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Jin Y, Wang H. Identification of hub genes affecting gestational diabetes mellitus based on GEO database. Biotechnol Genet Eng Rev 2024; 40:4653-4663. [PMID: 37224002 DOI: 10.1080/02648725.2023.2215966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 05/14/2023] [Indexed: 05/26/2023]
Abstract
This research aimed to obtain gestational diabetes mellitus (GDM) related hub genes, providing new targets for clinical diagnosis and treatment of GDM. The microarray data of GSE9984 and GSE103552 were obtained from the Gene Expression Omnibus (GEO). The dataset GSE9984 contained placental gene expression profiles of 8 GDM patients and four healthy specimens. The dataset GSE103552 contained 20 specimens from GDM patients and 17 normal specimens. The differentially expressed genes (DEGs) were identified by GEO2R online analysis. DAVID database was applied to conduct functional enrichment analysis of the DEGs. The Search Tool for the Retrieval of Interacting Genes (STRING) database was adopted to acquire protein-protein interaction (PPI) networks. A total of 195 up-regulated and 371 down-regulated DEGs were selected in the GSE9984, and total of 191 up-regulated and 229 down-regulated DEGs were selected in the GSE103552. In the two datasets, 24 common differential genes were obtained and named co-DEGs. The Gene Ontology (GO) annotation analysis indicated the DEGs participated in multi-multicellular organism process, endocrine hormone secretion, long-chain fatty acid biosynthetic process, cell division, unsaturated fatty acid biosynthetic process, cell adhesion and cell recognition. Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis suggested that GSE9984 and GSE103552 were related to vitamin digestion and absorption, tryptophan metabolism, steroid hormone biosynthesis, Ras signaling pathway, protein digestion and absorption, PPAR signaling pathway, PI3K-Akt signaling pathway, p53 signaling pathway. PPI was constructed in string database, and six hub genes were selected, including CCNB1, APOA2, AHSG and IGFBP1. Four critical genes were identified to be considered as therapeutic potential biomarkers of GDM, including CCNB1, APOA2, AHSG and IGFBP1.
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Affiliation(s)
- Yangqiu Jin
- Department of Reproductive Medicine, Liaocheng People's Hospital, Liaocheng, Shandong Province, China
| | - Hui Wang
- Department of Obstetrics and Gynecology,Liaocheng Tird People's Hospital, Liaocheng, Shandong Province, China
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Wang J, Chen Q, Zhang S. Influence of vitamin D-calcium on metabolic profile for gestational diabetes: a meta-analysis of randomized controlled trials. Gynecol Endocrinol 2024; 40:2409139. [PMID: 39340384 DOI: 10.1080/09513590.2024.2409139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 07/29/2024] [Accepted: 09/15/2024] [Indexed: 09/30/2024] Open
Abstract
INTRODUCTION The use of vitamin D-calcium supplementation for treating gestational diabetes remains unclear. This meta-analysis aims to evaluate the efficacy of vitamin D-calcium supplementation in the treatment of gestational diabetes. METHODS Several databases including PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases were systemically searched from inception to August 2023, and we included the randomized controlled trials (RCTs) assessing the effect of vitamin D-calcium supplementation on the metabolic profile of gestational diabetes. RESULTS We included five eligible RCTs and 306 pregnant women in this meta-analysis. Compared with control group in pregnant women with gestational diabetes, vitamin D-calcium supplementation was associated with remarkably decreased fasting plasma glucose (SMD=-0.67; 95% CI=-0.93 to -0.41; p <0.00001), serum insulin (SMD=-1.09; 95% CI=-1.89 to -0.29; p = .007) and LDL (SMD=-0.35; 95% CI=-0.63 to -0.06; p = .02), but demonstrated no impact on total cholesterol (SMD=-0.05; 95% CI=-0.81 to 0.71; p = .90) or triglycerides (SMD=-0.14; 95% CI=-0.86 to 0.58; p = .70). CONCLUSIONS Vitamin D-calcium supplementation is effective to improve metabolic profile for the treatment of gestational diabetes.
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Affiliation(s)
- Jin Wang
- Obstetrics and Gynecology, Chongqing Medical University Affiliated Banan Hospital, Chongqing, China
| | - Qiong Chen
- Obstetrics and Gynecology, Chongqing Medical University Affiliated Banan Hospital, Chongqing, China
| | - Shaomin Zhang
- Obstetrics and Gynecology, Chongqing Medical University Affiliated Banan Hospital, Chongqing, China
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de Albuquerque Lemos DE, de Brito Alves JL, de Souza EL. Probiotic therapy as a promising strategy for gestational diabetes mellitus management. Expert Opin Biol Ther 2024:1-13. [PMID: 39323363 DOI: 10.1080/14712598.2024.2409880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2024] [Revised: 08/16/2024] [Accepted: 09/24/2024] [Indexed: 09/27/2024]
Abstract
INTRODUCTION Gestational diabetes mellitus (GDM) has become the most common pregnancy medical complication, and its prevalence has increased in recent years. The GDM treatment primarily relies on adopting healthy eating habits, physical exercise, and insulin therapy. However, using probiotics to modulate the gut microbiota has been the subject of clinical trials as a promising therapeutic strategy for GDM management. AREAS COVERED Due to the adverse effects of gut dysbiosis in women with GDM, strategies targeting the gut microbiota to mitigate hyperglycemia, low-grade inflammation, and adverse pregnancy outcomes have been explored. Probiotic supplementation may improve glucose metabolism, lipid profile, oxidative stress, inflammation, and blood pressure in women with GDM. Furthermore, decreased fasting blood glucose, insulin resistance, and inflammatory markers, such as TNF-α and CRP, as well as increased total antioxidant capacity, lipid profile modulation, and improved blood pressure in women with GDM, are some of the important results reported in the available literature. EXPERT OPINION To fill the knowledge gap, further studies are needed focusing on modulating gut microbiota composition and metabolic activity and their systemic repercussions in GDM.
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Affiliation(s)
| | - José Luiz de Brito Alves
- Department of Nutrition, Health Sciences Center, Federal University of Paraiba, João Pessoa, Brazil
| | - Evandro Leite de Souza
- Department of Nutrition, Health Sciences Center, Federal University of Paraiba, João Pessoa, Brazil
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Ma S, Wang Y, Ji X, Dong S, Wang S, Zhang S, Deng F, Chen J, Lin B, Khan BA, Liu W, Hou K. Relationship between gut microbiota and the pathogenesis of gestational diabetes mellitus: a systematic review. Front Cell Infect Microbiol 2024; 14:1364545. [PMID: 38868299 PMCID: PMC11168118 DOI: 10.3389/fcimb.2024.1364545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 03/01/2024] [Indexed: 06/14/2024] Open
Abstract
Introduction Gestational diabetes mellitus (GDM) is a form of gestational diabetes mellitus characterized by insulin resistance and abnormal function of pancreatic beta cells. In recent years, genomic association studies have revealed risk and susceptibility genes associated with genetic susceptibility to GDM. However, genetic predisposition cannot explain the rising global incidence of GDM, which may be related to the increased influence of environmental factors, especially the gut microbiome. Studies have shown that gut microbiota is closely related to the occurrence and development of GDM. This paper reviews the relationship between gut microbiota and the pathological mechanism of GDM, in order to better understand the role of gut microbiota in GDM, and to provide a theoretical basis for clinical application of gut microbiota in the treatment of related diseases. Methods The current research results on the interaction between GDM and gut microbiota were collected and analyzed through literature review. Keywords such as "GDM", "gut microbiota" and "insulin resistance" were used for literature search, and the methodology, findings and potential impact on the pathophysiology of GDM were systematically evaluated. Results It was found that the composition and diversity of gut microbiota were significantly associated with the occurrence and development of GDM. Specifically, the abundance of certain gut bacteria is associated with an increased risk of GDM, while other changes in the microbiome may be associated with improved insulin sensitivity. In addition, alterations in the gut microbiota may affect blood glucose control through a variety of mechanisms, including the production of short-chain fatty acids, activation of inflammatory pathways, and metabolism of the B vitamin group. Discussion The results of this paper highlight the importance of gut microbiota in the pathogenesis of GDM. The regulation of the gut microbiota may provide new directions for the treatment of GDM, including improving insulin sensitivity and blood sugar control through the use of probiotics and prebiotics. However, more research is needed to confirm the generality and exact mechanisms of these findings and to explore potential clinical applications of the gut microbiota in the management of gestational diabetes. In addition, future studies should consider the interaction between environmental and genetic factors and how together they affect the risk of GDM.
