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Zhu Y, Zheng Q, Pan Y, Jiang X, Li J, Liu R, Huang L. Association between prepregnancy body mass index or gestational weight gain and adverse pregnancy outcomes among Chinese women with gestational diabetes mellitus: a systematic review and meta-analysis. BMJ Open 2024; 14:e075226. [PMID: 38367974 PMCID: PMC10875528 DOI: 10.1136/bmjopen-2023-075226] [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: 05/02/2023] [Accepted: 01/30/2024] [Indexed: 02/19/2024] Open
Abstract
OBJECTIVE The association between prepregnancy body mass index (BMI) or gestational weight gain (GWG) and adverse pregnancy outcomes among Chinese women with gestational diabetes mellitus (GDM) is unknown. This study aims to evaluate such association by synthesising the evidence. DESIGN Systematic review and meta-analysis. DATA SOURCES PubMed, Web of Science, Scopus, EMBASE, China Biology Medicine disc, China National Knowledge Infrastructure, Wangfang, and China Science and Technology Journal Database searched from inception to 11 August 2023. ELIGIBILITY CRITERIA Prospective cohort studies, retrospective cohort studies and case-control studies estimating the relationship of abnormal prepregnancy BMI (including underweight, overweight or obesity) or inappropriate GWG (including excess GWG or insufficient GWG) with adverse pregnancy outcomes of interest were included. Outcomes included macrosomia, caesarean section, preterm birth, gestational hypertension, large for gestational age (LGA) and small for gestational age (SGA). DATA EXTRACTION AND SYNTHESIS Two reviewers independently selected studies, extracted the data and assessed the risk of bias. OR estimate and its 95% CI were pooled using Stata software fixed-effect model. Subgroup analysis, meta-regression and sensitivity analysis were performed to ensure credibility of the results. RESULTS Twenty-three studies (eighteen retrospective cohort studies, three prospective cohort studies and two case control studies) involving 57 013 Chinese women with GDM were identified. Meta-analysis results showed that compared with GDM women with normal weight, GDM women with underweight were at a higher risk of SGA (OR=1.79 (1.54 to 2.07), five studies involving 31 967 women); women with overweight had higher risks of macrosomia (OR=1.65 (1.49 to 1.82), eleven studies involving 41 683 women), caesarean section (OR=1.48 (1.38 to 1.59), ten studies involving 34 935 women), preterm birth (OR=1.27 (1.13 to 1.43), eight studies involving 38 295 women) and LGA (OR=1.73 (1.54 to 1.95), seven studies involving 31 342 women) and women with obesity had higher risks of macrosomia (OR=2.37 (2.04 to 2.76), eleven studies involving 41 683 women), caesarean section (OR=2.07 (1.84 to 2.32), nine studies involving 34 829 women), preterm birth (OR=1.31 (1.09 to 1.57), eight studies involving 38 295 women) and LGA (OR=2.63 (2.15 to 3.21), six studies involving 31 236 women). Regard to GWG, compared with Chinese GDM women with sufficient GWG, GDM women with excessive GWG had higher risks of macrosomia (OR=1.74 (1.58 to 1.92), twelve studies involving 40 966 women), caesarean section (OR=1.44 (1.36 to 1.53), nine studies involving 36 205 women) and LGA (OR=2.12 (1.96 to 2.29), twelve studies involving 42 342 women); women with insufficient GWG conversely had higher risks of preterm birth (OR=1.59 (1.45 to 1.74), nine studies involving 37 461 women) and SGA (OR=1.38 (1.27 to 1.51), ten studies involving 41 080 women). CONCLUSIONS For Chinese women with GDM, abnormal prepregnancy BMI or inappropriate GWG were related to higher risks of many adverse pregnancy outcomes. Therefore, medical staff should pay more attention to the weight management of GDM women during pregnancy.
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Affiliation(s)
- Yu Zhu
- Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian, China
- Fujian Medical University School of Nursing, Fuzhou, Fujian, China
| | - QingXiang Zheng
- Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian, China
- Fujian Obstetrics and Gynecology Hospital College of Clinical Medicine for Obstetrics and Gynecology and Pediatrics, Fuzhou, Fujian, China
| | - YuQing Pan
- Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian, China
| | - XiuMin Jiang
- Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian, China
| | - JiaNing Li
- Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian, China
- Fujian Medical University School of Nursing, Fuzhou, Fujian, China
| | - RuLin Liu
- Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian, China
- Fujian Medical University School of Nursing, Fuzhou, Fujian, China
| | - Ling Huang
- Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian, China
- Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China
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Semnani-Azad Z, Gaillard R, Hughes AE, Boyle KE, Tobias DK, Perng W. Precision stratification of prognostic risk factors associated with outcomes in gestational diabetes mellitus: a systematic review. COMMUNICATIONS MEDICINE 2024; 4:9. [PMID: 38216688 PMCID: PMC10786838 DOI: 10.1038/s43856-023-00427-1] [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: 05/10/2023] [Accepted: 12/12/2023] [Indexed: 01/14/2024] Open
Abstract
BACKGROUND The objective of this systematic review is to identify prognostic factors among women and their offspring affected by gestational diabetes mellitus (GDM), focusing on endpoints of cardiovascular disease (CVD) and type 2 diabetes (T2D) for women, and cardiometabolic profile for offspring. METHODS This review included studies published in English language from January 1st, 1990, through September 30th, 2021, that focused on the above outcomes of interest with respect to sociodemographic factors, lifestyle and behavioral characteristics, traditional clinical traits, and 'omics biomarkers in the mothers and offspring during the perinatal/postpartum periods and across the lifecourse. Studies that did not report associations of prognostic factors with outcomes of interest among GDM-exposed women or children were excluded. RESULTS Here, we identified 109 publications comprising 98 observational studies and 11 randomized-controlled trials. Findings indicate that GDM severity, maternal obesity, race/ethnicity, and unhealthy diet and physical activity levels predict T2D and CVD in women, and greater cardiometabolic risk in offspring. However, using the Diabetes Canada 2018 Clinical Practice Guidelines for studies, the level of evidence was low due to potential for confounding, reverse causation, and selection biases. CONCLUSIONS GDM pregnancies with greater severity, as well as those accompanied by maternal obesity, unhealthy diet, and low physical activity, as well as cases that occur among women who identify as racial/ethnic minorities are associated with worse cardiometabolic prognosis in mothers and offspring. However, given the low quality of evidence, prospective studies with detailed covariate data collection and high fidelity of follow-up are warranted.
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Affiliation(s)
- Zhila Semnani-Azad
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - Romy Gaillard
- Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - Alice E Hughes
- Faculty of Health and Life Sciences, University of Exeter Medical School, Exeter, UK
| | - Kristen E Boyle
- Department of Pediatrics and the Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Deirdre K Tobias
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Wei Perng
- Department of Epidemiology and the Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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Francis EC, Powe CE, Lowe WL, White SL, Scholtens DM, Yang J, Zhu Y, Zhang C, Hivert MF, Kwak SH, Sweeting A. Refining the diagnosis of gestational diabetes mellitus: a systematic review and meta-analysis. COMMUNICATIONS MEDICINE 2023; 3:185. [PMID: 38110524 PMCID: PMC10728189 DOI: 10.1038/s43856-023-00393-8] [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: 05/16/2023] [Accepted: 10/25/2023] [Indexed: 12/20/2023] Open
Abstract
BACKGROUND Perinatal outcomes vary for women with gestational diabetes mellitus (GDM). The precise factors beyond glycemic status that may refine GDM diagnosis remain unclear. We conducted a systematic review and meta-analysis of potential precision markers for GDM. METHODS Systematic literature searches were performed in PubMed and EMBASE from inception to March 2022 for studies comparing perinatal outcomes among women with GDM. We searched for precision markers in the following categories: maternal anthropometrics, clinical/sociocultural factors, non-glycemic biochemical markers, genetics/genomics or other -omics, and fetal biometry. We conducted post-hoc meta-analyses of a subset of studies with data on the association of maternal body mass index (BMI, kg/m2) with offspring macrosomia or large-for-gestational age (LGA). RESULTS A total of 5905 titles/abstracts were screened, 775 full-texts reviewed, and 137 studies synthesized. Maternal anthropometrics were the most frequent risk marker. Meta-analysis demonstrated that women with GDM and overweight/obesity vs. GDM with normal range BMI are at higher risk of offspring macrosomia (13 studies [n = 28,763]; odds ratio [OR] 2.65; 95% Confidence Interval [CI] 1.91, 3.68), and LGA (10 studies [n = 20,070]; OR 2.23; 95% CI 2.00, 2.49). Lipids and insulin resistance/secretion indices were the most studied non-glycemic biochemical markers, with increased triglycerides and insulin resistance generally associated with greater risk of offspring macrosomia or LGA. Studies evaluating other markers had inconsistent findings as to whether they could be used as precision markers. CONCLUSIONS Maternal overweight/obesity is associated with greater risk of offspring macrosomia or LGA in women with GDM. Pregnancy insulin resistance or hypertriglyceridemia may be useful in GDM risk stratification. Future studies examining non-glycemic biochemical, genetic, other -omic, or sociocultural precision markers among women with GDM are warranted.
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Affiliation(s)
- Ellen C Francis
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, NJ, USA.
| | - Camille E Powe
- Diabetes Unit, Massachusetts General Hospital, Boston, MA, USA
| | - William L Lowe
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Sara L White
- Department of Women and Children's Health, King's College London, London, UK
| | - Denise M Scholtens
- Department of Preventive Medicine, Division of Biostatistics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Jiaxi Yang
- Global Center for Asian Women's Health (GloW), Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Department of Obstetrics and Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Bia-Echo Asia Centre for Reproductive Longevity & Equality (ACRLE), Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Yeyi Zhu
- Kaiser Permanente Northern California Division of Research, Oakland, CA, USA
| | - Cuilin Zhang
- Global Center for Asian Women's Health (GloW), Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Department of Obstetrics and Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Bia-Echo Asia Centre for Reproductive Longevity & Equality (ACRLE), Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Marie-France Hivert
- Diabetes Unit, Massachusetts General Hospital, Boston, MA, USA
- Department of Population Medicine, Harvard Medical School, Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Soo Heon Kwak
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Arianne Sweeting
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
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Ke JF, Liu S, Ge RL, Ma L, Li MF. Associations of maternal pre-pregnancy BMI and gestational weight gain with the risks of adverse pregnancy outcomes in Chinese women with gestational diabetes mellitus. BMC Pregnancy Childbirth 2023; 23:414. [PMID: 37270485 PMCID: PMC10239605 DOI: 10.1186/s12884-023-05657-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Accepted: 04/28/2023] [Indexed: 06/05/2023] Open
Abstract
BACKGROUND Give the high background risk of adverse pregnancy outcomes (APOs), it is important to understand the associations of maternal pre-pregnancy body mass index (ppBMI), gestational weight gain (GWG) with APOs in women with gestational diabetes mellitus (GDM). We addressed the independent and joint associations of maternal ppBMI and GWG with APOs in Chinese women with GDM. METHODS 764 GDM women with singleton delivery were studied and they were stratified into three weight groups by ppBMI (underweight, normal weight and overweight/obesity) following classification standards for Chinese adults and three GWG groups (inadequate, adequate, excessive GWG) by the 2009 Institute of Medicine guidelines, respectively. Univariate and multivariate logistic regression analyses were performed to estimate the odds ratios of APOs. RESULTS Maternal overweight/obesity was associated with increased odds of pregnancy-induced hypertension [PIH, adjusted odds ratio (aOR): 2.828, 95% confidence interval (CI) 1.382-5.787], cesarean delivery (CS) (aOR 2.466, 95%CI 1.694-3.590), preterm delivery (aOR 2.466, 95%CI 1.233-4.854), LGA (aOR 1.664, 95%CI 1.120-2.472), macrosomia (aOR 2.682, 95%CI 1.511-4.760) and any pregnancy complication (aOR 2.766, 95%CI 1.840-4.158) compared with healthy weight. Inadequate GWG was less likely to develop PIH (aOR 0.215, 95%CI 0.055-0.835), CS (aOR 0.612, 95%CI 0.421-0.889) and any pregnancy complication (aOR 0.628, 95%CI 0.435-0.907), but had higher risk of preterm birth (aOR 2.261, 95%CI 1.089-4.692), while excessive GWG was more vulnerable to LGA (aOR 1.929, 95%CI 1.272-2.923), macrosomia (aOR 2.753, 95%CI 1.519-4.989) and any pregnancy complication (aOR 1.548, 95%CI 1.006-2.382) as compared to adequate GWG. Furthermore, compared to normal weight mothers with adequate GWG, obese mothers with excessive GWG had the highest risk of any pregnancy complication (aOR 3.064, 95%CI 1.636-5.739). CONCLUSIONS Maternal overweight/obesity and GWG were associated with APOs in the already high-risk settings of GDM. Obese mothers with excessive GWG may confer the greatest risk of adverse outcomes. It was very helpful to reduce the burden of APOs and benefit GDM women by promoting a healthy pre-pregnancy BMI and GWG.
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Affiliation(s)
- Jiang-Feng Ke
- Department of Radiation Oncology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, China
- Department of Endocrinology & Metabolism, Shanghai Clinical Medical Center of Diabetes, Shanghai Key Clinical Center of Metabolic Diseases, Shanghai Institute for Diabetes, Shanghai Key Laboratory of Diabetes, Shanghai Sixth People's Hospital Affliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Sheng Liu
- Department of Emergency, Shanghai Sixth People's Hospital Affliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Medical Emergency Center, Shanghai, China
| | - Ri-Le Ge
- Department of General Practice, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Li Ma
- Department of Obstetrics and Gynecology, Shanghai Clinical Center for Severe Maternal Rescue, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Mei-Fang Li
- Department of Emergency, Shanghai Sixth People's Hospital Affliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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Semnani-Azad Z, Gaillard R, Hughes AE, Boyle KE, Tobias DK, Perng W. Predictors and risk factors of short-term and long-term outcomes among women with gestational diabetes mellitus (GDM) and their offspring: Moving toward precision prognosis? MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.04.14.23288199. [PMID: 37131686 PMCID: PMC10153333 DOI: 10.1101/2023.04.14.23288199] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
As part of the American Diabetes Association Precision Medicine in Diabetes Initiative (PMDI) - a partnership with the European Association for the Study of Diabetes (EASD) - this systematic review is part of a comprehensive evidence evaluation in support of the 2 nd International Consensus Report on Precision Diabetes Medicine. Here, we sought to synthesize evidence from empirical research papers published through September 1 st , 2021 to evaluate and identify prognostic conditions, risk factors, and biomarkers among women and children affected by gestational diabetes mellitus (GDM), focusing on clinical endpoints of cardiovascular disease (CVD) and type 2 diabetes (T2D) among women with a history of GDM; and adiposity and cardiometabolic profile among offspring exposed to GDM in utero. We identified a total of 107 observational studies and 12 randomized controlled trials testing the effect of pharmaceutical and/or lifestyle interventions. Broadly, current literature indicates that greater GDM severity, higher maternal body mass index, belonging to racial/ethnic minority group; and unhealthy lifestyle behaviors would predict a woman's risk of incident T2D and CVD, and an unfavorable cardiometabolic profile among offspring. However, the level of evidence is low (Level 4 according to the Diabetes Canada 2018 Clinical Practice Guidelines for diabetes prognosis) largely because most studies leveraged retrospective data from large registries that are vulnerable to residual confounding and reverse causation bias; and prospective cohort studies that may suffer selection and attrition bias. Moreover, for the offspring outcomes, we identified a relatively small body of literature on prognostic factors indicative of future adiposity and cardiometabolic risk. Future high-quality prospective cohort studies in diverse populations with granular data collection on prognostic factors, clinical and subclinical outcomes, high fidelity of follow-up, and appropriate analytical approaches to deal with structural biases are warranted.
