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Yu Y, Ma Q, Groth S. Prepregnancy weight loss and maternal metabolic and inflammatory biomarkers during pregnancy: An analysis of National Health and Nutrition Examination Survey. J Obstet Gynaecol Res 2024; 50:809-820. [PMID: 38369640 DOI: 10.1111/jog.15904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Accepted: 01/31/2024] [Indexed: 02/20/2024]
Abstract
AIM Women with overweight or obesity are recommended to lose weight before conception to optimize pregnancy outcomes. However, the obstetrical implications of prepregnancy weight loss have been minimally examined. The objective of this study was to investigate the association between prepregnancy weight loss and maternal metabolic and inflammatory profiles during a subsequent pregnancy. METHODS This study was a retrospective analysis of National Health and Nutrition Examination Survey data (2003-2018). Participants were women who were pregnant at the time of assessment. Prepregnancy weight loss was described as percent weight change based on self-reported baseline (1 year before pregnancy) and prepregnancy weight. Metabolic (e.g., blood pressure [BP]) and inflammatory biomarkers (i.e., high-sensitivity C-reactive protein [hs-CRP]) were determined by standard medical tests. Statistical analyses included linear regressions with appropriate imputation, weighting, and variance estimation techniques. RESULTS Participants (N = 236) reported a mean percent weight loss of 4.6% (standard error [SE] = 0.3%) during the year before pregnancy. Regression models showed that prepregnancy weight loss was inversely associated with levels of total cholesterol (β = -1.24, p = 0.01), low-density lipoprotein-cholesterol (β = -0.79, p < 0.01), and high-density lipoprotein-cholesterol (β = -0.18, p < 0.01). The effect of prepregnancy weight loss on BP, insulin sensitivity, and hs-CRP was not significant, although there was a trend toward higher levels of diastolic BP (β = 0.24, p = 0.07) and hs-CRP (β = 0.10, p = 0.08). CONCLUSIONS This study found favorable changes in lipid profiles following prepregnancy weight loss. Due to limitations such as a relatively small sample size, self-reported weight measures, and missing data on several outcome variables, future studies are needed to confirm study findings.
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Affiliation(s)
- Yang Yu
- School of Nursing, University of Rochester, Rochester, New York, USA
| | - Qianheng Ma
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California, USA
| | - Susan Groth
- School of Nursing, University of Rochester, Rochester, New York, USA
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Domouzoglou EM, Vlahos AP, Papafaklis MI, Cholevas VK, Chaliasos N, Siomou E, Michalis LK, Tsatsoulis A, Naka KK. Role of FGF21 and Leptin for the Diagnosis of Metabolic Health in Children with and without Obesity. J Pers Med 2023; 13:1680. [PMID: 38138907 PMCID: PMC10744927 DOI: 10.3390/jpm13121680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Revised: 11/27/2023] [Accepted: 11/30/2023] [Indexed: 12/24/2023] Open
Abstract
Obesity and unfavorable metabolic profiles increase the risk for cardiovascular complications in adults. Although it is important to distinguish different metabolic health states at an early stage, there are limited data on the related value of biomarkers in childhood. We aimed to identify biomarkers for the detection of different metabolic health states in children with and without obesity. The serum levels of metabolic regulators (fibroblast growth factor 21 [FGF21], leptin, adiponectin and insulin-like growth factor binding protein 1) and vascular indices (flow-mediated dilation [FMD] and carotid intima-media thickness) were assessed in 78 children. Differences between the metabolically healthy and unhealthy state within children with normal weight (MHN vs. MUN), and within children with overweight/obesity (MHO vs. MUO) were investigated; the discriminatory power of the biomarkers was studied. Both MUN and MUO groups expressed altered lipid and glucose homeostasis compared to their healthy counterparts. The metabolic unhealthy state in children with normal weight was linked to higher FGF21 levels which had good discriminatory ability (area under the curve [AUC]: 0.71, 95% CI: 0.54-0.88; p = 0.044). In overweight/obese children, leptin was increased in the metabolically unhealthy subgroup (AUC: 0.81, 95% CI: 0.68-0.95; p = 0.01). There was a decrease in FMD indicating worse endothelial function in overweight/obese children versus those with normal weight. Distinct states of metabolic health exist in both children with normal weight and overweight/obese children. FGF21 and leptin may help to identify the metabolic unhealthy state in children with normal weight and in overweight/obese children, respectively, early in life.
