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Gammeltoft TM, Nguyen TA, Dung TK, Thi Dang NA, Phuong Nguyen TM, Nguyen VT, Bygbjerg IC. The pioneers of Vietnam's epidemiological transition: an ethnographic study of pregnant women's experiences of gestational diabetes. Glob Health Action 2024; 17:2341521. [PMID: 38693861 PMCID: PMC11067556 DOI: 10.1080/16549716.2024.2341521] [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: 01/23/2024] [Accepted: 04/07/2024] [Indexed: 05/03/2024] Open
Abstract
BACKGROUND Gestational diabetes mellitus (GDM) is an abnormal glucose metabolism diagnosed during pregnancy that can have serious adverse consequences for mother and child. GDM is an exceptional health condition, as its management serves not only as treatment but also as prevention, reducing the risk of future diabetes in mother and child. OBJECTIVES This qualitative study aimed to explore how pregnant women experience and respond to GDM, focusing particularly on the role of the family environment in shaping women's experiences. METHODS The research was carried out in Vietnam's Thái Bình province in April-May 2023. We conducted in-depth ethnographic interviews with 21 women with GDM, visiting them in their homes. Our theoretical starting point was phenomenological anthropology, and the data were analysed using a thematic analysis approach. RESULTS At the centre of women's experiences was the contrast between GDM as a biomedical and a social condition. Whereas GDM was biomedically diagnosed and managed in the healthcare system, it was often deemed insignificant or non-existent by family members. This made GDM a biomedically present but socially absent health condition. This paradox posed challenges to women's GDM self-care, placing them in pioneering social positions. CONCLUSIONS The biomedical presence yet social absence of GDM turned women into pioneers at biomedical, digital, epidemiological, and family frontiers. This article calls for appreciation of pregnant women's pioneering roles and for health systems action to involve women and families in the development of GDM policies and programmes at a time of sweeping global health changes.
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Affiliation(s)
- Tine M. Gammeltoft
- Department of Anthropology, University of Copenhagen, København, Denmark
| | - Thi Ai Nguyen
- Department of Health Management & Organization, Faculty of Public Health, Thai Binh University of Medicine and Pharmacy, Hue, Vietnam
| | - Thi Kim Dung
- Department of Epidemiology, Faculty of Public Health, Thai Binh University of Medicine and Pharmacy, Hue, Vietnam
| | - Ngoc-Anh Thi Dang
- Department of Environmental Health, Faculty of Public Health, Thai Binh University of Medicine and Pharmacy, Hue, Vietnam
| | - Thi Minh Phuong Nguyen
- Department of Health Sociology, Faculty of Public Health, Thai Binh University of Medicine and Pharmacy, Hue, Vietnam
| | - Van Tien Nguyen
- Department of Health Management & Organization, Faculty of Public Health, Thai Binh University of Medicine and Pharmacy, Hue, Vietnam
| | - Ib C. Bygbjerg
- Department of Public Health, Global Health Section, University of Copenhagen, København, Denmark
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Han N, Chang XY, Yuan ZL, Wang YZ. Expression and correlation analysis of silent information regulator 1 (SIRT1), sterol regulatory element-binding protein-1 (SREBP1), and pyroptosis factor in gestational diabetes mellitus. J Matern Fetal Neonatal Med 2024; 37:2311809. [PMID: 38326276 DOI: 10.1080/14767058.2024.2311809] [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: 09/20/2023] [Accepted: 01/24/2024] [Indexed: 02/09/2024]
Abstract
BACKGROUND AND AIM Globally, the prevalence of gestational diabetes mellitus (GDM) is rising each year, yet its pathophysiology is still unclear. To shed new light on the pathogenesis of gestational diabetes mellitus and perhaps uncover new therapeutic targets, this study looked at the expression levels and correlations of SIRT1, SREBP1, and pyroptosis factors like NLRP3, Caspase-1, IL-1, and IL-18 in patients with GDM. METHODS This study involved a comparative analysis between two groups. The GDM group consisted of 50 GDM patients and the control group included 50 pregnant women with normal pregnancies. Detailed case data were collected for all participants. We utilized real-time quantitative PCR and Western Blot techniques to assess the expression levels of SIRT1 and SREBP1 in placental tissues from both groups. Additionally, we employed an enzyme-linked immunosorbent assay to measure the serum levels of SIRT1, SREBP1, and pyroptosis factors, namely NLRP3, Caspase-1, IL-1β, and IL-18, in the patients of both groups. Subsequently, we analyzed the correlations between these factors and clinical. RESULTS The results showed that there were significantly lower expression levels of SIRT1 in both GDM group placental tissue and serum compared to the control group (p < 0.01). In contrast, the expression of SREBP1 was significantly higher in the GDM group than in the control group (p < 0.05). Additionally, the serum levels of NLRP3, Caspase-1, IL-1β, and IL-18 were significantly elevated in the GDM group compared to the control group (p < 0.01). The expression of SIRT1 exhibited negative correlations with the expression of FPG, OGTT-1h, FINS, HOMA-IR, SREBP1, IL-1β, and IL-18. However, there was no significant correlation between SIRT1 expression and OGTT-2h, NLRP3, or Caspase-1. On the other hand, the expression of SREBP1 was positively correlated with the expression of IL-1β, Caspase-1, and IL-18, but has no apparent correlation with NLRP3. CONCLUSIONS Low SIRT1 levels and high SREBP1 levels in placental tissue and serum, coupled with elevated levels of pyroptosis factors NLRP3, Caspase-1, IL-1β, and IL-18 in serum, may be linked to the development of gestational diabetes mellitus. Furthermore, these three factors appear to correlate with each other in the pathogenesis of GDM, offering potential directions for future research and therapeutic strategies.
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Affiliation(s)
- Ning Han
- Department of Obstetrics and Gynecology, The Third Affiliated Hospital, Zhengzhou University, Zhengzhou, China
| | - Xin-Yuan Chang
- Department of Obstetrics and Gynecology, The Third Affiliated Hospital, Zhengzhou University, Zhengzhou, China
| | - Zi-Li Yuan
- Department of Obstetrics and Gynecology, The Third Affiliated Hospital, Zhengzhou University, Zhengzhou, China
| | - Yi-Zhan Wang
- Department of Obstetrics and Gynecology, The Third Affiliated Hospital, Zhengzhou University, Zhengzhou, China
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Da Correggio KS, Galluzzo RN, von Wangenheim A, Werner H, Castro PT, Araujo Júnior E, Onofre ASC. Available evidence on fetal liver changes detected by ultrasound in pregnant women with gestational diabetes mellitus: Systematic review. JOURNAL OF CLINICAL ULTRASOUND : JCU 2024. [PMID: 38994688 DOI: 10.1002/jcu.23760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2024] [Revised: 06/21/2024] [Accepted: 06/25/2024] [Indexed: 07/13/2024]
Abstract
The aim of this systematic review was to examine the available scientific literature on ultrasound-detected fetal liver changes in pregnant women with gestational diabetes mellitus (GDM) and to explore the potential of these markers to inform clinical management and improve outcomes. A total of four articles investigating fetal liver changes in GDM pregnancies were selected. The studies varied in methodology, gestational age studied, and diagnostic criteria for GDM. Fetal liver indices, such as fetal liver length and fetal liver volume, emerged as potential markers for identifying GDM and predicting adverse outcomes. Studies suggest an association between fetal liver changes and GDM, with implications for both maternal glycemic control and fetal metabolic adaptation. Variability in study methodology highlights the need for standardized approaches to assess fetal hepatic indices and their correlation with GDM outcomes.