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Zhang J, Zhang R, Chi J, Li Y, Bai W. Pre-pregnancy body mass index has greater influence on newborn weight and perinatal outcome than weight control during pregnancy in obese women. Arch Public Health 2023; 81:5. [PMID: 36639806 PMCID: PMC9838058 DOI: 10.1186/s13690-023-01025-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Accepted: 01/06/2023] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND The pre-pregnancy weight and gestational weight gain (GWG) are closely related to perinatal maternal and infant complications, but the relationship between pre-pregnancy weight and GWG and the pattern of interaction have not been reported. This study investigated the influence of weight control during pregnancy on the perinatal maternal and infant outcomes. METHODS A total of 835 singleton pregnant women who were hospitalized between January 2018 and December 2018 were retrospectively included in this study and divided into two groups: the diet guidance (DG) group (n = 167) and the control group (n = 668). The pre-pregnancy body mass index (BMI), GWG, and perinatal outcomes of the women and infants were determined in two groups. RESULTS The dietary modification and reasonable exercise during pregnancy effectively reduced the GWG, and even some women with pre-pregnancy obesity achieved weight loss during pregnancy. The GWG in the DG group was significantly lower than in the control group, especially in the second and third trimesters. GWG was positively related to birth weight. The birth weight in the DG group was significantly lower than in the control group when their mothers had similar GWG. In women with pre-pregnancy obesity, GWG seemed to be negatively related to birth weight. However, after adjusting the mean BMI, the pre-pregnancy BMI and GWG were positively related to the birth weight. Compared with the control group, the incidences of dystocia, postpartum hemorrhage, macrosomia, small for gestational age infants and neonatal complications significantly reduced in the DG group, and the preterm birth rate was comparable between two groups. Some women with pre-pregnancy obesity lose weight during pregnancy, but there was no premature birth or small for gestational age infant. The incidences of macrosomia, postpartum hemorrhage, dystocia, cesarean section and gestational diabetes increased significantly with the increase of pre-pregnancy BMI. CONCLUSION For women with increased pre-pregnancy BMI, strict weight control is required to reduce obesity-related complications of the mother and infant. The weight control in the second and third trimesters is especially important and most likely to prevent GWG. Compared with GWG, pre-pregnancy BMI has greater influence on the birth weight and maternal and infant complications, and may even compromise the benefits of weight control during pregnancy. Thus, weight control is recommended before pregnancy.
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Affiliation(s)
- Jin Zhang
- grid.24696.3f0000 0004 0369 153XDepartment of Obstetrics and Gynaecology, Beijing Shijitan Hospital, Capital Medical University, Haidian, Beijing, 100038 China
| | - Rui Zhang
- grid.24696.3f0000 0004 0369 153XDepartment of Obstetrics and Gynaecology, Beijing Shijitan Hospital, Capital Medical University, Haidian, Beijing, 100038 China
| | - Jingjing Chi
- grid.24696.3f0000 0004 0369 153XDepartment of Obstetrics and Gynaecology, Beijing Shijitan Hospital, Capital Medical University, Haidian, Beijing, 100038 China
| | - Ya Li
- grid.24696.3f0000 0004 0369 153XDepartment of Obstetrics and Gynaecology, Beijing Shijitan Hospital, Capital Medical University, Haidian, Beijing, 100038 China
| | - Wenpei Bai
- grid.24696.3f0000 0004 0369 153XDepartment of Obstetrics and Gynaecology, Beijing Shijitan Hospital, Capital Medical University, Haidian, Beijing, 100038 China
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Wang XH, Liu CL, Hu HP, Chen XT. Reducing the risk of gestational diabetes mellitus in pregnant women with metabolic syndrome by dietary intervention during early pregnancy. MATRIX SCIENCE MEDICA 2022. [DOI: 10.4103/mtsm.mtsm_19_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Koren R, Idan C, Elkan M, Koren S, Wiener Y. The risk of small and large for gestational age newborns in women with gestational diabetes according to pre-gestational body mass index and weight gain. J Matern Fetal Neonatal Med 2021; 35:8382-8387. [PMID: 34544322 DOI: 10.1080/14767058.2021.1974390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
AIM To explore the effects of pregestational body mass index (BMI) and gestational weight gain (GWG) on maternal and neonatal outcomes of women with gestational diabetes mellitus (GDM). METHODS We conducted retrospective cohort analyses of outcomes among women with GDM who delivered at Shamir Medical Center, Israel (2017-2018). RESULTS We included 673 women with GDM in our analysis, 217 (32.24%) with appropriate GWG (aGWG), 247 (36.7%) with excessive GWG (eGWG), and 209 (31%) with insufficient GWG (iGWG). Cesarean section (CS) was less prevalent among women with iGWG (19.6%), compared with women with eGWG (31.2%) and aGWG (31.1%) (p = .008). Small for gestational weight (SGA) newborns were more prevalent in women with iGWG 9.1%, compared with 2% and 0.9% for women with eGWG and aGWG, respectively (p<.001). Large for gestational age (LGA) newborns were significantly more prevalent in women with eGWG 17.4% compared with 4.8% and 9.7% in patients with iGWG and aGWG women, respectively (p<.001). SGA and LGA newborns were more prevalent in women with iGWG and e-GWG across all pre-gestational BMI groups >18.5 kg/m2. CONCLUSIONS A complex interplay exists between pregestational weight, GWG, and GDM and pregnancy outcomes, specifically SGA and LGA newborns. A strict follow-up considering the pregestational BMI, GWG, blood glucose levels, treatment modality, and fetal abdominal circumference could assist in managing the complex interplay of patients with GDM for better neonatal outcomes.
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Affiliation(s)
- Ronit Koren
- Department of Internal Medicine A, Shamir Medical Center (Assaf Harofeh), Zerifin, Israel.,Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Shamir Medical Center (Assaf Harofeh), Zerifin, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Chen Idan
- Department of Internal Medicine A, Shamir Medical Center (Assaf Harofeh), Zerifin, Israel
| | - Matan Elkan
- Department of Internal Medicine A, Shamir Medical Center (Assaf Harofeh), Zerifin, Israel
| | - Shlomit Koren
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Diabetes Unit, Shamir Medical Center (Assaf Harofeh), Zerifin, Israel
| | - Yifat Wiener
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Shamir Medical Center (Assaf Harofeh), Zerifin, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Watkins OC, Selvam P, Appukuttan Pillai R, Cracknell-Hazra VKB, Yong HEJ, Sharma N, Cazenave-Gassiot A, Bendt AK, Godfrey KM, Lewis RM, Wenk MR, Chan SY. Placental 13C-DHA metabolism and relationship with maternal BMI, glycemia and birthweight. Mol Med 2021; 27:84. [PMID: 34362294 PMCID: PMC8349043 DOI: 10.1186/s10020-021-00344-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Accepted: 07/23/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Fetal docosahexaenoic acid (DHA) supply relies on preferential transplacental transfer, which is regulated by placental DHA lipid metabolism. Maternal hyperglycemia and obesity associate with higher birthweight and fetal DHA insufficiency but the role of placental DHA metabolism is unclear. METHODS Explants from 17 term placenta were incubated with 13C-labeled DHA for 48 h, at 5 or 10 mmol/L glucose treatment, and the production of 17 individual newly synthesized 13C-DHA labeled lipids quantified by liquid chromatography mass spectrometry. RESULTS Maternal BMI positively associated with 13C-DHA-labeled diacylglycerols, triacylglycerols, lysophospholipids, phosphatidylcholine and phosphatidylethanolamine plasmalogens, while maternal fasting glycemia positively associated with five 13C-DHA triacylglycerols. In turn, 13C-DHA-labeled phospholipids and triacylglycerols positively associated with birthweight centile. In-vitro glucose treatment increased most 13C-DHA-lipids, but decreased 13C-DHA phosphatidylethanolamine plasmalogens. However, with increasing maternal BMI, the magnitude of the glucose treatment induced increase in 13C-DHA phosphatidylcholine and 13C-DHA lysophospholipids was curtailed, with further decline in 13C-DHA phosphatidylethanolamine plasmalogens. Conversely, with increasing birthweight centile glucose treatment induced increases in 13C-DHA triacylglycerols were exaggerated, while glucose treatment induced decreases in 13C-DHA phosphatidylethanolamine plasmalogens were diminished. CONCLUSIONS Maternal BMI and glycemia increased the production of different placental DHA lipids implying impact on different metabolic pathways. Glucose-induced elevation in placental DHA metabolism is moderated with higher maternal BMI. In turn, findings of associations between many DHA lipids with birthweight suggest that BMI and glycemia promote fetal growth partly through changes in placental DHA metabolism.
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Affiliation(s)
- Oliver C Watkins
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, 1E Kent Ridge Road, NUHS Tower Block, Level 12, Singapore, 119228, Singapore
| | - Preben Selvam
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, 1E Kent Ridge Road, NUHS Tower Block, Level 12, Singapore, 119228, Singapore
| | - Reshma Appukuttan Pillai
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, 1E Kent Ridge Road, NUHS Tower Block, Level 12, Singapore, 119228, Singapore
| | - Victoria K B Cracknell-Hazra
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, 1E Kent Ridge Road, NUHS Tower Block, Level 12, Singapore, 119228, Singapore
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore
- MRC Lifecourse Epidemiology Unit and NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Hannah E J Yong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore
| | - Neha Sharma
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, 1E Kent Ridge Road, NUHS Tower Block, Level 12, Singapore, 119228, Singapore
| | - Amaury Cazenave-Gassiot
- Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Singapore Lipidomics Incubator, Life Sciences Institute, National University of Singapore, Singapore, Singapore
| | - Anne K Bendt
- Singapore Lipidomics Incubator, Life Sciences Institute, National University of Singapore, Singapore, Singapore
| | - Keith M Godfrey
- MRC Lifecourse Epidemiology Unit and NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Rohan M Lewis
- MRC Lifecourse Epidemiology Unit and NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Markus R Wenk
- Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Singapore Lipidomics Incubator, Life Sciences Institute, National University of Singapore, Singapore, Singapore
| | - Shiao-Yng Chan
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, 1E Kent Ridge Road, NUHS Tower Block, Level 12, Singapore, 119228, Singapore.
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore.
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Tryggvadottir EA, Gunnarsdottir I, Birgisdottir BE, Hrolfsdottir L, Landberg R, Hreidarsdottir IT, Hardardottir H, Halldorsson TI. Early pregnancy plasma fatty acid profiles of women later diagnosed with gestational diabetes. BMJ Open Diabetes Res Care 2021; 9:e002326. [PMID: 34348919 PMCID: PMC8340288 DOI: 10.1136/bmjdrc-2021-002326] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 07/04/2021] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Fatty acid (FA) concentrations have previously been associated with gestational diabetes mellitus (GDM). However, few studies on GDM have examined FA profiles in early pregnancy or before diagnosis. This study aimed to compare early pregnancy plasma FA profiles of women with and without GDM diagnoses as well as their reported dietary consumption. RESEARCH DESIGN AND METHODS The subjects comprised 853 women from the prospective study: Pregnant Women in Iceland II (PREWICE II), attending their 11-14 weeks ultrasound appointment in 2017-2018. During the visit, blood samples were collected for plasma FA analysis, and dietary habits were assessed using a short food frequency questionnaire. Information on GDM diagnoses was then later extracted from medical records. Differences in FA profile between GDM cases and non-cases were evaluated using the Mann-Whitney U test. RESULTS GDM was diagnosed in 127 women (14.9%). Concentrations of saturated fatty acids, monounsaturated fatty acids, polyunsaturated fatty acids (PUFA) n-6, PUFA n-3 and total FA were higher in the women who later developed GDM compared with those who did not (p≤0.05). The medians for total FA were 2898 μg/mL for the women with GDM and 2681 μg/mL for those without GDM. Mean adjusted difference for total FA between the groups was 133 μg/mL (95% CI 33 to 233). Similar results were observed in prepregnancy normal-weight women and overweight women/women with obesity. Overall diet quality in early pregnancy appeared to be lower among the women later diagnosed with GDM. CONCLUSION We found that plasma FA profiles in early pregnancy were different for women later diagnosed with GDM compared with those who were not, independent of the women's body mass index.
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Affiliation(s)
- Ellen Alma Tryggvadottir
- Faculty of Food Science and Nutrition, University of Iceland, Reykjavik, Iceland
- Unit for Nutrition Research, Landspitali University Hospital, Reykjavík, Iceland
| | - Ingibjorg Gunnarsdottir
- Faculty of Food Science and Nutrition, University of Iceland, Reykjavik, Iceland
- Unit for Nutrition Research, Landspitali University Hospital, Reykjavík, Iceland
| | - Bryndis Eva Birgisdottir
- Faculty of Food Science and Nutrition, University of Iceland, Reykjavik, Iceland
- Unit for Nutrition Research, Landspitali University Hospital, Reykjavík, Iceland
| | - Laufey Hrolfsdottir
- Faculty of Food Science and Nutrition, University of Iceland, Reykjavik, Iceland
- Department of Education and Science, Akureyri Hospital, Akureyri, Iceland
| | - Rikard Landberg
- Biology and Biological Engineering, Chalmers University of Technology, Goteborg, Sweden
| | - Ingibjorg Th Hreidarsdottir
- Department of Obstetrics and Gynecology, Landspítali University Hospital, Reykjavík, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | | | - Thorhallur Ingi Halldorsson
- Faculty of Food Science and Nutrition, University of Iceland, Reykjavik, Iceland
- Unit for Nutrition Research, Landspitali University Hospital, Reykjavík, Iceland
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11
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Elwan D, Olveda R, Medrano R, Wojcicki JM. Excess pregnancy weight gain in latinas: Impact on infant's adiposity and growth hormones at birth. Prev Med Rep 2021; 22:101341. [PMID: 33898205 PMCID: PMC8053797 DOI: 10.1016/j.pmedr.2021.101341] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 02/17/2021] [Accepted: 02/20/2021] [Indexed: 01/03/2023] Open
Abstract
Immigrant Latinas with overweight and obesity have excessive gestational gain. Excessive gestational weight gain is associated with high birthweight percentiles. Higher IGF-1 and lower PYY in cord blood in context of excessive gestational gain. Gestational weight counseling in pregnancy may help prevent childhood obesity.
Excess maternal weight gain during pregnancy has been associated with childhood overweight and obesity both in mothers with and without obesity. Latinx children are at higher risk for earlier obesity compared with other population groups. A cohort of 82 self-identified pregnant Latina women were recruited at the prenatal clinics of Zuckerberg San Francisco General Hospital (ZSFG) prior to delivery during the second and third trimesters of pregnancy in 2011 and 2012. Maternal pre-pregnancy weight and weight prior to delivery were collected by self-report to calculate maternal pre-pregnancy body mass index (BMI) and weight gain in pregnancy. At delivery, anthropometric measurements of infants were obtained and cord blood and maternal finger stick blood samples were collected for hormonal assays. Fifty-three point seven percent of women had excessive weight gain in pregnancy. A high percentage of the cohort was overweight and obese prior to pregnancy (67.1%) with mean pre-pregnancy BMI 27.4 ± 4.5 kg/m2 and greater pre-pregnancy weight was independently associated with weight gain during pregnancy (OR 1.05, 95%CI 1.002–1.09). Mean infant birthweight was 3377.2 ± 481.5 g and excessive weight gain in pregnancy was independently associated with birthweight percentile (OR 13.46, 95%CI 2.43–34.50). Excessive gestational gain was positively associated with cord blood insulin-like growth factor-1 (IGF-1) and negatively with Peptide YY (PYY) levels. Latina women with pre-pregnancy overweight and obesity have a high rate of excessive gestational gain in pregnancy and could benefit from early counseling about appropriate gain in pregnancy. Excessive gestational weight impacts the intrauterine environment in high-risk infants impacting fetal growth and development.
