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Huang C, Liu Z, Chen M, Zhang H, Mo R, Chen R, Liu Y, Wang S, Xue Q. Up-regulation of BRD4 contributes to gestational diabetes mellitus-induced cardiac hypertrophy in offspring by promoting mitochondria dysfunction in sex-independent manner. Biochem Pharmacol 2024; 226:116387. [PMID: 38944397 DOI: 10.1016/j.bcp.2024.116387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 04/27/2024] [Accepted: 06/21/2024] [Indexed: 07/01/2024]
Abstract
Gestational diabetes mellitus (GDM) is associated with cardiovascular disease in postnatal life. The current study tested the hypothesis that GDM caused the cardiac hypertrophy in fetal (ED18.5), postnatal day 7 (PD7), postnatal day 21 (PD21) and postnatal day 90 (PD90) offspring by upregulation of BRD4 and mitochondrial dysfunction. Pregnant mice were divided into control and GDM groups. Hearts were isolated from ED18.5, PD7, PD21 and PD90. GDM increased the body weight (BW) and heart weight (HW) in ED18.5 and PD7, but not PD21 and PD90 offspring. However, HW/BW ratio was increased in all ages of GDM offspring compared to control group. Electron microscopy showed disorganized myofibrils, mitochondrial swelling, vacuolization, and cristae disorder in GDM offspring. GDM resulted in myocardial hypertrophy in offspring, which persisted from fetus to adult in a sex-independent manner. Echocardiography analysis revealed that GDM caused diastolic dysfunction, but had no effect on systolic function. Meanwhile, myocardial BRD4 was significantly upregulated in GDM offspring and BRD4 inhibition by JQ1 alleviated GDM-induced myocardial hypertrophy in offspring. Co-immunoprecipitation showed that BRD4 interacted with DRP1 and there was an increase of BRD4 and DRP1 interaction in GDM offspring. Furthermore, GDM caused the accumulation of damaged mitochondria in hearts from all ages of offspring, including mitochondrial fusion fission imbalance (upregulation of DRP1, and downregulation of MFN1, MFN2 and OPA1) and myocardial mitochondrial ROS accumulation, which was reversed by JQ1. These results suggested that the upregulation of BRD4 is involved in GDM-induced myocardial hypertrophy in the offspring through promoting mitochondrial damage in a gender-independent manner.
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Affiliation(s)
- Cailing Huang
- Department of Pharmacology, Guangzhou Municipal and Guangdong Provincial Key Laboratory of Molecular Target & Clinical Pharmacology, the NMPA and State Key Laboratory of Respiratory Disease, School of Pharmaceutical Sciences and the Fifth Affiliated Hospital, Guangzhou Medical University, Guangzhou 511436, China
| | - Zimo Liu
- Department of Pharmacology, Guangzhou Municipal and Guangdong Provincial Key Laboratory of Molecular Target & Clinical Pharmacology, the NMPA and State Key Laboratory of Respiratory Disease, School of Pharmaceutical Sciences and the Fifth Affiliated Hospital, Guangzhou Medical University, Guangzhou 511436, China
| | - Mei Chen
- Department of Pharmacology, Guangzhou Municipal and Guangdong Provincial Key Laboratory of Molecular Target & Clinical Pharmacology, the NMPA and State Key Laboratory of Respiratory Disease, School of Pharmaceutical Sciences and the Fifth Affiliated Hospital, Guangzhou Medical University, Guangzhou 511436, China
| | - Haichuan Zhang
- Department of Pharmacology, Guangzhou Municipal and Guangdong Provincial Key Laboratory of Molecular Target & Clinical Pharmacology, the NMPA and State Key Laboratory of Respiratory Disease, School of Pharmaceutical Sciences and the Fifth Affiliated Hospital, Guangzhou Medical University, Guangzhou 511436, China
| | - Ruyao Mo
- Department of Pharmacology, Guangzhou Municipal and Guangdong Provincial Key Laboratory of Molecular Target & Clinical Pharmacology, the NMPA and State Key Laboratory of Respiratory Disease, School of Pharmaceutical Sciences and the Fifth Affiliated Hospital, Guangzhou Medical University, Guangzhou 511436, China
| | - Renshan Chen
- Guangzhou Hospital of Integrated Traditional and Western Medicine, Guangzhou, Guangdong, China
| | - Yinghua Liu
- Department of Pharmacology, Guangzhou Municipal and Guangdong Provincial Key Laboratory of Molecular Target & Clinical Pharmacology, the NMPA and State Key Laboratory of Respiratory Disease, School of Pharmaceutical Sciences and the Fifth Affiliated Hospital, Guangzhou Medical University, Guangzhou 511436, China
| | - Shixiang Wang
- Department of Cardiology, the third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
| | - Qin Xue
- Department of Pharmacology, Guangzhou Municipal and Guangdong Provincial Key Laboratory of Molecular Target & Clinical Pharmacology, the NMPA and State Key Laboratory of Respiratory Disease, School of Pharmaceutical Sciences and the Fifth Affiliated Hospital, Guangzhou Medical University, Guangzhou 511436, China.