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Affiliation(s)
- Karine Souza Da Correggio
- Division of Tocogynecology, University Hospital Polydoro Ernani of São Thiago, Federal University of Santa Catarina (UFSC), Florianópolis, Brazil
| | - Roberto Noya Galluzzo
- Division of Tocogynecology, University Hospital Polydoro Ernani of São Thiago, Federal University of Santa Catarina (UFSC), Florianópolis, Brazil
| | - Aldo von Wangenheim
- Brazilian Institute for Digital Convergence, Federal University of Santa Catarina (UFSC), Florianópolis, Brazil
| | - Heron Werner
- Department of Fetal Medicine, Biodesign Laboratory DASA/PUC, Rio de Janeiro, Brazil
| | | | - Edward Araujo Júnior
- Department of Obstetrics, Paulista School of Medicine - Federal University of São Paulo (EPM-UNIFESP), São Paulo, Brazil
- Discipline of Woman Health, Municipal University of São Caetano do Sul (USCS), São Caetano do Sul, Brazil
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Zhang J, Suo Y, Wang L, Liu D, Jia Y, Fu Y, Fan W, Jiang Y. Association between atherogenic index of plasma and gestational diabetes mellitus: a prospective cohort study based on the Korean population. Cardiovasc Diabetol 2024; 23:237. [PMID: 38970008 PMCID: PMC11227226 DOI: 10.1186/s12933-024-02341-9] [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] [Received: 05/14/2024] [Accepted: 06/26/2024] [Indexed: 07/07/2024] Open
Abstract
BACKGROUND Atherogenic index of plasma (AIP) is a non-traditional lipid parameter that can reflect the burden of atherosclerosis. A lipid profile resembling atherosclerosis emerged during pregnancy. Although lipid metabolism is pivotal in diabetes pathogenesis, there is no evidence linking AIP to gestational diabetes mellitus (GDM). Therefore, our objective was to explore the relationship between AIP and GDM and assess AIP's predictive capability for GDM. METHODS This was a secondary analysis based on data from a prospective cohort study in Korea involving 585 single pregnant women. AIP was calculated as log10 (TG/HDL). We examined the relationship between AIP and GDM using logistic regression models, curve fitting, sensitivity analyses, and subgroup analyses. Receiver operating characteristic (ROC) analysis was also used to determine the ability of AIP to predict GDM. RESULTS The average age of the participants was 32.06 ± 3.76 years. The AIP was 0.24 ± 0.20 on average. The GDM incidence was 6.15%. After adjustment for potentially confounding variables, AIP showed a positive linear relationship with GDM (P for non-linearity: 0.801, OR 1.58, 95% CI 1.27-1.97). The robustness of the connection between AIP and GDM was demonstrated by sensitivity analyses and subgroup analyses. An area under the ROC curve of 0.7879 (95% CI 0.7087-0.8671) indicates that AIP is an excellent predictor of GDM. With a specificity of 75.41% and sensitivity of 72.22%, the ideal AIP cut-off value for identifying GDM was 0.3557. CONCLUSIONS This study revealed that the AIP at 10-14 weeks of gestation was independently and positively correlated with GDM risk. AIP could serve as an early screening and monitoring tool for pregnant women at high risk of GDM, thereby optimizing GDM prevention strategies. TRIAL REGISTRATION ClinicalTrials.gov registration no. NCT02276144.
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Affiliation(s)
- Juan Zhang
- School of Basic Medicine, Ningxia Medical University, Yinchuan, China
- General Hospital of Ningxia Medical University, Yinchuan, China
- National Health Commission Key Laboratory of Metabolic Cardiovascular Diseases Research, Ningxia Medical University, Yinchuan, China
| | - Yaoyu Suo
- School of Basic Medicine, Ningxia Medical University, Yinchuan, China
- General Hospital of Ningxia Medical University, Yinchuan, China
- National Health Commission Key Laboratory of Metabolic Cardiovascular Diseases Research, Ningxia Medical University, Yinchuan, China
| | - Li Wang
- General Hospital of Ningxia Medical University, Yinchuan, China
| | - Dong Liu
- School of Basic Medicine, Ningxia Medical University, Yinchuan, China
- General Hospital of Ningxia Medical University, Yinchuan, China
- National Health Commission Key Laboratory of Metabolic Cardiovascular Diseases Research, Ningxia Medical University, Yinchuan, China
| | - Yue Jia
- School of Basic Medicine, Ningxia Medical University, Yinchuan, China
- National Health Commission Key Laboratory of Metabolic Cardiovascular Diseases Research, Ningxia Medical University, Yinchuan, China
| | - Yajuan Fu
- School of Basic Medicine, Ningxia Medical University, Yinchuan, China.
- National Health Commission Key Laboratory of Metabolic Cardiovascular Diseases Research, Ningxia Medical University, Yinchuan, China.
| | - Weining Fan
- School of Basic Medicine, Ningxia Medical University, Yinchuan, China.
- General Hospital of Ningxia Medical University, Yinchuan, China.
| | - Yideng Jiang
- School of Basic Medicine, Ningxia Medical University, Yinchuan, China.
- National Health Commission Key Laboratory of Metabolic Cardiovascular Diseases Research, Ningxia Medical University, Yinchuan, China.
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Dragomir RE, Gheoca Mutu DE, Sima RM, Toader OD, Stănculescu RV. The Impact of Vitamin D Deficiency on Gestational Diabetes Mellitus Risk: A Retrospective Study. Cureus 2024; 16:e65037. [PMID: 39035594 PMCID: PMC11260427 DOI: 10.7759/cureus.65037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/21/2024] [Indexed: 07/23/2024] Open
Abstract
Background Nowadays, there has been growing attention to vitamin D deficiency's impact on women of reproductive age, both during pregnancy and the preconception period. Because of its possible impact on female reproductive ability, vitamin D deficiency may have multiple implications for maternal and fetal health. Currently, the correlation between vitamin D deficiency and gestational diabetes mellitus (GDM) is gaining attention, mainly due to contradictory findings in the literature. Methods We conducted a single-center, retrospective study involving data from 106 pregnant women to establish a possible link between vitamin D deficiency and GDM risk. We analyzed variables such as vitamin D status, the occurrence of gestational diabetes, and body mass index to identify significant statistical correlations among them. Results Within our study group, the average vitamin D level was 19.5 ± 7.8 ng/mL. Regarding vitamin D status, 59 (55.7%) pregnant women had vitamin D deficiency, 36 (34%) had vitamin D insufficiency, and 11 (10.4%) had optimal vitamin D levels. GDM was diagnosed in 18 cases, representing 17%. After the statistical analysis, we found a positive correlation between gestational diabetes and vitamin D deficiency (chi-square = 4.472, p = 0.049). However, we did not find a significant correlation between gestational diabetes and optimal vitamin D status. Conclusions Pregnant women with vitamin D deficiency are at an increased risk of developing GDM and may benefit from vitamin D supplementation. We believe that further research is necessary to have a comprehensive understanding of vitamin D's effects on pregnancy.
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Affiliation(s)
- Ramona E Dragomir
- Doctoral School, Carol Davila University of Medicine and Pharmacy, Bucharest, ROU
| | - Daniela E Gheoca Mutu
- Department of Anatomy, Carol Davila University of Medicine and Pharmacy, Bucharest, ROU
- Clinical Department of Plastic and Aesthetic Surgery and Reconstructive Microsurgery, Prof. Dr. Agrippa Ionescu Clinical Emergency Hospital, Bucharest, ROU
| | - Romina M Sima
- Department of Obstetrics and Gynecology, Carol Davila University of Medicine and Pharmacy, Bucharest, ROU
| | - Oana D Toader
- Department of Obstetrics and Gynecology, Alessandrescu-Rusescu National Institute for Mother and Child Health, Polizu Hospital, Bucharest, ROU
- Department of Obstetrics and Gynecology, Carol Davila University of Medicine and Pharmacy, Bucharest, ROU
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Wu Y, Liu Y, Yang X, Tong M, Jiang X, Gu X. Triple-Responsive, Multimodal, Visual Electronic Skin toward All-in-One Health Management for Gestational Diabetes Mellitus. ACS Sens 2024; 9:2634-2644. [PMID: 38669562 DOI: 10.1021/acssensors.4c00426] [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] [Indexed: 04/28/2024]
Abstract
Gestational diabetes mellitus (GDM) is one of the most common metabolic disorders during pregnancy, leading to serious complications for pregnant women and a threat to life safety of infants. Therefore, it is particularly important to establish a multipurpose monitoring pathway to important physiological indicators of pregnant women. In this work, three kinds of double network hydrogels are prepared with poly(vinyl alcohol) (PVA), borax, and cellulose ethers with varying substituents of methyl (methyl cellulose, MC), hydroxypropyl (hydroxypropyl cellulose, HPC), or both (hydroxypropyl methyl cellulose, HPMC), respectively. The corresponding toughness (143.9, 102.3, and 135.9 kJ cm-3) and conductivity (0.69, 0.45, and 0.51 S m-1) of the hydrogels demonstrate that PB-MC was endowed with the prominent performance. Molecular dynamics simulations further revealed the essence that hydrogen bond interactions between PVA and cellulose ethers play a critical role in regulating the structure and properties of hydrogels. Thermochromic capsule powders (TCPs) were subsequently doped in to achieve a composite hydrogel (TCPs@PB-MC) to indicate the change in human body temperature. Furthermore, the process of the TCPs@PB-MC response to glucose, pH, and temperature was tracked in-depth through the electrochemical window. This work provides a novel strategy for all-in-one health management of GDM.