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Affiliation(s)
- Sheng Ma
- Anhui Province Maternity & Child Health Hospital, Hefei, Anhui, China
| | - Yuping Wang
- School of Nursing, Anhui University of Chinese Medicine, Hefei, Anhui, China
| | - Xiaoxia Ji
- Nursing Department, Shantou Central Hospital, Shantou, Guangdong, China
| | - Sunjuan Dong
- School of Nursing, Anhui University of Chinese Medicine, Hefei, Anhui, China
| | - Shengnan Wang
- School of Nursing, Anhui University of Chinese Medicine, Hefei, Anhui, China
| | - Shuo Zhang
- Shantou University Medical College, Shantou, Guangdong, China
| | - Feiying Deng
- Shantou University Medical College, Shantou, Guangdong, China
| | - Jingxian Chen
- Shantou University Medical College, Shantou, Guangdong, China
| | - Benwei Lin
- School of Physiology, Pharmacology and Neuroscience, University of Bristol, Bristol, United Kingdom
| | - Barkat Ali Khan
- Drug Delivery and Cosmetic Lab (DDCL), Gomal Center of Pharmaceutical Sciences, Faculty of Pharmacy, Gomal University, Dera Ismail Khan, Pakistan
| | - Weiting Liu
- School of Nursing, Anhui University of Chinese Medicine, Hefei, Anhui, China
| | - Kaijian Hou
- School of Nursing, Anhui University of Chinese Medicine, Hefei, Anhui, China
- School of Public Health, Shantou University, Shantou, Guangdong, China
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Choi JK, Kwon OY, Lee SH. Oral Administration of Bifidobacterium lactis Ameliorates Cognitive Deficits in Mice Intracerebroventricularly Administered Amyloid Beta via Regulation the Activation of Mitogen-activated Protein Kinases. Food Sci Anim Resour 2024; 44:607-619. [PMID: 38765290 PMCID: PMC11097010 DOI: 10.5851/kosfa.2024.e5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 01/04/2024] [Accepted: 01/05/2024] [Indexed: 05/22/2024] Open
Abstract
Probiotics are functional microorganisms that exhibit various biological activities, such as allergic reactions, inflammation, and aging. The aim of this study is to evaluate the effects of Bifidobacterium lactis CBT BL3 (BL) on the amyloid beta (Aβ)-mediated cognitive impairments. Oral administration of live BL to intracerebroventricularly Aβ-injected mice significantly attenuated short- and long-term memory loss estimated using the Y-maze and Morris water maze tests. We found that expression of apoptosis-related proteins such as caspase-9, caspase-3, and cleaved poly (ADP-ribose) polymerase was significantly elevated in the brain tissues of Aβ-injected mouse brains when compared to that of the control mouse group. Interestingly, these expression levels were significantly decreased in the brain tissue of mice fed BL for 6 wk. In addition, the abnormal over-phosphorylation of mitogen-activated protein kinases (MAPKs) such as ERK1/2, p38 MAPK, and JNK in the brain tissue of intracerebroventricularly Aβ-injected mice was significantly attenuated by oral administration of BL. Taken together, the results indicate that Aβ-induced cognitive impairment may be ameliorated by the oral administration of BL by controlling the activation of MAPKs/apoptosis in the brain. This study strongly suggests that BL can be developed as a functional probiotic to attenuate Aβ-mediated cognitive deficits.
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Affiliation(s)
- Jong Kyu Choi
- Department of Nano-Bioengineering, Incheon National University, Incheon 22012, Korea
| | - Oh Yun Kwon
- Department of Nano-Bioengineering, Incheon National University, Incheon 22012, Korea
- Institute of New Drug Development, Incheon National University, Incheon 22012, Korea
| | - Seung Ho Lee
- Department of Nano-Bioengineering, Incheon National University, Incheon 22012, Korea
- Institute of New Drug Development, Incheon National University, Incheon 22012, Korea
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Li H, Li H, Li X, Wang J, Wang P, Zhao M. Effects of preventive nursing based on quantitative evaluation on psychological state and maternal–infant outcome in patients with gestational diabetes mellitus. J Matern Fetal Neonatal Med 2023; 36:2183473. [PMID: 36987871 DOI: 10.1080/14767058.2023.2183473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/30/2023]
Abstract
OBJECTIVE To explore the effects of preventive nursing based on quantitative evaluation on psychological state and maternal-infant outcome in patients with gestational diabetes mellitus (GDM), further, to provide a theoretical basis for the effective management of GDM patients in clinical work. METHODS From 1 February 2020 to 1 January 2021, 118 patients with GDM presenting to our hospital were included in this retrospective cohort study. According to the type of nursing care, patients were divided into study group and control groups. The study group consisted of 59 GDM patients who were given quantitative evaluation-based preventive nursing care. The control group included 59 GDM patients who were given routine nursing care. Outcome indicators included blood glucose level, degree of social support, resilience, coping style, and maternal-infant outcomes. RESULTS There was no significant difference between two groups in other baseline clinical characteristics (p > .05). After the intervention, fasting blood glucose (FBG), glycosylated hemoglobin (HbA1c), and 2 h postprandial blood glucose (2hPBG) levels were significantly lower in the study group than that in the control group (p < .05). The scores of objective support, subjective support, and social support utilization in the study group were significantly higher than those in the control group after intervention (p < .05). The scores of optimisms, self-strengthening and tenacity in the study group were significantly less than those in the control group (p < .05). The study group confrontation score was significantly higher, and the avoidance and acceptance scores were significantly lower, compared with the control group (p < .05). The maternal-infant outcome showed that the proportions of cesarean delivery, pregnancy-induced hypertension, polyhydramnios, premature delivery, hyperbilirubinemia, and neonatal hypoglycemia in the study group were significantly lower than those in the control group (p < .05). There was no significant difference in the incidence of postpartum hemorrhage and neonatal 5-min Apgar score between the two groups (p > .05). CONCLUSIONS In conclusion, preventive nursing based on quantitative assessment can effectively control the blood glucose level of GDM patients, improve their degree of social support, resilience, coping style, and maternal-infant outcomes, which is worthy of clinical application.
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Wang Y, Song M, Qi BR. Effects of insulin aspart and metformin on gestational diabetes mellitus and inflammatory markers. World J Diabetes 2023; 14:1532-1540. [PMID: 37970132 PMCID: PMC10642422 DOI: 10.4239/wjd.v14.i10.1532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 08/02/2023] [Accepted: 08/15/2023] [Indexed: 10/09/2023] Open
Abstract
BACKGROUND Gestational diabetes mellitus (GDM) refers to hyperglycemia caused by insulin resistance or insufficient insulin secretion during pregnancy. Patients with GDM have a high risk of pregnancy complications, which can adversely affect both maternal and fetal health. Therefore, early diagnosis, treatment and monitoring of GDM are essential. In recent years, a new treatment scheme represented by insulin aspart combined with metformin has received increasing attention. AIM To explore the effects of insulin aspart combined with metformin on patients with GDM and inflammatory markers. METHODS From April 2020 to September 2022, 124 patients with GDM in Sanya Women and Children's Hospital Managed by Shanghai Children's Medical Center were collected and analyzed retrospectively. The control group (CG) comprised 62 patients treated with insulin aspart alone, and 62 patients treated with insulin aspart and metformin formed the observation group (OG). Before and after treatment, improvement of blood-glucose-related indexes [fasting blood glucose (FBG), 2-h postprandial glucose (2h PG) and hemoglobin A1c (HbA1c)], serum related factor [serum homocysteine (Hcy)], serum inflammatory cytokines [tumor necrosis factor (TNF)-α, interleukin (IL)-6 and C-reactive protein (CRP)] were compared between the two groups. The clinical efficacy, adverse pregnancy outcomes and incidence of pregnancy complications were compared between the two groups. RESULTS After treatment, the levels of FBG, 2h PG, HbA1c, Hcy, TNF-α, IL-6 and CRP in both groups were significantly decreased (P < 0.05), and the levels of FBG, 2h PG, HbA1c, Hcy, TNF-α, IL-6 and CRP in the OG were lower than in the CG (P < 0.05). The total clinical effectiveness in the OG was higher than that in the CG (P < 0.05). The total incidence of adverse pregnancy outcomes and complications in the OG was significantly lower than in the CG (P < 0.05). CONCLUSION Insulin aspart combined with metformin are effective for treatment of GDM, which can reduce blood-glucose-related indexes, Hcy and serum inflammatory cytokines, and risk of adverse pregnancy outcomes and complications.
