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Usman TO, Chhetri G, Yeh H, Dong HH. Beta-cell compensation and gestational diabetes. J Biol Chem 2023; 299:105405. [PMID: 38229396 PMCID: PMC10694657 DOI: 10.1016/j.jbc.2023.105405] [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: 08/28/2023] [Revised: 10/16/2023] [Accepted: 10/18/2023] [Indexed: 01/18/2024] Open
Abstract
Gestational diabetes mellitus (GDM) is characterized by glucose intolerance in pregnant women without a previous diagnosis of diabetes. While the etiology of GDM remains elusive, the close association of GDM with increased maternal adiposity and advanced gestational age implicates insulin resistance as a culpable factor for the pathogenesis of GDM. Pregnancy is accompanied by the physiological induction of insulin resistance in the mother secondary to maternal weight gain. This effect serves to spare blood glucose for the fetus. To overcome insulin resistance, maternal β-cells are conditioned to release more insulin into the blood. Such an adaptive response, termed β-cell compensation, is essential for maintaining normal maternal metabolism. β-cell compensation culminates in the expansion of β-cell mass and augmentation of β-cell function, accounting for increased insulin synthesis and secretion. As a result, a vast majority of mothers are protected from developing GDM during pregnancy. In at-risk pregnant women, β-cells fail to compensate for maternal insulin resistance, contributing to insulin insufficiency and GDM. However, gestational β-cell compensation ensues in early pregnancy, prior to the establishment of insulin resistance in late pregnancy. How β-cells compensate for pregnancy and what causes β-cell failure in GDM are subjects of investigation. In this mini-review, we will provide clinical and preclinical evidence that β-cell compensation is pivotal for overriding maternal insulin resistance to protect against GDM. We will highlight key molecules whose functions are critical for integrating gestational hormones to β-cell compensation for pregnancy. We will provide mechanistic insights into β-cell decompensation in the etiology of GDM.
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Affiliation(s)
- Taofeek O Usman
- Division of Endocrinology, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Goma Chhetri
- Division of Endocrinology, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Hsuan Yeh
- Division of Endocrinology, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - H Henry Dong
- Division of Endocrinology, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
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Basu J, Mukherjee R, Sahu P, Datta C, Chowdhury S, Mandal D, Ghosh A. Association of common variants of TCF7L2 and PCSK2 with gestational diabetes mellitus in West Bengal, India. NUCLEOSIDES, NUCLEOTIDES & NUCLEIC ACIDS 2023; 43:185-202. [PMID: 37610142 DOI: 10.1080/15257770.2023.2248201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 08/07/2023] [Accepted: 08/09/2023] [Indexed: 08/24/2023]
Abstract
The genetic etiology of gestational diabetes mellitus (GDM) was suggested to overlap with type-2 diabetes(T2D). Transcription factor 7-like 2 (TCF7L2) and Proprotein Convertase Subtilisin/Kexin type 2 (PCSK2) are T2D susceptibility genes of the insulin synthesis/processing pathway. We analyzed associations of TCF7L2 and PCSK2 variants with GDM risk and evaluated their potential impact on impaired insulin processing in an eastern Indian population. The study included 114 GDM (case) and 228 non-GDM pregnant women (control). rs7903146, rs4132670, rs12255372 of TCF7L2, and rs2269023 of PCSK2 were genotyped by PCR-RFLP, and genotype distributions were compared between case and control. Fasting serum proinsulin and C-peptide levels were measured by ELISA and the Proinsulin/C-peptide ratio was considered an indicator of proinsulin conversion. Significantly higher frequency of risk allele (T) of rs12255372 (p = 0.02, OR = 2.0, 95%CI = 1.11-3.64) and rs4132670 (p = 0.002, OR = 2.26, 95%CI = 1.32-3.87) of TCF7L2 was found in GDM cases than non-GDM controls; TT genotype was associated with significantly increased disease risk. In rs7903146 (TCF7L2) and rs2269023 (PCSK2), although the frequency of risk allele (T) was not significantly higher in cases than controls, an association of TT for both variants remained significant with higher GDM risk in the recessive model. Increased serum pro-insulin and proinsulin:c-peptide ratio was found in GDM than non-GDM women and the phenomenon showed significant association with careers of risk alleles for TCF7L2 variants. In conclusion, TCF7L2 and PCSK2 variants are related to GDM risk in the studied population and hence may serve as potential biomarkers for assessing the disease risk. TCF7L2 variants contribute to impaired insulin processing.
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Affiliation(s)
- Jayita Basu
- Department of Life Sciences, Presidency University, Kolkata, India
| | | | - Pooja Sahu
- Department of Gynecology and Obstetrics, Institute of Post Graduate Medical Education and Research, Kolkata, India
| | - Chhanda Datta
- Department of Pathology, Institute of Post Graduate Medical Education and Research, Kolkata, India
| | - Subhankar Chowdhury
- Department of Endocrinology, Institute of Post Graduate Medical Education and Research, Kolkata, India
| | - Debasmita Mandal
- Department of Gynecology and Obstetrics, Institute of Post Graduate Medical Education and Research, Kolkata, India
| | - Amlan Ghosh
- Department of Life Sciences, Presidency University, Kolkata, India
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Lowe WL. Genetics and Epigenetics: Implications for the Life Course of Gestational Diabetes. Int J Mol Sci 2023; 24:6047. [PMID: 37047019 PMCID: PMC10094577 DOI: 10.3390/ijms24076047] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 03/19/2023] [Accepted: 03/21/2023] [Indexed: 04/14/2023] Open
Abstract
Gestational diabetes (GDM) is one of the most common complications of pregnancy, affecting as many as one in six pregnancies. It is associated with both short- and long-term adverse outcomes for the mother and fetus and has important implications for the life course of affected women. Advances in genetics and epigenetics have not only provided new insight into the pathophysiology of GDM but have also provided new approaches to identify women at high risk for progression to postpartum cardiometabolic disease. GDM and type 2 diabetes share similarities in their pathophysiology, suggesting that they also share similarities in their genetic architecture. Candidate gene and genome-wide association studies have identified susceptibility genes that are shared between GDM and type 2 diabetes. Despite these similarities, a much greater effect size for MTNR1B in GDM compared to type 2 diabetes and association of HKDC1, which encodes a hexokinase, with GDM but not type 2 diabetes suggest some differences in the genetic architecture of GDM. Genetic risk scores have shown some efficacy in identifying women with a history of GDM who will progress to type 2 diabetes. The association of epigenetic changes, including DNA methylation and circulating microRNAs, with GDM has also been examined. Targeted and epigenome-wide approaches have been used to identify DNA methylation in circulating blood cells collected during early, mid-, and late pregnancy that is associated with GDM. DNA methylation in early pregnancy had some ability to identify women who progressed to GDM, while DNA methylation in blood collected at 26-30 weeks gestation improved upon the ability of clinical factors alone to identify women at risk for progression to abnormal glucose tolerance post-partum. Finally, circulating microRNAs and long non-coding RNAs that are present in early or mid-pregnancy and associated with GDM have been identified. MicroRNAs have also proven efficacious in predicting both the development of GDM as well as its long-term cardiometabolic complications. Studies performed to date have demonstrated the potential for genetic and epigenetic technologies to impact clinical care, although much remains to be done.
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Affiliation(s)
- William L Lowe
- Department of Medicine, Division of Endocrinology, Metabolism and Molecular Medicine, Northwestern University Feinberg School of Medicine, Rubloff 12, 420 E. Superior Street, Chicago, IL 60611, USA
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Tang W, Wang X, Chen L, Lu Y, Kang X. Identification of potential gene markers in gestational diabetes mellitus. J Clin Lab Anal 2022; 36:e24515. [PMID: 35718998 PMCID: PMC9279970 DOI: 10.1002/jcla.24515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Revised: 03/31/2022] [Accepted: 04/24/2022] [Indexed: 11/18/2022] Open
Abstract
This study aims to investigate underlying mechanisms of gestational diabetes mellitus (GDM). In this work, the GSE70493 dataset from GDM and control samples was acquired from Gene Expression Omnibus (GEO) database. Afterward, differentially expressed genes (DEGs) were screened between GDM and control samples. Subsequently, functional enrichment analysis and protein–protein interaction (PPI) network analysis of these DEGs were carried out. Furthermore, significant sub‐modules were identified, and the functional analysis was also performed. Finally, we undertook a quantitative real‐time polymerase chain reaction (qRT‐PCR) with the purpose of confirming several key genes in GDM development. There were totally 528 up‐regulated and 684 down‐regulated DEGs between GDM and healthy samples. The functional analyses suggested that the above genes were dramatically enriched in type 1 diabetes mellitus (T1DM) process and immune‐related pathways. Moreover, PPI analysis revealed that several members of human leukocyte antigen (HLA) superfamily, including down‐regulated HLA‐DQA1, HLA‐DRB1, HLA‐DPA1, and HLA‐DQB1 served as hub genes. In addition, six significant sub‐clusters were extracted and functional analysis suggested that these four genes in sub‐module 1 were also associated with immune and T1DM‐related pathways. Finally, they were also confirmed by qRT‐PCR array. Besides, the four members of HLA superfamily might be implicated with molecular mechanisms of GDM, contributing to a deeper understanding of GDM development.