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Affiliation(s)
- Yue Wu
- Shandong Provincial Engineering Research Center of Novel Pharmaceutical Excipients, Sustained and Controlled Release Preparations, College of Medicine and Nursing, Dezhou University, Dezhou 253023, China
- College of Chemistry and Chemical Engineering, Jinan University, Jinan 250024, China
| | - Yong Liu
- Shandong Provincial Engineering Research Center of Novel Pharmaceutical Excipients, Sustained and Controlled Release Preparations, College of Medicine and Nursing, Dezhou University, Dezhou 253023, China
| | - Xueting Yang
- Shandong Provincial Engineering Research Center of Novel Pharmaceutical Excipients, Sustained and Controlled Release Preparations, College of Medicine and Nursing, Dezhou University, Dezhou 253023, China
| | - Mingqiong Tong
- Shandong Provincial Engineering Research Center of Novel Pharmaceutical Excipients, Sustained and Controlled Release Preparations, College of Medicine and Nursing, Dezhou University, Dezhou 253023, China
| | - Xubao Jiang
- College of Chemistry and Chemical Engineering, Jinan University, Jinan 250024, China
| | - Xiangling Gu
- Shandong Provincial Engineering Research Center of Novel Pharmaceutical Excipients, Sustained and Controlled Release Preparations, College of Medicine and Nursing, Dezhou University, Dezhou 253023, China
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Zhang R, Feng Y, Nie P, Wang W, Wu H, Wan X, Xu H, Fu F. Polystyrene microplastics disturb maternal glucose homeostasis and induce adverse pregnancy outcomes. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2024; 279:116492. [PMID: 38795415 DOI: 10.1016/j.ecoenv.2024.116492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 05/13/2024] [Accepted: 05/20/2024] [Indexed: 05/28/2024]
Abstract
Pregnant women are a special group that is sensitive to adverse external stimuli, causing metabolic abnormalities and adverse pregnancy outcomes. Microplastics (MPs), an environmental pollutant widely used in various fields, can induce a variety of toxic responses in mammals. Recent studies verified an association between MPs and metabolic disorders. Our research built a gestational mouse model in which polystyrene microplastics (PS-MPs) of 1 μm size were consumed at concentrations of 0.1, 1, and 10 mg/L during pregnancy. Results indicated that PS-MPs induced placental malfunction and fetal growth retardation. Significant glucose disorders, decreased liver function, hepatic inflammation, and oxidative stress were also observed after PS-MPs exposure. The hepatic SIRT1/IRS1/PI3K pathway was inhibited in the 10 mg/L PS-MPs exposure group. Our study found that PS-MPs activated inflammatory response and oxidative stress by increasing hepatic lipopolysaccharide (LPS) that inhibited the hepatic SIRT1/IRS1/PI3K pathway, ultimately leading to insulin resistance, glucose metabolism disorders, and adverse pregnancy outcomes. This study provides a basis for preventing environment-related gestational diabetes and concomitant adverse pregnancy outcomes.
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Affiliation(s)
- Ruiying Zhang
- The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang 330000, China; State Key Laboratory of Food Science and Resources, Nanchang University, Nanchang 330047, China
| | - Yueying Feng
- The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang 330000, China; State Key Laboratory of Food Science and Resources, Nanchang University, Nanchang 330047, China
| | - Penghui Nie
- State Key Laboratory of Food Science and Resources, Nanchang University, Nanchang 330047, China
| | - Wanzhen Wang
- The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang 330000, China
| | - Hua Wu
- The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang 330000, China; State Key Laboratory of Food Science and Resources, Nanchang University, Nanchang 330047, China
| | - Xianxian Wan
- The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang 330000, China
| | - Hengyi Xu
- State Key Laboratory of Food Science and Resources, Nanchang University, Nanchang 330047, China.
| | - Fen Fu
- The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang 330000, China.
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Shanmuganathan G, Agrawal DK. Diabetes and Abdominal Aortic Aneurysm: Is the Protective Effect on AAA Due to Antidiabetic Medications Alone, Due to the Disease Alone, or Both? ARCHIVES OF INTERNAL MEDICINE RESEARCH 2024; 7:104-113. [PMID: 38846325 PMCID: PMC11156236 DOI: 10.26502/aimr.0169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/09/2024]
Abstract
Diabetes is a metabolic disease that may result in multiple microvascular and macrovascular diseases. Interestingly, many studies have demonstrated the inverse relationship between diabetes and the development and expansion of abdominal aortic aneurysm (AAA). One hypothesis is that the aortic wall stiffness resulting from hyperglycemia and advanced glycation end products could delay the development and growth of AAA. Other studies have proposed that the concurrent use of antidiabetic medications which promote anti-inflammatory cytokines while hindering pro-inflammatory cytokines may potentially be the reason for this protective effect of diabetes on AAA. Contrastingly, the presence of diabetes has been found to have a negative effect on the outcome of AAA following its repair which may be due to elevated blood glucose negatively affecting the healing process. The current literature has also demonstrated the negative impact of the use of fluoroquinolones on AAA. This comprehensive review critically reviewed and summarized the role of diabetes, anti-diabetes medications and fluoroquinolones on AAA, and on the effect of diabetes and certain anti-diabetes medications on outcomes following its repair.
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Affiliation(s)
- Gaithrri Shanmuganathan
- Department of Translational Research College of Osteopathic Medicine of the Pacific Western University of Health Sciences Pomona, California 91766
| | - Devendra K Agrawal
- Department of Translational Research College of Osteopathic Medicine of the Pacific Western University of Health Sciences Pomona, California 91766
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Lis-Kuberka J, Berghausen-Mazur M, Orczyk-Pawiłowicz M. Gestational Diabetes Mellitus and Colostral Appetite-Regulating Adipokines. Int J Mol Sci 2024; 25:3853. [PMID: 38612666 PMCID: PMC11011253 DOI: 10.3390/ijms25073853] [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: 03/02/2024] [Revised: 03/25/2024] [Accepted: 03/26/2024] [Indexed: 04/14/2024] Open
Abstract
Gestational diabetes mellitus (GDM) is a complex metabolic disorder that has short- and long-term effects on maternal and offspring health. This study aimed to assess the impact of maternal hyperglycemia severity, classified as GDM-G1 (diet treatment) and GDM-G2 (insulin treatment) on colostral appetite-regulating molecules. Colostrum samples were collected from hyperglycemic (N = 30) and normoglycemic (N = 21) mothers, and the concentrations of milk hormones were determined by immunoenzymatic assay. A difference was found for milk ghrelin, but not for molecules such as adiponectin, leptin, resistin, or IGF-I levels, in relation to maternal hyperglycemia. The colostral ghrelin in the GDM-G1 cohort (0.21 ng/mL) was significantly lower than for GDM-G2 (0.38 ng/mL) and non-GDM groups (0.36 ng/mL). However, colostral resistin was higher, but not significantly, for GDM-G1 (13.33 ng/mL) and GDM-G2 (12.81 ng/mL) cohorts than for normoglycemic mothers (7.89 ng/mL). The lack of difference in relation to hyperglycemia for milk leptin, adiponectin, leptin-adiponectin ratio, resistin, and IGF-I levels might be the outcome of effective treatment of GDM during pregnancy. The shift between ghrelin and other appetite-regulating hormones might translate into altered ability to regulate energy balance, affecting offspring's metabolic homeostasis.