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Affiliation(s)
- Deena Elwan
- University of Hawai'i, Honolulu, Hawai'I, United States.,Department of Pediatrics (GI and Nutrition), University of California, San Francisco, San Francisco 94116, United States
| | - Rebecca Olveda
- Department of Pediatrics (GI and Nutrition), University of California, San Francisco, San Francisco 94116, United States
| | - Rosalinda Medrano
- Department of Pediatrics (GI and Nutrition), University of California, San Francisco, San Francisco 94116, United States
| | - Janet M Wojcicki
- Department of Pediatrics (GI and Nutrition), University of California, San Francisco, San Francisco 94116, United States
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12
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Fordjour L, Cai C, Bronshtein V, Bronshtein M, Aranda JV, Beharry KD. Growth factors in the fetus and pre-adolescent offspring of hyperglycemic rats. Diab Vasc Dis Res 2021; 18:14791641211011025. [PMID: 33913361 PMCID: PMC8482349 DOI: 10.1177/14791641211011025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Maternal hyperglycemia influences childhood metabolic syndrome, including obesity and hyperglycemia. We tested the hypothesis that the maternal hyperglycemia influences growth factors in the fetal and pre-adolescent offspring. METHODS Hyperglycemia was induced in pregnant rats on embryonic day (E)16 using streptozocin followed by implantation with insulin or placebo pellets at embryonic day 18 (E18). Fetuses at E20 and pre-adolescent pups at postnatal day 14 (P14) were studied: (1) normal untreated controls (CTL) at E20; (2) hyperglycemic placebo-treated (HPT) at E20; (3) hyperglycemic insulin-treated (HIT) at E20; (4) CTL at P14; and (5) HIT at P14. Fetal and pre-adolescent growth factors were determined. RESULTS Biomarkers of hypoxia were elevated in the HPT group at E20. This group did not survive to term. Maternal insulin improved fetal survival despite lower fetal body weight at E20, however, at normal birth (postnatal day 0 (P0)) and at P14, body weights and blood glucose were higher than CTL. These high levels correlated with aberrant growth factors. Maternal hyperglycemia influenced glucose-6-phosphate dehydrogenase, glucagon, insulin, interleukin-10, and leptin genes. CONCLUSIONS The impact of maternal hyperglycemia on pre-adolescent glucose and body weight was not a consequence of maternal overnutrition. This suggests an independent link which may affect offspring metabolic health in later life.
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Affiliation(s)
- Lawrence Fordjour
- Division of Neonatal-Perinatal
Medicine, Department of Pediatrics, State University of New York, Downstate Medical
Center, Brooklyn, NY, USA
| | - Charles Cai
- Division of Neonatal-Perinatal
Medicine, Department of Pediatrics, State University of New York, Downstate Medical
Center, Brooklyn, NY, USA
| | - Vadim Bronshtein
- Division of Neonatal-Perinatal
Medicine, Department of Pediatrics, State University of New York, Downstate Medical
Center, Brooklyn, NY, USA
| | - Mayan Bronshtein
- Division of Neonatal-Perinatal
Medicine, Department of Pediatrics, State University of New York, Downstate Medical
Center, Brooklyn, NY, USA
| | - Jacob V Aranda
- Division of Neonatal-Perinatal
Medicine, Department of Pediatrics, State University of New York, Downstate Medical
Center, Brooklyn, NY, USA
- Department of Ophthalmology, State
University of New York, Downstate Medical Center, Brooklyn, NY, USA
- State University of New York Eye
Institute, New York, NY, USA
| | - Kay D Beharry
- Division of Neonatal-Perinatal
Medicine, Department of Pediatrics, State University of New York, Downstate Medical
Center, Brooklyn, NY, USA
- Department of Ophthalmology, State
University of New York, Downstate Medical Center, Brooklyn, NY, USA
- State University of New York Eye
Institute, New York, NY, USA
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13
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Pykało-Gawińska D, Zaręba-Szczudlik J, Gawiński C, Stępień A, Dobrowolska-Redo A, Malinowska-Polubiec A, Romejko-Wolniewicz E. Gestational weight gain and glycemic control in GDM patients with positive genital culture. Taiwan J Obstet Gynecol 2021; 60:262-265. [DOI: 10.1016/j.tjog.2021.01.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2020] [Indexed: 01/15/2023] Open
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14
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Nasreen S, Wilk P, Mullowney T, Karp I. The effect of gestational diabetes mellitus on the risk of asthma in offspring. Ann Epidemiol 2021; 57:7-13. [PMID: 33596445 DOI: 10.1016/j.annepidem.2021.02.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 12/14/2020] [Accepted: 02/09/2021] [Indexed: 11/20/2022]
Abstract
PURPOSE To examine the effect of maternal gestational diabetes mellitus on the risk of asthma in the offspring. METHODS This cohort study used data from 19,933 children in the National Longitudinal Survey of Children and Youth (NLSCY), 1994/1995-2008/2009, Canada. Children were followed until the first-time report of having health professional-diagnosed asthma (hereafter incident asthma), loss to follow-up, or end of the NLSCY follow-up, whichever occurred first. As a surrogate for Cox proportional hazards regression, pooled logistic regression models, crude and adjusted for potential confounders, were fitted to estimate the effect of gestational diabetes mellitus on the risk of asthma in the offspring. RESULTS Among the 19,933 children, 1,178 (5.9%) had mothers with gestational diabetes mellitus. The median duration of follow-up was 4 (interquartile range: 4) years. A total of 1639 children in the cohort had reported incident asthma during the follow-up, and 119 of them had mothers with gestational diabetes mellitus. The adjusted hazard ratio for the association between gestational diabetes mellitus and incident asthma in offspring was 1.25 (95% confidence interval [CI] 1.03, 1.51). CONCLUSIONS Our findings suggest that gestational diabetes mellitus increases the risk of asthma in the offspring.
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Affiliation(s)
- Sharifa Nasreen
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
| | - Piotr Wilk
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Tara Mullowney
- Department of Pediatrics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Igor Karp
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada; Department of Social and Preventive Medicine, School of Public Health, University of Montreal, Montreal, QC, Canada
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15
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Hou X, Zhang J, Ma H, Li M, Wang P. Hypoxia-reoxygenation treatment attenuates gestational diabetes mellitus. Endocr Connect 2021; 10:84-91. [PMID: 33320105 PMCID: PMC7923137 DOI: 10.1530/ec-20-0555] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 12/14/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Oxidative stress leads to insulin resistance and gestational diabetes mellitus (GDM). The nuclear factor erythroid 2-related factor 2 (Nrf2)/heme oxygenase-1 (HO-1) signaling is an important anti-oxidative stress pathway, which can be activated by hypoxia-reoxygenation (H/R) treatment. We aimed to demonstrate the effects of H/R treatment on GDM symptoms as well as reproductive outcomes. METHODS Pregnant C57BL/KsJ db/+ mice were used as a genetic GDM model. Plasma insulin and other biochemical indexes of plasma, insulin sensitivity, glucose intolerance, blood glucose and liver biochemical indexes were evaluated. Protein abundance of HO-1 and Nrf2 were assessed with Western blot. RESULTS H/R treatment markedly ameliorated β-cell insufficiency and glucose intolerance, suppressed oxidative stress in vivo, stimulated the activities of anti-oxidant enzymes, and led to improved reproductive outcomes. The beneficial effects of H/R treatment were mechanistically mediated via the restoration of Nrf2/HO-1 anti-oxidant signaling pathway in the liver of GDM mice. CONCLUSION Our study, for the first time, suggests that H/R treatment is a potentially novel therapeutic approach against GDM symptoms, by activating the Nrf2/HO-1 signaling pathway and inhibiting oxidative stress.
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Affiliation(s)
- Xiuzhen Hou
- Division 1 of Obstetrics, Cangzhou Central Hospital, Cangzhou, Hebei, China
| | - Junfeng Zhang
- Division 1 of Obstetrics, Cangzhou Central Hospital, Cangzhou, Hebei, China
- Correspondence should be addressed to J Zhang:
| | - Hehong Ma
- Division 1 of Obstetrics, Cangzhou Central Hospital, Cangzhou, Hebei, China
| | - Ming Li
- Division 1 of Obstetrics, Cangzhou Central Hospital, Cangzhou, Hebei, China
| | - Pei Wang
- Division 1 of Obstetrics, Cangzhou Central Hospital, Cangzhou, Hebei, China
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16
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Does Birthweight Represent Imprinting for Life? Preliminary Findings from the Level and Timing of Diabetic Hyperglycemia in Utero: Transgenerational Effect on Adult Morbidity (TEAM) Study. REPORTS 2020. [DOI: 10.3390/reports3040036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Women with pre-gestational diabetes have a high rate of large for gestational age (LGA) babies compared to women without diabetes. In particular, there is a high rate of asymmetric LGA defined as ponderal index (PI) > 90th percentile for gestational age. We examined the association of birth weight and PI, with body mass index (BMI) and obesity status in adulthood, in a cohort of offspring of women with pre-gestational diabetes. The women participated in the Diabetes in Pregnancy (DiP) study at the University of Cincinnati from 1978 to 1995. The offspring of these women are the cohort participating in an observational study being conducted at Cincinnati Children’s Hospital Medical Center. Once located, the offspring were invited to come in for a one-day clinic visit to assess anthropometrics, and their metabolic, renal and cardiovascular status. Linear and logistic regression was used to assess the association between birth weight and PI with current BMI. We report on 107 offspring. A statistically significant association was found between offspring current BMI with birth PI (β = 1.89, 95% CI 0.40–3.38), and between offspring current obesity status and birth asymmetric LGA (aOR = 2.44, 95% CI 1.01–5.82). This is consistent with in utero “metabolic programming”.
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17
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Chen Y, Tang J, Zhang Y, Du J, Wang Y, Yu H, He Y. Astaxanthin alleviates gestational diabetes mellitus in mice through suppression of oxidative stress. NAUNYN-SCHMIEDEBERG'S ARCHIVES OF PHARMACOLOGY 2020; 393:2517-2527. [PMID: 32279084 DOI: 10.1007/s00210-020-01861-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Accepted: 03/24/2020] [Indexed: 12/11/2022]
Abstract
Gestational diabetes mellitus (GDM) affects 7% of pregnant women worldwide, which increases the risk of diabetes and cardiovascular disease for both the mother and the fetus. Natural compound Astaxanthin has been reported to have benefits in obesity and diabetes. A pregnant C57BL/KsJ db/+ mouse was used as a genetic GDM model to investigate the effect of Astaxanthin on GDM symptoms and reproductive outcomes. Blood glucose, plasma insulin, glucose intolerance, insulin sensitivity, biochemical indexes of plasma, and the liver were measured; Nrf2 and HO-1 protein levels were detected by Western blotting. Astaxanthin significantly alleviated the glucose intolerance and β cell insufficiency, inhibited in vivo oxidative stress, enhanced the activity of antioxidant enzymes, and improved reproductive outcomes. Mechanistically, the effect of Astaxanthin was mediated by restoring the Nrf2/HO-1 antioxidant pathway in the liver of GDM mice. Our findings supported that Astaxanthin was a potential therapeutic reagent for not only diabetes but also GDM symptomology.
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Affiliation(s)
- Yangyang Chen
- Department of Obstetrics, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, No. 20 Yuhuangding East Road, Yantai, 264000, Shandong, China
| | - Jichun Tang
- Department of Obstetrics, Penglai Traditional Chinese Medicine Hospital, Penglai, 265600, Shandong, China
| | - Yinghong Zhang
- Department of Obstetrics, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, No. 20 Yuhuangding East Road, Yantai, 264000, Shandong, China
| | - Juan Du
- Department of Obstetrics, Yantai Zhifu District Maternal and Child Health Hospital, No. 78 Huanshan Road, Zhifu District, Yantai, 264000, Shandong, China
| | - Yuanli Wang
- Department of Obstetrics, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, No. 20 Yuhuangding East Road, Yantai, 264000, Shandong, China
| | - Hui Yu
- Department of Obstetrics, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, No. 20 Yuhuangding East Road, Yantai, 264000, Shandong, China
| | - Yanling He
- Department of Obstetrics, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, No. 20 Yuhuangding East Road, Yantai, 264000, Shandong, China.
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18
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Liang Z, Liu H, Wang L, Song Q, Sun D, Li W, Leng J, Gao R, Hu G, Qi L. Maternal Gestational Diabetes Mellitus Modifies the Relationship Between Genetically Determined Body Mass Index During Pregnancy and Childhood Obesity. Mayo Clin Proc 2020; 95:1877-1887. [PMID: 32861332 PMCID: PMC7672776 DOI: 10.1016/j.mayocp.2020.04.042] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 03/29/2020] [Accepted: 04/10/2020] [Indexed: 01/10/2023]
Abstract
OBJECTIVE To analyze the interactions between maternal gestational diabetes mellitus (GDM) and genetically determined maternal body mass index (BMI) during pregnancy on offspring childhood obesity. RESEARCH DESIGN AND METHODS A total of 1114 Chinese mother-child pairs (560 GDM and 554 non-GDM) were included between August 2009 and July 2011. Maternal genetic risk score (GRS) of BMI during pregnancy was derived on the basis of 12 single nucleotide polymorphisms identified from a genome-wide association study. Offspring's BMI, BMI-for-age z score, weight, weight-for-age z score, waist circumference, sum of skinfolds, and body fat percentage during childhood were measured or calculated. RESULTS Maternal GRS of BMI during pregnancy significantly interacted with maternal GDM status on childhood risks of overweight and obesity (all P for interaction <.05). After multivariable adjustment, per unit of GRS was associated with a 24% (P<.001) and a 28% (P<.001) increased risk of overweight and obesity among children of GDM mothers, whereas no significant associations were observed among children of mothers without GDM. In addition, per unit GRS of BMI during pregnancy was significantly associated with 0.16 kg/m2 higher BMI (P=.002), 0.09 higher BMI-for-age z score (P=.002), 0.24 kg higher weight (P=.04), 0.06 higher weight-for-age z score (P=.02), 0.28 cm higher waist circumference (P=.03), 0.94 mm higher sum of skinfolds (P=.004), and 0.37% higher body fat percentage (P=.03) among children of GDM mothers. There were no significant associations between maternal GRS of BMI during pregnancy and offspring's obesity-related outcomes among children of mothers without GDM. CONCLUSION Our findings for the first time indicate that maternal GDM status may modify the relation between genetically determined maternal BMI during pregnancy and offspring's obesity risk during childhood.