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Affiliation(s)
- Weichun Tang
- The Department of Obstetrics and Gynecology, The Affiliated Hospital 2 of Nantong University, Nantong, China
| | - Xiaoyu Wang
- The Department of Obstetrics and Gynecology, The Affiliated Hospital 2 of Nantong University, Nantong, China
| | - Liping Chen
- The Department of Obstetrics and Gynecology, The Affiliated Hospital 2 of Nantong University, Nantong, China
| | - Yiling Lu
- The Department of Obstetrics and Gynecology, The Affiliated Hospital 2 of Nantong University, Nantong, China
| | - Xinyi Kang
- The Department of Obstetrics and Gynecology, The Affiliated Hospital 2 of Nantong University, Nantong, China
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Association of the Pro12Ala gene polymorphism with treatment response to thiazolidinediones in patients with type 2 diabetes: a meta-analysis. Int J Diabetes Dev Ctries 2022. [DOI: 10.1007/s13410-022-01086-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Zawiejska A, Bogacz A, Iciek R, Lewicka-Rabska A, Brązert M, Mikołajczak P, Brązert J. A 646C > G (rs41423247) polymorphism of the glucocorticoid receptor as a risk factor for hyperglycaemia diagnosed in pregnancy-data from an observational study. Acta Diabetol 2022; 59:259-267. [PMID: 34648084 PMCID: PMC8841327 DOI: 10.1007/s00592-021-01799-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 09/07/2021] [Indexed: 02/07/2023]
Abstract
AIM Hyperglycaemia diagnosed in pregnancy (HiP) is a serious and frequent complication of pregnancy, increasing the risk for adverse maternal and neonatal outcomes. Investigate whether allelic variations of the glucocorticoid receptor are related to an increased risk of HiP. METHOD The following polymorphisms of the glucocorticoid receptor (GR) were investigated in the cohort study of N = 197 pregnant women with HiP and N = 133 normoglycemic pregnant controls: 646C > G (rs41423247), N363S (rs6195), ER23/22EK (rs6190, rs6189). RESULTS A GG variant of the rs41423247 polymorphism was associated with a significantly higher risk for HiP: OR 1.94 (1.18; 3.18), p = 0.009. The relationship remained significant after controlling for maternal age and prepregnancy BMI: OR 3.09 (1.25; 7.64), p = 0.014. CONCLUSIONS The allelic GG variant of the 646C > G (rs41423247) polymorphism is associated with an increased risk for hyperglycaemia in pregnancy.
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Affiliation(s)
- Agnieszka Zawiejska
- Chair of Medical Education, Department of Medical Simulation, Poznan University of Medical Sciences, Poznan, Poland
| | - Anna Bogacz
- Institute of Natural Fibers and Medicinal Plants, National Research Institute, Poznan, Poland
| | - Rafał Iciek
- Department of Obstetrics and Women’s Diseases, Poznan University of Medical Sciences, Poznan, Poland
| | - Agnieszka Lewicka-Rabska
- Department of Hypertension, Angiology and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | - Maciej Brązert
- Department of Infertility and Reproductive Endocrinology, Poznan University of Medical Sciences, Poznan, Poland
| | | | - Jacek Brązert
- Department of Obstetrics and Women’s Diseases, Poznan University of Medical Sciences, Poznan, Poland
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Li X, Lai L, Su J, Chen S, Lin S, Wang B, Gao J, Zhang L, Yao K, Duan S. Novel association between a transient receptor potential cation channel subfamily M member 5 expression quantitative trait locus rs35197079 and decreased susceptibility of gestational diabetes mellitus in a Chinese population. J Diabetes Investig 2021; 12:2062-2070. [PMID: 33979016 PMCID: PMC8565411 DOI: 10.1111/jdi.13572] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 04/19/2021] [Accepted: 04/25/2021] [Indexed: 12/29/2022] Open
Abstract
AIMS/INTRODUCTION Emerging evidence suggests that expression quantitative trait loci (eQTLs) are more likely to associate with complex diseases. Transient receptor potential cation channel subfamily M member 5 (TRPM5) is a ubiquitously expressed voltage-gated cation channel that acts indispensably to trigger insulin secretion in pancreatic β-cells. The present study evaluated the association between TRPM5 eQTL single-nucleotide polymorphisms and the risk of gestational diabetes mellitus (GDM) in a Chinese population. MATERIALS AND METHODS A total of 380 unrelated Chinese pregnant women including 241 GDM patients and 139 controls were included in this study. The eQTL single-nucleotide polymorphisms of TRPM5 were obtained from the GTEx eQTL Browser, and were subsequently genotyped using the Agena MassARRAY iPLEX platform. RESULTS Logistic regression analysis and linear regression analysis showed that rs35197079 and rs74848824 were significantly associated with reduced GDM risk and lower fasting plasma glucose levels after adjusting confounder factors in dominant genetic models. Stratification analysis based on pre-pregnancy body mass index validated a strong association between rs35197079 and GDM susceptibility in underweight and normal weight individuals. Luciferase and electrophoretic mobility shift assays carried out in rat pancreatic β-cells showed that rs35197079 was functional. CONCLUSIONS The TRPM5 eQTL single-nucleotide polymorphism rs35197079 was associated with decreased GDM susceptibility in a Chinese population, especially in underweight and normal weight pregnant women, and it was functional in modulating gene transcription.
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Affiliation(s)
- Xi Li
- Shenzhen Maternity and Child Healthcare HospitalShenzhenChina
| | - Liping Lai
- Endocrine DepartmentFutian Center for Chronic Disease ControlShenzhenChina
| | - Jindi Su
- Shenzhen Maternity and Child Healthcare HospitalShenzhenChina
| | - Shiguo Chen
- Shenzhen Maternity and Child Healthcare HospitalShenzhenChina
| | - Sheng Lin
- Shenzhen Maternity and Child Healthcare HospitalShenzhenChina
| | - Baojiang Wang
- Shenzhen Maternity and Child Healthcare HospitalShenzhenChina
| | - Jian Gao
- Shenzhen Maternity and Child Healthcare HospitalShenzhenChina
| | - Linghua Zhang
- Shenzhen Health Development Research CenterShenzhenChina
| | - Keqin Yao
- Shenzhen Health Development Research CenterShenzhenChina
| | - Shan Duan
- Shenzhen Maternity and Child Healthcare HospitalShenzhenChina
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The association between the rs4987105 of 5-lipoxygenase (ALOX5) gene and gestational glucose metabolism in Chinese population. BMC Res Notes 2020; 13:102. [PMID: 32093765 PMCID: PMC7041080 DOI: 10.1186/s13104-020-04953-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Accepted: 02/12/2020] [Indexed: 01/28/2023] Open
Abstract
Objective The arachidonate 5-lipoxygenase (ALOX5) pathway has been investigated in diverse chronic inflammatory diseases including metabolic disorders. Recently, the ALOX5 polymorphism rs4987105 was identified to confer susceptibility to type 2 diabetes mellitus (T2DM), implicating its role in regulating glucose homeostasis. Gestational diabetes mellitus (GDM) shares similar pathogenic mechanism with T2DM. Thus, we aimed to evaluate the association between rs4987105 and gestational glucose metabolism in Chinese pregnant women. Results A total of 380 unrelated Chinese pregnant women including 241 GDM patients and 139 controls were included in this study. The genotypes of rs4987105 were examined by the Agena MassARRAY iPLEX platform, the association between rs4987105 and fasting plasma glucose (FPG) levels at 24–28 gestational weeks was evaluated using different statistical methods. We found that carriers of rs4987105 CT/TT genotypes exhibited significantly lower FPG levels (P = 0.011). In addition, we observed a significant association between rs4987105 and FPG levels after adjusting confounding variables in the linear regression analysis using dominant genetic model (b = − 0.218; P = 0.01). The present study for the first time reported that the rs4987105 of 5-lipoxygenase (ALOX5) gene was associated with gestational glucose metabolism in Chinese pregnant women.
