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Wang H, Iwama N, Yuwaki K, Nakamichi Y, Hamada H, Tomita H, Tagami K, Kudo R, Kumagai N, Metoki H, Nakaya N, Hozawa A, Kuriyama S, Yaegashi N, Saito M. Association of parity with the prevalence of hypertension in Japan: The Tohoku Medical Megabank Community-based cohort study. J Clin Hypertens (Greenwich) 2024; 26:102-121. [PMID: 38192049 PMCID: PMC10857469 DOI: 10.1111/jch.14756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 11/18/2023] [Accepted: 11/22/2023] [Indexed: 01/10/2024]
Abstract
This study investigated the association of parity with hypertension prevalence in Japanese women while considering a clinical history of hypertensive disorders of pregnancy (HDP) and menopausal status. This cross-sectional study included 30,530 Japanese women (6700 premenopausal; 23 830 postmenopausal). The association between parity and the prevalence of hypertension was evaluated using a multiple logistic regression model with possible confounders. In premenopausal women, no statistically significant association between parity and hypertension prevalence was found. When not adjusted for current body mass index (BMI), a linear graded association was observed between parity and the prevalence of hypertension in postmenopausal women. However, the association between parity and hypertension prevalence in postmenopausal women was attenuated after adjustment for current BMI. Both current BMI and a clinical history of HDP were significantly associated with a high risk of hypertension in both premenopausal and postmenopausal women. Our results also suggest that continuous surveillance and preventive measures for hypertension should be provided for women with HDP and high parity.
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Affiliation(s)
- Hongxin Wang
- Department of Obstetrics and GynecologyTohoku University Graduate School of MedicineSendaiMiyagiJapan
| | - Noriyuki Iwama
- Department of Obstetrics and GynecologyTohoku University Graduate School of MedicineSendaiMiyagiJapan
- Women's Health Care Medical ScienceTohoku University Graduate School of MedicineSendaiMiyagiJapan
- Tohoku Medical Megabank OrganizationTohoku UniversitySendaiMiyagiJapan
| | - Keiichi Yuwaki
- Underwriting and Medical DepartmentThe Dai‐ichi Life Insurance Company, LimitedKoto‐kuTokyoJapan
| | - You Nakamichi
- Underwriting and Medical DepartmentThe Dai‐ichi Life Insurance Company, LimitedKoto‐kuTokyoJapan
| | - Hirotaka Hamada
- Department of Obstetrics and GynecologyTohoku University Graduate School of MedicineSendaiMiyagiJapan
| | - Hasumi Tomita
- Department of Obstetrics and GynecologyTohoku University Graduate School of MedicineSendaiMiyagiJapan
| | - Kazuma Tagami
- Department of Obstetrics and GynecologyTohoku University Graduate School of MedicineSendaiMiyagiJapan
| | - Rie Kudo
- Department of Obstetrics and GynecologyTohoku University Graduate School of MedicineSendaiMiyagiJapan
| | - Natsumi Kumagai
- Department of Obstetrics and GynecologyTohoku University Graduate School of MedicineSendaiMiyagiJapan
| | - Hirohito Metoki
- Tohoku Medical Megabank OrganizationTohoku UniversitySendaiMiyagiJapan
- Division of Public Health, Hygiene and EpidemiologyTohoku Medical Pharmaceutical UniversitySendaiMiyagiJapan
| | - Naoki Nakaya
- Tohoku Medical Megabank OrganizationTohoku UniversitySendaiMiyagiJapan
| | - Atsushi Hozawa
- Tohoku Medical Megabank OrganizationTohoku UniversitySendaiMiyagiJapan
| | - Shinichi Kuriyama
- Division of Molecular EpidemiologyTohoku University Graduate School of MedicineSendaiMiyagiJapan
- International Research Institute of Disaster ScienceTohoku UniversitySendaiMiyagiJapan
- Environment and Genome Research CenterTohoku University Graduate School of MedicineSendaiMiyagiJapan
| | - Nobuo Yaegashi
- Department of Obstetrics and GynecologyTohoku University Graduate School of MedicineSendaiMiyagiJapan
- Women's Health Care Medical ScienceTohoku University Graduate School of MedicineSendaiMiyagiJapan
- Tohoku Medical Megabank OrganizationTohoku UniversitySendaiMiyagiJapan
- Environment and Genome Research CenterTohoku University Graduate School of MedicineSendaiMiyagiJapan
| | - Masatoshi Saito
- Department of Obstetrics and GynecologyTohoku University Graduate School of MedicineSendaiMiyagiJapan
- Women's Health Care Medical ScienceTohoku University Graduate School of MedicineSendaiMiyagiJapan
- Department of Maternal and Fetal TherapeuticsTohoku University Graduate School of MedicineSendaiMiyagiJapan
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Fogacci F, Rizzo M, Cicero AFG. PUFA treatment in patients with gestational diabetes mellitus: Lights and shadows. J Diabetes Complications 2023; 37:108526. [PMID: 37295291 DOI: 10.1016/j.jdiacomp.2023.108526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 05/29/2023] [Accepted: 05/31/2023] [Indexed: 06/12/2023]
Affiliation(s)
- Federica Fogacci
- Hypertension and Cardiovascular risk factors Research Centre, Medical and Surgical Sciences Department, Alma Mater Studiorum University of Bologna, Bologna, Italy.