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Affiliation(s)
- Zhaoxia Liang
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA; Department of Obstetrical, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
| | - Huikun Liu
- Tianjin Women's and Children's Health Center, Tianjin, China
| | - Leishen Wang
- Tianjin Women's and Children's Health Center, Tianjin, China
| | - Qiying Song
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA; Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China
| | - Dianjianyi Sun
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA
| | - Weiqin Li
- Tianjin Women's and Children's Health Center, Tianjin, China
| | - Junhong Leng
- Tianjin Women's and Children's Health Center, Tianjin, China
| | - Ru Gao
- Pennington Biomedical Research Center, Baton Rouge, LA
| | - Gang Hu
- Pennington Biomedical Research Center, Baton Rouge, LA
| | - Lu Qi
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.
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19
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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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Flynn AC, Thompson JMD, Dalrymple KV, Wall C, Begum S, Johny JP, Cutfield WS, North R, McCowan LME, Godfrey KM, Mitchell EA, Poston L. Childhood dietary patterns and body composition at age 6 years: the Children of SCOPE study. Br J Nutr 2020; 124:1-21. [PMID: 32098635 PMCID: PMC7116586 DOI: 10.1017/s0007114520000628] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Dietary patterns describe the quantity, variety, or combination of different foods and beverages in a diet and the frequency of habitual consumption. Better understanding of childhood dietary patterns and antenatal influences could inform intervention strategies to prevent childhood obesity. We derived empirical dietary patterns in 1142 children (average age 6.0 (0.2) years) in Auckland, New Zealand whose mothers had participated in the Screening for Pregnancy Endpoints (SCOPE) cohort study and explored associations with measures of body composition. Participants (Children of SCOPE) had their diet assessed by food frequency questionnaire (FFQ) and empirical dietary patterns were extracted using factor analysis. Three distinct dietary patterns were identified; 'Healthy', 'Traditional' and 'Junk'. Associations between dietary patterns and measures of childhood body composition (waist, hip, arm circumferences, body mass index (BMI), bioelectrical impedance analysis (BIA) derived body fat percentage, and sum of skinfold thicknesses (SST)) were assessed by linear regression, with adjustment for maternal influences. Children who had higher 'Junk' dietary pattern scores had 0.24cm greater arm (0.08 SD (95%CI 0.04, 0.13)) and 0.44cm hip (0.05 SD (95% CI 0.01, 0.10)) circumferences, 1.13cm greater SST (0.07 SD (95%CI 0.03, 0.12)) and were more likely to be obese (OR=1.74 (95%CI 1.07, 2.82)); those with higher 'Healthy' pattern scores were less likely to be obese (OR=0.62 (95%CI 0.39, 1.00)). In a large mother-child cohort, a dietary pattern characterised by high sugar and fat foods was associated with greater adiposity and obesity risk in children aged 6 years, while a 'Healthy' dietary pattern offered some protection against obesity. Targeting unhealthy dietary patterns could inform public health strategies to reduce the prevalence of childhood obesity.
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Affiliation(s)
- Angela C Flynn
- Department of Women and Children’s Health, School of Life Course Sciences, King’s College London, UK
| | - John M D Thompson
- Department of Paediatrics, Child & Youth Health, Faculty of Medical and health Sciences, University of Auckland, New Zealand
- Department of Obstetrics and Gynaecology, Faculty of Medical and Health Science, University of Auckland, New Zealand
| | - Kathryn V Dalrymple
- Department of Women and Children’s Health, School of Life Course Sciences, King’s College London, UK
| | - Clare Wall
- Department of Nutrition, School of Medical Sciences, University of Auckland, New Zealand
| | - Shahina Begum
- Department of Women and Children’s Health, School of Life Course Sciences, King’s College London, UK
| | - Jaijus Pallippadan Johny
- Department of Obstetrics and Gynaecology, Faculty of Medical and Health Science, University of Auckland, New Zealand
| | | | - Robyn North
- Department of General Medicine, Auckland City Hospital, Auckland New Zealand
| | - Lesley M E McCowan
- Department of Obstetrics and Gynaecology, Faculty of Medical and Health Science, University of Auckland, New Zealand
| | - Keith M Godfrey
- MRC Lifecourse Epidemiology Unit and NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, UK
| | - Edwin A Mitchell
- Department of Paediatrics, Child & Youth Health, Faculty of Medical and health Sciences, University of Auckland, New Zealand
| | - Lucilla Poston
- Department of Women and Children’s Health, School of Life Course Sciences, King’s College London, UK
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Wang X, Martinez MP, Chow T, Xiang AH. BMI growth trajectory from ages 2 to 6 years and its association with maternal obesity, diabetes during pregnancy, gestational weight gain, and breastfeeding. Pediatr Obes 2020; 15:e12579. [PMID: 31691508 DOI: 10.1111/ijpo.12579] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 09/08/2019] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To identify latent BMI growth trajectories from ages 2 to 6 years and examine their independent associations with maternal prepregnancy obesity or overweight, pre-existing type 1 (T1D) or type 2 diabetes (T2D) or gestational diabetes (GDM) with or without requiring antidiabetic medications during pregnancy, excessive gestational weight gain (EGWG), and breastfeeding ≤ 6 months. RESEARCH DESIGN AND METHOD Data included 71 892 children born at Kaiser Permanente Southern California hospitals in 2007 to 2011 with complete information on maternal risk factors. Group-based trajectory modelling was used to identify latent BMI trajectory groups. Logistic regression was used to assess independent associations adjusted for covariates. RESULTS Three distinct BMI trajectory groups were identified: Group 1 (59% of the cohort) had stable low BMI, Group 2 (35% of the cohort) had stable median BMI, and Group 3 (6% of the cohort) had high and increasing BMI over time. Relative to Groups 1 and 2 combined, the adjusted odds ratio (OR) (95% CI) of being in Group 3 associated with maternal exposures were 5.6 (5.1-6.2) for prepregnancy obesity, 2.4 (2.2-2.7) for prepregnancy overweight, 2.1 (1.2-3.7) for T1D, 1.6 (1.4-1.8) for T2D, 1.4 (1.3-1.6) for GDM requiring medication treatment, 1.1 (1.0-1.3) for GDM not requiring medication, 1.3 (1.2-1.4) for EGWG, and 1.2 (1.2-1.3) for breastfeeding ≤ 6 months. CONCLUSION Child's high and increasing BMI trajectory was strongly associated with maternal prepregnancy obesity and overweight, modestly associated with maternal T1D, T2D, and GDM requiring medication treatment and EGWG, and slightly associated with breastfeeding ≤ 6 months. GDM not requiring medication treatment during pregnancy had little association.
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Affiliation(s)
- Xinhui Wang
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
| | - Mayra P Martinez
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
| | - Ting Chow
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
| | - Anny H Xiang
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
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22
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Xiang S, Li L, Wang L, Liu J, Tan Y, Hu J. A decision tree model of cerebral palsy based on risk factors. J Matern Fetal Neonatal Med 2019; 34:3922-3927. [PMID: 31842640 DOI: 10.1080/14767058.2019.1702944] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Objective: A risk prediction model of cerebral palsy (CP) was established by a decision tree model to predict the individual risk of CP.Methods: A hospital-based case-control study was conducted with 109 cases of CP and 327 controls without CP. The cases and the controls were obtained from Hunan Children's Hospital. A questionnaire was administered to collect the variables relevant to CP by face to face interviews. Chi-square test was used to identify the factors associated with CP, and a decision tree model was used to construct the prediction model.Results: Univariate analysis showed that there were significant differences between cases group and controls group on maternal age, weight gain during pregnancy, medical treatment during pregnancy, preterm birth, low birth weight and birth asphyxia (all p-values <.05). Three factors, including preterm birth, birth asphyxia, and maternal age >35 years old, entered the decision tree model. The area under the receiver operating characteristic curve (AUC) was 0.722 (95%CI: 0.659-0.784, p < .001).Conclusion: The decision tree prediction model can be used for predicting the individual risk of CP. Further large-scale, population-based cerebral palsy studies are needed to improve the model.
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Affiliation(s)
- Shiting Xiang
- Paediatric Medicine Institution of Hunan Children's Hospital, Changsha, China
| | - Liping Li
- Paediatric Medicine Institution of Hunan Children's Hospital, Changsha, China
| | - Lili Wang
- Paediatric Medicine Institution of Hunan Children's Hospital, Changsha, China
| | - Juan Liu
- Paediatric Medicine Institution of Hunan Children's Hospital, Changsha, China
| | - Yaqiong Tan
- Paediatric Medicine Institution of Hunan Children's Hospital, Changsha, China
| | - Jihong Hu
- Paediatric Medicine Institution of Hunan Children's Hospital, Changsha, China
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23
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Vézina-Im LA, Nicklas TA, Baranowski T. Intergenerational Effects of Health Issues Among Women of Childbearing Age: a Review of the Recent Literature. Curr Nutr Rep 2019; 7:274-285. [PMID: 30259413 DOI: 10.1007/s13668-018-0246-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
PURPOSE OF REVIEW This review summarizes the latest scientific evidence, primarily from systematic reviews/meta-analyses and large cohort studies, on the impact of health issues among women of childbearing age and their effect on their offspring during pregnancy and from birth to adulthood. RECENT FINDINGS Women of childbearing age with overweight/obesity, diabetes, and hypertension prior to pregnancy are at increased risk for adverse outcomes during pregnancy, such as excessive gestational weight gain, gestational diabetes mellitus, and hypertensive disorders of pregnancy. These adverse outcomes could complicate delivery and put their offspring at risk of developing overweight/obesity, diabetes, and hypertension (i.e., intergenerational transmission of health issues). Interventions should target women of childbearing age, especially those who wish to conceive, in order to possibly stop the transmission of women's health issues to the offspring and favor a healthy pregnancy from the start. This could be one of the best strategies to promote both maternal and child health.
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Affiliation(s)
- Lydi-Anne Vézina-Im
- Children's Nutrition Research Center, Baylor College of Medicine, 1100 Bates Street, Houston, TX, 77030, USA.
| | - Theresa A Nicklas
- Children's Nutrition Research Center, Baylor College of Medicine, 1100 Bates Street, Houston, TX, 77030, USA
| | - Tom Baranowski
- Children's Nutrition Research Center, Baylor College of Medicine, 1100 Bates Street, Houston, TX, 77030, USA
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24
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Guo H, Zhang Y, Li P, Zhou P, Chen LM, Li SY. Evaluating the effects of mobile health intervention on weight management, glycemic control and pregnancy outcomes in patients with gestational diabetes mellitus. J Endocrinol Invest 2019; 42:709-714. [PMID: 30406378 DOI: 10.1007/s40618-018-0975-0] [Citation(s) in RCA: 64] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2018] [Accepted: 10/31/2018] [Indexed: 12/22/2022]
Abstract
PURPOSE To explore the effects of mobile health (mHealth) intervention on pregnancy weight management, blood glucose control and pregnancy outcomes. METHODS A total of 124 patients with gestational diabetes mellitus (GDM) were selected. Patients were randomly divided into two groups. The 60 patients in the control group received standard outpatient treatment, while the remaining 64 patients received a nurse's online guidance both through a mobile medical App installed on their phone and through regular offline clinical treatment in the mHealth group. Patients were treated for an average of 13 weeks and general conditions, compliance, blood glucose, glycosylated hemoglobin, weight gain, pregnancy, and neonatal outcomes were monitored in both groups longitudinally. RESULTS The mHealth group demonstrated higher levels of compliance (83.3 ± 12.5% vs. 70.4 ± 10.1%, t = - 6.293, df = 122, p < 0.001), lower frequency of outpatient service (8.1 ± 1.3 vs. 11.2 ± 1.1, t = 14.285, df = 122, p < 0.001), lower hemoglobin A1C before delivery (4.7 ± 0.2 vs. 5.3 ± 0.3, t = 13.216, df = 122, p < 0.001) as well as the rates of off-target measurements both fasting (4.6 ± 0.4% vs. 8.3 ± 0.6%, t = 40.659, df = 122, p < 0.001) and 2 h post-prandial (7.9 ± 0.7% vs. 14.7 ± 0.8%, t = 50.746, df = 122, p < 0.001). Weight gain in the mHealth group was less than control group (3.2 ± 0.8 vs. 4.8 ± 0.7, t = 11.851, df = 122 p < 0.001). CONCLUSION Mobile health intervention management of gestational diabetes mellitus improves patients' compliance and blood glucose control, and reduces weight gain, thereby reducing the rates of complications in both pregnant women and fetuses during delivery during pregnancy.
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Affiliation(s)
- H Guo
- NHC Key Laboratory of Hormones and Development (Tianjin Medical University), Tianjin Key Laboratory of Metabolic Diseases, Tianjin Medical University Metabolic Diseases Hospital, Tianjin Institute of Endocrinology, Tianjin, 300070, China
| | - Y Zhang
- NHC Key Laboratory of Hormones and Development (Tianjin Medical University), Tianjin Key Laboratory of Metabolic Diseases, Tianjin Medical University Metabolic Diseases Hospital, Tianjin Institute of Endocrinology, Tianjin, 300070, China
| | - P Li
- NHC Key Laboratory of Hormones and Development (Tianjin Medical University), Tianjin Key Laboratory of Metabolic Diseases, Tianjin Medical University Metabolic Diseases Hospital, Tianjin Institute of Endocrinology, Tianjin, 300070, China
| | - P Zhou
- NHC Key Laboratory of Hormones and Development (Tianjin Medical University), Tianjin Key Laboratory of Metabolic Diseases, Tianjin Medical University Metabolic Diseases Hospital, Tianjin Institute of Endocrinology, Tianjin, 300070, China
| | - L-M Chen
- NHC Key Laboratory of Hormones and Development (Tianjin Medical University), Tianjin Key Laboratory of Metabolic Diseases, Tianjin Medical University Metabolic Diseases Hospital, Tianjin Institute of Endocrinology, Tianjin, 300070, China
| | - S-Y Li
- NHC Key Laboratory of Hormones and Development (Tianjin Medical University), Tianjin Key Laboratory of Metabolic Diseases, Tianjin Medical University Metabolic Diseases Hospital, Tianjin Institute of Endocrinology, Tianjin, 300070, China.
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25
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Heslehurst N, Vieira R, Akhter Z, Bailey H, Slack E, Ngongalah L, Pemu A, Rankin J. The association between maternal body mass index and child obesity: A systematic review and meta-analysis. PLoS Med 2019; 16:e1002817. [PMID: 31185012 PMCID: PMC6559702 DOI: 10.1371/journal.pmed.1002817] [Citation(s) in RCA: 219] [Impact Index Per Article: 43.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 05/01/2019] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND There is a global obesity crisis, particularly among women and disadvantaged populations. Early-life intervention to prevent childhood obesity is a priority for public health, global health, and clinical practice. Understanding the association between childhood obesity and maternal pre-pregnancy weight status would inform policy and practice by allowing one to estimate the potential for offspring health gain through channelling resources into intervention. This systematic review and meta-analysis aimed to examine the dose-response association between maternal body mass index (BMI) and childhood obesity in the offspring. METHODS AND FINDINGS Searches in MEDLINE, Child Development & Adolescent Studies, CINAHL, Embase, and PsycInfo were carried out in August 2017 and updated in March 2019. Supplementary searches included hand-searching reference lists, performing citation searching, and contacting authors. Two researchers carried out independent screening, data extraction, and quality assessment. Observational studies published in English and reporting associations between continuous and/or categorical maternal and child BMI or z-score were included. Categorical outcomes were child obesity (≥95th percentile, primary outcome), overweight/obesity (≥85th percentile), and overweight (85th to 95th percentile). Linear and nonlinear dose-response meta-analyses were conducted using random effects models. Studies that could not be included in meta-analyses were summarised narratively. Seventy-nine of 41,301 studies identified met the inclusion criteria (n = 59 cohorts). Meta-analyses of child obesity included 20 studies (n = 88,872); child overweight/obesity, 22 studies (n = 181,800); and overweight, 10 studies (n = 53,238). Associations were nonlinear and there were significantly increased odds of child obesity with maternal obesity (odds ratio [OR] 3.64, 95% CI 2.68-4.95) and maternal overweight (OR 1.89, 95% CI 1.62-2.19). Significantly increased odds were observed for child overweight/obesity (OR 2.69, 95% CI 2.10-3.46) and for child overweight (OR 1.80, 95% CI 1.25, 2.59) with maternal obesity. A limitation of this research is that the included studies did not always report the data in a format that enabled inclusion in this complex meta-analysis. CONCLUSIONS This research has identified a 264% increase in the odds of child obesity when mothers have obesity before conception. This study provides substantial evidence for the need to develop interventions that commence prior to conception, to support women of childbearing age with weight management in order to halt intergenerational obesity.