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Affiliation(s)
- Jolanta Lis-Kuberka
- Division of Chemistry and Immunochemistry, Department of Biochemistry and Immunochemistry, Wroclaw Medical University, M. Skłodowskiej-Curie 48/50, 50-369 Wroclaw, Poland;
| | - Marta Berghausen-Mazur
- Department of Neonatology, J. Gromkowski Provincial Specialist Hospital, Koszarowa 5, 51-149 Wroclaw, Poland
- Faculty of Medicine, Wroclaw University of Science and Technology, Hoene-Wrońskiego 13c, 58-376 Wroclaw, Poland
| | - Magdalena Orczyk-Pawiłowicz
- Division of Chemistry and Immunochemistry, Department of Biochemistry and Immunochemistry, Wroclaw Medical University, M. Skłodowskiej-Curie 48/50, 50-369 Wroclaw, Poland;
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He Y, Li X, Li X, Cui W, Zhang S. Serum copeptin in women with gestational diabetes mellitus: A meta-analysis. BIOMOLECULES & BIOMEDICINE 2024; 24:753-763. [PMID: 38460170 PMCID: PMC11293242 DOI: 10.17305/bb.2024.10114] [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: 11/30/2023] [Revised: 01/06/2024] [Accepted: 03/07/2024] [Indexed: 03/11/2024]
Abstract
Previous studies have reported mixed results regarding the relationship between serum copeptin levels and gestational diabetes mellitus (GDM) risk. To address inconsistencies in prior research, this meta-analysis examines the potential link between serum copeptin levels and the risk of developing GDM. Our objective was to comprehensively evaluate this association. We systematically reviewed observational studies from Medline, Web of Science, Embase, Wanfang, and China National Knowledge Infrastructure (CNKI) databases up to October 15, 2023, employing a random-effects model to integrate the data while considering heterogeneity. This analysis incorporated 10 studies comprising 625 women with GDM and 1212 healthy pregnant controls. Our findings showed no significant difference in serum copeptin levels between women with GDM and those without (standardized mean difference [SMD] 0.01, 95% confidence interval [CI] -0.22 to 0.24, P = 0.92, I2 = 75%). Univariate meta-analysis indicated a positive correlation between the body mass index (BMI) of the participants and the outcomes (coefficient = 0.11, P = 0.002). Further subgroup analysis demonstrated that women with a mean BMI ≥ 26 kg/m2 and GDM had significantly higher serum copeptin levels compared to their non-GDM counterparts (SMD 0.31, 95% CI 0.05 to 0.57, P = 0.02, I2 = 46%). Conversely, no difference was observed in women with a BMI < 26 kg/m2 (SMD -0.23, 95% CI -0.37 to-0.09, P = 0.002, I2 = 0%, P for subgroup difference = 0.003). Variables, such as the country of study, maternal age, the timing of blood sampling, copeptin measurement methods, or GDM diagnostic criteria did not significantly affect the results. In summary, the association between serum copeptin levels and GDM risk is influenced by the BMI of pregnant women, indicating that elevated serum copeptin might be linked to GDM in individuals with a BMI ≥ 26 kg/m2.
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Affiliation(s)
- Yuanqi He
- Department of Obstetrics, Weihai Municipal Hospital, Cheeloo College of Medicine, Shandong University, Weihai, China
| | - Xue Li
- Department of Obstetrics, Weihai Municipal Hospital, Cheeloo College of Medicine, Shandong University, Weihai, China
| | - Xiaoxiao Li
- Department of Obstetrics, Weihai Municipal Hospital, Cheeloo College of Medicine, Shandong University, Weihai, China
| | - Weiwei Cui
- Department of Obstetrics, Weihai Municipal Hospital, Cheeloo College of Medicine, Shandong University, Weihai, China
| | - Shihong Zhang
- Department of Gynaecology and Obstetrics, Weihai Municipal Hospital, Cheeloo College of Medicine, Shandong University, Weihai, China
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Xie W, Zhang L, Cheng J, Wang Y, Kang H, Gao Y. Physical activity during pregnancy and the risk of gestational diabetes mellitus: a systematic review and dose-response meta-analysis. BMC Public Health 2024; 24:594. [PMID: 38395913 PMCID: PMC10893683 DOI: 10.1186/s12889-024-18131-7] [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: 09/11/2023] [Accepted: 02/16/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Previous research has indicated the inverse association between physical activity (PA) and gestational diabetes mellitus (GDM). However, the dose-response relationship currently remains undetermined. This study aims to explore the dose-response relationship between PA during the first and second trimesters of pregnancy and GDM risk. METHODS Studies on the relationship between PA during pregnancy and GDM risk published before April 25, 2023, were searched for in six databases. According to the inclusion and exclusion criteria, all literature was screened for eligibility. The Newcastle-Ottawa Scale (NOS) was used to assess risk of bias. Publication bias was examined using funnel plots, Begg's and Egger's tests, as well as trim-and-fill analysis. We harmonized exposure estimates of PA during pregnancy to the common unit of the metabolic equivalent of task (MET)-h/week. Restricted cubic splines were used to model the dose-response relationship. The criteria from the World Cancer Research Fund were used to assess the certainty of evidence across outcomes. All analyses were performed using Stata 15.1. RESULTS The results indicated that in contrast with the lowest level of PA, promoting the highest PA level lowers the risk of GDM by 36% (RR = 0.64, 95%CI: 0.53 ~ 0.78). We found a curvilinear dose-response association between PA during the first trimester and incident GDM (Pnonlinearity = 0.012). Compared to inactive pregnant women, for those who achieved the guidelines-suggested minimum level (10 MET-h/week) of PA during the first trimester, the GDM risk was decreased by 13% (RR = 0.87, 95%CI: 0.79 ~ 0.96). A linear relationship was found between PA during the second trimester and the GDM risk (Pnonlinearity = 0.276). The results with a restricted cubic spline model suggested that pregnant women who accumulate 10 MET-h/week have a 1% reduced risk of GDM compared to completely inactive individuals. Twice (20 MET-h/week) or a higher amount of PA (50 MET-h/week) contributed to further reductions in GDM risk. CONCLUSION There is a dose-response relationship between higher levels of PA in both the first and second trimesters and reduced risk of GDM; the relationship is stronger in the first trimester. Increasing PA during pregnancy can prevent the development of GDM. PROSPERO REGISTRATION NUMBER CRD42023420564.
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Affiliation(s)
- Wanting Xie
- Department of Physical Fitness and Health, School of Sport Science, Beijing Sport University, Beijing, 100084, China
| | - Liuwei Zhang
- Department of Physical Fitness and Health, School of Sport Science, Beijing Sport University, Beijing, 100084, China.
- Key Laboratory of Exercise and Physical Fitness, Ministry of Education, Beijing Sport University, Beijing, 100084, China.
| | - Jiaoying Cheng
- Department of Obstetrics and Gynecology, China-Japan Friendship Hospital, Beijing, 100029, China.
| | - Yirui Wang
- Department of Physical Fitness and Health, School of Sport Science, Beijing Sport University, Beijing, 100084, China
| | - Haixin Kang
- Department of Physical Fitness and Health, School of Sport Science, Beijing Sport University, Beijing, 100084, China
| | - Yi Gao
- School of Strength and Conditioning Training, Beijing Sport University, Beijing, 100084, China
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12
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Rosu LM, Prodan-Bărbulescu C, Maghiari AL, Bernad ES, Bernad RL, Iacob R, Stoicescu ER, Borozan F, Ghenciu LA. Current Trends in Diagnosis and Treatment Approach of Diabetic Retinopathy during Pregnancy: A Narrative Review. Diagnostics (Basel) 2024; 14:369. [PMID: 38396408 PMCID: PMC10887682 DOI: 10.3390/diagnostics14040369] [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: 01/11/2024] [Revised: 02/05/2024] [Accepted: 02/06/2024] [Indexed: 02/25/2024] Open
Abstract
Diabetes mellitus during pregnancy and gestational diabetes are major concerns worldwide. These conditions may lead to the development of severe diabetic retinopathy during pregnancy or worsen pre-existing cases. Gestational diabetes also increases the risk of diabetes for both the mother and the fetus in the future. Understanding the prevalence, evaluating risk factors contributing to pathogenesis, and identifying treatment challenges related to diabetic retinopathy in expectant mothers are all of utmost importance. Pregnancy-related physiological changes, including those in metabolism, blood flow, immunity, and hormones, can contribute to the development or worsening of diabetic retinopathy. If left untreated, this condition may eventually result in irreversible vision loss. Treatment options such as laser therapy, intravitreal anti-vascular endothelial growth factor drugs, and intravitreal steroids pose challenges in managing these patients without endangering the developing baby and mother. This narrative review describes the management of diabetic retinopathy during pregnancy, highlights its risk factors, pathophysiology, and diagnostic methods, and offers recommendations based on findings from previous literature.