| | - Manfredi Rizzo
- PROMISE Department, School of Medicine, University of Palermo, Palermo, Italy
| | - Arrigo F G Cicero
- Hypertension and Cardiovascular risk factors Research Centre, Medical and Surgical Sciences Department, Alma Mater Studiorum University of Bologna, Bologna, Italy; IRCCS AOU di Bologna, Bologna, Italy
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An Update on the Current and Emerging Use of Thiazolidinediones for Type 2 Diabetes. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58101475. [PMID: 36295635 PMCID: PMC9609741 DOI: 10.3390/medicina58101475] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Revised: 10/09/2022] [Accepted: 10/14/2022] [Indexed: 11/06/2022]
Abstract
Guidelines have increasingly stressed the concept that adequate glycemic control is required to prevent or decrease the macro- and microvascular complications of type 2 diabetes mellitus (T2DM). PPAR-gamma agonists (“glitazones”) are no longer prioritized due to their effects on heart failure. However, the association between these drugs and innovative therapies could be a valuable tool to attenuate the risk factors of the metabolic syndrome. Glitazones are used for the treatment of diabetes and associated comorbidities. There is substantial scientific evidence demonstrating the effect of glitazones at a cardiometabolic level, as well as on hematological and neurological pathologies that point to their usefulness. The use of glitazones has always been controversial both for the type of patients who must take these drugs and for the side effects associated with them. Unfortunately, the recent guidelines do not include them among the preferred drugs for the treatment of hyperglycemia and rosiglitazone is out of the market in many countries due to an adverse cardiovascular risk profile. Even though real-life studies have proven otherwise, and their pleiotropic effects have been highlighted, they have been unable to achieve primacy in the choice of antihyperglycemic drugs. It would be appropriate to demonstrate the usefulness of pioglitazone and its therapeutic benefit with further cardiovascular safety studies.
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Vekic J, Silva-Nunes J, Rizzo M. Glucose Metabolism Disorders: Challenges and Opportunities for Diagnosis and Treatment. Metabolites 2022; 12:metabo12080712. [PMID: 36005584 PMCID: PMC9412650 DOI: 10.3390/metabo12080712] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 07/26/2022] [Accepted: 07/26/2022] [Indexed: 01/01/2023] Open
Affiliation(s)
- Jelena Vekic
- Department of Medical Biochemistry, Faculty of Pharmacy, University of Belgrade, 11000 Belgrade, Serbia;
| | - José Silva-Nunes
- Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar Universitário de Lisboa Central, 1069-166 Lisbon, Portugal;
| | - Manfredi Rizzo
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90100 Palermo, Italy
- Correspondence:
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Girardi G, Bremer AA. The Intersection of Maternal Metabolic Syndrome, Adverse Pregnancy Outcomes, and Future Metabolic Health for the Mother and Offspring. Metab Syndr Relat Disord 2022; 20:251-254. [PMID: 35384734 DOI: 10.1089/met.2021.0124] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
The prevalence of obesity is ∼40% in the United States, and the prepregnancy prevalence of obesity in females is ∼30%. This has in part fueled an increase in metabolic syndrome (MetS) among females who are currently pregnant, have been pregnant, or are planning to become pregnant. Importantly, MetS in pregnancy is associated with increased pregnancy complications. Moreover, MetS in pregnancy may have long-lasting adverse cardiovascular and metabolic health implications for the mother and her offspring. To complicate matters, many adverse pregnancy outcomes seem to increase the risk of MetS in the mother after pregnancy. Herein, we describe the potential mechanisms behind the intersection of MetS, adverse pregnancy outcomes, and subsequent long-term disease in the mother and offspring. Because MetS is a cluster of coexisting conditions, it is challenging to identify mediators that can serve as biomarkers for early diagnosis and targets for MetS prevention and therapy.