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Khan MW, Priyadarshini M, Cordoba-Chacon J, Becker TC, Layden BT. Hepatic hexokinase domain containing 1 (HKDC1) improves whole body glucose tolerance and insulin sensitivity in pregnant mice. Biochim Biophys Acta Mol Basis Dis 2019; 1865:678-687. [PMID: 30543855 PMCID: PMC6387585 DOI: 10.1016/j.bbadis.2018.11.022] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Revised: 11/19/2018] [Accepted: 11/26/2018] [Indexed: 02/04/2023]
Abstract
Hexokinase domain containing 1, a recently discovered putative fifth hexokinase, is hypothesized to play key roles in glucose metabolism. Specifically, during pregnancy in a recent genome wide association study (GWAS), a strong correlation between HKDC1 and 2-h plasma glucose in pregnant women from different ethnic backgrounds was shown. Our earlier work also reported diminished glucose tolerance during pregnancy in our whole body HKDC1 heterozygous mice. Therefore, we hypothesized that HKDC1 plays important roles in gestational metabolism, and designed this study to assess the role of hepatic HKDC1 in whole body glucose utilization and insulin action during pregnancy. We overexpressed human HKDC1 in mouse liver by injecting a human HKDC1 adenoviral construct; whereas, for the liver-specific HKDC1 knockout model, we used AAV-Cre constructs in our HKDC1fl/fl mice. Both groups of mice were subjected to metabolic testing before and during pregnancy on gestation day 17-18. Our results indicate that hepatic HKDC1 overexpression during pregnancy leads to improved whole-body glucose tolerance and enhanced hepatic and peripheral insulin sensitivity while hepatic HKDC1 knockout results in diminished glucose tolerance. Further, we observed reduced gluconeogenesis with hepatic HKDC1 overexpression while HKDC1 knockout led to increased gluconeogenesis. These changes were associated with significantly enhanced ketone body production in HKDC1 overexpressing mice, indicating that these mice shift their metabolic needs from glucose reliance to greater fat oxidation and ketone utilization during fasting. Taken together, our results indicate that hepatic HKDC1 contributes to whole body glucose disposal, insulin sensitivity, and aspects of nutrient balance during pregnancy.
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Affiliation(s)
- Md Wasim Khan
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Illinois at Chicago, IL, USA
| | - Medha Priyadarshini
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Illinois at Chicago, IL, USA
| | - Jose Cordoba-Chacon
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Illinois at Chicago, IL, USA
| | - Thomas C Becker
- Duke Molecular Physiology Institute, Department of Internal Medicine, Duke University Medical Center, Durham, NC, USA
| | - Brian T Layden
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Illinois at Chicago, IL, USA; Jesse Brown Veterans Affairs Medical Center, Chicago, IL, USA.
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Kasuga Y, Hata K, Tajima A, Ochiai D, Saisho Y, Matsumoto T, Arata N, Miyakoshi K, Tanaka M. Association of common polymorphisms with gestational diabetes mellitus in Japanese women: A case-control study. Endocr J 2017; 64:463-475. [PMID: 28202837 DOI: 10.1507/endocrj.ej16-0431] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Gestational diabetes (GDM) and type 2 diabetes (T2DM) share part of pathomechanism and several T2DM susceptibility genes are demonstrated to be associated with GDM. No information on the genetics of GDM, however, was available in Japanese women. In this study, T2DM risk variants (45 single nucleotide polymorphisms [SNPs] from 36 genes) identified in previous studies were genotyped using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry in a cohort of 171 Japanese women with GDM and 128 normal glucose tolerance (NGT) diagnosed by the new International Association of Diabetes in Pregnancy Study Group criteria. Of 45 SNPs, three genetic variants were nominally associated with the development of GDM: rs266729 (p = 0.013, odds ratio [OR]: 1.56, 95% confidence interval [CI]: 1.10-2.23) in ADIPOQ, rs10811661 (p = 0.035, OR: 1.46, 95% CI: 1.03-2.08) in CDKN2A/2B, and rs9505118 (p = 0.046, OR: 1.41, 95% CI: 1.01-1.97) in SSR1-RREB1. There was a significant difference in the number of risk alleles of three variants between women with GDM and NGT (3.79 ± 1.33 vs. 3.05 ± 1.41, p = 6.0 × 10-6). In combined analysis of three genetic variants, women with five or more risk alleles had a 7.32-fold increased risk of GDM (p = 5.6 × 10-5, 95% CI: 4.54-11.96), compared with those having no more than one risk allele. Our results suggest several risk variants of T2DM had cumulative effects on the development of GDM in Japanese women.
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Affiliation(s)
- Yoshifumi Kasuga
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo 160-8582, Japan
- Department of Maternal-Fetal Biology, National Research Institute for Child Health and Development, Tokyo 157-8583, Japan
| | - Kenichiro Hata
- Department of Maternal-Fetal Biology, National Research Institute for Child Health and Development, Tokyo 157-8583, Japan
| | - Atsushi Tajima
- Department of Bioinformatics and Genomics, Graduate School of Advanced Preventive Medical Sciences, Kanazawa University, Kanazawa 920-8640, Japan
| | - Daigo Ochiai
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Yoshifumi Saisho
- Department of Internal Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Tadashi Matsumoto
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Naoko Arata
- Department of Women's Health, National Center for Child Health and Development, Tokyo 157-8583, Japan
| | - Kei Miyakoshi
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Mamoru Tanaka
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo 160-8582, Japan
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Ludvik AE, Pusec CM, Priyadarshini M, Angueira AR, Guo C, Lo A, Hershenhouse KS, Yang GY, Ding X, Reddy TE, Lowe WL, Layden BT. HKDC1 Is a Novel Hexokinase Involved in Whole-Body Glucose Use. Endocrinology 2016; 157:3452-61. [PMID: 27459389 PMCID: PMC5007896 DOI: 10.1210/en.2016-1288] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
In a recent genome-wide association study, hexokinase domain-containing protein 1, or HKDC1, was found to be associated with gestational glucose levels during 2-hour glucose tolerance tests at 28 weeks of pregnancy. Because our understanding of the mediators of gestational glucose homeostasis is incomplete, we have generated the first transgenic mouse model to begin to understand the role of HKDC1 in whole-body glucose homeostasis. Interestingly, deletion of both HKDC1 alleles results in in utero embryonic lethality. Thus, in this study, we report the in vivo role of HKDC1 in whole-body glucose homeostasis using a heterozygous-deleted HKDC1 mouse model (HKDC1(+/-)) as compared with matched wild-type mice. First, we observed no weight, fasting or random glucose, or fasting insulin abnormalities with aging in male and female HKDC1(+/-) mice. However, during glucose tolerance tests, glucose levels were impaired in both female and male HKDC1(+/-) mice at 15, 30, and 120 minutes at a later age (28 wk of age). These glucose tolerance differences also existed in the female HKDC1(+/-) mice at earlier ages but only during pregnancy. And finally, the impaired glucose tolerance in HKDC1(+/-) mice was likely due to diminished whole-body glucose use, as indicated by the decreased hepatic energy storage and reduced peripheral tissue uptake of glucose in HKDC1(+/-) mice. Collectively, these data highlight that HKDC1 is needed to maintain whole-body glucose homeostasis during pregnancy but also with aging, possibly through its role in glucose use.