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Affiliation(s)
- Yan Wang
- Department of Obstetrics and Gynecology, Sanya Women and Children’s Hospital Managed by Shanghai Children’s Medical Center, Sanya 572099, Hainan Province, China
| | - Min Song
- Department of Obstetrics and Gynecology, Sanya Women and Children’s Hospital Managed by Shanghai Children’s Medical Center, Sanya 572099, Hainan Province, China
| | - Bang-Ruo Qi
- Department of Obstetrics and Gynecology, Sanya Women and Children’s Hospital Managed by Shanghai Children’s Medical Center, Sanya 572099, Hainan Province, China
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Duan Y, Sun F, Li Y, Yang S. High glucose and high lipid induced mitochondrial dysfunction in JEG-3 cells through oxidative stress. Open Life Sci 2023; 18:20220561. [PMID: 36816801 PMCID: PMC9922060 DOI: 10.1515/biol-2022-0561] [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: 04/26/2022] [Revised: 01/04/2023] [Accepted: 01/04/2023] [Indexed: 02/09/2023] Open
Abstract
Few studies focused on the roles of high glucose combined with high lipid in placental development or fetal growth. This study was designed to investigate the roles of high glucose combined with high lipid in mitochondrial dysfunction of JEG-3 cells. We determined the cellular proliferation and apoptosis, superoxide dismutase (SOD) activity, concentration of malondialdehyde (MDA), and lactic acid dehydrogenase in control group, high glucose group, high lipid group, and high glucose and high lipid group, together with the mitochondrial dysfunction, Nrf2, HO-1, SMAC, and cytochrome C (Cyt-C) expression. Significant decrease of SOD and significant elevation of MDA was seen in high glucose and high lipid group compared with the other three groups. There was significant decrease in mitochondrial SMAC and Cyt-C in high glucose group, high lipid group, and high glucose and high lipid group compared with those of control group. Nrf2 and HO-1 protein expression in high glucose combined with high lipid group showed significant decrease compared with that of high lipid group or high glucose group. We speculated that combination of high glucose and high lipid induced oxidative stress in JEG-3 cells, and Nrf2/ARE pathway may be related to this process.
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Affiliation(s)
- Yang Duan
- Department of Neonatology, Second Hospital of Tianjin Medical University, No. 23 Pingjiang Road, Hexi District, Tianjin 300211, China
| | - Fuqiang Sun
- Department of Neonatology, Second Hospital of Tianjin Medical University, No. 23 Pingjiang Road, Hexi District, Tianjin 300211, China
| | - Yueqin Li
- Department of Neonatology, Second Hospital of Tianjin Medical University, No. 23 Pingjiang Road, Hexi District, Tianjin 300211, China
| | - Suyan Yang
- Department of Neonatology, Second Hospital of Tianjin Medical University, No. 23 Pingjiang Road, Hexi District, Tianjin 300211, China
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You L, Deng Y, Li D, Lin Y, Wang Y. GLP-1 rescued gestational diabetes mellitus-induced suppression of fetal thalamus development. J Biochem Mol Toxicol 2023; 37:e23258. [PMID: 36424357 DOI: 10.1002/jbt.23258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 10/19/2022] [Accepted: 11/15/2022] [Indexed: 11/26/2022]
Abstract
Diabetes can be classified as type 1, type 2, and gestational diabetes mellitus (GDM). It has been reported that children born from mothers with GDM present motor impairment, however, underlying mechanisms of GDM-induce fetal neurological diseases remain unknown. In this study, NOD (nonobese diabetic) mice were used to construct the GDM model; after 2 weeks of gestation, thalamocortical axon development of fetal was evaluated by immunofluorescence. PCR of LRRC4C was used to confirm axon development of the thalamus cortex. RNA array was used to predict possible targets affected by GDM during fetal neurodevelopment. Western blot was used to investigate the underlying mechanism, PI3K inhibitor, and MAPK inhibitor was used to determine key pathway involved in this model, in vitro axonal growth was evaluated using neural stem cells, tactile sensory behavior of offspring was assessed to confirm neurological influence further. The result shown that maternal diabetes significantly suppressed axonal development of fetal thalamus cortex, PCR array of GDM fetal brain indicated that upregulation of GLP-1R compared with normal fetal, ELISA confirmed that GLP-1 level was decreased in GDM maternal serum compared with that of wild type pregnant mice. In vitro study observed enhanced axonal elongation after supplements of GLP-1 analog, GLP-1 analog PI3K-dependently active ROCK1 activity, IP injection of GLP-1 analog could partly reverse GDM-induced suppression of fetal thalamocortical axon development and improve tactile sensory behavior of GDM offspring. Our study provided a novel mechanism of GDM induced-neurological diseases and predicted GLP-1 as possible prevention supplement during gestation.
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Affiliation(s)
- Longfei You
- Department of Rehabilitation Medicine, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yujie Deng
- Department of Rehabilitation Medicine, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Dan Li
- Interventional Center, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yangyang Lin
- Department of Rehabilitation Medicine, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yuling Wang
- Department of Rehabilitation Medicine, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
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Chen KH, Lin HS, Li YC, Sung PH, Chen YL, Yin TC, Yip HK. Synergic Effect of Early Administration of Probiotics and Adipose-Derived Mesenchymal Stem Cells on Alleviating Inflammation-Induced Chronic Neuropathic Pain in Rodents. Int J Mol Sci 2022; 23:ijms231911974. [PMID: 36233275 PMCID: PMC9570240 DOI: 10.3390/ijms231911974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 10/05/2022] [Accepted: 10/06/2022] [Indexed: 11/05/2022] Open
Abstract
This study investigated the hypothesis that probiotics enhanced the therapeutic effect of adipose-derived mesenchymal stem cells (ADMSCs) on alleviating neuropathic pain (NP) due to chronic constriction injury (CCI) mainly through regulating the microbiota in rats. SD rats (n = 50) were categorized into group 1 (sham-control), group 2 (NP), group 3 (NP + probiotics (i.e., 1.5 billion C.F.U./day/rat, orally 3 h after NP procedure, followed by QOD 30 times)), group 4 (NP + ADMSCs (3.0 × 105 cells) 3 h after CCI procedure, followed by QOD six times (i.e., seven times in total, i.e., mimic a clinical setting of drug use) and group 5 (NP + probiotics + ADMSCs (3.0 × 105 cells)) and euthanized by day 60 after NP induction. By day 28 after NP induction, flow-cytometric analysis showed circulating levels of early (AN-V+/PI−) and late (AN-V+/PI+) apoptotic, and three inflammatory (CD11b-c+, Ly6G+ and MPO+) cells were lowest in group 1 and significantly progressively reduced in groups 2 to 5 (all p < 0.0001). By days 7, 14, 21, 28, and 60 after CCI, the thresholds of thermal paw withdrawal latency (PWL) and mechanical paw withdrawal threshold (PWT) were highest in group 1 and significantly progressively increased in groups 2 to 5 (all p < 0.0001). Numbers of pain-connived cells (Nav1.8+/peripherin+, p-ERK+/peripherin+, p-p38+/peripherin+ and p-p38+/NF200+) and protein expressions of inflammatory (p-NF-κB, IL-1ß, TNF-α and MMP-9), apoptotic (cleaved-caspase-3, cleaved-PARP), oxidative-stress (NOX-1, NOX-2), DNA-damaged (γ-H2AX) and MAPK-family (p-P38, p-JNK, p-ERK1/2) biomarkers as well as the protein levels of Nav.1.3, Nav.1.8, and Nav.1.9 in L4-L5 in dorsal root ganglia displayed an opposite pattern of mechanical PWT among the groups (all p < 0.0001). In conclusion, combined probiotic and ADMSC therapy was superior to merely one for alleviating CCI-induced NP mainly through suppressing inflammation and oxidative stress.