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Affiliation(s)
- Guillermina Girardi
- Pregnancy and Perinatology Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland, USA
| | - Andrew A Bremer
- Pregnancy and Perinatology Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland, USA
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Han L, Yang X, Wang W, Yang X, Dong L, Lin S, Li J, Liu X. Cord blood metabolomics reveals gestational metabolic disorder associated with anti-thyroid peroxidase antibodies positivity. BMC Pregnancy Childbirth 2022; 22:244. [PMID: 35331172 PMCID: PMC8952885 DOI: 10.1186/s12884-022-04564-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 03/04/2022] [Indexed: 12/01/2022] Open
Abstract
Background Thyroid disease is one of the common endocrine disorders affecting the pregnant women, in which thyroid autoimmunity can alter the progress and the outcome of pregnancy. Women with euthyroid status but anti-thyroid peroxidase (anti-TPO) antibodies positivity before pregnancy are prone to subclinical gestational hypothyroidism. However, the connections between anti-TPO antibodies positivity and gestational hypothyroidism remain largely unknown. The aim of the present study is to investigate the differences of fetal metabolic profile at birth according to maternal anti-TPO status. Methods We performed 1H-NMR metabolomics on cord blood of a nested case control cohort of 22 pregnant women with matched thyroid hormone levels and demographic data, including 11 women with euthyroid status but anti-thyroid antibodies positivity (into the anti-TPO antibodies positivity group) and 11 matched women as controls with euthyroid status and negative anti-thyroid antibodies (into the control group). Results Distinct metabolic profiles were observed between the anti-TPO antibody positivity group and the nested control group, from which a total of 10 metabolites with between-group altered abundances were structurally identified. Five out of the 10 metabolites were up-regulated in the anti-TPO antibodies positivity group, including D-Glucose, L-Glutamine, 3-Hydroxybutyric acid, Myo-Inositol, Creatinine. The other 5 metabolites were down-regulated in the anti-TPO antibodies positivity group, including L-Leucine, L-Lysine, L-Glutamic acid, L-Tyrosine, and L-Phenylalanine. All the 10 metabolites have been previously reported to be correlated with hypothyroidism. Metabolite set enrichment analysis and pathway analysis suggested that amino acid metabolism pathways (especially the phenylalanine metabolism) were associated with anti-TPO antibodies positivity. Conclusion The results of this study suggested that fetal metabolic disorder is correlated with anti-TPO antibodies positivity, representing by abundance alteration of hypothyroidism associated metabolites and the related disturbance of amino acid metabolism pathways. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-022-04564-8.
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Affiliation(s)
- Lingna Han
- Department of Physiology, Changzhi Medical College, Changzhi, 046000, People's Republic of China
| | - Xin Yang
- The First Affiliated Hospital of Xi'an JiaoTong University, 277 Yanta West Road, Xi'an, 710061, People's Republic of China
| | - Wen Wang
- The First Affiliated Hospital of Xi'an JiaoTong University, 277 Yanta West Road, Xi'an, 710061, People's Republic of China
| | - Xueliang Yang
- The First Affiliated Hospital of Xi'an JiaoTong University, 277 Yanta West Road, Xi'an, 710061, People's Republic of China
| | - Lina Dong
- The First Affiliated Hospital of Xi'an JiaoTong University, 277 Yanta West Road, Xi'an, 710061, People's Republic of China
| | - Shumei Lin
- The First Affiliated Hospital of Xi'an JiaoTong University, 277 Yanta West Road, Xi'an, 710061, People's Republic of China.
| | - Jianguo Li
- Institutes of Biomedical Sciences, Shanxi University, Taiyuan, 030006, People's Republic of China. .,Key Laboratory of Chemical Biology and Molecular Engineering of Ministry of Education, Shanxi University, 92 Wucheng Road, Taiyuan, 030006, People's Republic of China.
| | - Xiaojing Liu
- The First Affiliated Hospital of Xi'an JiaoTong University, 277 Yanta West Road, Xi'an, 710061, People's Republic of China.