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Affiliation(s)
- Nicola Heslehurst
- Institute of Health & Society, Newcastle University, Newcastle upon
Tyne, United Kingdom
- * E-mail:
| | - Rute Vieira
- Institute of Health & Society, Newcastle University, Newcastle upon
Tyne, United Kingdom
- Institute of Applied Health Sciences, University of Aberdeen, Aberdeen,
United Kingdom
| | - Zainab Akhter
- Institute of Health & Society, Newcastle University, Newcastle upon
Tyne, United Kingdom
| | - Hayley Bailey
- Institute of Health & Society, Newcastle University, Newcastle upon
Tyne, United Kingdom
| | - Emma Slack
- Institute of Health & Society, Newcastle University, Newcastle upon
Tyne, United Kingdom
| | - Lem Ngongalah
- Institute of Health & Society, Newcastle University, Newcastle upon
Tyne, United Kingdom
| | - Augustina Pemu
- Institute of Health & Society, Newcastle University, Newcastle upon
Tyne, United Kingdom
| | - Judith Rankin
- Institute of Health & Society, Newcastle University, Newcastle upon
Tyne, United Kingdom
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26
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Vargas-Terrones M, Nagpal TS, Barakat R. Impact of exercise during pregnancy on gestational weight gain and birth weight: an overview. Braz J Phys Ther 2019; 23:164-169. [PMID: 30527949 PMCID: PMC6428912 DOI: 10.1016/j.bjpt.2018.11.012] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 11/05/2018] [Accepted: 11/08/2018] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE This article presents the state of knowledge related to the impact of exercise on gestational weight gain and birth weight. TRANSCENDENCE OF BABY WEIGHT Birth weight is an important indicator of intrauterine environment and maternal and newborn health. There are several factors that can affect birth weight including mother's pre-pregnancy Body Mass Index (BMI), gestational weight gain, Gestational Diabetes Mellitus (GDM), chronic diabetes and gestational age at birth. IMPACT OF EXERCISE DURING PREGNANCY Physical exercise has the potential to prevent excessive gestational weight gain, GDM and the potential complications associated with obesity during pregnancy. Therefore, women who regularly exercise during pregnancy are more likely to have an appropriate gestational weight gain and in turn, an appropriate birth weight infant, preventing being LGA without increasing risk of SGA, and this reduces risk factors for later life chronic disease development in the child including cardiovascular disease, obesity and diabetes. RECOMMENDATIONS It would be advisable to promote compliance with physical activity and exercise recommendations during pregnancy by using the specific resources to prescribe exercise to pregnant women without obstetric contraindications.
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Affiliation(s)
- Marina Vargas-Terrones
- AFIPE Research Group, Faculty of Sciences for Physical Activity and Sport, INEF, Universidad Politécnica de Madrid (UPM), Madrid, Spain.
| | - Taniya S Nagpal
- R. Samuel McLaughlin Foundation-Exercise and Pregnancy Laboratory, School of Kinesiology, The University of Western Ontario, London, Ontario, Canada
| | - Ruben Barakat
- AFIPE Research Group, Faculty of Sciences for Physical Activity and Sport, INEF, Universidad Politécnica de Madrid (UPM), Madrid, Spain
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27
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O'Brien CM, Louise J, Deussen A, Grivell R, Dodd JM. The effect of maternal obesity on fetal biometry, body composition, and growth velocity. J Matern Fetal Neonatal Med 2018; 33:2216-2226. [PMID: 30394153 DOI: 10.1080/14767058.2018.1543658] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Introduction: The aim of this secondary analysis was to investigate the relationship between maternal body mass index (BMI) and fetal biometry, body composition, and velocity measurements at 28 and 36 weeks gestation.Materials and methods: The current analysis involves 911 overweight or obese women who were randomized to the Standard Care group of the LIMIT randomized trial.Results: The fetus of women with Class 3 obesity (BMI ≥ 40.0) showed the greatest increase in all biometry z-scores, abdominal area (AA), and abdominal fat mass (AFM) compared with women classified as overweight (BMI 25.0-29.9). In women with Class 3 obesity, AA velocity was increased by 0.035 cm2 (0.004, 0.066, p = .029) and the z-score velocity was increased by 0.238 (0.022, 0.453, p = .03). Estimated fetal weight (EFW) velocity for women with Class 3 obesity was higher than that of overweight women by 2.028 g per day (0.861, 3.196, p<.001) and the z-score velocity was also higher by 0.441 per day (0.196, 0.687, p < .001).Conclusions: Maternal obesity is associated with an increase in fetal abdominal circumference, AFM and area along with EFW velocity over time. Women with Class 3 obesity (BMI ≥ 40.0) may represent a higher risk group for perpetuating the intergenerational transmission of obesity to their offspring.
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Affiliation(s)
- Cecelia M O'Brien
- Discipline of Obstetrics and Gynaecology, Robinson Research Institute, University of Adelaide, Adelaide, Australia
| | - Jennie Louise
- Discipline of Obstetrics and Gynaecology, Robinson Research Institute, University of Adelaide, Adelaide, Australia.,Adelaide Health Technology Assessment, Faculty of Health Sciences, University of Adelaide, Adelaide, Australia
| | - Andrea Deussen
- Discipline of Obstetrics and Gynaecology, Robinson Research Institute, University of Adelaide, Adelaide, Australia
| | - Rosalie Grivell
- Discipline of Obstetrics and Gynaecology, Robinson Research Institute, University of Adelaide, Adelaide, Australia.,Discipline of Obstetrics, Gynaecology and Reproductive Medicine Flinders Medical Centre, Adelaide, Australia
| | - Jodie M Dodd
- Discipline of Obstetrics and Gynaecology, Robinson Research Institute, University of Adelaide, Adelaide, Australia.,Department of Perinatal Medicine, Women's and Babies Division, Women's and Children's Hospital, Adelaide, Australia
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Craig SJC, Blankenberg D, Parodi ACL, Paul IM, Birch LL, Savage JS, Marini ME, Stokes JL, Nekrutenko A, Reimherr M, Chiaromonte F, Makova KD. Child Weight Gain Trajectories Linked To Oral Microbiota Composition. Sci Rep 2018; 8:14030. [PMID: 30232389 PMCID: PMC6145887 DOI: 10.1038/s41598-018-31866-9] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Accepted: 08/27/2018] [Indexed: 12/16/2022] Open
Abstract
Gut and oral microbiota perturbations have been observed in obese adults and adolescents; less is known about their influence on weight gain in young children. Here we analyzed the gut and oral microbiota of 226 two-year-olds with 16S rRNA gene sequencing. Weight and length were measured at seven time points and used to identify children with rapid infant weight gain (a strong risk factor for childhood obesity), and to derive growth curves with innovative Functional Data Analysis (FDA) techniques. We showed that growth curves were associated negatively with diversity, and positively with the Firmicutes-to-Bacteroidetes ratio, of the oral microbiota. We also demonstrated an association between the gut microbiota and child growth, even after controlling for the effect of diet on the microbiota. Lastly, we identified several bacterial genera that were associated with child growth patterns. These results suggest that by the age of two, the oral microbiota of children with rapid infant weight gain may have already begun to establish patterns often seen in obese adults. They also suggest that the gut microbiota at age two, while strongly influenced by diet, does not harbor obesity signatures many researchers identified in later life stages.
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Affiliation(s)
- Sarah J C Craig
- Center for Medical Genomics, Penn State University, University Park, PA, 16802, USA.,Department of Biology, Penn State University, University Park, PA, 16802, USA
| | - Daniel Blankenberg
- Department of Biochemistry and Molecular Biology, Penn State University, University Park, PA, 16802, USA.,Genomic Medicine Institute, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, 44195, USA
| | - Alice Carla Luisa Parodi
- Department of Mathematics, Politecnico di Milano, Piazza Leonardo da Vinci, 32, Milano, 20133, Italy
| | - Ian M Paul
- Center for Medical Genomics, Penn State University, University Park, PA, 16802, USA.,Department of Pediatrics, Penn State College of Medicine, 500 University Drive, Hershey, PA, 17033, USA
| | - Leann L Birch
- Department of Foods and Nutrition, 176 Dawson Hall, University of Georgia, Athens, GA, 30602, USA
| | - Jennifer S Savage
- Center for Childhood Obesity Research, Penn State University, University Park, PA, 16802, USA.,Department of Nutritional Sciences, Penn State University, University Park, PA, 16802, USA
| | - Michele E Marini
- Center for Childhood Obesity Research, Penn State University, University Park, PA, 16802, USA
| | - Jennifer L Stokes
- Department of Pediatrics, Penn State College of Medicine, 500 University Drive, Hershey, PA, 17033, USA
| | - Anton Nekrutenko
- Department of Biochemistry and Molecular Biology, Penn State University, University Park, PA, 16802, USA
| | - Matthew Reimherr
- Center for Medical Genomics, Penn State University, University Park, PA, 16802, USA. .,Department of Statistics, Penn State University, University Park, PA, 16802, USA.
| | - Francesca Chiaromonte
- Center for Medical Genomics, Penn State University, University Park, PA, 16802, USA. .,Department of Statistics, Penn State University, University Park, PA, 16802, USA. .,EMbeDS, Sant'Anna School of Advanced Studies, Piazza Martiri della Libertà, 33, Pisa, 56127, Italy.
| | - Kateryna D Makova
- Center for Medical Genomics, Penn State University, University Park, PA, 16802, USA. .,Department of Biology, Penn State University, University Park, PA, 16802, USA.
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Fensterseifer SR, Austin KJ, Ford SP, Alexander BM. Effects of maternal obesity on maternal and fetal plasma concentrations of adiponectin and expression of adiponectin and its receptor genes in cotyledonary and adipose tissues at mid- and late-gestation in sheep. Anim Reprod Sci 2018; 197:231-239. [PMID: 30172606 DOI: 10.1016/j.anireprosci.2018.08.033] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 08/16/2018] [Accepted: 08/24/2018] [Indexed: 12/15/2022]
Abstract
Adiponectin potentially influences fetal weight by altering insulin signaling and trans-placental amino acid and glucose transporters. The objective of this study was to determine how maternal obesity influences maternal and fetal plasma concentrations of adiponectin, expression of fetal adiponectin, its receptors, and adipogenic genes at mid- and late-gestation. Blood samples and tissues were collected from obese and control multiparous pregnant ewes at day 75 or 135 of gestation. Although day of gestation or maternal obesity did not influence (P > 0.6) maternal plasma concentrations of adiponectin, fetal weight was increased (P < 0.001) and adiponectin tended to decrease (P = 0.10) at mid-gestation in fetuses from obese ewes. Differences were not apparent at late-gestation (P > 0.70). Relative abundance of adiponectin (P = 0.01), AdipoR2 (P = 0.04) and PPARγ (P = 0.01) mRNA was less at mid-gestation in fetal adipose tissue from obese mothers. By late gestation, maternal obesity tended to associated with a decrease in relative abundance of adiponectin (P = 0.09) and SREBF1 (P = 0.10) mRNA in fetal adipose tissue. Maternal obesity did not influence (P ≥ 0.20) the relative abundance of adiponectin, AdipoR1 and AdipoR2 mRNA in cotyledonary tissue at mid or late- gestation. In conclusion, maternal obesity in sheep influences relative abundance of fetal adipose tissue mRNA for adiponectin and adipogenic, as well as plasma concentrations of total adiponectin. Although adiposity in pregnant ewes did not influence maternal adiponectin, maternal obesity potentially influenced fetal adipogenesis by altering the abundance of adiponectin, PPARγ and SREBF1 mRNA in fetal adipose tissue.
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Affiliation(s)
- S R Fensterseifer
- Department of Animal Science, University of Wyoming, Laramie, WY, 82071, United States
| | - K J Austin
- Department of Animal Science, University of Wyoming, Laramie, WY, 82071, United States
| | - S P Ford
- Department of Animal Science, University of Wyoming, Laramie, WY, 82071, United States; Center for the Study of Fetal Programming, Department of Animal Science, University of Wyoming, Laramie, WY, 82071, United States
| | - B M Alexander
- Department of Animal Science, University of Wyoming, Laramie, WY, 82071, United States.
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High glucose suppresses the viability and proliferation of HTR‑8/SVneo cells through regulation of the miR‑137/PRKAA1/IL‑6 axis. Int J Mol Med 2018; 42:799-810. [PMID: 29786111 PMCID: PMC6034938 DOI: 10.3892/ijmm.2018.3686] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Accepted: 04/27/2018] [Indexed: 12/19/2022] Open
Abstract
The aim of the present study was to investigate the mechanism underlying the high glucose (HG)-associated regulation of HTR-8/SVneo cell viability and proliferation during gestational diabetes mellitus (GDM), and to verify the association of microRNA (miR)-137, protein kinase AMP-activated catalytic subunit α1 (PRKAA1) and interlukin-6 (IL-6). miR-137-overexpressing and negative control HTR-8/SVneo cells were established by lentiviral vector infection. Cell Counting Kit-8 and colony formation assays were used to analyze the viability and proliferation of HTR-8/SVneo cells. Reverse transcription-quantitative polymerase chain reaction analysis was used to determine the transcriptional activity of miR-137, PRKAA1 and Il-6, and ELISA and western blot analysis were used to measure the protein levels of IL-6 and PRKAA1, respectively. It was demonstrated that PRKAA1 was decreased in the placental tissues of women with GDM and HG-treated HTR-8/SVneo cells, and that HG upregulated miR-137 and IL-6 in trophoblasts. The overexpression of miR-137 decreased levels of PRKAA1 and increased levels of IL-6 in the HTR-8/SVneo cells. An inhibitor of PRKAA1 promoted the secretion of IL-6, whereas an agonist of PRKAA1 suppressed the production of IL-6. HG treatment and the overexpression of miR-137 reduced the viability and proliferation of HTR-8/SVneo cells in vitro, whereas the activation of PRKAA1 or incubation with IL-6 antibody reversed these effects. Overall, it was concluded that HG suppressed the viability and proliferation of trophoblast cells through the miR-137/PRKAA1/IL-6 axis, which may contribute to pathological changes of placental tissues in GDM.
