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Hojeij B, Rousian M, Sinclair KD, Dinnyes A, Steegers-Theunissen RPM, Schoenmakers S. Periconceptional biomarkers for maternal obesity: a systematic review. Rev Endocr Metab Disord 2023; 24:139-175. [PMID: 36520252 PMCID: PMC10023635 DOI: 10.1007/s11154-022-09762-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/01/2022] [Indexed: 12/23/2022]
Abstract
Periconceptional maternal obesity is linked to adverse maternal and neonatal outcomes. Identifying periconceptional biomarkers of pathways affected by maternal obesity can unravel pathophysiologic mechanisms and identify individuals at risk of adverse clinical outcomes. The literature was systematically reviewed to identify periconceptional biomarkers of the endocrine, inflammatory and one-carbon metabolic pathways influenced by maternal obesity. A search was conducted in Embase, Ovid Medline All, Web of Science Core Collection and Cochrane Central Register of Controlled Trials databases, complemented by manual search in PubMed until December 31st, 2020. Eligible studies were those that measured biomarker(s) in relation to maternal obesity, overweight/obesity or body mass index (BMI) during the periconceptional period (14 weeks preconception until 14 weeks post conception). The ErasmusAGE score was used to assess the quality of included studies. Fifty-one articles were included that evaluated over 40 biomarkers. Endocrine biomarkers associated with maternal obesity included leptin, insulin, thyroid stimulating hormone, adiponectin, progesterone, free T4 and human chorionic gonadotropin. C-reactive protein was associated with obesity as part of the inflammatory pathway, while the associated one-carbon metabolism biomarkers were folate and vitamin B12. BMI was positively associated with leptin, C-reactive protein and insulin resistance, and negatively associated with Free T4, progesterone and human chorionic gonadotropin. Concerning the remaining studied biomarkers, strong conclusions could not be established due to limited or contradictory data. Future research should focus on determining the predictive value of the optimal set of biomarkers for their use in clinical settings. The most promising biomarkers include leptin, adiponectin, human chorionic gonadotropin, insulin, progesterone and CRP.
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Affiliation(s)
- Batoul Hojeij
- Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center, Rotterdam, 3015GD, The Netherlands
| | - Melek Rousian
- Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center, Rotterdam, 3015GD, The Netherlands
| | - Kevin D Sinclair
- School of Biosciences, Sutton Bonnington Campus, University of Nottingham, Leicestershire, LE12 6HD, UK
| | - Andras Dinnyes
- BioTalentum Ltd., Godollo, 2100, Hungary
- Department of Cell Biology and Molecular Medicine, University of Szeged, Szeged, 6720, Hungary
- Department of Physiology and Animal Health, Institute of Physiology and Animal Nutrition, Hungarian University of Agriculture and Life Sciences, Godollo, 2100, Hungary
| | | | - Sam Schoenmakers
- Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center, Rotterdam, 3015GD, The Netherlands.
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Palladino E, Van Mieghem T, Connor KL. Diet Alters Micronutrient Pathways in the Gut and Placenta that Regulate Fetal Growth and Development in Pregnant Mice. Reprod Sci 2021; 28:447-461. [PMID: 32886339 DOI: 10.1007/s43032-020-00297-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 08/10/2020] [Indexed: 11/30/2022]
Abstract
Maternal malnutrition and micronutrient deficiencies can alter fetal development. However, the mechanisms underlying these relationships are poorly understood. We used a systems physiology approach to investigate diet-induced effects on maternal gut microbes and folate/inositol transport in the maternal/fetal gut and placenta. Female mice were fed a control diet (CON) diet, undernourished (UN, restricted by 30% of CON intake) or a high-fat diet (HF, 60% kcals fat) during pregnancy to model normal pregnancy, fetal growth restriction or maternal metabolic dysfunction, respectively. At gestational day 18.5, we assessed circulating folate levels by microbiological assay, relative abundance of gut lactobacilli by G3PhyloChip™, and folate/inositol transporters in placenta and maternal/fetal gut by qPCR/immunohistochemistry. UN and HF-fed mothers had lower plasma folate concentrations vs. CON. Relative abundances of three lactobacilli taxa were higher in HF vs. UN and CON. HF-fed mothers had higher gut proton coupled folate transporter (Pcft) and reduced folate carrier 1 (Rfc1), and lower sodium myo-inositol co-transporter 2 (Smit2), mRNA expression vs. UN and CON. HF placentae had increased folate receptor beta (Frβ) expression vs. UN. mRNA expression of Pcft, folate receptor alpha (Frα), and Smit2 was higher in gut of HF fetuses vs. UN and CON. Transporter protein expression was not different between groups. Maternal malnutrition alters abundance of select gut microbes and folate/inositol transporters, which may influence maternal micronutrient status and delivery to the fetus, impacting pregnancy/fetal outcomes.