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Affiliation(s)
- Eleni M. Domouzoglou
- Child Health Department, Faculty of Medicine, School of Health Sciences, University of Ioannina, Stavrou Niarchou, 45110 Ioannina, Greece
| | - Antonios P. Vlahos
- Child Health Department, Faculty of Medicine, School of Health Sciences, University of Ioannina, Stavrou Niarchou, 45110 Ioannina, Greece
| | - Michail I. Papafaklis
- Second Department of Cardiology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Stavrou Niarchou, 45110 Ioannina, Greece; (M.I.P.); (K.K.N.)
| | - Vasileios K. Cholevas
- Child Health Department, Faculty of Medicine, School of Health Sciences, University of Ioannina, Stavrou Niarchou, 45110 Ioannina, Greece
| | - Nikolaos Chaliasos
- Child Health Department, Faculty of Medicine, School of Health Sciences, University of Ioannina, Stavrou Niarchou, 45110 Ioannina, Greece
| | - Ekaterini Siomou
- Child Health Department, Faculty of Medicine, School of Health Sciences, University of Ioannina, Stavrou Niarchou, 45110 Ioannina, Greece
| | - Lampros K. Michalis
- Second Department of Cardiology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Stavrou Niarchou, 45110 Ioannina, Greece; (M.I.P.); (K.K.N.)
| | - Agathocles Tsatsoulis
- Department of Endocrinology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Stavrou Niarchou, 45110 Ioannina, Greece
| | - Katerina K. Naka
- Second Department of Cardiology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Stavrou Niarchou, 45110 Ioannina, Greece; (M.I.P.); (K.K.N.)
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de Souza Marques DC, dos Santos Moraes LR, de Souza Marques MG, Ryal JJ, Santos IC, De Paula Silva Lalucci MP, Mota J, Valdés-Badilla P, Westphal Nardo G, Magnani Branco BH. Effects of 12 Weeks of Family and Individual Multi-Disciplinary Intervention in Overweight and Obese Adolescents under Cardiometabolic Risk Parameters: A Clinical Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6954. [PMID: 37887692 PMCID: PMC10606176 DOI: 10.3390/ijerph20206954] [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: 09/07/2023] [Revised: 10/16/2023] [Accepted: 10/17/2023] [Indexed: 10/28/2023]
Abstract
Adolescence is a complex period of human development in which young people are susceptible to unhealthy behaviors, such as physical inactivity and an unbalanced diet. This study aimed to analyze the effects of 12 weeks of multi-disciplinary family and individual intervention on cardiometabolic risk parameters in overweight and obese adolescents and compare sub-groups, considering possible differences between sexes (males vs. females vs. intervention approach). Forty-three adolescents (13.73 ± 2.46 years old) of both sexes were divided into two groups: family group (FG) (n = 21; 14.24 ± 2.61 years old) and individual group (IG) (n = 22; 13.23 ± 2.27 years old). The following parameters were evaluated: anthropometry (body weight, height, waist circumference (WC), hip circumference (HC), abdominal circumference (AC), calculation of body mass index (BMI), and waist-hip ratio (WHR)), body composition (fat mass (FM), lean mass (LM), fat-free mass (FFM), skeletal muscle mass (SMM), body fat percentage (BF), and visceral fat), biochemical measures (fasting glucose, triglycerides (TG), total cholesterol (TC), low-density lipoproteins (LDL-c), and high-density lipoproteins (HDL-c)), and the measurement of systolic and diastolic blood pressure (SBP and DBP) before and after the interventions. The multi-disciplinary interventions occurred for 12 weeks (three days a week lasting 1 h and 30 min, in which 30 min were dedicated to theoretical interventions (nutrition: nutritional education and psychology: psychoeducation) and 1 h to physical exercises. A time effect was observed for LM, FFM, SMM, FM, and HDL-c, with higher values after intervention and a significant decrease for FM, BF, visceral fat, fasting glucose, TG, TC, LDL-c, and DBP (p < 0.05). However, no group, sub-group, or interaction effects were observed when comparing FG, IG, or sexes (p > 0.05). The responses of the present study show that both multi-disciplinary approaches (family and individual) promoted improvement in the body composition indicators, biochemical markers, and DBP of overweight and obese adolescents independently of the intervention group. Given this finding, health professionals, families, and adolescents could choose the type of intervention based on their preferences.
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Affiliation(s)
- Déborah Cristina de Souza Marques
- Postgraduate Program in Health Promotion, Cesumar University, Maringá 87050-390, Brazil; (D.C.d.S.M.); (L.R.d.S.M.); (M.G.d.S.M.); (J.J.R.); (M.P.D.P.S.L.); (B.H.M.B.)
- Interdisciplinary Laboratory of Intervention in Health Promotion, Cesumar Institute of Science, Maringá 87050-390, Brazil;
| | - Lilian Rosana dos Santos Moraes
- Postgraduate Program in Health Promotion, Cesumar University, Maringá 87050-390, Brazil; (D.C.d.S.M.); (L.R.d.S.M.); (M.G.d.S.M.); (J.J.R.); (M.P.D.P.S.L.); (B.H.M.B.)