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Hassan NE, El-Masry SA, El Batrawy SR, Khalil A, Ali MM, Al Tohamy M, Abo Hashish M. Relationship between breast feeding duration and risk of overweight/obesity among Egyptian children. EGYPTIAN PEDIATRIC ASSOCIATION GAZETTE 2018. [DOI: 10.1016/j.epag.2018.01.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Ganer Herman H, Dekalo A, Jubran L, Schreiber L, Bar J, Kovo M. Obstetric outcomes and placental findings in gestational diabetes patients according to maternal prepregnancy weight and weight gain. J Matern Fetal Neonatal Med 2018; 32:1682-1687. [DOI: 10.1080/14767058.2017.1416078] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Hadas Ganer Herman
- Department of Obstetrics and Gynecology, the Edith Wolfson Medical Center, Holon, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ann Dekalo
- Department of Obstetrics and Gynecology, the Edith Wolfson Medical Center, Holon, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Lora Jubran
- Department of Obstetrics and Gynecology, the Edith Wolfson Medical Center, Holon, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Letizia Schreiber
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Pathology, The Edith Wolfson Medical Center, Holon, Israel
| | - Jacob Bar
- Department of Obstetrics and Gynecology, the Edith Wolfson Medical Center, Holon, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Michal Kovo
- Department of Obstetrics and Gynecology, the Edith Wolfson Medical Center, Holon, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Kawasaki M, Arata N, Miyazaki C, Mori R, Kikuchi T, Ogawa Y, Ota E. Obesity and abnormal glucose tolerance in offspring of diabetic mothers: A systematic review and meta-analysis. PLoS One 2018; 13:e0190676. [PMID: 29329330 PMCID: PMC5766126 DOI: 10.1371/journal.pone.0190676] [Citation(s) in RCA: 97] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Accepted: 12/19/2017] [Indexed: 12/21/2022] Open
Abstract
Background Rising prevalence of childhood obesity and type 2 diabetes mellitus (T2DM) is an emerging public health issue. Objectives To investigate the association of maternal hyperglycemia exposure during pregnancy with obesity and abnormal glucose tolerance in offspring, and the age at occurrence. Methods We searched MEDLINE and EMBASE for observational studies on obesity and diabetes in offspring of diabetic mothers (gestational diabetes mellitus (GDM), type 1 diabetes mellitus (T1DM) and T2DM), and those on non-diabetic mothers. We performed fixed effect meta-analysis for all studies except when heterogeneity was detected. The quality of studies was evaluated using the Risk of Bias Assessment Tool for Nonrandomized Studies (RoBANS) Results Twenty observational studies were included involving a total of 26,509 children. Offspring of GDM mother had higher BMI z-score in childhood (pooled MD: 0.14, 95%CI: 0.04–0.24, seven studies, 21,691children, low quality of evidence). Offspring of T1DM mothers had higher BMI z-score from prepubertal to adolescent (pooled MD: 0.35, 95% CI: 0.13–0.58, three studies, 844 children, low quality of evidence) compared with control. After adjustment for maternal pre-pregnancy BMI, this association remained in offspring of T1DM, but disappeared in those of GDM mothers. Offspring of GDM mother had higher 2-hour plasma glucose from prepubertal to early adulthood (pooled MD: 0.43 mmol/L, 95% CI: 0.18–0.69, five studies, 890 children), while those of T1DM mothers had higher rate of T2DM in 2–5 years old to early adulthood (pooled odds ratio [OR], 6.10: 95% CI: 1.23–30.37, two studies, 448 children, very low quality of evidence) compared with control. As there was only one study with offspring of T2DM mothers, evidence is sparse. Limitations Only observational studies were included, with a few adequately adjusted for covariables. Conclusions Exposure to maternal hyperglycemia was associated with offspring obesity and abnormal glucose tolerance especially in offspring of T1DM mothers, but the evidence relies on observational studies with low quality of evidence only.
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Affiliation(s)
- Maki Kawasaki
- Department of Health Policy, National Center for Child Health and Development, Tokyo, Japan
- Department of Molecular Endocrinology and Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Naoko Arata
- Division of Maternal Medicine, Center for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan
- * E-mail:
| | - Celine Miyazaki
- Department of Health Policy, National Center for Child Health and Development, Tokyo, Japan
| | - Rintaro Mori
- Department of Health Policy, National Center for Child Health and Development, Tokyo, Japan
| | - Toru Kikuchi
- Department of Pediatrics, Saitama Medical University Hospital, Saitama, Japan
| | - Yoshihiro Ogawa
- Department of Molecular Endocrinology and Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Erika Ota
- Department of Health Policy, National Center for Child Health and Development, Tokyo, Japan
- St. Luke’s International University, Graduate School of Nursing, Global Health Nursing, Tokyo, Japan
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Huang Y, Yin B, Liang X, Mei H, Lu H, Xie S, Bei W, Mei W, Zhang J. Effect of maternal glycemia and weight status on offspring birth measures and BMI-z among Chinese population in the first year. Sci Rep 2017; 7:16030. [PMID: 29167502 PMCID: PMC5700092 DOI: 10.1038/s41598-017-15932-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Accepted: 11/03/2017] [Indexed: 11/25/2022] Open
Abstract
To investigate the effects of maternal fasting plasma glucose (FPG) and pre-pregnancy weight status (PPWS) on offspring birth measures and body mass index z-score (BMI-z) in the first year, we conducted a prospective study of 1,096 mother-infant dyads in Guangdong, China, 2014–2015. Multivariate logistic regression was used to test independent/interaction associations of maternal FPG and PPWS with macrosomia/large for gestational age (LGA). Association of PPWS and FPG with offspring BMI-z in the first year was assessed by the linear mixed effects models. For each 1-mmol/L increase in FPG, the risk of macrosomia and LGA was elevated by 2.74 and 2.01 (95% CI: 1.85, 7.60 and 1.54, 5.88), respectively. No main effect of PPWS or interaction association of FPG and PPWS on macrosomia/LGA was observed (P > 0.05). A relation between maternal FPG and PPWS was detected (P < 0.05). Infants of Q5 FPG mothers, those who were born to OWO mothers, had a 0.35 increase in the BMI-z (95% CI: 0.16, 0.55) compared with infants of NW mothers. In conclusion, maternal FPG is positively associated with macrosomia/LGA. Maternal PPWS and FPG considerably interacted for the association with the risk of offspring high BMI-z in the first year.
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Affiliation(s)
- Yilin Huang
- Department of Maternal and Child Health Care, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Rd., Wuhan, 430030, Hubei, China
| | - Baoming Yin
- Department of Gynecology and Obstetric, Maternal and Child Health Hospital of Zhuhai Municipality,, 543 Ningxi Rd., Zhuhai, 519001, Guangdong, China
| | - Xiaohong Liang
- Department of Child Health, Maternal and Child Health Hospital of Zhuhai Municipality,, 543 Ningxi Rd., Zhuhai, 519001, Guangdong, China
| | - Hong Mei
- Department of Maternal and Child Health Care, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Rd., Wuhan, 430030, Hubei, China
| | - Hongyan Lu
- Department of Maternal and Child Health Care, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Rd., Wuhan, 430030, Hubei, China
| | - Shuixian Xie
- Department of Maternal and Child Health Care, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Rd., Wuhan, 430030, Hubei, China
| | - Weihong Bei
- Department of Child Health, Maternal and Child Health Hospital of Zhuhai Municipality,, 543 Ningxi Rd., Zhuhai, 519001, Guangdong, China
| | - Wenhua Mei
- Public Hospital Administration of Zhuhai Municipality,, 41 Jiaoyu Rd., Zhuhai, 519000, Guangdong, China
| | - Jianduan Zhang
- Department of Maternal and Child Health Care, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Rd., Wuhan, 430030, Hubei, China.
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Chi DL, Luu M, Chu F. A scoping review of epidemiologic risk factors for pediatric obesity: Implications for future childhood obesity and dental caries prevention research. J Public Health Dent 2017; 77 Suppl 1:S8-S31. [PMID: 28600842 DOI: 10.1111/jphd.12221] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Accepted: 04/06/2017] [Indexed: 01/31/2023]
Abstract
RESEARCH QUESTIONS What are the non-modifiable (socioeconomic, genetic) and modifiable factors (physical activity, dietary behaviors) related to childhood (under age 12) obesity? How can this knowledge be applied to oral health professionals' efforts to prevent or manage dental caries in children? OBJECTIVES Studies have identified risk factors for childhood obesity. The purpose of this scoping review was to develop a conceptual model to identify non-modifiable and modifiable risk factors for childhood obesity and to illustrate how these findings are relevant in developing interventions aimed at preventing obesity and dental caries in children. METHODS The authors searched PubMed and Embase and limited the study to English-language publications. A total of 2,572 studies were identified. After de-duplication, 2,479 studies remained and were downloaded into a citation-management tool. Two authors screened the titles and abstracts for relevance. Two hundred and sixty studies remained and were retrieved for a full-text review, and 80 studies were excluded, resulting in 180 studies included in the scoping review. An inductive content analytic methods was used to organize all statistically significant obesity risk factors into seven domains, which were classified as non-modifiable or modifiable; then a conceptual model of common risk factors associated with childhood obesity and dental caries was developed. RESULTS Non-modifiable obesity risk factors include biological and developmental (e.g., genes, developmental conditions, puberty), sociodemographic and household (e.g., race/ethnicity, socioeconomic status, parent education, unemployment), cultural (e.g., degree of acculturation), and community (e.g., neighborhood composition). Modifiable risk factors included behavioral (e.g., diet, physical activity, weight), psychosocial (e.g., maternal stress, family functioning, parenting practices, child temperament), and medical (e.g., parent smoking, maternal health, child health). CONCLUSIONS Identifying common risk factors has important implications for future oral health research aimed at preventing childhood obesity and dental caries. Epidemiologic knowledge gleaned from the literature can be used to develop rigorous interventions and programs aimed at preventing these highly prevalent diseases and improving health outcomes for children.
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Affiliation(s)
- Donald L Chi
- Oral Health Sciences, University of Washington, Seattle, WA, USA
| | - Monique Luu
- Oral Health Sciences, University of Washington, Seattle, WA, USA
| | - Frances Chu
- Oral Health Sciences, University of Washington, Seattle, WA, USA
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Gao X, Yan Y, Xiang S, Zeng G, Liu S, Sha T, He Q, Li H, Tan S, Chen C, Li L, Yan Q. The mutual effect of pre-pregnancy body mass index, waist circumference and gestational weight gain on obesity-related adverse pregnancy outcomes: A birth cohort study. PLoS One 2017; 12:e0177418. [PMID: 28575041 PMCID: PMC5456032 DOI: 10.1371/journal.pone.0177418] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Accepted: 04/26/2017] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVE The aim of this study was to examine the mutual effect of pre-pregnancy body mass index (BMI), waist circumference (WC) and gestational weight gain (GWG) on obesity-related adverse pregnancy outcomes. METHODS This birth cohort study was conducted in three Streets in Changsha, China, including a total of 976 mother-child pairs. All data was collected within 15 days after deliveries from a self-administered questionnaire, maternal health manual and perinatal health care information system. Multivariate logistic regression models were conducted to estimate the effects of maternal pre-pregnancy BMI, WC and GWG on obesity-related adverse pregnancy outcomes including gestational diabetes mellitus (GDM), primary cesarean section (P-CS), large for gestational age (LGA) and composite outcome (one or more adverse pregnancy outcomes). RESULTS After controlling for all confounders, both maternal pre-pregnancy overweight/obesity and central adiposity contributed to increased risks of GDM [ORs 95% CIs = 2.19 (1.02-4.76) and 2.26 (1.11-4.60), respectively], P-CS [ORs 95% CIs = 1.66 (1.05-2.65) and 1.71 (1.11-2.63), respectively], LGA [ORs 95% CIs = 1.93 (1.07-3.50) and 2.14 (1.21-3.75), respectively] and composite outcome [ORs 95% CIs = 1.82 (1.15-2.87) and 1.98 (1.30-3.01), respectively] compared with mothers with normal pre-pregnancy weight and normal WC. Excessive GWG was found to be associated with an increased risk of LGA [OR 95% CI = 1.74 (1.05-2.89)], but was not significantly related to higher risks of GDM, P-CS and composite outcome [ORs 95% CIs = 0.90 (0.47-1.72), 1.08 (0.77-1.52), and 1.30 (0.94-1.79), respectively]. In terms of the joint effect of maternal pregestational BMI and WC on obesity-related composite outcome, mothers with both pre-pregnancy overweight and central adiposity had the highest risk of composite outcome [OR 95% CI = 3.96 (2.40-6.54)], compared with mothers without pre-pregnancy overweight or central adiposity. CONCLUSIONS The results of this study suggest that maternal pre-pregnancy overweight/obesity and central adiposity may contribute to multiple obesity-related adverse pregnancy outcomes, excessive weight gain during pregnancy is associated with an increased risk of LGA. Healthcare providers should carry out health education, and guide women to keep an ideal BMI and WC prior to pregnancy and help them gain optimal weight during pregnancy based on their pre-pregnancy BMI and WC.
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Affiliation(s)
- Xiao Gao
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan Province, China
| | - Yan Yan
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan Province, China
- * E-mail:
| | - Shiting Xiang
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan Province, China
| | - Guangyu Zeng
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan Province, China
| | - Shiping Liu
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan Province, China
| | - Tingting Sha
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan Province, China
| | - Qiong He
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan Province, China
| | - Hongyan Li
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan Province, China
| | - Shan Tan
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan Province, China
| | - Cheng Chen
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan Province, China
| | - Ling Li
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan Province, China
| | - Qiang Yan
- Department of Maternal and Child Health, Kaifu District Health Bureau, Changsha, China
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Abstract
BACKGROUND The present study examined the effects of breastfeeding and its duration on the development of childhood obesity from 24 months through grade 6. METHODS U.S. longitudinal data collected from 1234 children were analyzed using logistic regression models and generalized estimating equation (GEE). Child height and weight were measured six times at ages of 24 months, 36 months, 54 months, grade 1, grade 3, and grade 6. RESULTS During the early 1990s, prevalence of breastfeeding was low in the United States, 60% and 48% at 1 and 6 months, respectively. Nonsmoking, white, married mothers with both parents in the household, and with income above the poverty line, were more likely to breastfeed at 1 month of age of their babies. Obesity rate of the children increased with age from 24 months to grade 6. Logistic regression showed that breastfeeding at month 1 was associated with 53% (odds ratio [OR]: 0.47, 95% confidence interval [CI]: 0.30-0.73) and 47% (OR: 0.53, 95% CI: 0.36-0.78) decreased risks for childhood obesity at grades 1 and 6, respectively. GEE analysis showed that breastfeeding at 1 month reduced risk for childhood obesity by 36% (95% CI: 0.47-0.88) from ages 24 months through grade 6. Regarding breastfeeding duration, more than 6 months (vs. never) was associated with a decreased risk for childhood obesity by 42% (OR: 0.58, 95% CI: 0.36-0.94). CONCLUSIONS Breastfeeding at 1 month and more than 6 months reduced the risk of childhood obesity. Rate of breastfeeding was low in the United States in the 1990s, which may have had long-term implications on children.