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Affiliation(s)
- Kuan-Hung Chen
- Department of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan
| | - Hung-Sheng Lin
- Division of Neurology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan
| | - Yi-Chen Li
- Center of Cell Therapy, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70403, Taiwan
| | - Pei-Hsun Sung
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan
| | - Yi-Ling Chen
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan
| | - Tsung-Cheng Yin
- Department of Orthopaedic Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan
- Correspondence: (T.-C.Y.); (H.-K.Y.)
| | - Hon-Kan Yip
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan
- Institute for Translational Research in Biomedicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan
- Center for Shockwave Medicine and Tissue Engineering, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan
- School of Medicine, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
- Department of Medical Research, China Medical University Hospital, China Medical University, Taichung 40402, Taiwan
- Department of Nursing, Asia University, Taichung 41354, Taiwan
- Division of Cardiology, Department of Internal Medicine, Xiamen Chang Gung Hospital, Xiamen 361028, China
- Correspondence: (T.-C.Y.); (H.-K.Y.)
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Effect of Targeted Care plus Exercise Intervention on Blood Glucose Levels and Maternal and Newborn Outcomes in Patients with Gestational Diabetes Mellitus. DISEASE MARKERS 2022; 2022:7584936. [PMID: 36204512 PMCID: PMC9532130 DOI: 10.1155/2022/7584936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 09/08/2022] [Accepted: 09/08/2022] [Indexed: 11/18/2022]
Abstract
Objective. To evaluate the effect of targeted care plus exercise intervention on blood glucose levels and maternal and newborn outcomes in patients with gestational diabetes mellitus (GDM). Methods. A total of 96 patients with GDM admitted to our hospital between March 2018 and January 2020 were recruited and assigned to receive either routine nursing (routine group) or targeted care plus exercise intervention (study group) via random method, with 48 patients in each group. Outcome measures included blood glucose, immune function, maternal and newborn outcome, and nursing satisfaction. Results. The patients in the study group had significantly lower amniotic fluid index (AFI), weight at delivery, body mass index (BMI), and weight gain during pregnancy than patients in the routine group (
). There was no statistically significant difference in blood glucose between the two groups of patients before the intervention (
). Targeted care plus exercise intervention resulted in significantly lower levels of fasting blood glucose (FBG), 2 h postprandial blood glucose (2hPBG), and blood glucose before bed versus routine care (
). The patients with targeted care plus exercise intervention had higher immunoglobulin G (IgG) and IgM levels; higher CD3+, CD4+, and CD8+ levels; and lower lgA levels versus those with routine care (
). Targeted care plus exercise intervention was associated with a lower incidence of negative pregnancy outcomes and a higher satisfaction versus routine care (
). Conclusion. Targeted treatment plus exercise intervention efficiently controls blood glucose levels in GDM patients, improves immunological function, lowers the risk of pregnancy problems, improves pregnancy outcomes, and promotes patient satisfaction, indicating a high potential for therapeutic development. Targeted treatment combined with exercise intervention is encouraged following effective pharmacological interventions to facilitate recovery.
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12
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Ramirez Zegarra R, Dall’Asta A, Revelli A, Ghi T. COVID-19 and Gestational Diabetes: The Role of Nutrition and Pharmacological Intervention in Preventing Adverse Outcomes. Nutrients 2022; 14:nu14173562. [PMID: 36079820 PMCID: PMC9460671 DOI: 10.3390/nu14173562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 08/14/2022] [Accepted: 08/23/2022] [Indexed: 12/15/2022] Open
Abstract
Pregnant women with GDM affected by COVID-19 seem to be at higher risk of adverse maternal and neonatal outcomes, especially those with overweight or obesity. Good glycemic control seems to be the most effective measure in reducing the risk of GDM and severe COVID-19. For such purposes, the Mediterranean diet, micronutrient supplementation, and physical activity are considered the first line of treatment. Failure to achieve glycemic control leads to the use of insulin, and this clinical scenario has been shown to be associated with an increased risk of adverse maternal and neonatal outcomes. In this review, we explore the current evidence pertaining to the pathogenesis of SARS-CoV-2 leading to the main complications caused by COVID-19 in patients with GDM. We also discuss the incidence of complications caused by COVID-19 in pregnant women with GDM according to their treatment.
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Affiliation(s)
- Ruben Ramirez Zegarra
- Obstetrics and Gynaecology Unit, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
- Department of Obstetrics and Gynaecology, University Hospital Rechts der Isar, Technical University of Munich, 81675 Munich, Germany
| | - Andrea Dall’Asta
- Obstetrics and Gynaecology Unit, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
| | - Alberto Revelli
- Sant’Anna Hospital, Department of Surgical Sciences, University of Turin, 10126 Turin, Italy
| | - Tullio Ghi
- Obstetrics and Gynaecology Unit, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
- Correspondence:
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13
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Effects of Probiotic Supplementation during Pregnancy on the Future Maternal Risk of Metabolic Syndrome. Int J Mol Sci 2022; 23:ijms23158253. [PMID: 35897822 PMCID: PMC9330652 DOI: 10.3390/ijms23158253] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 07/21/2022] [Accepted: 07/23/2022] [Indexed: 12/12/2022] Open
Abstract
Probiotics are live microorganisms that induce health benefits in the host. Taking probiotics is generally safe and well tolerated by pregnant women and their children. Consumption of probiotics can result in both prophylactic and therapeutic effects. In healthy adult humans, the gut microbiome is stable at the level of the dominant taxa: Bacteroidetes, Firmicutes and Actinobacteria, and has a higher presence of Verrucomicrobia. During pregnancy, an increase in the number of Proteobacteria and Actinobacteria phyla and a decrease in the beneficial species Roseburia intestinalis and Faecalibacterium prausnitzii are observed. Pregnancy is a "window" to the mother's future health. The aim of this paper is to review studies assessing the potentially beneficial effects of probiotics in preventing the development of diseases that appear during pregnancy, which are currently considered as risk factors for the development of metabolic syndrome, and consequently, reducing the risk of developing maternal metabolic syndrome in the future. The use of probiotics in gestational diabetes mellitus, preeclampsia and excessive gestational weight gain is reviewed. Probiotics are a relatively new intervention that can prevent the development of these disorders during pregnancy, and thus, would reduce the risk of metabolic syndrome resulting from these disorders in the mother's future.
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14
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Zhang L, Hu X, Wang Y, He C, Yu J, Fang X, Zhang Y, Xu X, Yang J. Effects of probiotic supplementation on glucose metabolism in pregnant women without diabetes: a systematic review and meta-analysis. Food Funct 2022; 13:8388-8398. [PMID: 35856090 DOI: 10.1039/d1fo04333a] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Background: The preventive effects of probiotic supplementation against gestational diabetes mellitus (GDM) in pregnant women remain unclear. The objective of this review was to investigate the effect of probiotic supplementation on the profiles of glucose metabolism in pregnant women without diabetes. The published literature was retrieved and screened from PubMed, Embase, Web of Science, CNKI (China National Knowledge Infrastructure), Wanfang, and Cochrane Center Register of Controlled Trails up to April 1st, 2021. Random controlled trials (RCTs) of probiotic supplementation on pregnant women without GDM were included. Results: 12 RCTs (2213 participants) were eligible for meta-analyses. Overall, probiotic supplementation significantly reduced GDM incidence (Risk Ratio (RR) = 0.62, 95% CI: 0.39-0.99), serum fasting blood glucose (FBG) (Mean Difference (MD) = -0.14 mmol L-1; 95% CI: -0.26 mmol L-1, -0.01 mmol L-1), insulin concentration (MD = -1.91 pmol L-1, 95% CI: -2.41 to -1.41), the homeostasis model assessment of insulin resistance (HOMA-IR) (MD = -0.32 mmol L-1; 95% CI: -0.42 mmol L-1, -0.22 mmol L-1), and Quantitative Insulin sensitivity Check Index (QUICKI) (MD = 0.02, 95% CI: 0.01,0.03) in pregnant women. Probiotic supplementation had no significant effects on the results of the oral glucose tolerance test (OGTT) (1 h OGTT, MD = -0.10, 95% CI: -0.30, 0.09; 2 h OGTT, MD = -0.06, 95% CI: -0.31, 0.20). Conclusion: This meta-analysis suggested that probiotic supplementation may lead to an improvement in glycemic control and reduction of GDM incidence in pregnant women.