- Interdisciplinary Laboratory of Intervention in Health Promotion, Cesumar Institute of Science, Maringá 87050-390, Brazil;
| | - Marilene Ghiraldi de Souza Marques
- Postgraduate Program in Health Promotion, Cesumar University, Maringá 87050-390, Brazil; (D.C.d.S.M.); (L.R.d.S.M.); (M.G.d.S.M.); (J.J.R.); (M.P.D.P.S.L.); (B.H.M.B.)
- Interdisciplinary Laboratory of Intervention in Health Promotion, Cesumar Institute of Science, Maringá 87050-390, Brazil;
| | - Joed Jacinto Ryal
- Postgraduate Program in Health Promotion, Cesumar University, Maringá 87050-390, Brazil; (D.C.d.S.M.); (L.R.d.S.M.); (M.G.d.S.M.); (J.J.R.); (M.P.D.P.S.L.); (B.H.M.B.)
- Interdisciplinary Laboratory of Intervention in Health Promotion, Cesumar Institute of Science, Maringá 87050-390, Brazil;
| | - Isabella Caroline Santos
- Interdisciplinary Laboratory of Intervention in Health Promotion, Cesumar Institute of Science, Maringá 87050-390, Brazil;
| | - Marielle Priscila De Paula Silva Lalucci
- Postgraduate Program in Health Promotion, Cesumar University, Maringá 87050-390, Brazil; (D.C.d.S.M.); (L.R.d.S.M.); (M.G.d.S.M.); (J.J.R.); (M.P.D.P.S.L.); (B.H.M.B.)
- Interdisciplinary Laboratory of Intervention in Health Promotion, Cesumar Institute of Science, Maringá 87050-390, Brazil;
| | - Jorge Mota
- Research Centre of Physical Activity, Health, and Leisure, Laboratory for Integrative and Translational Research in Population Health (ITR), Faculty of Sports, University of Porto, 4200-450 Porto, Portugal;
| | - Pablo Valdés-Badilla
- Department of Physical Activity Sciences, Faculty of Education Sciences, Universidad Católica del Maule, Talca 3530000, Chile;
- Sports Coach Career, School of Education, Universidad Viña del Mar, Vinã del Mar 2520000, Chile
| | - Greice Westphal Nardo
- Department of Physical Activity Sciences, Faculty of Education Sciences, Universidad Católica del Maule, Talca 3530000, Chile;
| | - Braulio Henrique Magnani Branco
- Postgraduate Program in Health Promotion, Cesumar University, Maringá 87050-390, Brazil; (D.C.d.S.M.); (L.R.d.S.M.); (M.G.d.S.M.); (J.J.R.); (M.P.D.P.S.L.); (B.H.M.B.)
- Interdisciplinary Laboratory of Intervention in Health Promotion, Cesumar Institute of Science, Maringá 87050-390, Brazil;
- Research Centre of Physical Activity, Health, and Leisure, Laboratory for Integrative and Translational Research in Population Health (ITR), Faculty of Sports, University of Porto, 4200-450 Porto, Portugal;
- Medicine Course, Department of Health Sciences, Cesumar University, Maringá 87050-390, Brazil
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Dettlaff-Dunowska M, Brzeziński M, Zagierska A, Borkowska A, Zagierski M, Szlagatys-Sidorkiewicz A. Changes in Body Composition and Physical Performance in Children with Excessive Body Weight Participating in an Integrated Weight-Loss Programme. Nutrients 2022; 14:nu14173647. [PMID: 36079907 PMCID: PMC9459952 DOI: 10.3390/nu14173647] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 08/29/2022] [Accepted: 09/01/2022] [Indexed: 11/26/2022] Open
Abstract
The problem of overweight and obesity is a growing phenomenon in the entire population. Obesity is associated with many different metabolic disorders and is directly associated with an increased risk of death. The aim of the study was to assess the changes in body composition and physical fitness in children participating in an integrated weight-loss programme and to analyse the possible relationship between changes in body composition and improvements in fitness. Participants of the study were recruited from the “6–10–14 for Health”-multidisciplinary intervention programme for children aged 6 to 15 years old. A total of 170 patients qualified for the study, and 152 patients were enrolled. Statistically significant changes in body composition were found after the end of the intervention program, as measured by both BIA (bioimpedance) and DXA (Dual Energy X-ray Absorptiometry). The differences in KPRT (Kasch Pulse Recovery Test) results at baseline and after intervention are positively correlated with the difference in fat mass between baseline and the after-intervention measure. Improving physical fitness is positively correlated with a decrease in FM (fat mass) and an increase in FFM (fat-free mass) measured in both absolute values and %. Both BIA and DXA methods proved to be equally useful for measuring body composition.
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