clinical pathology Department, Faculty of Medicine, Assuit University, Assuit, Egypt
| | - Ebtesam Farouk
- Clinical pathology Department, Faculty of Medicine, Assuit University, Assuit, Egypt
| | - Ebtesam M El-Gezawy
- Clinical pathology Department, Faculty of Medicine, Assuit University, Assuit, Egypt
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Aye ILMH, Jansson T, Powell TL. TNF-α stimulates System A amino acid transport in primary human trophoblast cells mediated by p38 MAPK signaling. Physiol Rep 2015; 3:3/10/e12594. [PMID: 26508738 PMCID: PMC4632960 DOI: 10.14814/phy2.12594] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Maternal obesity and gestational diabetes mellitus (GDM) increase the risk of delivering infants that are large for gestational age with greater adiposity, who are prone to the development of metabolic disease in childhood and beyond. These maternal conditions are also associated with increased levels of the proinflammatory cytokine TNF-α in maternal tissues and the placenta. Recent evidence suggests that changes in placental amino acid transport contribute to altered fetal growth. TNF-α was previously shown to stimulate System A amino acid transport in primary human trophoblasts (PHTs), however the molecular mechanisms remain unknown. In this study, we tested the hypothesis that TNF-α regulates amino acid uptake in cultured PHTs by a mitogen-activated protein kinase (MAPK)-dependent mechanism. Treatment of PHTs with TNF-α significantly increased System A amino acid transport, as well as Erk and p38 MAPK signaling. Pharmacological antagonism of p38, but not Erk MAPK activity, inhibited TNF-α stimulated System A activity. Silencing of p38 MAPK using siRNA transfections prevented TNF-α stimulated System A transport in PHTs. TNF-α significantly increased the protein expression of System A transporters SNAT1 and SNAT2, but did not affect their mRNA expression. The effects of TNF-α on SNAT1 and SNAT2 protein expression were reversed by p38 MAPK siRNA silencing. In conclusion, TNF-α regulates System A activity through increased SNAT1 and SNAT2 transporter protein expression in PHTs. These findings suggest that p38 MAPK may represent a critical mechanistic link between elevated proinflammatory cytokines and increased placental amino acid transport in obese and GDM pregnancies associated with fetal overgrowth.
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Affiliation(s)
- Irving L M H Aye
- Division of Reproductive Sciences, Department of Obstetrics and Gynecology, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Thomas Jansson
- Division of Reproductive Sciences, Department of Obstetrics and Gynecology, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Theresa L Powell
- Division of Reproductive Sciences, Department of Obstetrics and Gynecology, University of Colorado Anschutz Medical Campus, Aurora, Colorado Section of Neonatology, Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado
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Carolan-Olah M, Duarte-Gardea M, Lechuga J. A critical review: early life nutrition and prenatal programming for adult disease. J Clin Nurs 2015; 24:3716-29. [PMID: 26255862 DOI: 10.1111/jocn.12951] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/13/2015] [Indexed: 12/17/2022]
Abstract
AIM AND OBJECTIVE To present the evidence in relation to early life nutrition and foetal programming for adult disease. BACKGROUND Epigenetics is a new and growing area of study investigating the impact of the intrauterine environment on the lifelong health of individuals. DESIGN Discursive paper. METHOD Searches were conducted in a range of electronic health databases. Hand searches located additional articles for review. Maternal search terms included: pregnancy; nutrition; diet; obesity; over nutrition; under nutrition. Offspring related search terms included: macrosomia; intrauterine growth restriction; epigenetics; foetal programming; childhood obesity; adolescent obesity; adolescent type 2 diabetes. DISCUSSION Results indicate that foetal programming for adult disease occurs in response to particular insults during vulnerable developmental periods. Four main areas of foetal exposure were identified in this review: (1) under nutrition; (2) over nutrition; (3) gestational diabetes mellitus; and (4) infant catch-up growth. Numerous studies also described the trans-generational nature of foetal programming. CONCLUSIONS Overall, foetal exposure to excess or insufficient nutrition during vulnerable developmental periods appears to result in a lifelong predisposition to obesity and adult disease, such as type 2 diabetes and cardiac disease. For the infant who has been undernourished during early life, a predisposition to renal disease also occurs. RELEVANCE TO CLINICAL PRACTICE Pregnancy is a time when women are engaged in health systems and are receptive to health messages. These factors suggest that pregnancy may be an optimal time for dietary education and intervention. There is a particular need for education on healthy diet and for interventions which aim to limit over consumption of calories.