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Affiliation(s)
- Elia Palladino
- Carleton University (Health Sciences), Ottawa, Ontario, Canada
| | - Tim Van Mieghem
- Mount Sinai Hospital (Obstetrics and Gynaecology), Toronto, Ontario, Canada
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Mlodzik-Czyzewska MA, Malinowska AM, Chmurzynska A. Low folate intake and serum levels are associated with higher body mass index and abdominal fat accumulation: a case control study. Nutr J 2020; 19:53. [PMID: 32498709 PMCID: PMC7273685 DOI: 10.1186/s12937-020-00572-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 05/28/2020] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND The link between folate metabolism and obesity has recently been underlined, suggesting that folate deficiency may lead to body weight gain and adiposity. We thus wished to determine whether the inefficiency in folate metabolism caused by genetic variation in the MTHFR and DHFR genes in folate metabolism, or inadequate folate intake, is associated with obesity. METHODS A case-control study including 421 healthy participants (aged 20-40) was performed in Poznań, Poland. The cases were 213 subjects with BMI > 25 kg/m2, while the controls were 208 subjects with BMI < 25 kg/m2. Genotyping of rs70991108 (DHFR) and rs1801133 (MTHFR) was performed using TaqMan probes. Serum folate concentrations were measured using an enzyme-linked immunosorbent assay and homocysteine was assessed with high performance liquid chromatography. RESULTS Subjects with overweight and obesity had 12% lower folate intake (p < 0.05) and 8.5% lower folate serum concentrations (p < 0.01) than the controls. Serum folate concentrations and folate intake were inversely associated with body fat percentage (p < 0.05) and waist circumference (p < 0.05 and p < 0.001, respectively). Serum folate concentration, though not folate intake, was negatively associated with WHR and BMI (p < 0.05, for both associations). CONCLUSIONS Lower folate intake and serum levels are weakly, but independently, associated with greater body weight and central adiposity in people aged 20-40. MTHFR and DHFR polymorphism seems not to have significant impact on body weight.
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Affiliation(s)
- Monika A Mlodzik-Czyzewska
- Institute of Human Nutrition and Dietetics, Poznań University of Life Sciences, Wojska Polskiego 31, 60-624, Poznań, Poland
| | - Anna M Malinowska
- Institute of Human Nutrition and Dietetics, Poznań University of Life Sciences, Wojska Polskiego 31, 60-624, Poznań, Poland
| | - Agata Chmurzynska
- Institute of Human Nutrition and Dietetics, Poznań University of Life Sciences, Wojska Polskiego 31, 60-624, Poznań, Poland.
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Thomas-Valdés S, Tostes MDGV, Anunciação PC, da Silva BP, Sant'Ana HMP. Association between vitamin deficiency and metabolic disorders related to obesity. Crit Rev Food Sci Nutr 2018; 57:3332-3343. [PMID: 26745150 DOI: 10.1080/10408398.2015.1117413] [Citation(s) in RCA: 95] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Inappropriate food behavior contributes to obesity and leads to vitamin deficiency. This review discusses the nutritional status of water- and fat-soluble vitamins in obese subjects. We verified that most vitamins are deficient in obese individuals, especially the fat-soluble vitamins, folic acid, vitamin B12 and vitamin C. However, some vitamins have been less evaluated in cases of obesity. The adipose tissue is considered a metabolic and endocrine organ, which in excess leads to changes in body homeostasis, as well as vitamin deficiency which can aggravate the pathological state. Therefore, the evaluation of vitamin status is of fundamental importance in obese individuals.