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Yu J, Li Y, Zheng Z, Jia H, Cao P, Qiangba Y, Yu X. Analysis of multimorbidity networks associated with different factors in Northeast China: a cross-sectional analysis. BMJ Open 2021; 11:e051050. [PMID: 34732482 PMCID: PMC8572406 DOI: 10.1136/bmjopen-2021-051050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES This study aimed to identify and study the associations and co-occurrence of multimorbidity, and assessed the associations of diseases with sex, age and hospitalisation duration. DESIGN Cross-sectional. SETTING 15 general hospitals in Jilin Province, China. PARTICIPANTS A total of 431 295 inpatients were enrolled through a cross-sectional study in Jilin Province, China. PRIMARY OUTCOME MEASURES The complex relationships of multimorbidity were presented as weighted networks. RESULTS The distributions of the numbers of diseases differed significantly by sex, age and hospitalisation duration (p<0.001). Cerebrovascular diseases (CD), hypertensive diseases (HyD), ischaemic heart diseases (IHD) and other forms of heart disease (OFHD) showed the highest weights in the multimorbidity networks. The connections between different sexes or hospitalisation duration and diseases were similar, while those between different age groups and diseases were different. CONCLUSIONS CD, HyD, IHD and OFHD were the central points of disease clusters and directly or indirectly related to other diseases or factors. Thus, effective interventions for these diseases should be adopted. Furthermore, different intervention strategies should be developed according to multimorbidity patterns in different age groups.
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Affiliation(s)
- Jianxing Yu
- Social Medicine and Health Service Management, School of Public Health, Jilin University, Changchun, China
| | - Yingying Li
- Social Medicine and Health Service Management, School of Public Health, Jilin University, Changchun, China
| | - Zhou Zheng
- Social Medicine and Health Service Management, School of Public Health, Jilin University, Changchun, China
| | - Huanhuan Jia
- Social Medicine and Health Service Management, School of Public Health, Jilin University, Changchun, China
| | - Peng Cao
- Social Medicine and Health Service Management, School of Public Health, Jilin University, Changchun, China
| | - Yuzhen Qiangba
- Social Medicine and Health Service Management, School of Public Health, Jilin University, Changchun, China
| | - Xihe Yu
- Social Medicine and Health Service Management, School of Public Health, Jilin University, Changchun, China
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Giglio RV, Stoian AP, Haluzik M, Pafili K, Patti AM, Rizvi AA, Ciaccio M, Papanas N, Rizzo M. Novel molecular markers of cardiovascular disease risk in type 2 diabetes mellitus. Biochim Biophys Acta Mol Basis Dis 2021; 1867:166148. [PMID: 33892081 DOI: 10.1016/j.bbadis.2021.166148] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 03/15/2021] [Accepted: 04/13/2021] [Indexed: 02/07/2023]
Abstract
Diabetes represents the leading risk factor for the development of cardiovascular disease (CVD). Chronic hyperglycemia and/or acute post-prandial changes in blood glucose determine an increase in reactive oxygen species (ROS), which play a fundamental role in endothelial dysfunction and in the nuclear transport of pro-atherogenic transcription factors that activate the "inflammasome". In addition, the glycemic alteration favors the formation and stabilization of atherosclerotic plaque through the mechanism of non-enzymatic glycation of different molecules, with the establishment of the so-called "advanced glycosylation end products" (AGE). Laboratory information provided by the level of biomarkers could make a quantitative and qualitative contribution to the clinical process of screening, prediction, prevention, diagnosis, prognosis and monitoring of cardiovascular (CV) risk linked to diabetes. This review describes the importance of specific biomarkers, with particular focus on novel ones, for stratifying and management of diabetes CV risk.
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Affiliation(s)
- Rosaria Vincenza Giglio
- Department of Biomedicine, Neuroscience, and Advanced Diagnostics, Institute of Clinical Biochemistry, Clinical Molecular Medicine, and Laboratory Medicine, University of Palermo, Palermo, Italy
| | - Anca Pantea Stoian
- Faculty of General Medicine, Diabetes, Nutrition and Metabolic Diseases Department, Carol Davila University, Bucharest, Romania
| | - Martin Haluzik
- Centre for Experimental Medicine and Department of Diabetes, Diabetes Centre, Institute for Clinical and Experimental Medicine, Prague, Czech Republic; Institute of Medical Biochemistry and Laboratory Diagnostics, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Kalliopi Pafili
- Diabetes Centre, Second Department of Internal Medicine, Democritus University of Thrace, University Hospital of Alexandroupolis, Greece
| | - Angelo Maria Patti
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy.