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Affiliation(s)
- Lijun Zhang
- Department of Nutrition and Toxicology, Hangzhou Normal University School of Public Health, Hangzhou, 311121, China.
| | - Xiaoqiang Hu
- Department of Nutrition and Toxicology, Hangzhou Normal University School of Public Health, Hangzhou, 311121, China.
| | - Ying Wang
- Department of Nutrition and Toxicology, Hangzhou Normal University School of Public Health, Hangzhou, 311121, China.
| | - Chuncao He
- Department of Nutrition and Toxicology, Hangzhou Normal University School of Public Health, Hangzhou, 311121, China.
| | - Jingjing Yu
- Department of Nutrition and Toxicology, Hangzhou Normal University School of Public Health, Hangzhou, 311121, China.
| | - Xuexian Fang
- Department of Nutrition and Toxicology, Hangzhou Normal University School of Public Health, Hangzhou, 311121, China.
| | - Yan Zhang
- Department of Nutrition and Toxicology, Hangzhou Normal University School of Public Health, Hangzhou, 311121, China.
| | - Xianrong Xu
- Department of Nutrition and Toxicology, Hangzhou Normal University School of Public Health, Hangzhou, 311121, China.
| | - Jun Yang
- Department of Nutrition and Toxicology, Hangzhou Normal University School of Public Health, Hangzhou, 311121, China. .,Zhejiang Provincial Center for Uterine Cancer Diagnosis and Therapy Research, The Affiliated Women's Hospital, Zhejiang University, Hangzhou, 310006, China
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15
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Silva JL, de Almeida Paula D, Lelis CA, Vieira ÉNR, Ramos AM. Double emulsions containing probiotic cells
(
Lactiplantibacillus plantarum
)
added in
a
mango dessert. J FOOD PROCESS PRES 2022. [DOI: 10.1111/jfpp.16783] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Jamille Lisboa Silva
- Department of Food Technology Federal University of Viçosa (UFV) Viçosa MG Brazil
| | | | - Carini Aparecida Lelis
- Center for Food Analysis (NAL), Technological Development Support Laboratory (LADETEC) Federal University of Rio de Janeiro (UFRJ), Cidade Universitária Rio de Janeiro RJ Brazil
| | | | - Afonso Mota Ramos
- Department of Food Technology Federal University of Viçosa (UFV) Viçosa MG Brazil
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16
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Correlation Analysis of Umbilical Cord Blood Metabolic Phenotype and Inflammation in Patients with Gestational Diabetes Mellitus Complicated with Overweight and Obesity. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:6072286. [PMID: 35600958 PMCID: PMC9122673 DOI: 10.1155/2022/6072286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 04/15/2022] [Accepted: 04/22/2022] [Indexed: 12/01/2022]
Abstract
Background Gestational diabetes mellitus (GDM) is a common metabolic disorder in pregnancy. The incidence rate is increasing year by year, which seriously threatens the safety of maternal and infant. Obesity is a vital factor in inducing GDM. Pregnant women with GDM account for a large proportion of overweight and obese pregnant women. Our study aimed to explore the potential mechanism of differential metabolites on inflammation and find the intervention and management methods for GDM in overweight and obese pregnant women. Methods Umbilical cord blood samples and placenta were collected from normal weight pregnant women with GDM (control group) and overweight and obese pregnant women with GDM (obesity group) for a comparative study. Serum inflammatory factors IL-10, TNF-α, IL-6, lipopolysaccharide (LPS), and TLR4 expression were detected by ELISA. The expression levels of BCL-2 and caspase-3 were measured by Western blot. TUNEL staining was used to observe the apoptosis of placental villi. KEGG combined with metabolomics was used to compare the differences of metabolic maps between the two groups. Results Compared with the control group, the level of anti-inflammatory factor IL-10 in the cord blood was decreased in the obesity group, while the levels of proinflammatory factors TNF-α, IL-6, and LPS were increased. In the placental tissues, the obesity group had higher concentrations of LPS, TLR4, and caspase-3 and lower concentration of BCL-2. Placental villi in the obesity group were more likely to undergo apoptosis than the control group. Correlation analysis showed that the above metabolite concentrations were negatively correlated with TNF-α or LPS. Conclusion Metabolites could control obesity in the process of controlling the occurrence and development of inflammation.
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17
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Sew SW, Lu Y, Taniasuri F, Liu SQ. Chemical analysis and flavour compound changes of vegetable blend slurry fermented with selected probiotic bacteria. FOOD BIOSCI 2022. [DOI: 10.1016/j.fbio.2022.101784] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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18
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Ibrahim I, Bashir M, Singh P, Al Khodor S, Abdullahi H. The Impact of Nutritional Supplementation During Pregnancy on the Incidence of Gestational Diabetes and Glycaemia Control. Front Nutr 2022; 9:867099. [PMID: 35464031 PMCID: PMC9024356 DOI: 10.3389/fnut.2022.867099] [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: 02/03/2022] [Accepted: 03/18/2022] [Indexed: 11/13/2022] Open
Abstract
The nutritional state before and throughout pregnancy has a critical impact on the women's health and the baby's development and growth. The release of placental hormones during pregnancy induces/ increases maternal insulin resistance and promotes nutrition utilization by the fetus. Gestational Diabetes Mellitus (GDM) is the most common medical complication in pregnancy and is associated with significant maternal and fetal morbidity. Several studies have examined the effect of physical activity, healthy eating, and various food supplements on the risk of developing gestational diabetes (GDM) and related outcomes. Among those, Myo-Inositol supplementation has shown encouraging results in the prevention of GDM. Maternal vitamin D deficiency has been associated with an elevated risk of GDM, and supplementation can improve glucose haemostasis by lowering fasting blood glucose, HbA1c, and serum insulin concentration. Probiotics modulate the gut microbiota leading to an improved glucose and lipid metabolism, which is proposed to reduce the risk of GDM. We aim to review the strength and limitation of the current evidence for using some nutritional supplements either as single agents or in combinations on the risk of developing GDM and on glycaemic control.
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Affiliation(s)
- Ibrahim Ibrahim
- Sidra Medicine, Weill Cornell Medical College-Qatar, Doha, Qatar
| | - Mohammed Bashir
- Endocrine Department, Hamad Medical Corporation, Doha, Qatar
| | - Parul Singh
- Research Department, Sidra Medicine, Doha, Qatar
- College of Health and Life Sciences, Hamad Bin Khalifa University, Doha, Qatar
| | | | - Hala Abdullahi
- Sidra Medicine, Weill Cornell Medical College-Qatar, Doha, Qatar
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19
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Feng T, Liu Y. Microorganisms in the reproductive system and probiotic's regulatory effects on reproductive health. Comput Struct Biotechnol J 2022; 20:1541-1553. [PMID: 35465162 PMCID: PMC9010680 DOI: 10.1016/j.csbj.2022.03.017] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 03/16/2022] [Accepted: 03/18/2022] [Indexed: 12/18/2022] Open
Abstract
The presence of microbial communities in the reproductive tract has been revealed, and this resident microbiota is involved in the maintenance of health. Intentional modulation via probiotics has been proposed as a possible strategy to enhance reproductive health and reduce the risk of diseases. The male seminal microbiota has been suggested as an important factor that influences a couple’s health, pregnancy outcomes, and offspring health. Probiotics have been reported to play a role in male fertility and to affect the health of mothers and offspring. While the female reproductive microbiota is more complicated and has been identified in both the upper and lower reproductive systems, they together contribute to health maintenance. Probiotics have shown regulatory effects on the female reproductive tract, thereby contributing to homeostasis of the tract and influencing the health of offspring. Further, through transmission of bacteria or through other indirect mechanisms, the parent’s reproductive microbiota and probiotic intervention influence infant gut colonization and immunity development, with potential health consequences. In vitro and in vivo studies have explored the mechanisms underlying the benefits of probiotic administration and intervention, and an array of positive results, such as modulation of microbiota composition, regulation of metabolism, promotion of the epithelial barrier, and improvement of immune function, have been observed. Herein, we review the state of the art in reproductive system microbiota and its role in health and reproduction, as well as the beneficial effects of probiotics on reproductive health and their contributions to the prevention of associated diseases.