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Affiliation(s)
- Mary Carolan-Olah
- College of Health and Biomedicine, Nursing and Midwifery, St Alban's Campus, Victoria University, Melbourne, Vic., Australia
| | - Maria Duarte-Gardea
- Department of Public Health Sciences, College of Health Sciences, The University of Texas at El Paso, El Paso, TX, USA
| | - Julia Lechuga
- Department of Psychology, College of Health Sciences, The University of Texas at El Paso, El Paso, TX, USA
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Gaccioli F, Aye ILMH, Roos S, Lager S, Ramirez VI, Kanai Y, Powell TL, Jansson T. Expression and functional characterisation of System L amino acid transporters in the human term placenta. Reprod Biol Endocrinol 2015; 13:57. [PMID: 26050671 PMCID: PMC4462079 DOI: 10.1186/s12958-015-0054-8] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2014] [Accepted: 05/28/2015] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND System L transporters LAT1 (SLC7A5) and LAT2 (SLC7A8) mediate the uptake of large, neutral amino acids in the human placenta. Many System L substrates are essential amino acids, thus representing crucial nutrients for the growing fetus. Both LAT isoforms are expressed in the human placenta, but the relative contribution of LAT1 and LAT2 to placental System L transport and their subcellular localisation are not well established. Moreover, the influence of maternal body mass index (BMI) on placental System L amino acid transport is poorly understood. Therefore the aims of this study were to determine: i) the relative contribution of the LAT isoforms to System L transport activity in primary human trophoblast (PHT) cells isolated from term placenta; ii) the subcellular localisation of LAT transporters in human placenta; and iii) placental expression and activity of System L transporters in response to maternal overweight/obesity. METHODS System L mediated leucine uptake was measured in PHT cells after treatment with si-RNA targeting LAT1 and/or LAT2. The localisation of LAT isoforms was studied in isolated microvillous plasma membranes (MVM) and basal membranes (BM) by Western blot analysis. Results were confirmed by immunohistochemistry in sections of human term placenta. Expression and activity System L transporters was measured in isolated MVM from women with varying pre-pregnancy BMI. RESULTS Both LAT1 and LAT2 isoforms contribute to System L transport activity in primary trophoblast cells from human term placenta. LAT1 and LAT2 transporters are highly expressed in the MVM of the syncytiotrophoblast layer at term. LAT2 is also localised in the basal membrane and in endothelial cells lining the fetal capillaries. Measurements in isolated MVM vesicles indicate that System L transporter expression and activity is not influenced by maternal BMI. CONCLUSIONS LAT1 and LAT2 are present and functional in the syncytiotrophoblast MVM, whereas LAT2 is also expressed in the BM and in the fetal capillary endothelium. In contrast to placental System A and beta amino acid transporters, MVM System L activity is unaffected by maternal overweight/obesity.
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Affiliation(s)
- Francesca Gaccioli
- Department of Obstetrics and Gynaecology, University of Cambridge, Cambridge, UK.
| | - Irving L M H Aye
- Division of Basic Reproductive Sciences, Department of Obstetrics and Gynaecology, University of Colorado Denver Anschutz Medical Campus, Aurora, Denver, CO, USA.
| | - Sara Roos
- Institute of Biomedicine, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.
| | - Susanne Lager
- Department of Obstetrics and Gynaecology, University of Cambridge, Cambridge, UK.
| | - Vanessa I Ramirez
- Center for Pregnancy and Newborn Research, Department of Obstetrics and Gynecology, University of Texas Health Science Center, San Antonio, TX, USA.
| | - Yoshikatsu Kanai
- Division of Bio-System Pharmacology, Department of Pharmacology, Osaka University Graduate School of Medicine, Osaka, Japan.
| | - Theresa L Powell
- Section of Neonatology, Department of Pediatrics, University of Colorado Denver Anschutz Medical Campus, Aurora, Denver, CO, USA.
| | - Thomas Jansson
- Division of Basic Reproductive Sciences, Department of Obstetrics and Gynaecology, University of Colorado Denver Anschutz Medical Campus, Aurora, Denver, CO, USA.
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Abstract
PURPOSE OF REVIEW The impact of fatty acids in early nutrition on later body composition and obesity risk remains elusive. Aim of this review was to summarize and discuss recent studies on the role of early supply with long-chain polyunsaturated fatty acids (LCPUFAs) through maternal nutrition during pregnancy and lactation for later offspring obesity. RECENT FINDINGS Recent human studies, either interventional or observational, investigating the role of dietary fatty acids, in particular of LCPUFAs, on body composition and later obesity risk provide inconsistent results concerning BMI as well as fat mass development in the offspring. A recent meta-analysis of randomized controlled trials found no significant effect of maternal supplementation with n-3 LCPUFA on BMI in both preschool and school-aged children. SUMMARY There is currently no conclusive evidence that dietary intervention to modify fat intake during pregnancy and lactation is a reasonable strategy to prevent childhood obesity in humans, but more research is clearly needed to address this issue.
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Affiliation(s)
- Hans Hauner
- Else Kröner-Fresenius-Center for Nutritional Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
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