| | - Ali Abbas Rizvi
- Division of Endocrinology, Metabolism, and Lipids, Department of Medicine, Emory University, Atlanta, Georgia, USA; Division of Endocrinology, Diabetes and Metabolism, University of South Carolina School of Medicine Columbia, South Carolina, USA
| | - Marcello Ciaccio
- Department of Biomedicine, Neuroscience, and Advanced Diagnostics, Institute of Clinical Biochemistry, Clinical Molecular Medicine, and Laboratory Medicine, University of Palermo, Palermo, Italy; Department of Laboratory Medicine, University-Hospital, Palermo, Italy
| | - Nikolaos Papanas
- Diabetes Centre, Second Department of Internal Medicine, Democritus University of Thrace, University Hospital of Alexandroupolis, Greece
| | - Manfredi Rizzo
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy; Division of Endocrinology, Diabetes and Metabolism, University of South Carolina School of Medicine Columbia, South Carolina, USA
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Ramanjaneya M, Butler AE, Bashir M, Bettahi I, Moin ASM, Ahmed L, Elrayess MA, Hunt SC, Atkin SL, Abou-Samra AB. apoA2 correlates to gestational age with decreased apolipoproteins A2, C1, C3 and E in gestational diabetes. BMJ Open Diabetes Res Care 2021; 9:9/1/e001925. [PMID: 33674281 PMCID: PMC7938976 DOI: 10.1136/bmjdrc-2020-001925] [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: 09/28/2020] [Revised: 01/29/2021] [Accepted: 02/07/2021] [Indexed: 12/30/2022] Open
Abstract
INTRODUCTION Pregnant women with gestational diabetes mellitus (GDM) are at risk of adverse outcomes, including gestational hypertension, pre-eclampsia, and preterm delivery. This study was undertaken to determine if apolipoprotein (apo) levels differed between pregnant women with and without GDM and if they were associated with adverse pregnancy outcome. RESEARCH DESIGN AND METHODS Pregnant women (46 women with GDM and 26 women without diabetes (ND)) in their second trimester were enrolled in the study. Plasma apos were measured and correlated to demographic, biochemical, and pregnancy outcome data. RESULTS apoA2, apoC1, apoC3 and apoE were lower in women with GDM compared with control women (p=0.0019, p=0.0031, p=0.0002 and p=0.015, respectively). apoA1, apoB, apoD, apoH, and apoJ levels did not differ between control women and women with GDM. Pearson bivariate analysis revealed significant correlations between gestational age at delivery and apoA2 for women with GDM and control women, and between apoA2 and apoC3 concentrations and C reactive protein (CRP) as a measure of inflammation for the whole group. CONCLUSIONS Apoproteins apoA2, apoC1, apoC3 and apoE are decreased in women with GDM and may have a role in inflammation, as apoA2 and C3 correlated with CRP. The fact that apoA2 correlated with gestational age at delivery in both control women and women with GDM raises the hypothesis that apoA2 may be used as a biomarker of premature delivery, and this warrants further investigation.
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Affiliation(s)
| | - Alexandra E Butler
- Diabetes Research Center (DRC), Qatar Biomedical Research Institute (QBRI), Hamad Bin Khalifa University (HBKU), Qatar Foundation (Q.F.), Doha, Qatar
| | - Mohammed Bashir
- Endocrinology Department, Qatar Metabolic Institute, Hamad Medical Corporation, Doha, Qatar
| | - Ilham Bettahi
- Qatar Metabolic Institute, Hamad Medical Corporation, Doha, Qatar
| | - Abu Saleh Md Moin
- Diabetes Research Center (DRC), Qatar Biomedical Research Institute (QBRI), Hamad Bin Khalifa University (HBKU), Qatar Foundation (Q.F.), Doha, Qatar
| | - Lina Ahmed
- Weill Cornell Medicine-Qatar, Doha, Qatar
| | | | | | - Stephen L Atkin
- Royal College of Surgeons in Ireland Bahrain, Adliya, Bahrain
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Ramanjaneya M, Butler AE, Alkasem M, Bashir M, Jerobin J, Godwin A, Moin ASM, Ahmed L, Elrayess MA, Hunt SC, Atkin SL, Abou-Samra AB. Association of Complement-Related Proteins in Subjects With and Without Second Trimester Gestational Diabetes. Front Endocrinol (Lausanne) 2021; 12:641361. [PMID: 33859618 PMCID: PMC8043150 DOI: 10.3389/fendo.2021.641361] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 01/28/2021] [Indexed: 12/30/2022] Open
Abstract
INTRODUCTION Gestational Diabetes Mellitus (GDM) development is related to underlying metabolic syndrome that is associated with elevated complement C3 and C4. Elevated C3 levels have been associated with preeclampsia and the development of macrosomia. METHODS This case-control study included 34 pregnant women with GDM and 16 non-diabetic (ND) women in their second trimester. Complement-related proteins were measured and correlated with demographic, biochemical, and pregnancy outcome data. RESULTS GDM women were older with a higher BMI (p<0.001); complement C3, C4 and Factor-H were significantly elevated (p=0.001, p=0.05, p=0.01, respectively). When adjusted for age and BMI, Complement C3 (p=0.04) and Factor-H (p=0.04) remained significant. Partial correlation showed significant correlation between C4 with serum alanine aminotransferase (ALT) (p<0.05) and 2nd term diastolic blood pressure (p<0.05); Factor-H and C-reactive protein (CRP; p<0.05). Pearson bivariate analysis revealed significant correlations between C3, C4, and Factor-H and CRP; p<0.05; C3 and gestational age at delivery (GA; p<0.05); C4 and ALT and second-trimester systolic blood pressure (STBP) (p=0.008 and p<0.05, respectively); Factor-H and glycated hemoglobin (HbA1c) (p<0.05). Regression analysis showed that the elevation of C3 could be accounted for by age, BMI, GA and CRP, with CRP being the most important predictor (p=0.02). C4 elevation could be accounted for by ALT, CRP and STBP. CRP predicted Factor-H elevation. CONCLUSION The increased C3, C4 and Factor-H during the second trimester of pregnancy in GDM are not independently associated with GDM; inflammation and high BMI may be responsible for their elevation. The elevation of second trimester C3 in GDM is associated with earlier delivery and further work is needed to determine if this is predictive.