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Affiliation(s)
- Liang Wang
- 1 Department of Biostatistics and Epidemiology, College of Public Health, East Tennessee State University , Johnson City, TN
| | - Candice Collins
- 1 Department of Biostatistics and Epidemiology, College of Public Health, East Tennessee State University , Johnson City, TN
| | - Melanie Ratliff
- 1 Department of Biostatistics and Epidemiology, College of Public Health, East Tennessee State University , Johnson City, TN
| | - Bin Xie
- 2 School of Community and Global Health, Claremont Graduate University , Claremont, CA
| | - Youfa Wang
- 3 Fisher Institute of Health and Well-Being, Systems-Oriented Global Childhood Obesity Intervention Program, Department of Nutrition and Health Sciences, College of Health, Ball State University , Muncie, IN
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Shapiro ALB, Sauder KA, Tregellas JR, Legget KT, Gravitz SL, Ringham BM, Glueck DH, Johnson SL, Dabelea D. Exposure to maternal diabetes in utero and offspring eating behavior: The EPOCH study. Appetite 2017; 116:610-615. [PMID: 28478063 DOI: 10.1016/j.appet.2017.05.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Revised: 05/01/2017] [Accepted: 05/02/2017] [Indexed: 02/09/2023]
Abstract
The risk of becoming overweight among offspring exposed to gestational diabetes (GDM) in utero is two-fold higher than in the general population. The responsible mechanisms are likely multifactorial, with some evidence that GDM exposure alters brain satiety signaling, which may impact eating behavior. To better understand these effects, we investigated the relationship between GDM exposure, eating behavior, and total energy intake in 268 adolescents from the Exploring Perinatal Outcomes among Children cohort, who were exposed (n = 50) or not exposed (n = 217) to GDM in utero. Eating behavior was measured by the Eating in the Absence of Hunger in Children and Adolescents (EAH-C) questionnaire, which included subscale scores for Negative Affect, External Stimuli, and Fatigue/Boredom. Total energy intake (kcal/day) was derived from the Block Kid's Food Questionnaire. The associations between GDM exposure and the outcomes of total score and each EAH-C subscale were evaluated in separate multivariable models. In addition to the main predictor, GDM, the models included a GDM-by-sex interaction term and were adjusted for important covariates. The associations between EAH-C total and subscale scores and the outcome of total energy intake were also tested in separate multivariable models. Female offspring exposed to GDM in utero (vs unexposed males and females) were more likely to continue eating beyond satiation due to feelings of boredom and fatigue (β = 0.47, 95% CI: 0.11, 0.83), and in general (EAH-C total score; β = 4.20, 95% CI: 0.56, 7.86) compared to unexposed males. All EAH-C subscale and total scores were significantly, positively associated with higher energy intake (p < 0.05 for all, respectively). Our findings highlight the need for further investigation into the possible early life programming of eating behaviors by GDM exposure in utero.
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Affiliation(s)
- Allison L B Shapiro
- Department of Epidemiology, Colorado School of Public Health (CoSPH), University of Colorado at Anschutz (UC-Anschutz), Mail Stop F426, 12474 E. 19th Ave., Aurora, CO 80045, USA.
| | - Katherine A Sauder
- Department of Pediatrics, Section of Nutrition, School of Medicine, UC-Anschutz, Mail Stop F426, 12474 E. 19th Ave., Aurora, CO 80045, USA
| | - Jason R Tregellas
- Department of Psychiatry, School of Medicine, UC-Anschutz, Mail Stop F546, 13001 E. 17th Place, Aurora, CO 80045, USA
| | - Kristina T Legget
- Department of Psychiatry, School of Medicine, UC-Anschutz, Mail Stop F546, 13001 E. 17th Place, Aurora, CO 80045, USA
| | - Stephanie L Gravitz
- Department of Epidemiology, Colorado School of Public Health (CoSPH), University of Colorado at Anschutz (UC-Anschutz), Mail Stop F426, 12474 E. 19th Ave., Aurora, CO 80045, USA
| | - Brandy M Ringham
- Department of Biostatistics and Bioinformatics, CoSPH, UC-Anschutz, Mail Stop C245, 13001 E. 17th Place, Aurora, CO 80045, USA
| | - Deborah H Glueck
- Department of Biostatistics and Bioinformatics, CoSPH, UC-Anschutz, Mail Stop C245, 13001 E. 17th Place, Aurora, CO 80045, USA
| | - Susan L Johnson
- Department of Pediatrics, Section of Nutrition, School of Medicine, UC-Anschutz, Mail Stop F426, 12474 E. 19th Ave., Aurora, CO 80045, USA
| | - Dana Dabelea
- Department of Epidemiology, Colorado School of Public Health (CoSPH), University of Colorado at Anschutz (UC-Anschutz), Mail Stop F426, 12474 E. 19th Ave., Aurora, CO 80045, USA
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Viecceli C, Remonti LR, Hirakata VN, Mastella LS, Gnielka V, Oppermann MLR, Silveiro SP, Reichelt AJ. Weight gain adequacy and pregnancy outcomes in gestational diabetes: a meta-analysis. Obes Rev 2017; 18:567-580. [PMID: 28273690 DOI: 10.1111/obr.12521] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Revised: 12/27/2016] [Accepted: 01/03/2017] [Indexed: 02/06/2023]
Abstract
The Institute of Medicine updated guidelines for gestational weight gain in 2009, with no special recommendations for gestational diabetes. Our objectives were to describe the prevalence of weight gain adequacy and their association with adverse pregnancy outcomes in gestational diabetes. We searched MEDLINE, EMBASE, COCHRANE and SCOPUS. We calculated the pooled prevalence of gain adequacy and relative risks for pregnancy outcomes within Institute of Medicine categories. Thirty-three studies/abstracts (88,599 women) were included. Thirty-one studies provided data on the prevalence of weight gain adequacy; it was adequate in 34% (95% CI: 29-39%) of women, insufficient in 30% (95% CI: 27-34%) and excessive in 37% (95% CI: 33-41%). Excessive gain was associated with increased risks of pharmacological treatment, hypertensive disorders of pregnancy, caesarean section, large for gestational age and macrosomic babies, compared to adequate or non-excessive gain. Weight gain below the guidance had a protective effect on large babies (RR: 0.71; 95% CI: 0.56-0.90) and macrosomia (RR 0.57; 95% CI 0.40-0.83), and did not increase the risk of small babies (RR 1.40; 95% CI 0.86-2.27). Less than recommended weight gain would be beneficial, while effective prevention of excessive gain is of utmost importance, in gestational diabetes pregnancies. Nevertheless, no ideal range for weight gain could be established.
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Affiliation(s)
- C Viecceli
- Endocrinology Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - L R Remonti
- Endocrinology Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - V N Hirakata
- Biostatistics Unit, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - L S Mastella
- Post-graduate Course in Medical Sciences: Endocrinology, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - V Gnielka
- Post-graduate Course in Medical Sciences: Endocrinology, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - M L R Oppermann
- Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - S P Silveiro
- Endocrinology Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.,Post-graduate Course in Medical Sciences: Endocrinology, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - A J Reichelt
- Endocrinology Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
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Zhang S, Wang L, Leng J, Liu H, Li W, Zhang T, Li N, Li W, Tian H, Baccarelli AA, Hou L, Hu G. Hypertensive disorders of pregnancy in women with gestational diabetes mellitus on overweight status of their children. J Hum Hypertens 2017; 31:731-736. [PMID: 28300070 PMCID: PMC5600626 DOI: 10.1038/jhh.2017.17] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Revised: 12/20/2016] [Accepted: 01/17/2017] [Indexed: 12/16/2022]
Abstract
Hypertensive disorders of pregnancy (HDP) as a group of medical complications in pregnancy are believed to be associated with an increased risk of poor fetal growth, but the influence on offspring’s body composition is not clear. The aim of the present study was to evaluate the association between maternal hypertensive disorders of pregnancy and overweight status in the offspring of mothers with gestational diabetes mellitus (GDM). A cross-sectional study among 1263 GDM mother-child pairs was performed in Tianjin, China. General linear models and logistic regression models were used to assess the associations of maternal hypertension in pregnancy with anthropometry and overweight status in the offspring from birth to 1–5 years old. Offspring of GDM mothers who were diagnosed with hypertensive disorders during pregnancy had higher mean values of Z scores for birth weight for gestational age and birth weight for length, and higher mean values of Z scores for weight for age, weight for length/height, and body mass index for age at 1–5 years old than those of GDM mothers with normal blood pressure during pregnancy. Maternal hypertensive disorders of pregnancy were associated with increased risks of large for gestational age (OR 1.74, 95%CI 1.08–2.79) and macrosomia (OR 2.02, 95%CI 1.23–3.31) at birth and childhood overweight/obesity at 1–5 years old age (OR 1.88, 95%CI 1.16–3.04). For offspring of mothers with GDM, maternal hypertension during pregnancy was a risk factor for macrosomia at birth and childhood overweight and obesity, and controlling the maternal hypertension may be more important for preventing large for gestational age babies and childhood obesity.
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Affiliation(s)
- S Zhang
- Tianjin Women's and Children's Health Center, Tianjin, China
| | - L Wang
- Tianjin Women's and Children's Health Center, Tianjin, China
| | - J Leng
- Tianjin Women's and Children's Health Center, Tianjin, China
| | - H Liu
- Tianjin Women's and Children's Health Center, Tianjin, China
| | - W Li
- Tianjin Women's and Children's Health Center, Tianjin, China
| | - T Zhang
- Tianjin Women's and Children's Health Center, Tianjin, China.,Chronic Disease Epidemiology Laboratory, Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - N Li
- Tianjin Women's and Children's Health Center, Tianjin, China
| | - W Li
- Tianjin Women's and Children's Health Center, Tianjin, China
| | - H Tian
- Tianjin Women's and Children's Health Center, Tianjin, China
| | - A A Baccarelli
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, USA
| | - L Hou
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - G Hu
- Chronic Disease Epidemiology Laboratory, Pennington Biomedical Research Center, Baton Rouge, LA, USA
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Physical Activity, TV Watching Time, Sleeping, and Risk of Obesity and Hyperglycemia in the Offspring of Mothers with Gestational Diabetes Mellitus. Sci Rep 2017; 7:41115. [PMID: 28120866 PMCID: PMC5264639 DOI: 10.1038/srep41115] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Accepted: 12/15/2016] [Indexed: 01/06/2023] Open
Abstract
We investigated the association of physical activity, TV watching time, sleeping time with the risks of obesity and hyperglycemia among 1263 offspring aged 1-5 years of mothers with gestational diabetes (GDM) in a cross-sectional study. Logistic regression models were used to obtain the odd ratios (ORs) (95% confidence intervals [CI]) of childhood obesity and hyperglycemia associated with different levels of indoor activity, outdoor activity, TV watching, and sleeping time. The multivariable-adjusted ORs of obesity based on different levels of TV watching time (0, <1.0, and ≥1.0 hour/day) were 1.00, 1.21 (95% CI 0.72-2.05), and 2.20 (95% CI 1.33-3.63) (Ptrend = 0.003), respectively. The multivariable-adjusted ORs of hyperglycemia based on different levels of indoor activity (<5.0, 5.0-6.9, and ≥7.0 hours/day) were 1.00, 0.74 (95% CI 0.45-1.21), and 0.49 (95% CI 0.28-0.84) (Ptrend = 0.034), respectively. The multivariable-adjusted ORs of hyperglycemia associated with different levels of sleeping time (<11.0, 11.0-11.9, and ≥12.0 hours/day) were 1.00, 0.67 (95% CI 0.42-1.05), and 0.39 (95% CI 0.23-0.67) (Ptrend = 0.003), respectively. The present study indicated a positive association of TV watching with the risk of obesity, and an inverse association of either indoor activity or sleeping time with the risk of hyperglycemia among offspring born to GDM mothers in Tianjin, China.
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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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Independent and Combined Effects of Maternal Prepregnancy Body Mass Index and Gestational Weight Gain on Offspring Growth at 0-3 Years of Age. BIOMED RESEARCH INTERNATIONAL 2016; 2016:4720785. [PMID: 27652262 PMCID: PMC5019937 DOI: 10.1155/2016/4720785] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Revised: 07/27/2016] [Accepted: 08/02/2016] [Indexed: 02/05/2023]
Abstract
Background. The objective of this study was to investigate the independent and combined effects of maternal prepregnancy body mass index (BMI) and gestational weight gain (GWG) on offspring growth at 0-3 years old. Methods. A total of 826 pairs of nondiabetic mothers and their offspring were recruited in this study. Maternal information was abstracted from medical records and questionnaires. Offspring growth trajectories of weights and BMIs were depicted based on anthropometric measurements. Results. Offspring of mothers who were prepregnancy overweight/obese or obtained excessive GWGs continuously had greater weight and BMI Z-scores throughout the first 3 years of life. Children of prepregnancy overweight/obese mothers with excessive GWGs had a phenotype of higher weight and BMI Z-scores than those prepregnancy overweight/obese ones with nonexcessive GWGs from birth to 18 months. Maternal excessive GWGs increased offspring's risk of overweight/obesity at 12 months (AOR = 1.43, 95% CI: 1.03-2.00) and 24 months (AOR = 1.51, 95% CI: 1.02-2.25). Combination of excessive prepregnancy BMIs and GWGs was significantly associated with offspring's overweight/obesity at 30 months (AOR = 2.98, 95% CI: 1.36-6.53). Conclusions. Maternal prepregnancy overweight/obesity and excessive GWG are both significantly associated with rapid offspring growth from birth to 3 years old. Excessive GWGs strengthen the effects of high maternal prepregnancy BMIs on excessive offspring growth during their early life.
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Talton OO, Pennington KA, Pollock KE, Bates K, Ma L, Ellersieck MR, Schulz LC. Maternal Hyperleptinemia Improves Offspring Insulin Sensitivity in Mice. Endocrinology 2016; 157:2636-48. [PMID: 27145007 DOI: 10.1210/en.2016-1039] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Maternal obesity and gestational diabetes are prevalent worldwide. Offspring of mothers with these conditions weigh more and are predisposed to metabolic syndrome. A hallmark of both conditions is maternal hyperleptinemia, but the role of elevated leptin levels during pregnancy on developmental programming is largely unknown. We previously found that offspring of hyperleptinemic mothers weighed less and had increased activity. The goal of this study was to determine whether maternal leptin affects offspring insulin sensitivity by investigating offspring glucose metabolism and lipid accumulation. Offspring from two maternal hyperleptinemic models were compared. The first model of hyperleptinemia is the Lepr(db/+) mouse, which has a mutation in one copy of the gene that encodes the leptin receptor, resulting in a truncated long form of the receptor, and hyperleptinemia. Wild-type females served as the control for the Lepr(db/+) females. For the second hyperleptinemic model, wild-type females were implanted with miniosmotic pumps, which released leptin (350 ng/h) or saline (as the control) just prior to mating and throughout gestation. In the offspring of these dams, we measured glucose tolerance; serum leptin, insulin, and triglyceride levels; liver triglycerides; pancreatic α- and β-cell numbers; body composition; incidence of nonalcoholic fatty liver disease; and the expression of key metabolic genes in the liver and adipose tissue. We found that the offspring of hyperleptinemic dams exhibited improved glucose tolerance, reduced insulin and leptin concentrations, reduced liver triglycerides, and a lower incidence of nonalcoholic fatty liver disease. Overall, maternal hyperleptinemia was beneficial for offspring glucose and lipid metabolism.