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Sweeting A, Hannah W, Backman H, Catalano P, Feghali M, Herman WH, Hivert MF, Immanuel J, Meek C, Oppermann ML, Nolan CJ, Ram U, Schmidt MI, Simmons D, Chivese T, Benhalima K. Epidemiology and management of gestational diabetes. Lancet 2024; 404:175-192. [PMID: 38909620 DOI: 10.1016/s0140-6736(24)00825-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 04/07/2024] [Accepted: 04/19/2024] [Indexed: 06/25/2024]
Abstract
Gestational diabetes is defined as hyperglycaemia first detected during pregnancy at glucose concentrations that are less than those of overt diabetes. Around 14% of pregnancies globally are affected by gestational diabetes; its prevalence varies with differences in risk factors and approaches to screening and diagnosis; and it is increasing in parallel with obesity and type 2 diabetes. Gestational diabetes direct costs are US$1·6 billion in the USA alone, largely due to complications including hypertensive disorders, preterm delivery, and neonatal metabolic and respiratory consequences. Between 30% and 70% of gestational diabetes is diagnosed in early pregnancy (ie, early gestational diabetes defined by hyperglycaemia before 20 weeks of gestation). Early gestational diabetes is associated with worse pregnancy outcomes compared with women diagnosed with late gestational diabetes (hyperglycaemia from 24 weeks to 28 weeks of gestation). Randomised controlled trials show benefits of treating gestational diabetes from 24 weeks to 28 weeks of gestation. The WHO 2013 recommendations for diagnosing gestational diabetes (one-step 75 gm 2-h oral glucose tolerance test at 24-28 weeks of gestation) are largely based on the Hyperglycemia and Adverse Pregnancy Outcomes Study, which confirmed the linear association between pregnancy complications and late-pregnancy maternal glycaemia: a phenomenon that has now also been shown in early pregnancy. Recently, the Treatment of Booking Gestational Diabetes Mellitus (TOBOGM) trial showed benefit in diagnosis and treatment of early gestational diabetes for women with risk factors. Given the diabesity epidemic, evidence for gestational diabetes heterogeneity by timing and subtype, and advances in technology, a life course precision medicine approach is urgently needed, using evidence-based prevention, diagnostic, and treatment strategies.
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Affiliation(s)
- Arianne Sweeting
- Department of Endocrinology, Royal Prince Alfred Hospital and University of Sydney, Sydney, NSW, Australia
| | - Wesley Hannah
- Department of Epidemiology, Madras Diabetes Research Foundation, Chennai, India
| | - Helena Backman
- Department of Obstetrics and Gynecology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Patrick Catalano
- Maternal Infant Research Institute, Obstetrics and Gynecology Research, Friedman School of Nutrition Science and Policy, Tufts University School of Medicine, Tufts University, Boston, MA, USA
| | - Maisa Feghali
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh, Pittsburgh, PA, USA
| | - Willliam H Herman
- Schools of Medicine and Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Marie-France Hivert
- Department of Population Medicine, Division of Chronic Disease Research Across the Lifecourse, Harvard Pilgrim Health Care Institute, Harvard Medical School, Harvard University, Boston, MA, USA; Diabetes Unit, Massachusetts General Hospital, Boston, MA, USA
| | - Jincy Immanuel
- School of Medicine, Western Sydney University, Sydney, NSW, Australia; Texas Woman's University, Denton, TX, USA
| | - Claire Meek
- Leicester Diabetes Centre, Leicester General Hospital, Leicester, UK
| | - Maria Lucia Oppermann
- Department of Obstetrics and Gynecology, School of Medicine of Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Christopher J Nolan
- School of Medicine and Psychology, College of Health and Medicine, Australian National University, Canberra, ACT, Australia; Department of Endocrinology, Canberra Health Services, Woden, ACT, Australia
| | - Uma Ram
- Seethapathy Clinic and Hospital, Chennai, India
| | - Maria Inês Schmidt
- Postgraduate Program in Epidemiology, School of Medicine of Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - David Simmons
- School of Medicine, Western Sydney University, Sydney, NSW, Australia.