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Affiliation(s)
- Manjunath Ramanjaneya
- Qatar Metabolic Institute, Hamad Medical Corporation, Doha, Qatar
- Translational Research Institute, Hamad Medical Corporation, Doha, Qatar
- *Correspondence: Manjunath Ramanjaneya,
| | - Alexandra E. Butler
- Diabetes Research Center (DRC), Qatar Biomedical Research Institute (QBRI), Hamad Bin Khalifa University (HBKU), Qatar Foundation (QF), Doha, Qatar
| | - Meis Alkasem
- Qatar Metabolic Institute, Hamad Medical Corporation, Doha, Qatar
| | - Mohammed Bashir
- Qatar Metabolic Institute, Hamad Medical Corporation, Doha, Qatar
| | - Jayakumar Jerobin
- Qatar Metabolic Institute, Hamad Medical Corporation, Doha, Qatar
- Translational Research Institute, Hamad Medical Corporation, Doha, Qatar
| | - Angela Godwin
- Department of Laboratory Medicine and Pathology, Qatar Rehabilitation Institute, Hamad Medical Corporation, Doha, Qatar
| | - Abu Saleh Md Moin
- Diabetes Research Center (DRC), Qatar Biomedical Research Institute (QBRI), Hamad Bin Khalifa University (HBKU), Qatar Foundation (QF), Doha, Qatar
| | - Lina Ahmed
- Department of Genetic Medicine, Weill Cornell Medicine-Qatar, Doha, Qatar
| | | | - Steven C. Hunt
- Department of Genetic Medicine, Weill Cornell Medicine-Qatar, Doha, Qatar
| | - Stephen L. Atkin
- Post Graduate Studies and Research, Royal College of Surgeons in Ireland Bahrain, Adliya, Bahrain
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Tomsett KI, Barrett HL, Dekker EE, Callaway LK, McIntyre DH, Dekker Nitert M. Dietary Fiber Intake Alters Gut Microbiota Composition but Does Not Improve Gut Wall Barrier Function in Women with Future Hypertensive Disorders of Pregnancy. Nutrients 2020; 12:nu12123862. [PMID: 33348731 PMCID: PMC7766248 DOI: 10.3390/nu12123862] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 12/15/2020] [Accepted: 12/15/2020] [Indexed: 01/14/2023] Open
Abstract
Pregnancy alters the inflammatory state, metabolic hormones, and gut microbiota composition. It is unclear if the lower abundance of dietary fiber-fermenting, short-chain fatty acid-producing bacteria observed in hypertension also occurs in hypertensive disorders of pregnancy (HDP). This study investigated the relationship between dietary fiber intake and the gut microbiota profile at 28 weeks gestation in women who developed HDP in late pregnancy (n = 22) or remained normotensive (n = 152) from the Study of PRobiotics IN Gestational diabetes (SPRING). Dietary fiber intake was classified as above or below the median of 18.2 g/day. Gut microbiota composition was examined using 16S rRNA gene amplicon sequencing. The gut permeability marker zonulin was measured in a subset of 46 samples. In women with future HPD, higher dietary fiber intake was specifically associated with increased abundance of Veillonella, lower abundance of Adlercreutzia, Anaerotruncus and Uncl. Mogibacteriaceae and higher zonulin levels than normotensive women. Fiber intake and zonulin levels were negatively correlated in women with normotensive pregnancies but not in pregnancies with future HDP. In women with normotensive pregnancies, dietary fiber intake may improve gut barrier function. In contrast, in women who develop HDP, gut wall barrier function is impaired and not related to dietary fiber intake.