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Affiliation(s)
- Omonseigho O Talton
- Departments of Obstetrics, Gynecology, and Women's Health (O.O.T., K.A.P., K.E.P., K.B., L.C.S.) and Radiology (L.M.) and Divisions of Biological Sciences (O.O.T., K.B., L.C.S.) and Animal Sciences (K.E.P., M.R.E., L.C.S.), University of Missouri, Columbia, Missouri 65212; and Biomolecular Imaging Center (L.M.), Harry S. Truman Veterans Affairs Hospital, Columbia, Missouri 65201
| | - Kathleen A Pennington
- Departments of Obstetrics, Gynecology, and Women's Health (O.O.T., K.A.P., K.E.P., K.B., L.C.S.) and Radiology (L.M.) and Divisions of Biological Sciences (O.O.T., K.B., L.C.S.) and Animal Sciences (K.E.P., M.R.E., L.C.S.), University of Missouri, Columbia, Missouri 65212; and Biomolecular Imaging Center (L.M.), Harry S. Truman Veterans Affairs Hospital, Columbia, Missouri 65201
| | - Kelly E Pollock
- Departments of Obstetrics, Gynecology, and Women's Health (O.O.T., K.A.P., K.E.P., K.B., L.C.S.) and Radiology (L.M.) and Divisions of Biological Sciences (O.O.T., K.B., L.C.S.) and Animal Sciences (K.E.P., M.R.E., L.C.S.), University of Missouri, Columbia, Missouri 65212; and Biomolecular Imaging Center (L.M.), Harry S. Truman Veterans Affairs Hospital, Columbia, Missouri 65201
| | - Keenan Bates
- Departments of Obstetrics, Gynecology, and Women's Health (O.O.T., K.A.P., K.E.P., K.B., L.C.S.) and Radiology (L.M.) and Divisions of Biological Sciences (O.O.T., K.B., L.C.S.) and Animal Sciences (K.E.P., M.R.E., L.C.S.), University of Missouri, Columbia, Missouri 65212; and Biomolecular Imaging Center (L.M.), Harry S. Truman Veterans Affairs Hospital, Columbia, Missouri 65201
| | - Lixin Ma
- Departments of Obstetrics, Gynecology, and Women's Health (O.O.T., K.A.P., K.E.P., K.B., L.C.S.) and Radiology (L.M.) and Divisions of Biological Sciences (O.O.T., K.B., L.C.S.) and Animal Sciences (K.E.P., M.R.E., L.C.S.), University of Missouri, Columbia, Missouri 65212; and Biomolecular Imaging Center (L.M.), Harry S. Truman Veterans Affairs Hospital, Columbia, Missouri 65201
| | - Mark R Ellersieck
- Departments of Obstetrics, Gynecology, and Women's Health (O.O.T., K.A.P., K.E.P., K.B., L.C.S.) and Radiology (L.M.) and Divisions of Biological Sciences (O.O.T., K.B., L.C.S.) and Animal Sciences (K.E.P., M.R.E., L.C.S.), University of Missouri, Columbia, Missouri 65212; and Biomolecular Imaging Center (L.M.), Harry S. Truman Veterans Affairs Hospital, Columbia, Missouri 65201
| | - Laura C Schulz
- Departments of Obstetrics, Gynecology, and Women's Health (O.O.T., K.A.P., K.E.P., K.B., L.C.S.) and Radiology (L.M.) and Divisions of Biological Sciences (O.O.T., K.B., L.C.S.) and Animal Sciences (K.E.P., M.R.E., L.C.S.), University of Missouri, Columbia, Missouri 65212; and Biomolecular Imaging Center (L.M.), Harry S. Truman Veterans Affairs Hospital, Columbia, Missouri 65201
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Liu H, Zhang S, Wang L, Leng J, Li W, Li N, Li M, Qiao Y, Tian H, Tuomilehto J, Yang X, Yu Z, Hu G. Fasting and 2-hour plasma glucose, and HbA1c in pregnancy and the postpartum risk of diabetes among Chinese women with gestational diabetes. Diabetes Res Clin Pract 2016; 112:30-36. [PMID: 26686048 PMCID: PMC4753114 DOI: 10.1016/j.diabres.2015.11.007] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Revised: 10/26/2015] [Accepted: 11/18/2015] [Indexed: 01/11/2023]
Abstract
AIMS Very few studies have assessed the association of fasting and 2h glucose, and HbA1c during pregnancy with postpartum diabetes risk among women with prior gestational diabetes mellitus (GDM). We assessed the association of fasting glucose, 2h glucose and HbA1c at 26-30 gestational weeks with postpartum diabetes risk among women with prior GDM. METHODS A cohort study in 1263 GDM women at 1-5 years after delivery was performed. Cox proportional hazards regression models were used to evaluate the association of fasting and 2h plasma glucose, and HbA1c at 26-30 gestational weeks with the risk of diabetes at postpartum. RESULTS The multivariable-adjusted (age, pre-pregnancy body mass index, weight gain during pregnancy, current body mass index, family history of diabetes, marital status, education, family income, smoking status, passive smoking, leisure-time physical activity, alcohol drinking, and intake of energy, saturated fat, and dietary fiber) hazard ratios of postpartum diabetes were 1.61 (95% confidence interval [CI]: 1.36-1.91) for each 1 mmol/l increase in fasting glucose during pregnancy, 1.63 (95% CI: 1.45-1.84) for each 1 mmol/l increase in 2h glucose during pregnancy, 2.11 (95% CI: 1.50-2.97) for each 1 unit (%) increase in HbA1c during pregnancy. When fasting glucose, 2h glucose and HbA1c during pregnancy were entered multivariable-adjusted model simultaneously, 2h glucose and HbA1c but not fasting glucose remained to be significant and positive predictors for postpartum diabetes. CONCLUSIONS For women with prior GDM, 2h plasma glucose and HbA1c during pregnancy are independent predictors of postpartum diabetes, but fasting plasma glucose during pregnancy is not.
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Affiliation(s)
- Huikun Liu
- Tianjin Women's and Children's Health Center, 96 Guizhou Road, Heping District, Tianjin 300070, China
| | - Shuang Zhang
- Tianjin Women's and Children's Health Center, 96 Guizhou Road, Heping District, Tianjin 300070, China
| | - Leishen Wang
- Tianjin Women's and Children's Health Center, 96 Guizhou Road, Heping District, Tianjin 300070, China
| | - Junhong Leng
- Tianjin Women's and Children's Health Center, 96 Guizhou Road, Heping District, Tianjin 300070, China
| | - Weiqin Li
- Tianjin Women's and Children's Health Center, 96 Guizhou Road, Heping District, Tianjin 300070, China
| | - Nan Li
- Tianjin Women's and Children's Health Center, 96 Guizhou Road, Heping District, Tianjin 300070, China
| | - Min Li
- Tianjin Women's and Children's Health Center, 96 Guizhou Road, Heping District, Tianjin 300070, China
| | - Yijuan Qiao
- Tianjin Women's and Children's Health Center, 96 Guizhou Road, Heping District, Tianjin 300070, China
| | - Huiguang Tian
- Tianjin Women's and Children's Health Center, 96 Guizhou Road, Heping District, Tianjin 300070, China
| | - Jaakko Tuomilehto
- Department of Public Health, University of Helsinki, Helsinki, Finland; Centre for Vascular Prevention, Danube-University Krems, 3500 Krems, Austria; Department of Chronic Disease Prevention, National Institute for Health and Welfare, 00271 Helsinki, Finland; Diabetes Research Group, King Abdulaziz University, 21589 Jeddah, Saudi Arabia
| | - Xilin Yang
- Department of Epidemiology and Biostatistics, Tianjin Medical University, 22 Qixiangtai Road, Heping district, Tianjin 300070, China
| | - Zhijie Yu
- Population Cancer Research program, Dalhousie University, 6299 South Street, Halifax, NS, Canada B3H 4R2
| | - Gang Hu
- Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, LA 70808, USA.
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Early life nutrition and the opportunity to influence long-term health: an Australasian perspective. J Dev Orig Health Dis 2016; 7:440-448. [PMID: 26810498 DOI: 10.1017/s2040174415007989] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
There are now significant data to support the hypothesis that early life nutrition in the fetus, infant and young child can have profound effects on long-term health. This review considers some of this evidence with specific reference to the current burden of disease in Australia and New Zealand. As the findings of further research become available, recommendations on optimizing early life nutrition should be formulated and made widely available as part of the preventative health policy agenda in both Australia and New Zealand.
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Mazaki-Tovi S, Vaisbuch E, Tarca AL, Kusanovic JP, Than NG, Chaiworapongsa T, Dong Z, Hassan SS, Romero R. Characterization of Visceral and Subcutaneous Adipose Tissue Transcriptome and Biological Pathways in Pregnant and Non-Pregnant Women: Evidence for Pregnancy-Related Regional-Specific Differences in Adipose Tissue. PLoS One 2015; 10:e0143779. [PMID: 26636677 PMCID: PMC4670118 DOI: 10.1371/journal.pone.0143779] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2015] [Accepted: 11/08/2015] [Indexed: 12/13/2022] Open
Abstract
Objective The purpose of this study was to compare the transcriptome of visceral and subcutaneous adipose tissues between pregnant and non-pregnant women. Study Design The transcriptome of paired visceral and abdominal subcutaneous adipose tissues from pregnant women at term and matched non-pregnant women (n = 11) was profiled with the Affymetrix Human Exon 1.0 ST array. Differential expression of selected genes was validated with the use of quantitative reverse transcription–polymerase chain reaction. Results Six hundred forty-four transcripts from 633 known genes were differentially expressed (false discovery rate (FDR) <0.1; fold-change >1.5), while 42 exons from 36 genes showed differential usage (difference in FIRMA scores >2 and FDR<0.1) between the visceral and subcutaneous fat of pregnant women. Fifty-six known genes were differentially expressed between pregnant and non-pregnant subcutaneous fat and three genes in the visceral fat. Enriched biological processes in the subcutaneous adipose tissue of pregnant women were mostly related to inflammation. Conclusion The transcriptome of visceral and subcutaneous fat depots reveals pregnancy-related gene expression and splicing differences in both visceral and subcutaneous adipose tissue. Furthermore, for the first time, alternative splicing in adipose tissue has been associated with regional differences and human parturition.
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Affiliation(s)
- Shali Mazaki-Tovi
- Department of Obstetrics and Gynecology, Sheba Medical Center, Tel Hashomer, Israel
- Tel Aviv University, Tel Aviv, Israel
- * E-mail: (SMT); (RR)
| | - Edi Vaisbuch
- Department of Obstetrics and Gynecology, Kaplan Medical Center, Rehovot, Israel
| | - Adi L. Tarca
- Perinatology Research Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, and Detroit, Michigan, United States of America
- Department of Computer Science, Wayne State University, Detroit, Michigan, United States of America
- Center for Molecular Medicine and Genetics, Wayne State University School of Medicine, Detroit, Michigan, United States of America
| | - Juan Pedro Kusanovic
- Perinatology Research Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, and Detroit, Michigan, United States of America
- Department of Obstetrics and Gynecology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
- Center for Research and Innovation in Maternal-Fetal Medicine (CIMAF), Department of Obstetrics and Gynecology, Sótero del Río Hospital, Santiago, Chile
| | - Nandor Gabor Than
- Perinatology Research Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, and Detroit, Michigan, United States of America
- Institute of Enzymology, Research Centre for Natural Sciences, Hungarian Academy of Sciences, Budapest, Hungary
- First Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary
| | - Tinnakorn Chaiworapongsa
- Perinatology Research Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, and Detroit, Michigan, United States of America
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, Michigan, United States of America
| | - Zhong Dong
- Perinatology Research Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, and Detroit, Michigan, United States of America
| | - Sonia S. Hassan
- Perinatology Research Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, and Detroit, Michigan, United States of America
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, Michigan, United States of America
| | - Roberto Romero
- Perinatology Research Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, and Detroit, Michigan, United States of America
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, Michigan, United States of America
- * E-mail: (SMT); (RR)
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Rivera HM, Kievit P, Kirigiti MA, Bauman LA, Baquero K, Blundell P, Dean TA, Valleau JC, Takahashi DL, Frazee T, Douville L, Majer J, Smith MS, Grove KL, Sullivan EL. Maternal high-fat diet and obesity impact palatable food intake and dopamine signaling in nonhuman primate offspring. Obesity (Silver Spring) 2015; 23:2157-64. [PMID: 26530932 PMCID: PMC4636015 DOI: 10.1002/oby.21306] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Revised: 07/15/2015] [Accepted: 07/31/2015] [Indexed: 01/31/2023]
Abstract
OBJECTIVE To utilize a nonhuman primate model to examine the impact of maternal high-fat diet (HFD) consumption and pre-pregnancy obesity on offspring intake of palatable food and to examine whether maternal HFD consumption impaired development of the dopamine system, critical for the regulation of hedonic feeding. METHODS The impact of exposure to maternal HFD and obesity on offspring consumption of diets of varying composition was assessed after weaning. The influence of maternal HFD consumption on the development of the prefrontal cortex-dopaminergic system at 13 months of age was also examined. RESULTS During a preference test, offspring exposed to maternal HFD consumption and obesity displayed increased intake of food high in fat and sugar content relative to offspring from lean control mothers. Maternal HFD consumption suppressed offspring dopamine signaling (as assessed by immunohistochemistry) relative to control offspring. Specifically, there was decreased abundance of dopamine fibers and of dopamine receptor 1 and 2 proteins. CONCLUSIONS This study reveals that offspring exposed to both maternal HFD consumption and maternal obesity during early development are at increased risk for obesity due to overconsumption of palatable energy-dense food, a behavior that may be related to reduced central dopamine signaling.
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Affiliation(s)
- Heidi M. Rivera
- Division of Diabetes, Obesity, and Metabolism, Oregon National Primate Research Center Beaverton, OR 97006, United States
| | - Paul Kievit
- Division of Diabetes, Obesity, and Metabolism, Oregon National Primate Research Center Beaverton, OR 97006, United States
| | - Melissa A. Kirigiti
- Division of Diabetes, Obesity, and Metabolism, Oregon National Primate Research Center Beaverton, OR 97006, United States
| | - Leigh Ann Bauman
- Division of Diabetes, Obesity, and Metabolism, Oregon National Primate Research Center Beaverton, OR 97006, United States
| | - Karalee Baquero
- Division of Diabetes, Obesity, and Metabolism, Oregon National Primate Research Center Beaverton, OR 97006, United States
| | - Peter Blundell
- Division of Diabetes, Obesity, and Metabolism, Oregon National Primate Research Center Beaverton, OR 97006, United States
| | - Tyler A. Dean
- Division of Diabetes, Obesity, and Metabolism, Oregon National Primate Research Center Beaverton, OR 97006, United States
| | - Jeanette C. Valleau
- Division of Diabetes, Obesity, and Metabolism, Oregon National Primate Research Center Beaverton, OR 97006, United States
| | - Diana L. Takahashi
- Division of Diabetes, Obesity, and Metabolism, Oregon National Primate Research Center Beaverton, OR 97006, United States
| | - Tim Frazee
- Division of Diabetes, Obesity, and Metabolism, Oregon National Primate Research Center Beaverton, OR 97006, United States
| | - Luke Douville
- Division of Diabetes, Obesity, and Metabolism, Oregon National Primate Research Center Beaverton, OR 97006, United States
- Department of Biology, University of Portland, Portland, OR, 97203, United States
| | - Jordan Majer
- Division of Diabetes, Obesity, and Metabolism, Oregon National Primate Research Center Beaverton, OR 97006, United States
| | - M. Susan Smith
- Division of Diabetes, Obesity, and Metabolism, Oregon National Primate Research Center Beaverton, OR 97006, United States
| | - Kevin L. Grove
- Division of Diabetes, Obesity, and Metabolism, Oregon National Primate Research Center Beaverton, OR 97006, United States
| | - Elinor L. Sullivan
- Division of Diabetes, Obesity, and Metabolism, Oregon National Primate Research Center Beaverton, OR 97006, United States
- Department of Biology, University of Portland, Portland, OR, 97203, United States
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