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Affiliation(s)
- Luminioara M. Rosu
- Department of Anatomy and Embryology, Victor Babeș University of Medicine and Pharmacy, E. Murgu Square, No. 2, 300041 Timisoara, Romania; (L.M.R.); (A.L.M.); (R.I.); (F.B.)
| | - Cătălin Prodan-Bărbulescu
- Department of Anatomy and Embryology, Victor Babeș University of Medicine and Pharmacy, E. Murgu Square, No. 2, 300041 Timisoara, Romania; (L.M.R.); (A.L.M.); (R.I.); (F.B.)
| | - Anca Laura Maghiari
- Department of Anatomy and Embryology, Victor Babeș University of Medicine and Pharmacy, E. Murgu Square, No. 2, 300041 Timisoara, Romania; (L.M.R.); (A.L.M.); (R.I.); (F.B.)
| | - Elena S. Bernad
- Department of Obstetrics and Gynecology, Victor Babeș University of Medicine and Pharmacy, 300041 Timisoara, Romania;
- Clinic of Obstetrics and Gynecology, “Pius Brinzeu” County Clinical Emergency Hospital, 300723 Timisoara, Romania
- Center for Laparoscopy, Laparoscopic Surgery and In Vitro Fertilization, Victor Babeș University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Department of Automatic Control and Applied Informatics, Politehnica University, 300223 Timisoara, Romania;
| | - Robert L. Bernad
- Department of Automatic Control and Applied Informatics, Politehnica University, 300223 Timisoara, Romania;
| | - Roxana Iacob
- Department of Anatomy and Embryology, Victor Babeș University of Medicine and Pharmacy, E. Murgu Square, No. 2, 300041 Timisoara, Romania; (L.M.R.); (A.L.M.); (R.I.); (F.B.)
- Discipline of Radiology and Medical Imaging, Victor Babeș University of Medicine and Pharmacy, E. Murgu Square, No. 2, 300041 Timisoara, Romania;
| | - Emil Robert Stoicescu
- Discipline of Radiology and Medical Imaging, Victor Babeș University of Medicine and Pharmacy, E. Murgu Square, No. 2, 300041 Timisoara, Romania;
- Research Center for Pharmaco-Toxicological Evaluations, Victor Babeș University of Medicine and Pharmacy, E. Murgu Square, No. 2, 300041 Timisoara, Romania
| | - Florina Borozan
- Department of Anatomy and Embryology, Victor Babeș University of Medicine and Pharmacy, E. Murgu Square, No. 2, 300041 Timisoara, Romania; (L.M.R.); (A.L.M.); (R.I.); (F.B.)
| | - Laura Andreea Ghenciu
- Department of Functional Sciences, Victor Babeș University of Medicine and Pharmacy, E. Murgu Square, No. 2, 300041 Timisoara, Romania;
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13
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Sonaglioni A, Piergallini E, Naselli A, Nicolosi GL, Ferrulli A, Bianchi S, Lombardo M, Ambrosio G. The effect of gestational diabetes mellitus on carotid artery intima-media thickness in and after pregnancy: a systematic review and meta-analysis. Acta Diabetol 2024; 61:139-149. [PMID: 37936027 DOI: 10.1007/s00592-023-02206-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 10/18/2023] [Indexed: 11/09/2023]
Abstract
AIMS The association between gestational diabetes mellitus (GDM) and common carotid artery (CCA) intima-media thickness (IMT) is still controversial. This systematic review and meta-analysis was performed to assess the correlation between GDM and CCA-IMT in and after pregnancy. METHODS PubMed and EMBASE databases were systematically reviewed on April 2023. Studies measuring CCA-IMT in both pregnant women with GDM and women with previous history of GDM (pGDM) vs. healthy controls were included. The subtotal and overall standardized mean differences (SMDs) of CCA-IMT were calculated using the random-effect model. RESULTS Nineteen studies with a total of 302 GDM and 861 pGDM women were analyzed. The average value of CCA-IMT measured in GDM/pGDM (0.59 ± 0.12 mm) was slightly increased in comparison to the accepted reference limits of IMT according to age classes. Substantial heterogeneity was detected for the studies involving both GDM and pGDM women, with an overall statistic I2 of 86.0% (p < 0.001). Large SMDs were obtained for the studies conducted on both GDM and pGDM women, with an overall SMD of 0.89 (95%CI 0.63-1.15, p < 0.001). Egger's test for a regression intercept gave a p-value of 0.37, indicating no publication bias. On meta-regression analysis, all potential confounders (number of patients, age at pregnancy, body mass index, measuring time, follow-up duration and GDM criteria) were not significantly associated with effect modification. CONCLUSIONS GDM in and after pregnancy is independently associated with subclinical atherosclerosis. The association between GDM and carotid remodeling is potentially mediated by the longstanding underlying risk.
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Affiliation(s)
| | | | | | | | - Anna Ferrulli
- Department of Endocrinology, Nutrition and Metabolic Diseases, IRCCS MultiMedica, Sesto San Giovanni, Milan, Italy
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Stefano Bianchi
- Division of Gynecology and Obstetrics, IRCCS MultiMedica, Milan, Italy
| | | | - Giuseppe Ambrosio
- Cardiology and Cardiovascular Pathophysiology, Azienda Ospedaliero-Universitaria "S. Maria Della Misericordia", Perugia, Italy
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14
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Mavroeidi I, Manta A, Asimakopoulou A, Syrigos A, Paschou SA, Vlachaki E, Nastos C, Kalantaridou S, Peppa M. The Role of the Glycemic Index and Glycemic Load in the Dietary Approach of Gestational Diabetes Mellitus. Nutrients 2024; 16:399. [PMID: 38337683 PMCID: PMC10857473 DOI: 10.3390/nu16030399] [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: 12/14/2023] [Revised: 01/19/2024] [Accepted: 01/20/2024] [Indexed: 02/12/2024] Open
Abstract
Gestational diabetes mellitus (GDM) is a common metabolic disorder that often develops during pregnancy, characterized by glucose intolerance and insulin resistance (IR). To ensure the well-being of both the mother and the fetus, the body undergoes multiple metabolic and immunological changes that result in peripheral IR and, under certain hereditary or acquired abnormalities, GDM in predisposed women. The adverse short- and long-term effects of GDM impact both the mother and the fetus. Nutrition seems to play an important role to prevent GDM or improve its evolution. An emphasis has been given to the proportion of carbohydrates (CHO) relative to protein and lipids, as well as dietary patterns, in GDM. The effects of CHO on postprandial glucose concentrations are reflected in the glycemic index (GI) and glycemic load (GL). Diets rich in GI and GL may induce or exacerbate IR, whereas diets low in GI and GL appear to enhance insulin sensitivity and improve glycemic control. These positive outcomes may be attributed to direct interactions with insulin and glucose homeostasis or indirect effects through improved body composition and weight management. This comprehensive narrative review aims to explore the significance of nutrition, with a focus on the critical evaluation of GI and GL in the dietary management of women with GDM.
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Affiliation(s)
- Ioanna Mavroeidi
- Endocrine Unit, 2nd Propaedeutic Department of Internal Medicine, Research Institute and Diabetes Center, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, 12461 Athens, Greece
| | - Aspasia Manta
- Endocrine Unit, 2nd Propaedeutic Department of Internal Medicine, Research Institute and Diabetes Center, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, 12461 Athens, Greece
| | - Athina Asimakopoulou
- 3rd Department of Internal Medicine, Sotiria General Hospital, 11527 Athens, Greece
| | - Alexandros Syrigos
- 3rd Department of Internal Medicine, Sotiria General Hospital, 11527 Athens, Greece
| | - Stavroula A Paschou
- Endocrine Unit and Diabetes Center, Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Efthimia Vlachaki
- Hematological Laboratory, 2nd Department of Internal Medicine, Hippokrateion Hospital, Aristotle University, 54640 Thessaloniki, Greece
| | - Constantinos Nastos
- 3rd Department of Surgery, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, 12461 Athens, Greece
| | - Sophia Kalantaridou
- Department of Obstetrics and Gynecology, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, 12461 Athens, Greece
| | - Melpomeni Peppa
- Endocrine Unit, 2nd Propaedeutic Department of Internal Medicine, Research Institute and Diabetes Center, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, 12461 Athens, Greece
- 3rd Department of Internal Medicine, Sotiria General Hospital, 11527 Athens, Greece
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15
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Bednarz K, Kozieł K, Urbańska EM. Novel Activity of Oral Hypoglycemic Agents Linked with Decreased Formation of Tryptophan Metabolite, Kynurenic Acid. Life (Basel) 2024; 14:127. [PMID: 38255742 PMCID: PMC10820136 DOI: 10.3390/life14010127] [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: 12/12/2023] [Revised: 12/29/2023] [Accepted: 01/13/2024] [Indexed: 01/24/2024] Open
Abstract
Kynurenic acid is a tryptophan (Trp) metabolite formed along the kynurenine (KYN) pathway in the brain and in peripheral tissues. The disturbed formation of kynurenic acid, which targets glutamate-mediated neurotransmission, GPR35, and aryl hydrocarbon receptors of immune or redox status, was implicated in the development of neuropsychiatric and metabolic disorders among others. Kynurenic acid exerts neuroprotective and immunomodulatory effects, yet its high brain levels may negatively impact cognition. Changes in the Trp-KYN pathway are also linked with the pathogenesis of diabetes mellitus, which is an established risk factor for cardiovascular and neurological diseases or cognitive deficits. Here, the effects of metformin and glibenclamide on the brain synthesis of kynurenic acid were evaluated. Acute exposure of rat cortical slices in vitro to either of the drugs reduced kynurenic acid production de novo. Glibenclamide, but not metformin, inhibited the activity of kynurenic acid biosynthetic enzymes, kynurenine aminotransferases (KATs) I and II, in semi-purified cortical homogenates. The reduced availability of kynurenic acid may be regarded as an unwanted effect, possibly alleviating the neuroprotective action of oral hypoglycemic agents. On the other hand, considering that both compounds ameliorate the cognitive deficits in animal and human studies and that high brain kynurenic acid may hamper learning and memory, its diminished synthesis may improve cognition.