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20
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Evidence and possible mechanisms of probiotics in the management of type 1 diabetes mellitus. J Diabetes Metab Disord 2022; 21:1081-1094. [PMID: 35673472 PMCID: PMC9167374 DOI: 10.1007/s40200-022-01006-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 02/12/2022] [Indexed: 10/19/2022]
Abstract
Abstract Type 1 diabetes mellitus (T1DM) is one of the most common chronic immune-mediated diseases. The prevalence is worldwide especially among children and young adults. The destruction of the pancreatic β-cells due to some abnormalities in the immune system characterizes T1DM. Considering the high burden of the disease and its impact on human health, researchers have made great efforts during the last decades; investigating the disease pathogenesis and discovering new strategies for its management. Fortunately, probiotics have been found as potential remedies for T1DM. This review aims to explore the potentialities of probiotics in managing T1DM and its complications. Based on the outcomes of human and animal studies carried out from 2016 to 2021, the review hopes to assess the effectiveness of probiotics in the prevention and treatment of T1DM and its complications. We first tried to explain the disease's pathogenesis, and highlighted the possible mechanisms involved in these potentialities of probiotics. We concluded that, probiotics can be used as possible therapeutic tools for the management of T1DM. Possible mechanisms of action of probiotics include; the modulation of the gut microbiota, the regulation of inflammation-related cytokines, the production of short chain fatty acids (SCFAs), and the regulation of GLP-1. However, we recommend further studies especially human trials should be carried out to investigate these potentialities of probiotics. Highlights • T1DM is highly prevalent worldwide, causing high morbidity and mortality especially among children and young adults• Gut microbiota plays a significant role in the pathogenesis of T1DM via an interconnection with the immune system• Probiotics can be used as possible therapeutic tools for the management of T1DM• Possible mechanisms of action of probiotics include the modulation of the gut microbiota, the regulation of inflammation-related cytokines, the production of SCFAs, and the regulation of GLP-1.
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21
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Alamri A, AlKhater SA. Evaluating the knowledge on microbiome and dysbiosis in allergic diseases among medical sciences students in Saudi Arabia. Clin Mol Allergy 2022; 20:2. [PMID: 35094706 PMCID: PMC8802525 DOI: 10.1186/s12948-022-00168-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 01/06/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Microbiome science deals with the development of diseases that are derived from the interaction between the host immune system and microbes. Microbiome disturbance or dysbiosis has been increasingly recognized as an important contributor to the pathogenesis of allergic diseases. Thus, this field is pivotal in the management of allergic disorders. Despite the increasing prevalence of allergic disorders in Saudi Arabia, medical students lack knowledge of microbiome science. Therefore, this study aimed to assess the level of knowledge of medical sciences students on the human microbiome, dysbiosis, and management of the impaired microbiome with a focus on allergic diseases and asthma. METHODS An online survey was designed, validated, and distributed to 100 final-year students and interns majoring in clinical nutrition, public health, and clinical laboratory sciences at a single university in Saudi Arabia. The study period was from November 2020 to January 2021. RESULTS The overall knowledge of the human microbiome was adequate among the participants, but their understanding of dysbiosis and management of the impaired microbiome was low to moderate. Knowledge of dysbiosis management was significantly higher in students majoring in clinical nutrition than in those majoring in public health and clinical laboratory sciences. CONCLUSIONS Collectively, this study provides the first evidence that knowledge of specific domains of microbiome science among a cohort of medical sciences students in Saudi Arabia is insufficient. Large-scale studies are warranted to confirm these observations at a national level, and specific curriculum modifications are necessary to improve the knowledge of future healthcare professionals about clinical applications of microbiome science.
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Affiliation(s)
- Aisha Alamri
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Suzan A AlKhater
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia. .,Department of Pediatrics, King Fahad Hospital of the University, Al-Khobar, Saudi Arabia.
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22
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Li S, Yang Y, Liu F, Song Q. Molecular Mechanism of miR-29b on Gestational Diabetes and Its Influence on Trophoblast Cell Function. J BIOMATER TISS ENG 2022. [DOI: 10.1166/jbt.2022.2871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
To explore the mechanism of miR-29b in gestational diabetes mellitus (GDM) and its effect on the function of trophoblast cell (TBC), the placenta tissues of 55 normal term pregnancies and 55 GDM patients were selected and rolled into control group and observation group. In the early
stage, microRNA (miRNA) chips were utilized to screen the differentially expressed miRNAs in the placenta of observation group and control group. According to the microarray results of miRNAs, three differentially expressed miRNAs, namely let-7b, miR-1202, and miR-29b were selected. Then,
the differences in the miR-29b level in the four groups were analyzed, namely the microRNA-29b (miR-29b minic), mini-control (minic control), microRNA-29b inhibitor (miR-29b inhibitor), and inhibitor control (inhibitor control). The results showed that miR-29b level in the placenta of observation
group was substantially inferior to that of controls, with remarkable differences (P < 0.05). miR-29b level in miR-29b minic and minic control had significant changes (P < 0.01). The TBC activity of minic control was greatly superior to that of minic control, and there
was considerable difference between the two (P < 0.05). The difference between miR-29b inhibitor and inhibitor control in TBC was not obvious, without considerable differences (P > 0.05). The invasion ability of miR-29b inhibitor TBC was notably superior to inhibitor control,
and there were substantial differences (P < 0.05). To sum up, miR-29b had a significant inhibitory effect on the proliferation and cell activity of TBC, and can promote the apoptosis and death of TBC. Moreover, its inhibitory effect on cell migration and invasion was also suggested.
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Affiliation(s)
- Sheng Li
- School of Medicine, Jianghan University, Wuhan, 430056, Hubei, China
| | - Youhua Yang
- Department of Basic Medical Sciences, Jianghan University, Wuhan, 430056, Hubei, China
| | - Fang Liu
- Department of Obstetrics, Hubei Maternal and Child Health Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology, Wuhan, 430070, Hubei, China
| | - Qian Song
- Department of Obstetrics, Wuhan No. 6 Hospital Affiliated to Jianghan University, Wuhan, 430014, Hubei, China
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23
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Analysis and Intervention of Factors Affecting Abnormal Postpartum Glucose Tolerance and Gestational Recurrence in Gestational Diabetes. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:8470944. [PMID: 34697551 PMCID: PMC8541864 DOI: 10.1155/2021/8470944] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 09/29/2021] [Indexed: 11/17/2022]
Abstract
ObjectiveTo investigate the influencing factors of abnormal postpartum glucose tolerance and pregnancy recurrence in gestational diabetes mellitus (GDM) and to develop reasonable interventions to prevent postpartum glucose tolerance and recurrence of pregnancy. Methods. Retrospective analysis of clinical data of 238 GDM patients during pregnancy, including age, body mass index (BMI) before and after pregnancy, regular exercise during pregnancy, insulin use, family history of diabetes, fasting blood glucose (FPG) during pregnancy, oral glucose tolerance test (OGTT) 2 h time value, blood lipid index, and whether pregnant again. At the same time, the women were followed up by telephone or home visits to understand and guide the patient's diet and exercise. The clinical characteristics of the two groups of patients were compared. According to the OGTT test, the recovery of glucose tolerance in pregnant women 6–8 weeks postpartum was divided into the normal postpartum glucose tolerance group and the abnormal group. Logistic multivariate analysis was used to find the influencing factors of postpartum glucose tolerance and recurrence of pregnancy. Results. Between 238 patients of followed-up, 150 pregnant women had abnormal postpartum glucose tolerance, accounting for 63.03%. There were 115 repregnants, of whom 37 (32.17%) had a recurrence of postpartum glucose tolerance. Pre and postpregnancy BMI, insulin use during pregnancy, family history of diabetes, FPG during pregnancy, OGTT 2 h values, and triglyceride (TG) were independent risk factors for abnormal postpartum diabetes and recurrence of pregnancy in GDM patients. Conclusions. Patients with GDM are at high risk of postpartum abnormal glucose tolerance and pregnancy recurrence, which may be influenced by the pregnant woman's prepregnancy and postpartum BMI, insulin use during pregnancy, family history of diabetes, FPG, OGGT 2 h values during pregnancy, and TG levels. Therefore, health education for pregnant women should be strengthened in the clinic, with guidance on proper diet for weight control, increased exercise, and regular blood glucose screening and monitoring for those at risk.