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Affiliation(s)
- Samanta Thomas-Valdés
- a Escuela de Nutrición y Dietética, Facultad de Ciencias de la Salud , Universidad de Talca , Talca , Chile
| | - Maria das Graças V Tostes
- b Center of Agrarian Sciences , Universidade Federal do Espírito Santo , Alegre , Espírito Santo , Brazil
| | - Pamella C Anunciação
- c Department of Nutrition and Health , Universidade Federal de Viçosa , Viçosa , Minas Gerais , Brazil
| | - Bárbara P da Silva
- c Department of Nutrition and Health , Universidade Federal de Viçosa , Viçosa , Minas Gerais , Brazil
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Kaner G, Adiguzel KT, Kurklu NS. Are Obese Women a Risk Group for Vitamin B12 and Folic Acid Deficiencies ? ROMANIAN JOURNAL OF DIABETES NUTRITION AND METABOLIC DISEASES 2016. [DOI: 10.1515/rjdnmd-2016-0035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Yamauchi K, Katayama T, Yamauchi T, Kotani K, Tsuzaki K, Takahashi K, Sakane N. Efficacy of a 3-month lifestyle intervention program using a Japanese-style healthy plate on body weight in overweight and obese diabetic Japanese subjects: a randomized controlled trial. Nutr J 2014; 13:108. [PMID: 25418542 PMCID: PMC4258043 DOI: 10.1186/1475-2891-13-108] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2014] [Accepted: 11/14/2014] [Indexed: 11/16/2022] Open
Abstract
Background and objectives The portion size of food is a determinant of energy intake, linking with obese traits. A healthy plate for portion control has recently been made in a Japanese style. The aim of the current study was to assess the efficacy of a lifestyle intervention program using the Japanese-style healthy plate on weight reduction in overweight and obese diabetic Japanese subjects. Methods We randomized overweight and obese diabetic subjects (n = 19, 10 women) into an intervention group including educational classes on lifestyle modification incorporating the healthy plate (n = 10) or a waiting-list control group (n = 9). The intervention period was three months, and the educational classes using the healthy plate were conducted monthly in a group session for the intervention group. The body weight, blood glycemic and metabolic measures, and psychosocial variables were measured at the baseline and after the 3-month intervention in both groups. The impression of the intervention was interviewed using a structured questionnaire. Results There was one drop-out in the control group. No adverse events were reported in the groups. Subjects in the intervention group had a greater weight change from baseline to the end of the 3-month intervention period (-3.7 +/- 2.5 [SD] kg in the intervention group vs. -0.1 +/- 1.4 kg in the control group, P = 0.002). Most subjects recorded that the use of a healthy plate could be recommended to other people. Conclusions The lifestyle intervention program using the Japanese-style healthy plate, which was developed for portion control, may effectively reduce body weight in overweight and obese diabetic subjects in Japan. Further studies are needed to establish the efficacy of this methodology on weight management.
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Affiliation(s)
| | | | | | | | | | | | - Naoki Sakane
- Division of Preventive Medicine, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, Kyoto, Japan.
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Relation of body mass index to blood folate and total homocysteine concentrations in Japanese adults. Eur J Nutr 2011; 50:581-5. [PMID: 21221977 DOI: 10.1007/s00394-010-0165-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2010] [Accepted: 12/22/2010] [Indexed: 12/16/2022]
Abstract
PURPOSE Plasma folate concentrations are suggested to be negatively associated with body mass index (BMI, kg/m(2)), although these findings are controversial. Our objective was to evaluate the association of BMI with blood folate and total homocysteine (tHcy) concentrations. METHODS We measured plasma and erythrocyte folate and plasma tHcy concentrations in 434 healthy adults (343 women and 91 men; mean age of 63.8 ± 10.7 [SD, range 23-88] years), who participated in a 2007 population-based survey in western Japan. RESULTS The overall mean plasma and erythrocyte folate and tHcy were 21.6 (±11.0, SD) nmol/L, 844 (±291) nmol/L and 11.6 (±3.9) μmol/L, respectively. The mean BMI was 22.8 (±3.0; 15.6-33.3) kg/m(2), and only 72 subjects (17%) had BMI > 26.0 kg/m(2). Mean plasma folate decreased as BMI increased (p-trend < 0.01), whereas mean erythrocyte folate and plasma tHcy were similar regardless of BMI (p-trends = 0.49 and 0.28, respectively). CONCLUSION Our data indicate that the interpretation of plasma folate concentrations to assess folate nutritional status is complicated by BMI, although the impact of BMI on plasma folate was relatively small. It is important to take this association into account for the selection of subjects for future large-scale studies. The mechanism of this inverse association between BMI and plasma folate concentrations should be investigated.
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