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Affiliation(s)
| | | | - Ewa M. Urbańska
- Laboratory of Cellular and Molecular Pharmacology, Chair and Department of Clinical and Experimental Pharmacology, Medical University, 20-090 Lublin, Poland; (K.B.)
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Gao BB, Zhang QQ, Dong SQ, Gao F, Liu X, Wei J, Lu Y. Association of MST1 in the First Trimester of Pregnancy with Gestational Diabetes Mellitus and Adverse Pregnancy Outcomes. Diabetes Metab Syndr Obes 2024; 17:19-29. [PMID: 38192496 PMCID: PMC10773263 DOI: 10.2147/dmso.s436178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 12/12/2023] [Indexed: 01/10/2024] Open
Abstract
Aim We investigate the association of mammalian sterile line 20-like kinase 1 (MST1) in the first trimester with the risks of gestational diabetes mellitus (GDM) and adverse pregnancy outcomes. Methods Pregnancies were recruited during their first antenatal care visit between 8 and 12 gestational weeks. These pregnancies underwent an oral glucose tolerance test between 24 and 28 gestational weeks and were followed up until delivery. Serum MST1 levels at 8-12 gestational weeks and 24-28 gestational weeks were measured using an enzyme-linked immunosorbent assay (ELISA) kit. Logistic regression models were used to evaluate the association between MST1 levels in the first trimester and the risks of GDM and adverse pregnancy outcomes. Results This cohort study enrolled a total of 231 pregnancies. GDM was present in 42 (18.18%) women. Compared to the normal glucose tolerance (NGT) group, the GDM group had higher levels of FPG, HOMA-IR, and MST1 both in the first and second trimesters, but had lower HOMA-β levels only in the second trimester. Then participants were classified according to the median MST1 value in the first trimester. Incidences of GDM, composite adverse pregnancy outcomes, preterm birth, and macrosomia increased in women with higher MST1 values. Serum MST1 in the first trimester was correlated with FPG, 1hr PG, 2hr PG, and HOMA-IR, while inversely correlated with HOMA-β in the second trimester. Furthermore, after adjusting for traditional risk factors, women with higher first-trimester MST1 values had greater odds of GDM, composite adverse pregnancy outcomes, preterm birth, and macrosomia (aOR 2.276, P=0.030; aOR 2.690, P=0.003; aOR 3.210, P=0.048; aOR 5.488, P=0.010). Conclusion Elevated levels of MST1 in the first trimester of pregnancies are associated with increased risks of GDM and adverse pregnancy outcomes.
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Affiliation(s)
- Bai-Bing Gao
- Department of Endocrinology, The Affiliated Taizhou People’s Hospital of Nanjing Medical University, Taizhou School of Clinical Medicine, Nanjing Medical University, Taizhou, 225300, People’s Republic of China
- Dalian Medical University, Dalian, Liaoning, 116044, People’s Republic of China
| | - Qing-qing Zhang
- Department of Endocrinology, The Affiliated Taizhou People’s Hospital of Nanjing Medical University, Taizhou School of Clinical Medicine, Nanjing Medical University, Taizhou, 225300, People’s Republic of China
| | - Shu-qin Dong
- Department of Endocrinology, The Affiliated Taizhou People’s Hospital of Nanjing Medical University, Taizhou School of Clinical Medicine, Nanjing Medical University, Taizhou, 225300, People’s Republic of China
- Dalian Medical University, Dalian, Liaoning, 116044, People’s Republic of China
| | - Fei Gao
- Department of Endocrinology, The Affiliated Taizhou People’s Hospital of Nanjing Medical University, Taizhou School of Clinical Medicine, Nanjing Medical University, Taizhou, 225300, People’s Republic of China
- Dalian Medical University, Dalian, Liaoning, 116044, People’s Republic of China
| | - Xia Liu
- Department of Obstetrics and Gynecology, The Affiliated Taizhou People’s Hospital of Nanjing Medical University, Taizhou School of Clinical Medicine, Nanjing Medical University, Taizhou, 225300, People’s Republic of China
| | - Jing Wei
- Department of Obstetrics and Gynecology, The Affiliated Taizhou People’s Hospital of Nanjing Medical University, Taizhou School of Clinical Medicine, Nanjing Medical University, Taizhou, 225300, People’s Republic of China
| | - Yu Lu
- Department of Endocrinology, The Affiliated Taizhou People’s Hospital of Nanjing Medical University, Taizhou School of Clinical Medicine, Nanjing Medical University, Taizhou, 225300, People’s Republic of China
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17
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Xie YP, Lin S, Xie BY, Zhao HF. Recent progress in metabolic reprogramming in gestational diabetes mellitus: a review. Front Endocrinol (Lausanne) 2024; 14:1284160. [PMID: 38234430 PMCID: PMC10791831 DOI: 10.3389/fendo.2023.1284160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 12/11/2023] [Indexed: 01/19/2024] Open
Abstract
Gestational diabetes mellitus is a prevalent metabolic disease that can impact the normal course of pregnancy and delivery, leading to adverse outcomes for both mother and child. Its pathogenesis is complex and involves various factors, such as insulin resistance and β-cell dysfunction. Metabolic reprogramming, which involves mitochondrial oxidative phosphorylation and glycolysis, is crucial for maintaining human metabolic balance and is involved in the pathogenesis and progression of gestational diabetes mellitus. However, research on the link and metabolic pathways between metabolic reprogramming and gestational diabetes mellitus is limited. Therefore, we reviewed the relationship between metabolic reprogramming and gestational diabetes mellitus to provide new therapeutic strategies for maternal health during pregnancy and reduce the risk of developing gestational diabetes mellitus.
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Affiliation(s)
- Ya-ping Xie
- Nursing Department, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian, China
| | - Shu Lin
- Centre of Neurological and Metabolic Research, the Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian, China
- Group of Neuroendocrinology, Garvan Institute of Medical Research, Sydney, NSW, Australia
| | - Bao-yuan Xie
- Nursing Department, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian, China
| | - Hui-fen Zhao
- Nursing Department, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian, China
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18
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Slouha E, Gates KM, Al-Geizi H, Baah E, Clunes LA, Kollias TF. The Relationship Between Gestational Diabetes and the Risk of Cancer: A Systematic Review. Cureus 2024; 16:e53328. [PMID: 38435884 PMCID: PMC10906975 DOI: 10.7759/cureus.53328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/31/2024] [Indexed: 03/05/2024] Open
Abstract
Gestational diabetes mellitus (GDM) is one of the most common endocrine disorders to occur during pregnancy due to the increase in circulating human placental lactogen (hPL) and possible beta-cell sensitivity. While GDM can be managed either with diet and exercise or pharmacological interventions, it is associated with significant maternal and neonatal complications. Maternal complications include short- and long-term conditions such as pre-eclampsia, preterm birth, arrest of labor, future development of type 2 diabetes mellitus (T2DM), and cardiovascular disorders. Neonates can develop hypoglycemia and hypocalcemia and have a large gestational age (LGA). New research has also highlighted another possible long-term complication for both mothers and offspring, which is the development of cancer. Cancer has various types of progression, but most cause systemic symptoms leading to a reduced quality of life. Cancer can be terminal and can affect the majority of the population; thus, significant effort is being employed to try and reduce its occurrence. This systematic review was conducted with adherence to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines using PubMed, ScienceDirect, and ProQuest databases. Initially, 136,019 publications were identified. Through the screening process, a total of 27 publications were finalized within the scope of this paper. Most studies observing maternal cancer with a history of GDM found that there was an association between the increased risk of cancer and GDM. Specifically, these studies identified the association of GDM with breast, ovarian, cervical, and uterine cancer, as well as other non-reproductive organs such as the thyroid and pancreas. Cancer development in the offspring also presented an association with mothers who developed GDM. The most prevalent cancer evaluated was leukemia, and it was specifically associated with a maternal history of GDM. With the consistent rise in the incidence of cancer, any attempts to reduce its development are imperative to assess. While GDM is essentially a temporary condition that resolves following pregnancy in most patients, the possibility of contributing to future conditions years after its occurrence creates a sense of urgency and necessity to reduce the incidence of GDM. Researchers should be able to identify other unknown biomarkers that contribute to the development of cancer in mothers who experienced GDM as well as their infants.