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Affiliation(s)
- Anton E Ludvik
- Division of Endocrinology, Metabolism, and Molecular Medicine (A.E.L., C.M.P., M.P., A.R.A., K.S.H., W.L.L., B.T.L.), Department of Pathology (A.L., G.-Y.Y.), Northwestern University Feinberg School of Medicine, Chicago, Illinois 60611; Department of Biostatistics and Bioinformatics (T.E.R.), and Center for Genomic and Computational Biology (C.G., T.E.R.), Duke University Medical School, and University Program in Genetics and Genomics (C.G.), Duke University, Durham, North Carolina 27710; Department of Pathology (X.D.), Loyola University Chicago, Maywood, Illinois 60153; and Jesse Brown Veterans Affairs Medical Center (B.T.L.), Chicago, Illinois 60612
| | - Carolina M Pusec
- Division of Endocrinology, Metabolism, and Molecular Medicine (A.E.L., C.M.P., M.P., A.R.A., K.S.H., W.L.L., B.T.L.), Department of Pathology (A.L., G.-Y.Y.), Northwestern University Feinberg School of Medicine, Chicago, Illinois 60611; Department of Biostatistics and Bioinformatics (T.E.R.), and Center for Genomic and Computational Biology (C.G., T.E.R.), Duke University Medical School, and University Program in Genetics and Genomics (C.G.), Duke University, Durham, North Carolina 27710; Department of Pathology (X.D.), Loyola University Chicago, Maywood, Illinois 60153; and Jesse Brown Veterans Affairs Medical Center (B.T.L.), Chicago, Illinois 60612
| | - Medha Priyadarshini
- Division of Endocrinology, Metabolism, and Molecular Medicine (A.E.L., C.M.P., M.P., A.R.A., K.S.H., W.L.L., B.T.L.), Department of Pathology (A.L., G.-Y.Y.), Northwestern University Feinberg School of Medicine, Chicago, Illinois 60611; Department of Biostatistics and Bioinformatics (T.E.R.), and Center for Genomic and Computational Biology (C.G., T.E.R.), Duke University Medical School, and University Program in Genetics and Genomics (C.G.), Duke University, Durham, North Carolina 27710; Department of Pathology (X.D.), Loyola University Chicago, Maywood, Illinois 60153; and Jesse Brown Veterans Affairs Medical Center (B.T.L.), Chicago, Illinois 60612
| | - Anthony R Angueira
- Division of Endocrinology, Metabolism, and Molecular Medicine (A.E.L., C.M.P., M.P., A.R.A., K.S.H., W.L.L., B.T.L.), Department of Pathology (A.L., G.-Y.Y.), Northwestern University Feinberg School of Medicine, Chicago, Illinois 60611; Department of Biostatistics and Bioinformatics (T.E.R.), and Center for Genomic and Computational Biology (C.G., T.E.R.), Duke University Medical School, and University Program in Genetics and Genomics (C.G.), Duke University, Durham, North Carolina 27710; Department of Pathology (X.D.), Loyola University Chicago, Maywood, Illinois 60153; and Jesse Brown Veterans Affairs Medical Center (B.T.L.), Chicago, Illinois 60612
| | - Cong Guo
- Division of Endocrinology, Metabolism, and Molecular Medicine (A.E.L., C.M.P., M.P., A.R.A., K.S.H., W.L.L., B.T.L.), Department of Pathology (A.L., G.-Y.Y.), Northwestern University Feinberg School of Medicine, Chicago, Illinois 60611; Department of Biostatistics and Bioinformatics (T.E.R.), and Center for Genomic and Computational Biology (C.G., T.E.R.), Duke University Medical School, and University Program in Genetics and Genomics (C.G.), Duke University, Durham, North Carolina 27710; Department of Pathology (X.D.), Loyola University Chicago, Maywood, Illinois 60153; and Jesse Brown Veterans Affairs Medical Center (B.T.L.), Chicago, Illinois 60612
| | - Amy Lo
- Division of Endocrinology, Metabolism, and Molecular Medicine (A.E.L., C.M.P., M.P., A.R.A., K.S.H., W.L.L., B.T.L.), Department of Pathology (A.L., G.-Y.Y.), Northwestern University Feinberg School of Medicine, Chicago, Illinois 60611; Department of Biostatistics and Bioinformatics (T.E.R.), and Center for Genomic and Computational Biology (C.G., T.E.R.), Duke University Medical School, and University Program in Genetics and Genomics (C.G.), Duke University, Durham, North Carolina 27710; Department of Pathology (X.D.), Loyola University Chicago, Maywood, Illinois 60153; and Jesse Brown Veterans Affairs Medical Center (B.T.L.), Chicago, Illinois 60612
| | - Korri S Hershenhouse
- Division of Endocrinology, Metabolism, and Molecular Medicine (A.E.L., C.M.P., M.P., A.R.A., K.S.H., W.L.L., B.T.L.), Department of Pathology (A.L., G.-Y.Y.), Northwestern University Feinberg School of Medicine, Chicago, Illinois 60611; Department of Biostatistics and Bioinformatics (T.E.R.), and Center for Genomic and Computational Biology (C.G., T.E.R.), Duke University Medical School, and University Program in Genetics and Genomics (C.G.), Duke University, Durham, North Carolina 27710; Department of Pathology (X.D.), Loyola University Chicago, Maywood, Illinois 60153; and Jesse Brown Veterans Affairs Medical Center (B.T.L.), Chicago, Illinois 60612
| | - Guang-Yu Yang
- Division of Endocrinology, Metabolism, and Molecular Medicine (A.E.L., C.M.P., M.P., A.R.A., K.S.H., W.L.L., B.T.L.), Department of Pathology (A.L., G.-Y.Y.), Northwestern University Feinberg School of Medicine, Chicago, Illinois 60611; Department of Biostatistics and Bioinformatics (T.E.R.), and Center for Genomic and Computational Biology (C.G., T.E.R.), Duke University Medical School, and University Program in Genetics and Genomics (C.G.), Duke University, Durham, North Carolina 27710; Department of Pathology (X.D.), Loyola University Chicago, Maywood, Illinois 60153; and Jesse Brown Veterans Affairs Medical Center (B.T.L.), Chicago, Illinois 60612
| | - Xianzhong Ding
- Division of Endocrinology, Metabolism, and Molecular Medicine (A.E.L., C.M.P., M.P., A.R.A., K.S.H., W.L.L., B.T.L.), Department of Pathology (A.L., G.-Y.Y.), Northwestern University Feinberg School of Medicine, Chicago, Illinois 60611; Department of Biostatistics and Bioinformatics (T.E.R.), and Center for Genomic and Computational Biology (C.G., T.E.R.), Duke University Medical School, and University Program in Genetics and Genomics (C.G.), Duke University, Durham, North Carolina 27710; Department of Pathology (X.D.), Loyola University Chicago, Maywood, Illinois 60153; and Jesse Brown Veterans Affairs Medical Center (B.T.L.), Chicago, Illinois 60612
| | - Timothy E Reddy
- Division of Endocrinology, Metabolism, and Molecular Medicine (A.E.L., C.M.P., M.P., A.R.A., K.S.H., W.L.L., B.T.L.), Department of Pathology (A.L., G.-Y.Y.), Northwestern University Feinberg School of Medicine, Chicago, Illinois 60611; Department of Biostatistics and Bioinformatics (T.E.R.), and Center for Genomic and Computational Biology (C.G., T.E.R.), Duke University Medical School, and University Program in Genetics and Genomics (C.G.), Duke University, Durham, North Carolina 27710; Department of Pathology (X.D.), Loyola University Chicago, Maywood, Illinois 60153; and Jesse Brown Veterans Affairs Medical Center (B.T.L.), Chicago, Illinois 60612
| | - William L Lowe
- Division of Endocrinology, Metabolism, and Molecular Medicine (A.E.L., C.M.P., M.P., A.R.A., K.S.H., W.L.L., B.T.L.), Department of Pathology (A.L., G.-Y.Y.), Northwestern University Feinberg School of Medicine, Chicago, Illinois 60611; Department of Biostatistics and Bioinformatics (T.E.R.), and Center for Genomic and Computational Biology (C.G., T.E.R.), Duke University Medical School, and University Program in Genetics and Genomics (C.G.), Duke University, Durham, North Carolina 27710; Department of Pathology (X.D.), Loyola University Chicago, Maywood, Illinois 60153; and Jesse Brown Veterans Affairs Medical Center (B.T.L.), Chicago, Illinois 60612
| | - Brian T Layden
- Division of Endocrinology, Metabolism, and Molecular Medicine (A.E.L., C.M.P., M.P., A.R.A., K.S.H., W.L.L., B.T.L.), Department of Pathology (A.L., G.-Y.Y.), Northwestern University Feinberg School of Medicine, Chicago, Illinois 60611; Department of Biostatistics and Bioinformatics (T.E.R.), and Center for Genomic and Computational Biology (C.G., T.E.R.), Duke University Medical School, and University Program in Genetics and Genomics (C.G.), Duke University, Durham, North Carolina 27710; Department of Pathology (X.D.), Loyola University Chicago, Maywood, Illinois 60153; and Jesse Brown Veterans Affairs Medical Center (B.T.L.), Chicago, Illinois 60612
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Abstract
Gestational diabetes mellitus (GDM) is defined as abnormal glucose tolerance with onset or first recognition during pregnancy. Women with a history of GDM are at long-term risk for developing type 2 diabetes (T2DM), raising the question to what extent GDM and T2DM share a common genetic architecture. Meta-analysis of candidate gene studies and genome-wide association analysis (GWAS) have identified a number of genes which are reproducibly associated with GDM, including TCF7L2, GCK, KCNJ11, KCNQ1, CDKAL1, IGF2BP2, MTNR1B, and IRS1. These genes are also associated with T2DM. Candidate gene and GWAS have also identified genes associated with maternal metabolic traits, most of which are also associated with metabolic traits in the general population. Two genes, BACE2 and HKDC1, are uniquely associated with maternal metabolic traits. These studies suggest that there are similarities and differences between the genetic architecture of GDM and T2DM and metabolic quantitative traits in pregnant and non-pregnant populations.
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Affiliation(s)
- William L Lowe
- Division of Endocrinology, Metabolism, and Molecular Medicine and Department of Medicine, Northwestern University Feinberg School of Medicine, Rubloff Building 420 E. Superior St., 12th Floor, Chicago, IL, 60611, USA.
| | - Denise M Scholtens
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Suite 1400 680 N Lake Shore Drive, Chicago, IL, 60611, USA.
| | - Victoria Sandler
- Division of Endocrinology, Metabolism, and Molecular Medicine and Department of Medicine, Northwestern University Feinberg School of Medicine, Rubloff Building 420 E. Superior St., 12th Floor, Chicago, IL, 60611, USA.
- Division of Endocrinology, Metabolism and Molecular Medicine, Suite 530, 645 N Michigan Avenue, Chicago, IL, 60611, USA.
| | - M Geoffrey Hayes
- Division of Endocrinology, Metabolism, and Molecular Medicine and Department of Medicine, Northwestern University Feinberg School of Medicine, Rubloff Building 420 E. Superior St., 12th Floor, Chicago, IL, 60611, USA.
- Division of Endocrinology, Metabolism and Molecular Medicine, Tarry Building, Room 15-759, 300 E Chicago Ave, Chicago, IL, 60611, USA.