| | - Tawanda Chivese
- Department of Population Medicine, College of Medicine, QU Health, Qatar University, Doha, Qatar
| | - Katrien Benhalima
- Endocrinology, University Hospital Gasthuisberg, KU Leuven, Leuven, Belgium
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Rute-Larrieta C, Mota-Cátedra G, Carmona-Torres JM, Mazoteras-Pardo V, Barroso-Corroto E, Navarrete-Tejero C, Zografakis-Sfakianakis M, Patelarou A, Martins MM, Faria ADCA, Laredo-Aguilera JA. Physical Activity during Pregnancy and Risk of Gestational Diabetes Mellitus: A Meta-Review. Life (Basel) 2024; 14:755. [PMID: 38929738 PMCID: PMC11204808 DOI: 10.3390/life14060755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2024] [Revised: 06/07/2024] [Accepted: 06/10/2024] [Indexed: 06/28/2024] Open
Abstract
BACKGROUND Nowadays, pregnant women require more individualized attention in their assistance process during pregnancy. One of the aspects that requires the most focus is the suitability of carrying out physical activity. The objective of this meta-review is to find out the effects of physical activity during pregnancy on the incidence of GDM compared to women who do not perform physical activity. METHODS A search was conducted in Cochrane, CSIC, Ebscohost, Proquest, Pubmed, Scielo, and Scopus. The search focused on systematic reviews and meta-analyses published in the last five years. The AMSTAR-2 scale was used as a quality assessment tool for the final sample. RESULTS A total of 18 systematic reviews and meta-analyses were included. Sixteen of them found out that physical activity during pregnancy has preventive effects for GDM compared with women who lacked physical activity. Among the studies, we found a reduction in the risk of GDM of between 24% and 38% and odds ratios ranging between 0.39 and 0.83 calculated for a 95% CI. Only two studies did not find statistically significant effects. Other variables such as type and duration of physical activity, overweight and obesity, gestational age, etc., were also considered. CONCLUSIONS Physical activity prevents the incidence of GDM. The main characteristics that enhance this preventive effect are starting at the initial stages of pregnancy and maintaining during the whole pregnancy as well as combining strength and aerobic exercise at a low to moderate intensity.
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Affiliation(s)
| | | | - Juan Manuel Carmona-Torres
- Grupo de Investigación Multidisciplinar en Cuidados, Universidad de Castilla-La Mancha, 45071 Toledo, Spain; (E.B.-C.); (J.A.L.-A.)
- Facultad de Fisioterapia y Enfermería, Universidad de Castilla-La Mancha, Campus Tecnológico Fábrica de Armas, Edificio 6. Despacho 1.4, Avd. Carlos III s/n, 45071 Toledo, Spain;
| | - Victoria Mazoteras-Pardo
- Facultad de Enfermería de Ciudad Real, Universidad de Castilla-La Mancha, 13071 Ciudad Real, Spain;
| | - Esperanza Barroso-Corroto
- Grupo de Investigación Multidisciplinar en Cuidados, Universidad de Castilla-La Mancha, 45071 Toledo, Spain; (E.B.-C.); (J.A.L.-A.)
- Facultad de Fisioterapia y Enfermería, Universidad de Castilla-La Mancha, Campus Tecnológico Fábrica de Armas, Edificio 6. Despacho 1.4, Avd. Carlos III s/n, 45071 Toledo, Spain;
| | - Carlos Navarrete-Tejero
- Facultad de Fisioterapia y Enfermería, Universidad de Castilla-La Mancha, Campus Tecnológico Fábrica de Armas, Edificio 6. Despacho 1.4, Avd. Carlos III s/n, 45071 Toledo, Spain;
| | - Michail Zografakis-Sfakianakis
- Department of Nursing, Faculty of Health Sciences, Hellenic Mediterranean University, 71401 Crete, Greece; (M.Z.-S.); (A.P.)
| | - Athina Patelarou
- Department of Nursing, Faculty of Health Sciences, Hellenic Mediterranean University, 71401 Crete, Greece; (M.Z.-S.); (A.P.)
| | - Maria Manuela Martins
- Abel Salazar Biomedical Sciences Institute, University of Porto, 4099-002 Porto, Portugal; (M.M.M.); (A.d.C.A.F.)
| | | | - José Alberto Laredo-Aguilera
- Grupo de Investigación Multidisciplinar en Cuidados, Universidad de Castilla-La Mancha, 45071 Toledo, Spain; (E.B.-C.); (J.A.L.-A.)