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Affiliation(s)
- Ethan Slouha
- Anatomical Sciences, St. George's University School of Medicine, St. George's, GRD
| | - Kaitlyn M Gates
- Pharmacology, St. George's University School of Medicine, St. George's, GRD
| | - Hanin Al-Geizi
- Pharmacology, St. George's University School of Medicine, St. George's, GRD
| | - Esther Baah
- Pharmacology, St. George's University School of Medicine, St. George's, GRD
| | - Lucy A Clunes
- Pharmacology, St. George's University School of Medicine, St. George's, GRD
| | - Theofanis F Kollias
- Microbiology, Immunology, and Pharmacology, St. George's University School of Medicine, St. George's, GRD
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Hou S, Xiao X, Chen D. Ultrasonographic abdominal adipose tissue thickness for the prediction of gestational diabetes mellitus: A meta-analysis. BIOMOLECULES & BIOMEDICINE 2023; 24:698-707. [PMID: 38112517 PMCID: PMC11293221 DOI: 10.17305/bb.2023.9902] [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: 10/10/2023] [Revised: 11/04/2023] [Accepted: 12/18/2023] [Indexed: 12/21/2023]
Abstract
Obesity has been linked to the risk of gestational diabetes mellitus (GDM). The meta-analysis aimed to assess the predictive role of ultrasonographic measurements of the abdominal adipose tissue thickness for GDM in pregnant women. Cohort studies evaluating the association between abdominal subcutaneous and/or visceral adipose thickness (SAT and/or VAT) and subsequent risk of GDM were retrieved from PubMed, Embase, and Web of Science databases. Only studies with SAT/VAT measured before the diagnosis of GDM were included. Random-effects models incorporating the influence of potential heterogeneity were used to pool the results. A total of 13 studies involving 5616 pregnant women were included. Pooled results showed that both a high abdominal SAT (odds ratio [OR] for per 1-cm increment: 1.23, 95% confidence interval [CI]: 1.07 to 1.41, P = 0.003, I2 = 13%; OR for high versus low category: 3.42, 95% CI: 2.31 to 5.07, P < 0.001, I2 = 0%) and VAT (OR for per 1-cm increment: 1.54, 95% CI: 1.16 to 2.06, P = 0.003, I2 = 63%; OR for high versus low category: 5.73, 95% CI: 3.39 to 9.77, P < 0.001, I2 = 31%) at early stages of pregnancy were associated with a higher subsequent risk of GDM. Subgroup analysis based on study design, timing of ultrasound examination, GDM diagnostic criteria, and study quality score showed consistent results. In conclusion, ultrasound-measured abdominal adipose tissue thickness may be useful for predicting the subsequent risk of GDM in pregnant women.
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Affiliation(s)
- Shuhong Hou
- Department of Ultrasound, Longyan First Hospital Affiliated to Fujian Medical University, Longyan, Fujian Province, China
| | - Xiaoqing Xiao
- Department of Ultrasound, Longyan First Hospital Affiliated to Fujian Medical University, Longyan, Fujian Province, China
| | - Dongping Chen
- Department of Internal Medicine, Longyan First Hospital Affiliated to Fujian Medical University, Longyan, Fujian Province, China
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Minami M, Watanabe T, Eitoku M, Maeda N, Fujieda M, Suganuma N. Association between eating habits during adolescence and gestational diabetes: data from the Japan environment and children's study. J Diabetes Metab Disord 2023; 22:1625-1633. [PMID: 37975095 PMCID: PMC10638231 DOI: 10.1007/s40200-023-01294-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 08/28/2023] [Indexed: 11/19/2023]
Abstract
Purpose It is difficult to change pre-pregnancy eating habits, yet establishing healthy eating habits before pregnancy is important for preventing gestational diabetes mellitus (GDM). This study aimed to examine whether the weight-loss behavior of avoiding between-meal and midnight snacking in teenagers is associated with a reduction in the risk of subsequent GDM. Methods We used a dataset (jecs-an-20,180,131) from a nationwide, prospective birth cohort study, the Japan Environment and Children's Study (JECS). We included 89,227 (85.7% of the total) mother-infant pairs with live births. Participants in their second or third trimester were asked to report their weight-loss behavior during their teenage years. The prevalence of GDM was investigated. Differences in maternal characteristics were examined using chi-square tests. Crude and adjusted logistic regression models were constructed to assess the associations of various maternal characteristics with the weight-loss behavior of avoiding between-meal and midnight snacking during teenage years. Results A total of 2,066 (2.3%) participants had GDM. Weight-loss behavior in teenagers was associated with a decreased risk of GDM. Among participants with normal weight or overweight prior to pregnancy, the adjusted odds ratios were 0.79 (95% confidence interval, 0.70-0.89) and 0.82 (95% confidence interval, 0.69-0.98), respectively. Conclusions The results suggest that teenage weight-loss behaviors, such as avoiding between-meal and midnight snacking, are associated with a decreased risk of developing GDM. Supplementary Information The online version contains supplementary material available at 10.1007/s40200-023-01294-2.
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Affiliation(s)
- Marina Minami
- Department of Environmental Medicine, Kochi Medical School, Kochi University, Nankoku, Kochi Japan
- Integrated Center for Advanced Medical Technologies (ICAM-Tech), Kochi Medical School, Nankoku, Kochi Japan
| | - Takafumi Watanabe
- Department of Obstetrics and Gynecology, Kochi Medical School, Kochi University, Nankoku, Kochi Japan
| | - Masamitsu Eitoku
- Department of Environmental Medicine, Kochi Medical School, Kochi University, Nankoku, Kochi Japan
| | - Nagamasa Maeda
- Integrated Center for Advanced Medical Technologies (ICAM-Tech), Kochi Medical School, Nankoku, Kochi Japan
| | - Mikiya Fujieda
- Department of Pediatrics, Kochi Medical School, Kochi University, Nankoku, Kochi Japan
| | - Narufumi Suganuma
- Department of Environmental Medicine, Kochi Medical School, Kochi University, Nankoku, Kochi Japan
| | - the Japan Environment and Children’s Study (JECS) Group
- Department of Environmental Medicine, Kochi Medical School, Kochi University, Nankoku, Kochi Japan
- Integrated Center for Advanced Medical Technologies (ICAM-Tech), Kochi Medical School, Nankoku, Kochi Japan
- Department of Obstetrics and Gynecology, Kochi Medical School, Kochi University, Nankoku, Kochi Japan
- Department of Pediatrics, Kochi Medical School, Kochi University, Nankoku, Kochi Japan
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21
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Sun Y, Zhang Y. Blood manganese level and gestational diabetes mellitus: a systematic review and meta-analysis. J OBSTET GYNAECOL 2023; 43:2266646. [PMID: 37921106 DOI: 10.1080/01443615.2023.2266646] [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: 05/26/2023] [Accepted: 09/29/2023] [Indexed: 11/04/2023]
Abstract
BACKGROUND Previous studies evaluating the relationship between blood manganese (Mn) level and gestational diabetes mellitus (GDM) in pregnant women showed inconsistent results. A systematic review and meta-analysis was therefore performed to investigate the above association. METHODS Relevant observational studies were obtained by search of electronic databases including Medline, Embase, Cochrane Library and Web of Science from database inception to 10 March 2023. Two authors independently performed database search, literature identification and data extraction. A randomised-effects model was selected to pool the data by incorporating the influence of potential heterogeneity. Subgroup analysis was performed to evaluate the influence of study characteristics on the results of the meta-analysis. RESULTS Six datasets from five observational studies, involving 91,249 pregnant women were included in the meta-analysis. Among the participants, 3597 (3.9%) were diagnosed as GDM. Overall, pooled results showed that a high blood level of Mn was associated with a higher risk of GDM (compared between women with highest versus lowest category blood Mn, odds ratio: 1.31, 95% confidence interval: 1.19-1.44, p < .001) with no significant heterogeneity (p for Cochrane Q-test = 0.93, I2 = 0%). Subgroup analyses according to study design, mean maternal age, matrix or methods for measuring blood Mn, and the incidence of GDM also showed consistent results (p for subgroup difference all >.05). CONCLUSIONS Results of the meta-analysis suggest that a high blood Mn level may be a risk factor of GDM in pregnant women. Studies are needed to determine the underlying mechanisms, and to investigate if the relationship between blood Mn level and GDM is dose-dependent.