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de Melo SF, Frigeri HR, dos Santos-Weiss ICR, Réa RR, de Souza EM, Alberton D, Gomes de Moraes Rego F, Picheth G. Polymorphisms in FTO and TCF7L2 genes of Euro-Brazilian women with gestational diabetes. Clin Biochem 2015; 48:1064-7. [PMID: 26102344 DOI: 10.1016/j.clinbiochem.2015.06.013] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Revised: 05/14/2015] [Accepted: 06/15/2015] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To investigate the association between fat mass and obesity-associated (FTO) gene polymorphisms rs8050136C>A and rs9939609T>A, and transcription factor 7-like 2 (TCF7L2) gene polymorphisms rs12255372G>T and rs7903146C>T, in a sample group of pregnant Euro-Brazilian women with or without gestational diabetes mellitus (GDM). METHODS Subjects were classified as either healthy pregnant control (n=200) or GDM (n=200) according to the 2010 criteria of the American Diabetes Association. The polymorphisms were genotyped using fluorescent probes (TaqMan®). RESULTS All groups were in the Hardy-Weinberg equilibrium. The genotype and allele frequencies of the examined polymorphisms did not exhibit significant difference (P>0.05) between the groups. In the healthy and GDM pregnant women groups, the A-allele frequencies (95% CI) of FTO polymorphisms rs8050136 and rs9939609 were 39% (34-44%); 38% (33-43%) and 40% (35-45%); 41% (36-46%), respectively; and the T-allele frequencies of TCF7L2 polymorphisms rs12255372 and rs7903146 were 30% (26-35%), 32% (27-37%) and 29% (25-34%), 36% (31-41%), respectively. CONCLUSION The examined polymorphisms were not associated with GDM in the Euro-Brazilian population studied.
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Affiliation(s)
| | - Henrique Ravanhol Frigeri
- Post-Graduate Program in Pharmaceutical Science, Federal University of Parana, Brazil; Health and Biosciences School, Pontifical Catholic University of Parana, Curitiba, Parana, Brazil
| | | | - Rosângela Roginski Réa
- Endocrinology and Metabolism Service (SEMPR), Clinical Hospital, Federal University of Parana, Brazil
| | | | - Dayane Alberton
- Post-Graduate Program in Pharmaceutical Science, Federal University of Parana, Brazil
| | | | - Geraldo Picheth
- Post-Graduate Program in Pharmaceutical Science, Federal University of Parana, Brazil.
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Arnold DL, Enquobahrie DA, Qiu C, Huang J, Grote N, VanderStoep A, Williams MA. Early pregnancy maternal vitamin D concentrations and risk of gestational diabetes mellitus. Paediatr Perinat Epidemiol 2015; 29:200-10. [PMID: 25808081 PMCID: PMC4400239 DOI: 10.1111/ppe.12182] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND While associations of vitamin D deficiency with type 2 diabetes have been well demonstrated, investigations of vitamin D and risk of gestational diabetes mellitus (GDM) reported inconsistent findings. We examined associations of vitamin D status with GDM. METHODS In a nested case-cohort study (135 GDM cases and 517 non-GDM controls), we measured maternal serum vitamin D status (total 25[OH]D and 25[OH]D3 ) in early pregnancy (16 weeks on average) using liquid chromatography-tandem mass spectroscopy. GDM was diagnosed according to the American Diabetes Association guidelines. We calculated adjusted odds ratios and 95% confidence intervals (CIs) using logistic regression models. RESULTS GDM cases had lower mean total 25[OH]D (27.3 vs. 29.3 ng/mL) and 25[OH]D3 (23.9 vs. 26.7 ng/mL) concentrations compared with women who did not develop GDM (both P-values < 0.05). Overall, 25[OH]D3 concentrations, but not total 25[OH]D concentrations, were significantly associated with GDM risk. A 5-ng/mL increase in 25[OH]D3 concentration was associated with a 14% decrease in GDM risk (P-value = 0.02). Women in the lowest quartile for 25[OH]D3 concentration had a twofold [95% CI 1.15, 3.58] higher risk of GDM compared with women in the highest quartile (P-value for trend < 0.05). CONCLUSIONS Early pregnancy vitamin D status, particularly 25[OH]D3 , is inversely associated with GDM risk.
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Affiliation(s)
- Dodie L. Arnold
- Department of Epidemiology, University of Washington School of Public Health and Community Medicine, Seattle, Washington, United States of America
,Center for Perinatal Studies, Swedish Medical Center, Seattle, Washington, United States of America
,Louisiana Public Health Institute, New Orleans, Louisiana
| | - Daniel A. Enquobahrie
- Department of Epidemiology, University of Washington School of Public Health and Community Medicine, Seattle, Washington, United States of America
,Center for Perinatal Studies, Swedish Medical Center, Seattle, Washington, United States of America
| | - Chungfang Qiu
- Center for Perinatal Studies, Swedish Medical Center, Seattle, Washington, United States of America
| | - Jonathan Huang
- Department of Epidemiology, University of Washington School of Public Health and Community Medicine, Seattle, Washington, United States of America
| | - Nancy Grote
- School of Social Work, University of Washington, Seattle, Washington, United States of America
| | - Ann VanderStoep
- Department of Epidemiology, University of Washington School of Public Health and Community Medicine, Seattle, Washington, United States of America
| | - Michelle A. Williams
- Department of Epidemiology, University of Washington School of Public Health and Community Medicine, Seattle, Washington, United States of America
,Center for Perinatal Studies, Swedish Medical Center, Seattle, Washington, United States of America
,Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts
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15
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Prasad RB, Groop L. Genetics of type 2 diabetes-pitfalls and possibilities. Genes (Basel) 2015; 6:87-123. [PMID: 25774817 PMCID: PMC4377835 DOI: 10.3390/genes6010087] [Citation(s) in RCA: 279] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Revised: 01/28/2015] [Accepted: 02/27/2015] [Indexed: 12/11/2022] Open
Abstract
Type 2 diabetes (T2D) is a complex disease that is caused by a complex interplay between genetic, epigenetic and environmental factors. While the major environmental factors, diet and activity level, are well known, identification of the genetic factors has been a challenge. However, recent years have seen an explosion of genetic variants in risk and protection of T2D due to the technical development that has allowed genome-wide association studies and next-generation sequencing. Today, more than 120 variants have been convincingly replicated for association with T2D and many more with diabetes-related traits. Still, these variants only explain a small proportion of the total heritability of T2D. In this review, we address the possibilities to elucidate the genetic landscape of T2D as well as discuss pitfalls with current strategies to identify the elusive unknown heritability including the possibility that our definition of diabetes and its subgroups is imprecise and thereby makes the identification of genetic causes difficult.
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Affiliation(s)
- Rashmi B Prasad
- Department of Clinical Sciences, Diabetes and Endocrinology, Lund University Diabetes Centre, Lund University, CRC, Skåne University Hospital SUS, SE-205 02 Malmö, Sweden.
| | - Leif Groop
- Department of Clinical Sciences, Diabetes and Endocrinology, Lund University Diabetes Centre, Lund University, CRC, Skåne University Hospital SUS, SE-205 02 Malmö, Sweden.
- Finnish Institute of Molecular Medicine (FIMM), Helsinki University, Helsinki 00014, Finland.
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ISHAK AMIENRAMADHAN, PUSPITANINGRUM RINI, UTARI RISMADWI, FERANIA MELLA, ADHIYANTO CHRIS, NITTA TAKENORI, SUSANTO AB, YUKIO HATTORI, YAMASHIRO YASUHIRO. Mutation of mtDNA ND1 Gene in 20 Type 2 Diabetes Mellitus Patients of Gorontalonese and Javanese Ethnicity. HAYATI JOURNAL OF BIOSCIENCES 2014. [DOI: 10.4308/hjb.21.4.159] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Cormier H, Vigneault J, Garneau V, Tchernof A, Vohl MC, Weisnagel SJ, Robitaille J. An explained variance-based genetic risk score associated with gestational diabetes antecedent and with progression to pre-diabetes and type 2 diabetes: a cohort study. BJOG 2014; 122:411-9. [PMID: 25041170 DOI: 10.1111/1471-0528.12937] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2014] [Indexed: 01/11/2023]
Abstract
OBJECTIVE To determine whether an explained-variance genetic risk score (GRS), with 36 single nucleotide polymorphisms (SNPs) previously associated with type 2 diabetes (T2D), is also associated with gestational diabetes mellitus (GDM), and with the progression to pre-diabetes and T2D among women with prior GDM. DESIGN A cohort study. SETTING Clinical investigation unit of Laval University, Quebec, Canada. POPULATION A cohort of 214 women with prior GDM and 82 controls recruited between 2009 and 2012. METHODS Associations between the GRS and GDM. MAIN OUTCOMES MEASURES GDM and prevalence of pre-diabetes and T2D. RESULTS Women with prior GDM had a higher GRS compared with controls (38.6 ± 3.9, 95% CI 38.1-39.1, versus 37.4 ± 3.2, 95% CI 36.7-38.1; P < 0.0001). In women with prior GDM, the explained-variance GRS was higher for pre-diabetic women compared with women who remained normoglucotolerant at testing (1.21 ± 0.18, 95% CI 1.18-1.23, versus 1.17 ± 0.15, 95% CI 1.13-1.20; P < 0.0001). Similarly, women with T2D had a higher explained-variance GRS compared with women with prior GDM who remained normoglucotolerant (1.20 ± 0.18, 95% CI 1.14-1.25, versus 1.17 ± 0.17, 95% CI 1.13-1.20; P < 0.0001). The predictive effects of the explained-variance GRS, age, and body mass index (BMI), or the additive effects of the three variables, were tested for pre-diabetes and T2D. We observed an area under the curve of 0.6269 (95% CI 0.5638-0.6901) for age and BMI, and adding the explained-variance GRS into the model increased the area to 0.6672 (95% CI 0.6064-0.7281) for the prediction of pre-diabetes. CONCLUSIONS An explained-variance GRS is associated with both GDM and progression to pre-diabetes and T2D in women with prior GDM.