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Mierzyński R, Poniedziałek-Czajkowska E, Sotowski M, Szydełko-Gorzkowicz M. Nutrition as Prevention Factor of Gestational Diabetes Mellitus: A Narrative Review. Nutrients 2021; 13:nu13113787. [PMID: 34836042 PMCID: PMC8625817 DOI: 10.3390/nu13113787] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 10/22/2021] [Accepted: 10/25/2021] [Indexed: 12/16/2022] Open
Abstract
Gestational diabetes mellitus (GDM) is defined as a glucose tolerance disorder with onset or first recognition during pregnancy. GDM is associated with several adverse maternal and neonatal outcomes. Management to reduce the incidence of GDM could decrease the incidence of these complications. Modification of nutrition in the prevention of GDM is postulated. The vital issue in GDM prevention is the implementation of proper dietary patterns, appropriate physical activity, and a combination of diet and lifestyle modifications. However, intervention studies examining the effects of diet and lifestyle on GDM prevention are contradictory. The aim of this study was to review the scientific evidence on nutritional prevention strategies, including diet and supplementation of some substances such as probiotics, micro/macroelements, fiber, myoinositol, and vitamins that may be effective in reducing the risk of GDM. The presented article is a narrative review. This article indicates that certain nutritional factors may have some benefit in preventing GDM. However, further studies in a variety of populations and large groups of patients are needed. At present, no definitive conclusions can be drawn as to the best intervention in the prevention of GDM.
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Banerjee S, Huang Z, Wang Z, Nakashima A, Saito S, Sharma S, Cheng S. Etiological Value of Sterile Inflammation in Preeclampsia: Is It a Non-Infectious Pregnancy Complication? Front Cell Infect Microbiol 2021; 11:694298. [PMID: 34485175 PMCID: PMC8415471 DOI: 10.3389/fcimb.2021.694298] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 07/30/2021] [Indexed: 12/25/2022] Open
Abstract
Understanding of sterile inflammation and its associated biological triggers and diseases is still at the elementary stage. This becomes more warranted in cases where infections are not associated with the pathology. Detrimental effects of bacterial and viral infections on the immune responses at the maternal-fetal interface as well as pregnancy outcomes have been well documented. However, an infection-induced etiology is not thought to be a major contributing component to severe pregnancy complications such as preeclampsia (PE) and gestational diabetes. How is then an inflammatory signal thought to be associated with these pregnancy complications? It is not clear what type of inflammation is involved in the onset of PE-like features. We opine that sterile inflammation regulated by the inflammasome-gasdermins-caspase-1 axis is a contributory factor to the onset of PE. We hypothesize that increased production and release of damage-associated molecular patterns (DAMPs) or Alarmins such as high-mobility group box1 (HMGB1), cell-free fetal DNA, uric acid, the NOD-like receptor pyrin-containing receptor 3 (NLRP3) inflammasome, IL-1β and IL-18 occur in the PE placenta. Some of these molecules have already been observed in the placenta from women with PE. Mechanistically, emerging evidence has demonstrated that excessive placental endoplasmic reticulum (ER) stress, impaired autophagy and gasdermine D (GSDMD)-mediated intrinsic pyroptosis are key events that contribute to systemic sterile inflammation in patients with PE, especially early-onset PE (e-PE). In this review, we highlight the advances on the roles of sterile inflammation and inflammatory signaling cascades involving ER stress, autophagy deficiency and pyroptosis in PE pathophysiology. Deciphering the mechanisms underlying these inflammatory pathways may provide potential diagnostic biomarkers and facilitate the development of therapeutic strategies to treat this devastating disease.
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Affiliation(s)
- Sayani Banerjee
- Department of Pediatrics, Women and Infants Hospital-Warren Alpert Medical School of Brown University, Providence, RI, United States
| | - Zheping Huang
- Department of Pediatrics, Women and Infants Hospital-Warren Alpert Medical School of Brown University, Providence, RI, United States
| | - Zhengke Wang
- Department of Pediatrics, Women and Infants Hospital-Warren Alpert Medical School of Brown University, Providence, RI, United States
| | - Akitoshi Nakashima
- Department of Obstetrics and Gynecology, University of Toyama, Toyama, Japan
| | - Shigeru Saito
- Department of Obstetrics and Gynecology, University of Toyama, Toyama, Japan
| | - Surendra Sharma
- Department of Pediatrics, Women and Infants Hospital-Warren Alpert Medical School of Brown University, Providence, RI, United States
| | - Shibin Cheng
- Department of Pediatrics, Women and Infants Hospital-Warren Alpert Medical School of Brown University, Providence, RI, United States
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26
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Zhang Y, Zhang Y, Zhao L, Shang Y, He D, Chen J. Distribution of complete blood count constituents in gestational diabetes mellitus. Medicine (Baltimore) 2021; 100:e26301. [PMID: 34115037 PMCID: PMC8202579 DOI: 10.1097/md.0000000000026301] [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] [Received: 01/09/2021] [Accepted: 05/17/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND TRIAL DESIGN The incidence rate of gestational diabetes is high. In the long run, it harms the health of both the mother and child. In order to understand the distribution of hematological cells with gestational diabetes mellitus (GDM), a longitudinal cohort study was conducted from 2012 to 2018. METHODS A longitudinal case control study of 1860 pregnant women was conducted between 2012 and 2018. Data of hematological parameters at 11 time points of gestational stage were obtained from a laboratory database. Repeated measures analysis and independent t-test were used to analyze the effect of the hematological parameters on GDM. RESULTS The trend of blood cells fluctuated with gestational age in normal controls but was more remarkable in GDM. Compared with the controls, blood neutrophils, lymphocytes, and monocytes augmented in the second trimester but decreased in the third trimester; platelet (PLT) and thrombocytocrit increased throughout the three trimesters, and red blood cell (RBC) was abundant in the last 2 trimesters in GDM. CONCLUSIONS Peripheral blood leukocytes, platelets, and erythrocytes were significantly different during gestation between GDM and normal controls. Inflammation may also be involved in GMD.
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Affiliation(s)
| | | | - Limin Zhao
- Scientific Research Management Department, Shenzhen Longhua District Central Hospital, Guangdong Medical University, Shenzhen
| | - Yanyan Shang
- Department of Clinical Laboratory, Cancer Center of Guangzhou Medical University, Guangzhou
| | - Dabao He
- Department of Clinical Laboratory
| | - Jiying Chen
- Department of Obstetrics and Gynecology, Shenzhen Longhua District Central Hospital, Guangdong Medical University, Shenzhen, Guangdong, China
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Fu F, Yan P, You S, Mao X, Qiao T, Fu L, Wang Y, Dai Y, Maimaiti P. The pregnancy-related anxiety characteristics in women with gestational diabetes mellitus: why should we care? BMC Pregnancy Childbirth 2021; 21:424. [PMID: 34112107 PMCID: PMC8194142 DOI: 10.1186/s12884-021-03887-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 05/20/2021] [Indexed: 12/24/2022] Open
Abstract
Background Gestational diabetes mellitus (GDM) is very commonly-seen in clinical settings, and GDM patients may have higher levels of anxiety. It’s necessary to evaluate the anxiety level and potentially influencing factors in patients with GDM, to provide insights for the management of anxiety of GDM patients. Methods Patients with GDM treated in our hospital from May, 2018 to May, 2020 were included. We evaluated the characteristics of patients and the scores of pregnancy-related anxiety scale for anxiety level, vulnerable personality style questionnaire (VPSQ) for personality, general self-efficacy scale (GSES) for self-efficacy, social support rating scale (SSRS) for social support level. Logistic regression analyses were conducted to identify the potential influencing factors of anxiety in GDM patients. Results A total of 386 GDM patients were included, the incidence of anxiety in patients with GDM was 59.07%. Anxiety was positively correlated with the susceptible personality (r = 0.604, p = 0.023), and it was negatively correlated with self-efficacy and social support (r = -0.586 and -0.598 respectively, all p < 0.05). The education level, monthly income, abnormal pregnancy (miscarriage, premature rupture of membranes) and cesarean section history and first pregnancy were the independent influencing factors for the anxiety in the patients with GDM (all p < 0.05). Conclusions The anxiety of GDM patients is very common, early care and interventions are warranted for those patients with abnormal pregnancy and cesarean section history, first pregnancy, lower education level, and less monthly income.
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Affiliation(s)
- Feng Fu
- School of Nursing, Xinjiang Medical University, No. 567, Shangde North Road, Urumqi, 830000, Xinjiang, China
| | - Ping Yan
- School of Nursing, Xinjiang Medical University, No. 567, Shangde North Road, Urumqi, 830000, Xinjiang, China
| | - Shuping You
- School of Nursing, Xinjiang Medical University, No. 567, Shangde North Road, Urumqi, 830000, Xinjiang, China
| | - Xinmin Mao
- School of Nursing, Xinjiang Medical University, No. 567, Shangde North Road, Urumqi, 830000, Xinjiang, China
| | - Tingting Qiao
- Reproductive Medicine Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Li Fu
- Emergency Trauma Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Yanni Wang
- School of Nursing, Xinjiang Medical University, No. 567, Shangde North Road, Urumqi, 830000, Xinjiang, China
| | - Yali Dai
- School of Nursing, Xinjiang Medical University, No. 567, Shangde North Road, Urumqi, 830000, Xinjiang, China
| | - Palida Maimaiti
- School of Nursing, Xinjiang Medical University, No. 567, Shangde North Road, Urumqi, 830000, Xinjiang, China.