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Affiliation(s)
- Kate I. Tomsett
- School of Chemistry and Molecular Biosciences, The University of Queensland, St Lucia, QLD 4072, Australia;
| | - Helen L. Barrett
- Mater Medical Research Institute, The University of Queensland, South Brisbane, QLD 4001, Australia; (H.L.B.); (D.H.M.)
| | - Evelyn E. Dekker
- Queensland Academy for Science, Mathematics and Technology, Toowong, QLD 4066, Australia;
| | - Leonie K. Callaway
- Women’s and Newborns, Royal Brisbane and Women’s Hospital, Herston, QLD 4029, Australia;
| | - David H. McIntyre
- Mater Medical Research Institute, The University of Queensland, South Brisbane, QLD 4001, Australia; (H.L.B.); (D.H.M.)
| | - Marloes Dekker Nitert
- School of Chemistry and Molecular Biosciences, The University of Queensland, St Lucia, QLD 4072, Australia;
- Correspondence: ; Tel.: +61-7-3365-4633
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Diboun I, Ramanjaneya M, Majeed Y, Ahmed L, Bashir M, Butler AE, Abou-Samra AB, Atkin SL, Mazloum NA, Elrayess MA. Metabolic profiling of pre-gestational and gestational diabetes mellitus identifies novel predictors of pre-term delivery. J Transl Med 2020; 18:366. [PMID: 32972433 PMCID: PMC7517617 DOI: 10.1186/s12967-020-02531-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 09/15/2020] [Indexed: 12/23/2022] Open
Abstract
Background Pregnant women with gestational diabetes mellitus (GDM) or type 2 diabetes mellitus (T2DM) are at increased risks of pre-term labor, hypertension and preeclampsia. In this study, metabolic profiling of blood samples collected from GDM, T2DM and control pregnant women was undertaken to identify potential diagnostic biomarkers in GDM/T2DM and compared to pregnancy outcome. Methods Sixty-seven pregnant women (21 controls, 32 GDM, 14 T2DM) in their second trimester underwent targeted metabolomics of plasma samples using tandem mass spectrometry with the Biocrates MxP® Quant 500 Kit. Linear regression models were used to identify the metabolic signature of GDM and T2DM, followed by generalized linear model (GLMNET) and Receiver Operating Characteristic (ROC) analysis to determine best predictors of GDM, T2DM and pre-term labor. Results The gestational age at delivery was 2 weeks earlier in T2DM compared to GDM and controls and correlated negatively with maternal HbA1C and systolic blood pressure and positively with serum albumin. Linear regression models revealed elevated glutamate and branched chain amino acids in GDM + T2DM group compared to controls. Regression models also revealed association of lower levels of triacylglycerols and diacylglycerols containing oleic and linoleic fatty acids with pre-term delivery. A generalized linear model ROC analyses revealed that that glutamate is the best predictors of GDM compared to controls (area under curve; AUC = 0.81). The model also revealed that phosphatidylcholine diacyl C40:2, arachidonic acid, glycochenodeoxycholic acid, and phosphatidylcholine acyl-alkyl C34:3 are the best predictors of GDM + T2DM compared to controls (AUC = 0.90). The model also revealed that the triacylglycerols C17:2/36:4 and C18:1/34:1 are the best predictors of pre-term delivery (≤ 37 weeks) (AUC = 0.84). Conclusions This study highlights the metabolite alterations in women in their second trimester with diabetes mellitus and identifies predictive indicators of pre-term delivery. Future studies to confirm these associations in other cohorts and investigate their functional relevance and potential utilization for targeted therapies are warranted.