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Affiliation(s)
- H Cormier
- Department of Food Sciences and Nutrition, Laval University, Quebec City, QC, Canada; Institute of Nutrition and Functional Foods (INAF), Laval University, Quebec City, QC, Canada
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Delvecchio M, Di Paola R, Mangiacotti D, Sacco M, Menzaghi C, Trischitta V. Clinical heterogeneity of abnormal glucose homeostasis associated with the HNF4A R311H mutation. Ital J Pediatr 2014; 40:58. [PMID: 24947580 PMCID: PMC4100025 DOI: 10.1186/1824-7288-40-58] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Accepted: 06/12/2014] [Indexed: 11/10/2022] Open
Affiliation(s)
- Maurizio Delvecchio
- Dipartimento di Scienze e Chirurgia Pediatriche, U,O, "B Trambusti", A,O,U, Consorziale Policlinico Giovanni XXIII, Bari 70100, Italy.
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20
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Evangelista AF, Collares CVA, Xavier DJ, Macedo C, Manoel-Caetano FS, Rassi DM, Foss-Freitas MC, Foss MC, Sakamoto-Hojo ET, Nguyen C, Puthier D, Passos GA, Donadi EA. Integrative analysis of the transcriptome profiles observed in type 1, type 2 and gestational diabetes mellitus reveals the role of inflammation. BMC Med Genomics 2014; 7:28. [PMID: 24885568 PMCID: PMC4066312 DOI: 10.1186/1755-8794-7-28] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2013] [Accepted: 03/27/2014] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Type 1 diabetes (T1D) is an autoimmune disease, while type 2 (T2D) and gestational diabetes (GDM) are considered metabolic disturbances. In a previous study evaluating the transcript profiling of peripheral mononuclear blood cells obtained from T1D, T2D and GDM patients we showed that the gene profile of T1D patients was closer to GDM than to T2D. To understand the influence of demographical, clinical, laboratory, pathogenetic and treatment features on the diabetes transcript profiling, we performed an analysis integrating these features with the gene expression profiles of the annotated genes included in databases containing information regarding GWAS and immune cell expression signatures. METHODS Samples from 56 (19 T1D, 20 T2D, and 17 GDM) patients were hybridized to whole genome one-color Agilent 4x44k microarrays. Non-informative genes were filtered by partitioning, and differentially expressed genes were obtained by rank product analysis. Functional analyses were carried out using the DAVID database, and module maps were constructed using the Genomica tool. RESULTS The functional analyses were able to discriminate between T1D and GDM patients based on genes involved in inflammation. Module maps of differentially expressed genes revealed that modulated genes: i) exhibited transcription profiles typical of macrophage and dendritic cells; ii) had been previously associated with diabetic complications by association and by meta-analysis studies, and iii) were influenced by disease duration, obesity, number of gestations, glucose serum levels and the use of medications, such as metformin. CONCLUSION This is the first module map study to show the influence of epidemiological, clinical, laboratory, immunopathogenic and treatment features on the transcription profiles of T1D, T2D and GDM patients.
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Affiliation(s)
- Adriane F Evangelista
- Molecular Immunogenetics Group, Department of Genetics, Faculty of Medicine of Ribeirão Preto, University of São Paulo (USP), 14049-900 Ribeirão Preto, SP, Brazil
| | - Cristhianna VA Collares
- Molecular Immunogenetics Group, Department of Genetics, Faculty of Medicine of Ribeirão Preto, University of São Paulo (USP), 14049-900 Ribeirão Preto, SP, Brazil
- Division Clinical Immunology, Faculty of Medicine of Ribeirão Preto, (USP), 14049-900 Ribeirão Preto, SP, Brazil
| | - Danilo J Xavier
- Molecular Immunogenetics Group, Department of Genetics, Faculty of Medicine of Ribeirão Preto, University of São Paulo (USP), 14049-900 Ribeirão Preto, SP, Brazil
| | - Claudia Macedo
- Molecular Immunogenetics Group, Department of Genetics, Faculty of Medicine of Ribeirão Preto, University of São Paulo (USP), 14049-900 Ribeirão Preto, SP, Brazil
| | - Fernanda S Manoel-Caetano
- Molecular Immunogenetics Group, Department of Genetics, Faculty of Medicine of Ribeirão Preto, University of São Paulo (USP), 14049-900 Ribeirão Preto, SP, Brazil
| | - Diane M Rassi
- Molecular Immunogenetics Group, Department of Genetics, Faculty of Medicine of Ribeirão Preto, University of São Paulo (USP), 14049-900 Ribeirão Preto, SP, Brazil
| | - Maria C Foss-Freitas
- Division Clinical Immunology, Faculty of Medicine of Ribeirão Preto, (USP), 14049-900 Ribeirão Preto, SP, Brazil
| | - Milton C Foss
- Division Clinical Immunology, Faculty of Medicine of Ribeirão Preto, (USP), 14049-900 Ribeirão Preto, SP, Brazil
| | - Elza T Sakamoto-Hojo
- Molecular Immunogenetics Group, Department of Genetics, Faculty of Medicine of Ribeirão Preto, University of São Paulo (USP), 14049-900 Ribeirão Preto, SP, Brazil
- Department of Biology, Faculty of Philosophy, Sciences and Letters, (USP), 14040-900 Ribeirão Preto, SP, Brazil
| | - Catherine Nguyen
- INSERM U1090, TAGC, Aix-Marseille Université IFR137, 13100 Marseille, France
| | - Denis Puthier
- INSERM U1090, TAGC, Aix-Marseille Université IFR137, 13100 Marseille, France
| | - Geraldo A Passos
- Molecular Immunogenetics Group, Department of Genetics, Faculty of Medicine of Ribeirão Preto, University of São Paulo (USP), 14049-900 Ribeirão Preto, SP, Brazil
- Disciplines of Genetics and Molecular Biology, Department of Morphology, Physiology and Basic Pathology, School of Dentistry of Ribeirão Preto, USP, 14040-904 Ribeirão Preto, SP, Brazil
| | - Eduardo A Donadi
- Molecular Immunogenetics Group, Department of Genetics, Faculty of Medicine of Ribeirão Preto, University of São Paulo (USP), 14049-900 Ribeirão Preto, SP, Brazil
- Division Clinical Immunology, Faculty of Medicine of Ribeirão Preto, (USP), 14049-900 Ribeirão Preto, SP, Brazil
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Kwak SH, Jang HC, Park KS. Finding genetic risk factors of gestational diabetes. Genomics Inform 2012; 10:239-43. [PMID: 23346036 PMCID: PMC3543924 DOI: 10.5808/gi.2012.10.4.239] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2012] [Revised: 11/15/2012] [Accepted: 11/16/2012] [Indexed: 01/08/2023] Open
Abstract
Gestational diabetes mellitus (GDM) is a complex metabolic disorder of pregnancy that is suspected to have a strong genetic predisposition. It is associated with poor perinatal outcome, and both GDM women and their offspring are at increased risk of future development of type 2 diabetes mellitus (T2DM). During the past several years, there has been progress in finding the genetic risk factors of GDM in relation to T2DM. Some of the genetic variants that were proven to be significantly associated with T2DM are also genetic risk factors of GDM. Recently, a genome-wide association study of GDM was performed and reported that genetic variants in CDKAL1 and MTNR1B were associated with GDM at a genome-wide significance level. Current investigations using next-generation sequencing will improve our insight into the pathophysiology of GDM. It would be important to know whether genetic information revealed from these studies could improve our prediction of GDM and the future development of T2DM. We hope further research on the genetics of GDM would ultimately lead us to personalized genomic medicine and improved patient care.