- Facultad de Fisioterapia y Enfermería, Universidad de Castilla-La Mancha, Campus Tecnológico Fábrica de Armas, Edificio 6. Despacho 1.4, Avd. Carlos III s/n, 45071 Toledo, Spain;
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Menek MY, Kaya AK. Comparison of home exercise under supervision and self home exercise in pregnant women with gestational diabetes: randomized controlled trial. Arch Gynecol Obstet 2024; 309:1075-1082. [PMID: 38184491 DOI: 10.1007/s00404-023-07339-4] [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: 09/09/2023] [Accepted: 12/07/2023] [Indexed: 01/08/2024]
Abstract
OBJECTIVE Exercise programs at home are successful in treating gestational diabetes by controlling blood glucose. The aim is to compare the efficacy of the self-directed home exercise program, the standard care alone and the supervised home exercise program in pregnant women with gestational diabetes on blood glucose, quality of life and pregnancy outcomes. METHODS This randomized, parallel, single-blind study included 45 pregnant women who were 24-28 weeks of gestation. Participants were randomly divided into the supervised home exercise group (SHEG), home exercise group (HEG) and control group (CG). While the home exercises program was taught and controlled by a physiotherapist in SHEG, the home exercise brochure was given without any training by the gynecologist in HEG. Control group maintained their usual daily care. The home exercise intervention included low to moderate structured exercise performed three days per week for 8 weeks. Their glucose responses, quality of life and pregnancy outcomes were assessed pre- and post intervention. RESULTS Fasting glucose and 2 h postprandial glucose levels were improved statistically in SHEG and HEG groups after intervention (p < 0.05). Differences in SHEG were statistically higher than HEG (p < 0.017). When the HEG and CG were compared, there was no superiority between the two groups in all outcome measures except the physical health. Additionally, there were no statistically significant differences in values of cesarean birth and preterm birth between groups (p > 0.05). CONCLUSIONS This study revealed that pregnant women should be under the supervision of physiotherapists while doing home exercises. Clinical Trial Registration The trial was approved by the registration of ClinicalTrials.gov and registration number: NCT05195333.
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Affiliation(s)
- Merve Yilmaz Menek
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Istanbul Medipol University, Istanbul, Turkey.
| | - Ayse Kavasoglu Kaya
- Department of Obstetrics and Gynecology, Medipol University Camlıca Hospital, Istanbul, Turkey
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Kasoha M, Hamza A, Leube A, Solomayer EF, Frenzel J, Schwab R, Sima RM, Haj Hamoud B. Physical Activity and the Impact of Continued Exercise on Health-Related Quality of Life Prior to and during Pregnancy: A German Cohort Study. Healthcare (Basel) 2023; 11:2143. [PMID: 37570383 PMCID: PMC10418755 DOI: 10.3390/healthcare11152143] [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: 06/12/2023] [Revised: 07/24/2023] [Accepted: 07/25/2023] [Indexed: 08/13/2023] Open
Abstract
The goal of this study was to examine how regular physical activity before and during pregnancy affected life quality throughout pregnancy. Between July 2020 and May 2021, 218 pregnant women were recruited from 11 outpatient clinics for this survey. Data were collected prospectively in a panel format beginning with the 10th gestational week over a 20-week period. Prior to pregnancy, a previous time point was also defined. The International Physical Activity Questionnaire, the EQ-5D-3L questionnaire, and the EQ-VAS questionnaire were used to collect data on the duration and intensity of daily physical exercises, as well as to assess health-related quality of life and self-estimated health status. The final survey included data from 113 women. During pregnancy, physical activity decreased dramatically. The duration of strenuous activities, but not moderate activities, was significantly reduced. Continuous physical activity independently predicted higher life quality scores at all points of assessment. Cases who participated in moderate and strenuous activities on a regular basis had higher self-estimated health status scores than cases who only participated in moderate activity. Instead of focusing solely on specific types of physical activity, we believe that strategies for motivating all pregnant women to be constantly active should be developed.
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Affiliation(s)
- Mariz Kasoha
- Department of Gynecology, Obstetrics and Reproductive Medicine, University Medical School of Saarland, 66421 Homburg, Saarland, Germany; (A.H.); (A.L.); (E.-F.S.); (B.H.H.)
| | - Amr Hamza
- Department of Gynecology, Obstetrics and Reproductive Medicine, University Medical School of Saarland, 66421 Homburg, Saarland, Germany; (A.H.); (A.L.); (E.-F.S.); (B.H.H.)
- Kantonsspital Baden, Im Ergel 1, 5404 Baden, Switzerland
| | - Ayse Leube
- Department of Gynecology, Obstetrics and Reproductive Medicine, University Medical School of Saarland, 66421 Homburg, Saarland, Germany; (A.H.); (A.L.); (E.-F.S.); (B.H.H.)
| | - Erich-Franz Solomayer
- Department of Gynecology, Obstetrics and Reproductive Medicine, University Medical School of Saarland, 66421 Homburg, Saarland, Germany; (A.H.); (A.L.); (E.-F.S.); (B.H.H.)
| | - Jochen Frenzel
- Frauenarztpraxis, Berliner Promenade 15, 66111 Saarbrücken, Germany;
| | - Roxana Schwab
- Department of Gynecology and Obstetrics, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany;
| | - Romina Marina Sima
- Department of Obstetrics and Gynecology, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Bashar Haj Hamoud
- Department of Gynecology, Obstetrics and Reproductive Medicine, University Medical School of Saarland, 66421 Homburg, Saarland, Germany; (A.H.); (A.L.); (E.-F.S.); (B.H.H.)
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