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Affiliation(s)
| | - Manjunath Ramanjaneya
- Qatar Metabolic Institute, Hamad Medical Corporation, Doha, Qatar.,Translational Research Institute, Hamad Medical Corporation, Doha, Qatar
| | | | - Lina Ahmed
- Weill Cornell Medicine-Qatar, Doha, Qatar
| | - Mohammed Bashir
- Qatar Metabolic Institute, Hamad Medical Corporation, Doha, Qatar
| | - Alexandra E Butler
- Diabetes Research Center (DRC), Qatar Biomedical Research Institute (QBRI), Hamad Bin Khalifa University (HBKU), Qatar Foundation (QF), PO Box 34110, Doha, Qatar
| | | | - Stephen L Atkin
- Royal College of Surgeons in Ireland Bahrain, Adliya, Kingdom of Bahrain
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Patti AM, Giglio RV, Papanas N, Rizzo M, Rizvi AA. Future perspectives of the pharmacological management of diabetic dyslipidemia. Expert Rev Clin Pharmacol 2019; 12:129-143. [PMID: 30644763 DOI: 10.1080/17512433.2019.1567328] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
INTRODUCTION Diabetic dyslipidemia is frequent among patients with type 2 diabetes mellitus (T2DM) and is characterized by an increase in triglycerides (TGs), low-density lipoprotein cholesterol (LDL-C), and small-dense (atherogenic) particles, and by a decrease in low high-density lipoprotein cholesterol (HDL-C) and apolipoprotein (Apo) A1 that are strongly related to insulin resistance. The increased flux of free fatty acids from adipose tissue to the liver aggravates hepatic insulin resistance and promotes all of aspects of the dyslipidemic state. Areas covered: Statins are the first-line agents for treatment while other lipid-lowering drugs (ezetimibe, fibrate and proprotein convertase subtilisin/kexin type 9) or novel anti-diabetic agents (dipeptidyl peptidase-4 inhibitors (DPP-4is), glucagon like peptide-1 receptor agonist (GLP-1RA), sodium/glucose cotransporter 2 inhibitors (SGLT2is)) or nutraceuticals (berberine, omega 3 fatty acid, red yeast rice) can be used alone or in combination. Expert commentary: In patients with T2DM, lipid abnormalities should be identified and treated as part of the overall diabetic treatment, in order to prevent cardiovascular disease. The choice of drugs to be used is mainly based on the lipid profile and on the characteristic lipoprotein abnormalities; the use of new drugs for the treatment of hyperglycemia and lipids alteration in these patients can improve diabetic dyslipidemia.
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Affiliation(s)
- Angelo Maria Patti
- a Biomedical Department of Internal Medicine and Medical Specialties , University of Palermo , Palermo , Italy
| | - Rosaria Vincenza Giglio
- a Biomedical Department of Internal Medicine and Medical Specialties , University of Palermo , Palermo , Italy
| | - Nikolaos Papanas
- b Diabetes Centre, Second Department of Internal Medicine , Democritus University of Thrace, University Hospital of Alexandroupolis , Alexandroupolis , Greece
| | - Manfredi Rizzo
- a Biomedical Department of Internal Medicine and Medical Specialties , University of Palermo , Palermo , Italy.,c Division of Endocrinology , Diabetes and Metabolism University of South Carolina School of Medicine Columbia , South Carolina , SC , USA
| | - Ali A Rizvi
- c Division of Endocrinology , Diabetes and Metabolism University of South Carolina School of Medicine Columbia , South Carolina , SC , USA
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Patti AM, Giglio RV, Pafili K, Rizzo M, Papanas N. Pharmacotherapy for gestational diabetes. Expert Opin Pharmacother 2018; 19:1407-1414. [PMID: 30136869 DOI: 10.1080/14656566.2018.1509955] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Gestational diabetes mellitus (GDM) represents impaired carbohydrate metabolism during pregnancy and is characterized by progressive insulin resistance and compensatory hyperinsulinaemia. If inadequately treated, it may lead to fetal macrosomia and other adverse outcomes. AREAS COVERED In this review, the authors summarize the current evidence from studies on the use of insulin and other agents for the treatment of women with GDM. EXPERT OPINION Lifestyle management is of paramount importance for the treatment of GDM. In pharmacotherapy, insulin remains the long-established mainstay of treatment. NPH (Neutral Protamine Hagedorn) and soluble human insulin have long been established for use, but favorable experience has now also accumulated with the newer insulins (aspart, lispro, detemir). Alternatively, metformin and glyburide have been used in GDM, but they have never gained wide acceptance. Nutritional supplements based on micronutrients and bioactives (probiotics and myoinositol) have shown promising results as well. Further experience with incretin agents (DPP-4 inhibitors and GLP-1 receptor agonists) is awaited.
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Affiliation(s)
- Angelo Maria Patti
- a Department of Internal Medicine and Medical Specialties , University of Palermo , Palermo , Italy
| | - Rosaria Vincenza Giglio
- a Department of Internal Medicine and Medical Specialties , University of Palermo , Palermo , Italy
| | - Kalliopi Pafili
- b Diabetes Centre, Second Department of Internal Medicine , Democritus University of Thrace, University Hospital of Alexandroupolis , Alexandroupolis , Greece
| | - Manfredi Rizzo
- a Department of Internal Medicine and Medical Specialties , University of Palermo , Palermo , Italy
| | - Nikolaos Papanas
- b Diabetes Centre, Second Department of Internal Medicine , Democritus University of Thrace, University Hospital of Alexandroupolis , Alexandroupolis , Greece
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