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Affiliation(s)
- Soo Heon Kwak
- Department of Internal Medicine, Seoul National University Hospital, Seoul 110-744, Korea
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The common C49620T polymorphism in the sulfonylurea receptor gene SUR1 (ABCC8) in patients with gestational diabetes and subsequent glucose metabolism abnormalities. EXPERIMENTAL DIABETES RESEARCH 2012; 2012:712617. [PMID: 22927833 PMCID: PMC3426201 DOI: 10.1155/2012/712617] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2012] [Accepted: 07/09/2012] [Indexed: 01/08/2023]
Abstract
AIM The aim of this study is to investigate the relationship between the common C49620T polymorphism in the sulfonylurea receptor (SUR1) gene and glucose metabolism, β-cell secretory function and insulin resistance in women with a history of gestational diabetes (GDM). MATERIAL AND METHODS Study group included 199 women, diagnosed GDM within the last 5-12 years and control group of comparable 50 women in whom GDM was excluded during pregnancy. Blood glucose and insulin levels were measured during oral glucose tolerance test. Indices of insulin resistance (HOMA-IR) and β-cell function (HOMA %B) were calculated. In all patients, the C49620T polymorphism in intron 15 of the SUR1 gene was determined. RESULTS The distribution of the studied polymorphism in the two groups did not differ from each other (χ(2) = 0.34, P = 0.8425). No association between the distribution of polymorphisms and coexisting glucose metabolism disorders (χ(2) = 7,13, P = 0, 3043) was found. No association was also observed between the polymorphism and HOMA %B or HOMA-IR. CONCLUSIONS The polymorphism C49620T in the SUR1 gene is not associated with insulin resistance and/or insulin secretion in women with a history of GDM and does not affect the development of GDM, or the development of glucose intolerance in the studied population.
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Becker SA, Novak CK. Genetics in the real world: resources for pediatric nurses using monogenic diabetes as an exemplar. J Pediatr Nurs 2011; 26:511-5. [PMID: 21930042 DOI: 10.1016/j.pedn.2011.07.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Susan A Becker
- Clinical Trials Office, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
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Abstract
Despite years of investigation, very little is known about the genetic predisposition for gestational diabetes mellitus (GDM). However, the advent of genome-wide association and identification of loci contributing to susceptibility to type 2 diabetes mellitus has opened a small window into the genetics of GDM. More importantly, the study of the genetics of GDM has not only illuminated potential new biology underlying diabetes in pregnancy, but has also provided insights into fetal outcomes. Here, I review some of the insights into GDM and fetal outcomes gained through the study of both rare and common genetic variation. I also discuss whether recent testing of type 2 diabetes mellitus susceptibility loci in GDM case-control samples changes views of whether GDM is a distinct form of diabetes. Finally, I examine how the study of susceptibility loci can be used to influence clinical care, one of the great promises of the new era of human genome analysis.
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Affiliation(s)
- Richard M Watanabe
- Department of Preventive Medicine, Keck School of Medicine of USC, 1540 Alcazar St, CHP-220, Los Angeles, CA 90089-9011, USA.
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Abstract
GSTP1 Ile105Val Polymorphism in Serbian Patients with Pancreatic DiseasesThe aim of the current preliminary case-control study was to identify glutathione S-transferase P1 (GSTP1) Ile105Val allele and genotype frequency and to evaluate its impact on susceptibility to pancreatic diseases in a Serbian population. This study has encompassed 157 patients with three major types of chronic pancreatic pathology: 47 with pancreatic cancer, 50 with chronic pancreatitis and 60 with type 2 diabetes mellitus, as well as 107 healthy individuals. The presence of GSTP1 Ile105Val polymorphism was analyzed using a PCR-RFLP method. Allele 105Val was less frequent in patients with pancreatic cancer (24.5%) and chronic pancreatitis (24.0%) and slightly more frequent in patients with type 2 diabetes mellitus (31.7%) in comparison to healthy individuals (29.9%), but the differences were not statistically significant. Distribution of Ile105Val polymorphism genotypes differed between the analyzed groups, but differences were also not statistically significant. There are only a few studies regarding the role of GSTP1 Ile105Val polymorphism in pancreatic diseases and their results are inconsistent. The significance of GSTP1 Ile105Val polymorphism for pancreatic pathology remains unclear and further studies are needed in order to elucidate its role in pancreatic diseases.
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Chaves EGS, Franciscon PDM, Nascentes GAN, Paschoini MC, Silva APD, Borges MDF. Estudo retrospectivo das implicações maternas, fetais e perinatais em mulheres portadoras de diabetes, em 20 anos de acompanhamento no Hospital Escola da Universidade Federal do Triângulo Mineiro. ACTA ACUST UNITED AC 2010; 54:620-9. [DOI: 10.1590/s0004-27302010000700006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2010] [Accepted: 09/14/2010] [Indexed: 11/22/2022]
Abstract
OBJETIVOS: Avaliar implicações do diabetes melito (DM) na morbimortalidade materno-fetal, segundo experiência da Universidade Federal do Triângulo Mineiro. MATERIAIS E METODOS: Procedeu-se à análise retrospectiva dos prontuários de gestantes diabéticas assistidas entre 1990 e 2009 focando dados e complicações maternas e neonatais. RESULTADOS: A última gestação de 93 diabéticas foi avaliada, sendo 34 com DM tipo 1, em que se observou maior ocorrência de tocotrauma (p = 0,023) e retinopatia (p = 0,023). Vinte e uma pacientes tinham DM tipo 2; suas necessidades de insulina aumentaram progressivamente (p < 0,01) e observou-se maior prevalência de tabagismo (p = 0,004). Trinta e oito tiveram diabetes gestacional e iniciaram acompanhamento do diabetes em idade gestacional mais tardia (p < 0,001), tiveram mais antecedentes de macrossomia fetal (p = 0,028) e maior prevalência de fatores de risco cardiovascular. CONCLUSÕES: Não obstante melhora do controle glicêmico durante a gestação, nenhum dos grupos atingiu alvos glicêmicos ideais. Ainda assim, a maioria das gestações em diabéticas, conduzidas em nosso meio, evoluiu favoravelmente.
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Abstract
The Hyperglycemia and Adverse Pregnancy Outcome (HAPO) study of over 23000 diabetes-free pregnancies has shown that at a population level an unequivocal linear relationship exists between maternal glucose concentrations around the beginning of the third trimester of pregnancy and the risk of their baby being born above the ninetieth centile for weight. With the rising incidence of gestational diabetes (GDM) across the developed world, largely paralleling the increased prevalence of obesity, there has been a sharp increase in the risk of pregnancy complications developing related to the birth of macrosomic babies. The associated additional long-term complications of GDM pregnancies means that in the future there is likely to be a large increase in the incidence of type 2 diabetes and associated conditions in both the mothers and their affected offspring. The present review seeks to highlight recent advances and remaining gaps in knowledge about GDM in terms of its genetics (where some of the recently discovered polymorphic risk factors for type 2 diabetes have also proved to be risk factors for GDM) and its treatment by diet, exercise and drugs.
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Petry CJ, Evans ML, Wingate DL, Ong KK, Reik W, Constância M, Dunger DB. Raised late pregnancy glucose concentrations in mice carrying pups with targeted disruption of H19delta13. Diabetes 2010; 59:282-6. [PMID: 19794064 PMCID: PMC2797934 DOI: 10.2337/db09-0757] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2009] [Accepted: 09/04/2009] [Indexed: 11/21/2022]
Abstract
OBJECTIVE We have hypothesized that variation in imprinted growth-promoting fetal genes may affect maternal glucose concentrations in pregnancy. To test this hypothesis we evaluated the effects of fetal disruption of murine H19(Delta13) on maternal glucose concentrations in pregnancy. RESEARCH DESIGN AND METHODS Experimental mice were pregnant females that had inherited the disrupted H19(Delta13) from their fathers and were therefore phenotypically wild type due to imprinting; approximately half of their litters were null for H19(Delta13) through maternal inheritance of the disrupted gene. In control mice approximately half the litter paternally inherited the disrupted H19(Delta13), so the pups were either genetically wild type or phenotypically wild type due to imprinting. Blood glucose concentrations were assessed by intraperitoneal glucose tolerance tests on days 1, 16, and 18 of pregnancy. RESULTS There were no differences in the glucose concentrations of control and experimental pregnant mice at day 1. However, at day 16 mothers carrying H19(Delta13)-null pups had a significantly higher area under the glucose tolerance test curves than controls (1,845 +/- 378 vs. 1,386 +/- 107 mmol * min * l(-1) [P = 0.01]) in association with increasing pregnancy-related insulin resistance. Although this difference lessened toward term, overall, mothers of maternally inherited H19(Delta13) mutants had significantly higher glucose concentrations during the last trimester (1,602 +/- 321 [n = 17] vs. 1,359 +/- 147 [n = 18] mmol * min * l(-1) [P = 0.009]). CONCLUSIONS This study provides evidence that maternal glucose concentrations in pregnant mice can be affected by targeted disruption of fetal H19(Delta13). This implies that variable fetal IGF2 expression could affect risk for gestational diabetes.
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Affiliation(s)
- Clive J Petry
- Department of Paediatrics, University of Cambridge, Cambridge, U.K.