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Chen Y, Zhou J, Wang L. Role and Mechanism of Gut Microbiota in Human Disease. Front Cell Infect Microbiol 2021; 11:625913. [PMID: 33816335 PMCID: PMC8010197 DOI: 10.3389/fcimb.2021.625913] [Citation(s) in RCA: 210] [Impact Index Per Article: 70.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 01/26/2021] [Indexed: 12/12/2022] Open
Abstract
The human gut microbiome is a huge microbial community that plays an irreplaceable role in human life. With the further development of research, the influence of intestinal flora on human diseases has been gradually excavated. Gut microbiota (GM) dysbiosis has adverse health effects on the human body that will lead to a variety of chronic diseases. The underlying mechanisms of GM on human diseases are incredibly complicated. This review focuses on the regulation and mechanism of GM on neurodegenerative diseases, cardiovascular diseases, metabolic diseases and gastrointestinal diseases, thus providing a potential target for the prevention and treatment of disease.
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Affiliation(s)
- Yinwei Chen
- School of Medicine, Hangzhou Normal University, Hangzhou, China
| | - Jinghua Zhou
- Institute of Aging Research, School of Medicine, Hangzhou Normal University, Hangzhou, China.,School of Medicine, Zhejiang University, Hangzhou, China
| | - Li Wang
- Institute of Aging Research, School of Medicine, Hangzhou Normal University, Hangzhou, China.,Department of Evolutionary Studies of Biosystems, School of Advanced Sciences, Graduate University for Advanced Studies (SOKENDAI), Hayama, Japan
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Ma S, You Y, Huang L, Long S, Zhang J, Guo C, Zhang N, Wu X, Xiao Y, Tan H. Alterations in Gut Microbiota of Gestational Diabetes Patients During the First Trimester of Pregnancy. Front Cell Infect Microbiol 2020; 10:58. [PMID: 32175285 PMCID: PMC7056672 DOI: 10.3389/fcimb.2020.00058] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 02/06/2020] [Indexed: 12/14/2022] Open
Abstract
Background: Dysbiosis of human gut microbiota is associated with a wide range of metabolic disorders, including gestational diabetes mellitus (GDM). Yet whether gut microbiota dysbiosis participates in the etiology of GDM remains largely unknown. Objectives: Our study was initiated to determine whether the alternations in gut microbial composition during early pregnancy linked to the later development of GDM, and explore the feasibility of microbial biomarkers for the early prediction of GDM. Study design: This nested case-control study was based upon an early pregnancy follow-up cohort (ChiCTR1900020652). Gut microbiota profiles of 98 subjects with GDM and 98 matched healthy controls during the early pregnancy (10–15 weeks) were assessed via 16S rRNA gene amplicon sequencing of V4 region. The data set was randomly split into a discovery set and a validation set, the former was used to analyze the differences between GDM cases and controls in gut microbial composition and functional annotation, and to establish an early identification model of GDM, then the performance of the model was verified by the external validation set. Results: Bioinformatic analyses revealed changes to gut microbial composition with significant differences in relative abundance between the groups. Specifically, Eisenbergiella, Tyzzerella 4, and Lachnospiraceae NK4A136 were enriched in the GDM group, whereas Parabacteroides, Megasphaera, Eubacterium eligens group, etc. remained dominant in the controls. Correlation analysis revealed that GDM-enriched genera Eisenbergiella and Tyzzerella 4 were positively correlated with fasting blood glucose levels, while three control-enriched genera (Parabacteroides, Parasutterella, and Ruminococcaceae UCG 002) were the opposite. Further, GDM functional annotation modules revealed enrichment of modules for sphingolipid metabolism, starch and sucrose metabolism, etc., while lysine biosynthesis and nitrogen metabolism were reduced. Finally, five genera and two clinical indices were included in the linear discriminant analysis model for the prediction of GDM; the areas under receiver operating characteristic curves of the training and validation sets were 0.736 (95% confidence interval: 0.663–0.808) and 0.696 (0.575–0.818), respectively. Conclusions: Gut bacterial dysbiosis in early pregnancy was found to be associated with the later development of GDM, and gut microbiota-targeted biomarkers might be utilized as potential predictors of GDM.
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Affiliation(s)
- Shujuan Ma
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Yiping You
- Department of Obstetrics, Hunan Provincial Maternal and Child Health Hospital, Changsha, China
| | - Lingting Huang
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Sisi Long
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Jiayue Zhang
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Chuhao Guo
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Na Zhang
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Xinrui Wu
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Yanni Xiao
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Hongzhuan Tan
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
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Ye Y, Xiong Y, Zhou Q, Wu J, Li X, Xiao X. Comparison of Machine Learning Methods and Conventional Logistic Regressions for Predicting Gestational Diabetes Using Routine Clinical Data: A Retrospective Cohort Study. J Diabetes Res 2020; 2020:4168340. [PMID: 32626780 PMCID: PMC7306091 DOI: 10.1155/2020/4168340] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 05/06/2020] [Accepted: 05/14/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Gestational diabetes mellitus (GDM) contributes to adverse pregnancy and birth outcomes. In recent decades, extensive research has been devoted to the early prediction of GDM by various methods. Machine learning methods are flexible prediction algorithms with potential advantages over conventional regression. OBJECTIVE The purpose of this study was to use machine learning methods to predict GDM and compare their performance with that of logistic regressions. METHODS We performed a retrospective, observational study including women who attended their routine first hospital visits during early pregnancy and had Down's syndrome screening at 16-20 gestational weeks in a tertiary maternity hospital in China from 2013.1.1 to 2017.12.31. A total of 22,242 singleton pregnancies were included, and 3182 (14.31%) women developed GDM. Candidate predictors included maternal demographic characteristics and medical history (maternal factors) and laboratory values at early pregnancy. The models were derived from the first 70% of the data and then validated with the next 30%. Variables were trained in different machine learning models and traditional logistic regression models. Eight common machine learning methods (GDBT, AdaBoost, LGB, Logistic, Vote, XGB, Decision Tree, and Random Forest) and two common regressions (stepwise logistic regression and logistic regression with RCS) were implemented to predict the occurrence of GDM. Models were compared on discrimination and calibration metrics. RESULTS In the validation dataset, the machine learning and logistic regression models performed moderately (AUC 0.59-0.74). Overall, the GBDT model performed best (AUC 0.74, 95% CI 0.71-0.76) among the machine learning methods, with negligible differences between them. Fasting blood glucose, HbA1c, triglycerides, and BMI strongly contributed to GDM. A cutoff point for the predictive value at 0.3 in the GBDT model had a negative predictive value of 74.1% (95% CI 69.5%-78.2%) and a sensitivity of 90% (95% CI 88.0%-91.7%), and the cutoff point at 0.7 had a positive predictive value of 93.2% (95% CI 88.2%-96.1%) and a specificity of 99% (95% CI 98.2%-99.4%). CONCLUSION In this study, we found that several machine learning methods did not outperform logistic regression in predicting GDM. We developed a model with cutoff points for risk stratification of GDM.
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Affiliation(s)
- Yunzhen Ye
- Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
- The Shanghai Key Laboratory of Female Reproductive Endocrine-Related Diseases, Shanghai, China
| | - Yu Xiong
- Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
- The Shanghai Key Laboratory of Female Reproductive Endocrine-Related Diseases, Shanghai, China
| | - Qiongjie Zhou
- Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
- The Shanghai Key Laboratory of Female Reproductive Endocrine-Related Diseases, Shanghai, China
| | - Jiangnan Wu
- Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
| | - Xiaotian Li
- Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
- The Shanghai Key Laboratory of Female Reproductive Endocrine-Related Diseases, Shanghai, China
- The Shanghai Key Laboratory of Birth Defects, Shanghai, China
- Institute of Biochemical Science, Fudan University, Shanghai, China
| | - Xirong Xiao
- Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
- The Shanghai Key Laboratory of Female Reproductive Endocrine-Related Diseases, Shanghai, China
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