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Retnakaran R, Qi Y, Sermer M, Connelly PW, Zinman B, Hanley AJG. Pre-gravid physical activity and reduced risk of glucose intolerance in pregnancy: the role of insulin sensitivity. Clin Endocrinol (Oxf) 2009; 70:615-22. [PMID: 18793347 PMCID: PMC2878329 DOI: 10.1111/j.1365-2265.2008.03393.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Pre-gravid physical activity has been associated with a reduced risk of gestational diabetes mellitus (GDM), although neither the types of exercise nor the physiologic mechanisms underlying this protective effect have been well-studied. Thus, we sought to study the relationships between types of pre-gravid physical activity and metabolic parameters in pregnancy, including glucose tolerance, insulin sensitivity and beta-cell function. DESIGN/PATIENTS/MEASUREMENTS A total of 851 women underwent a glucose challenge test (GCT) and a 3-h oral glucose tolerance test (OGTT) in late pregnancy, yielding four glucose tolerance groups: (i) GDM; (ii) gestational impaired glucose tolerance (GIGT); (iii) abnormal GCT with normal glucose tolerance on OGTT (abnormal GCT NGT); and (iv) normal GCT with NGT on OGTT (normal GCT NGT). Pre-gravid physical activity was assessed using the Baecke questionnaire, which measures (i) total physical activity and (ii) its three component domains: work, nonsport leisure-time, and vigorous/sports activity. RESULTS Glucose tolerance status improved across increasing quartiles of pre-gravid total physical activity (P = 0.0244). Whereas neither work nor nonsport leisure-time activity differed between glucose tolerance groups, pre-gravid vigorous/sports activity was significantly higher in women with normal GCT NGT compared to women with (i) abnormal GCT NGT (P = 0.0018) (ii) GIGT (P = 0.0025), and (iii) GDM (P = 0.0044). In particular, vigorous/sports activity correlated with insulin sensitivity (measured by IS(OGTT)) (r = 0.21, P < 0.0001). Furthermore, on multiple linear regression analysis, pre-gravid vigorous/sports activity emerged as a significant independent predictor of IS(OGTT) in pregnancy (t = 4.97, P < 0.0001). CONCLUSIONS Pre-gravid vigorous/sports activity is associated with a reduced risk of glucose intolerance in pregnancy, an effect likely mediated by enhanced insulin sensitivity.
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Affiliation(s)
- Ravi Retnakaran
- Leadership Sinai Centre for Diabetes, Mount Sinai Hospital, Toronto, Canada
- Division of Endocrinology, University of Toronto
| | - Ying Qi
- Leadership Sinai Centre for Diabetes, Mount Sinai Hospital, Toronto, Canada
| | - Mathew Sermer
- Division of Obstetrics and Gynecology, Mount Sinai Hospital, Toronto
| | - Philip W Connelly
- Division of Endocrinology, University of Toronto
- Department of Laboratory Medicine and Pathobiology, University of Toronto
- Keenan Research Centre in the Li Ka Shing Knowledge Institute of St. Michael’s Hospital, Toronto
| | - Bernard Zinman
- Leadership Sinai Centre for Diabetes, Mount Sinai Hospital, Toronto, Canada
- Division of Endocrinology, University of Toronto
| | - Anthony JG Hanley
- Leadership Sinai Centre for Diabetes, Mount Sinai Hospital, Toronto, Canada
- Division of Endocrinology, University of Toronto
- Department of Nutritional Sciences, University of Toronto
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Kwak SH, Jang HC, Park KS. Genetics of Gestational Diabetes Mellitus. JOURNAL OF THE KOREAN MEDICAL ASSOCIATION 2009. [DOI: 10.5124/jkma.2009.52.7.688] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Soo Heon Kwak
- Department of Internal Medicine, Seoul National University College of Mediicne, Korea.
| | - Hak Chul Jang
- Department of Internal Medicine, Seoul National University College of Mediicne, Korea.
| | - Kyong Soo Park
- Department of Internal Medicine, Seoul National University College of Mediicne, Korea.
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Forsman M, Iliadou A, Magnusson P, Falconer C, Altman D. Diabetes and obesity-related risks for pelvic reconstructive surgery in a cohort of Swedish twins. Diabetes Care 2008; 31:1997-9. [PMID: 18628571 PMCID: PMC2551642 DOI: 10.2337/dc08-0988] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To determine the diabetes- and obesity-related risks for surgically managed stress urinary incontinence and pelvic organ prolapse. RESEARCH DESIGN AND METHODS This twin cohort study used the Swedish Twin Register to identify 8,443 female twin pairs born from 1926 through 1958. The association between diabetes and pelvic floor surgery was estimated while taking into account the correlated (twin) structure of the data. RESULTS For type 1 and type 2 diabetes, no significant associations were observed for stress urinary incontinence (odds ratio [OR] 1.0 [95% CI 0.1-9.2] and 2.0 [1.0-4.0], respectively). There were no cases of prolapse surgery in type 1 diabetic subjects, and for type 2 diabetes the risk estimate was nonsignificant (1.6 [1.0-2.7]). BMI >25 kg/m(2), age >or=60 years, and childbirth were the strongest risk factors for having incontinence surgery. CONCLUSIONS Our data suggest that diabetes is not associated with stress urinary incontinence or pelvic organ prolapse surgery.
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Affiliation(s)
- Mats Forsman
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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Abstract
The epidemic of obesity took off from about 1980 and in almost all countries has been rising inexorably ever since. Only in 1997 did WHO accept that this was a major public health problem and, even then, there was no accepted method for monitoring the problem in children. It was soon evident, however, that the optimum population body mass index is about 21 and this is particularly true in Asia and Latin America where the populations are very prone to developing abdominal obesity, type 2 diabetes and hypertension. These features are now being increasingly linked to epigenetic programming of gene expression and body composition in utero and early childhood, both in terms of fat/lean tissue ratios and also in terms of organ size and metabolic pathway regulation. New Indian evidence suggests that insulin resistance at birth seems linked to low birth weight and a higher proportion of body fat with selective B12 deficiency and abnormalities of one carbon pool metabolism potentially responsible and affecting 75% of Indians and many populations in the developing world. Biologically there are also adaptive biological mechanisms which limit weight loss after weight gain and thereby in part account for the continuing epidemic despite the widespread desire to slim. Logically, the burden of disease induced by inappropriate diets and widespread physical inactivity can be addressed by increasing physical activity (PA), but simply advocating more leisure time activity is unrealistic. Substantial changes in urban planning and diet are needed to counter the removal of any every day need for PA and the decades of misdirected food policies which with free market forces have induced our current 'toxic environment'. Counteracting this requires unusual policy initiatives.
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Affiliation(s)
- W P T James
- London School of Hygiene and Tropical Medicine, International Obesity TaskForce, London, UK.
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Friedman JE, Kirwan JP, Jing M, Presley L, Catalano PM. Increased skeletal muscle tumor necrosis factor-alpha and impaired insulin signaling persist in obese women with gestational diabetes mellitus 1 year postpartum. Diabetes 2008; 57:606-13. [PMID: 18083784 PMCID: PMC4697130 DOI: 10.2337/db07-1356] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE Women with gestational diabetes mellitus (GDM) demonstrate chronic and progressive insulin resistance and a markedly increased risk of converting to type 2 diabetes after pregnancy. However, the cellular mechanisms underlying this insulin resistance are unknown. RESEARCH DESIGN AND METHODS We investigated the progression of insulin resistance in nine obese women with GDM during late pregnancy (30-36 weeks) and 1 year postpartum. Skeletal muscle biopsies were obtained at each visit, and insulin resistance was determined by the hyperinsulinemic-euglycemic clamp technique. RESULTS Insulin resistance was not significantly improved in GDM women (4.1 +/- 0.4 vs. 5.8 +/- 1.1 10(-2) mg x kg FFM x min(-1)/microU x ml(-1)). Subjects did not experience significant weight loss postpartum. Body weight, fat mass, fasting glucose, and plasma tumor necrosis factor (TNF)-alpha remained higher 1 year postpartum than seen in previously studied normal glucose-tolerant women. Skeletal muscle TNF-alpha mRNA was elevated five- to sixfold in GDM women and remained higher 1 year postpartum. While levels of insulin receptor (IR), IR substrate (IRS)-1, and p85 alpha improved postpartum, insulin-stimulated IR tyrosine phosphorylation and receptor tyrosine kinase activity did not significantly improve postpartum in GDM. The levels of (312)Ser-IRS-1 also did not improve postpartum and correlated with TNF-alpha mRNA (r(2) = 0.19, P < 0.03), consistent with a state of subclinical inflammation and chronic skeletal muscle insulin resistance. CONCLUSIONS These results suggest the mechanisms underlying chronic insulin resistance in GDM women may be driven by increased inflammation that impinges on the IR and IRS-1 signaling cascade in skeletal muscle. These findings have important implications for the health of GDM women during subsequent pregnancies and their risk for progression to type 2 diabetes.
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Affiliation(s)
- Jacob E Friedman
- Department of Pediatrics, University of Colorado Denver, P.O. Box 6511, MS-8106, Aurora, CO 80045, USA.
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