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Affiliation(s)
- Yingmei Sun
- Department of Gynaecology and Obstetrics, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Yu Zhang
- Department of Gynaecology and Obstetrics, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
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Zeng Q, Yang T, Wei W, Zou D, Wei Y, Han F, He J, Huang J, Guo R. Association between GLO1 variants and gestational diabetes mellitus susceptibility in a Chinese population: a preliminary study. Front Endocrinol (Lausanne) 2023; 14:1235581. [PMID: 38027126 PMCID: PMC10656739 DOI: 10.3389/fendo.2023.1235581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 10/06/2023] [Indexed: 12/01/2023] Open
Abstract
Background Glyoxalase 1 (GLO1) plays a crucial role in defending against glycation. Single nucleotide polymorphism (SNP) variants in the GLO1 gene may affect gene expression and alter enzyme activity. However, there have been limited studies evaluating the association between GLO1 and diabetes, especially gestational diabetes mellitus (GDM). Therefore, this study is the first to explore the association of GLO1 SNPs and GDM risk. Methods The study included a total of 500 GDM patients and 502 control subjects. The SNPscan™ genotyping assay was used to genotype rs1781735, rs4746 and rs1130534. To assess the disparities in genotype, allele, and haplotype distributions and their correlation with GDM risk, the independent sample t-test, logistic regression, and chi-square test were employed during the data processing phase. Furthermore, one-way ANOVA was conducted to determine the differences in genotype and blood glucose and methylglyoxal(MG) levels. Results Significant differences were observed in prepregnancy body mass index (pre-BMI), age, systolic blood pressure (SBP), diastolic blood pressure (DBP), and parity between GDM and healthy subjects (P < 0.05). After adjusting for these factors, GLO1 rs1130534 TA remained associated with an increased risk of GDM (TA vs. TT + AA: OR = 1.320; 95% CI: 1.008-1.728; P = 0.044), especially in the pre-BMI ≥ 24 subgroup (TA vs. TT + AA: OR = 2.424; 95% CI: 1.048-5.607; P = 0.039), with fasting glucose levels being significantly elevated in the TA genotype compared to the TT genotype (P < 0.05). Conversely, the GLO1 rs4746 TG was associated with a decreased risk of GDM (TG vs. TT: OR = 0.740; 95% CI: 0.548-0.999; P = 0.049; TG vs. TT + GG: OR = 0.740; 95% CI: 0.548-0.998; P = 0.048). Additionally, the haplotype T-G-T of rs1781735, rs4746 and rs1130534 was associated with a decreased risk of GDM among individuals with a pre-BMI ≥ 24 (OR = 0.423; 95% CI: 0.188-0.955; P = 0.038). Furthermore, the rs1781735 GG genotype was found to be more closely related to maternal MG accumulation and neonatal weight gain (P < 0.05). Conclusion Our findings suggested that GLO1 rs1130534 was associated with an increased susceptibility to GDM and higher blood glucose levels, but GLO1 rs4746 was associated with a decreased risk of GDM. The rs1781735 has been associated with the accumulation of maternal MG and subsequent weight gain in neonates.
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Affiliation(s)
- Qiaoli Zeng
- Department of Internal Medicine, Shunde Women and Children’s Hospital (Maternity and Child Healthcare Hospital of Shunde Foshan), Guangdong Medical University, Foshan, Guangdong, China
- Key Laboratory of Research in Maternal and Child Medicine and Birth Defects, Guangdong Medical University, Foshan, Guangdong, China
- Maternal and Child Research Institute, Shunde Women and Children’s Hospital (Maternity and Child Healthcare Hospital of Shunde Foshan), Guangdong Medical University, Foshan, Guangdong, China
| | - Taili Yang
- Department of Internal Medicine, Shunde Women and Children’s Hospital (Maternity and Child Healthcare Hospital of Shunde Foshan), Guangdong Medical University, Foshan, Guangdong, China
- Key Laboratory of Research in Maternal and Child Medicine and Birth Defects, Guangdong Medical University, Foshan, Guangdong, China
| | - Wenfeng Wei
- Department of Internal Medicine, Shunde Women and Children’s Hospital (Maternity and Child Healthcare Hospital of Shunde Foshan), Guangdong Medical University, Foshan, Guangdong, China
| | - Dehua Zou
- State Key Laboratory of Quality Research in Chinese Medicine, School of Pharmacy, Macau University of Science and Technology, Taipa, Macao, Macao SAR, China
- Guangdong Engineering Research Center of Chinese Medicine & Disease Susceptibility, Jinan University, Guangzhou, Guangdong, China
| | - Yue Wei
- Department of Ultrasound, Shunde Women and Children’s Hospital (Maternity and Child Healthcare Hospital of Shunde Foshan), Guangdong Medical University, Foshan, Guangdong, China
- Department of Ultrasound, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China
| | - Fengqiong Han
- Department of Obstetric, Shunde Women and Children’s Hospital (Maternity and Child Healthcare Hospital of Shunde Foshan), Guangdong Medical University, Foshan, Guangdong, China
| | - Jieyun He
- Department of Obstetric, Shunde Women and Children’s Hospital (Maternity and Child Healthcare Hospital of Shunde Foshan), Guangdong Medical University, Foshan, Guangdong, China
| | - Jinzhi Huang
- Key Laboratory of Research in Maternal and Child Medicine and Birth Defects, Guangdong Medical University, Foshan, Guangdong, China
- Department of Gynecology, Shunde Women and Children’s Hospital (Maternity and Child Healthcare Hospital of Shunde Foshan), Guangdong Medical University, Foshan, Guangdong, China
| | - Runmin Guo
- Department of Internal Medicine, Shunde Women and Children’s Hospital (Maternity and Child Healthcare Hospital of Shunde Foshan), Guangdong Medical University, Foshan, Guangdong, China
- Key Laboratory of Research in Maternal and Child Medicine and Birth Defects, Guangdong Medical University, Foshan, Guangdong, China
- Maternal and Child Research Institute, Shunde Women and Children’s Hospital (Maternity and Child Healthcare Hospital of Shunde Foshan), Guangdong Medical University, Foshan, Guangdong, China
- Department of Endocrinology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China
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Zhao Y, Gao Q, Li B, Wang Y, Wang Y. Ferroptosis and its potential role in gestational diabetes mellitus: updated evidence from pathogenesis to therapy. Front Endocrinol (Lausanne) 2023; 14:1177547. [PMID: 37664858 PMCID: PMC10471987 DOI: 10.3389/fendo.2023.1177547] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 08/03/2023] [Indexed: 09/05/2023] Open
Abstract
Background Studies have demonstrated that high iron status is positively associated with gestational diabetes mellitus (GDM), implying that iron overload and ferroptosis play important roles in the development of GDM. The aim of this study was to explore effective therapeutic drugs from traditional Chinese medicine (TCM)formulas for the treatment of GDM based on ferroptosis. Methods In this study, the presence of ferroptosis in the placenta was verified through clinical and experimental data, and key genes were subsequently screened for association with ferroptosis in the development of GDM. The analysis was based on transcriptome sequencing of datasets combined with differentially expressed genes (DEGs) analysis and weighted gene correlation network analysis (WGCNA); functional enrichment analysis was also performed. A protein-protein interaction (PPI) network was constructed and pivotal genes were identified using Cytoscape. Finally, traditional Chinese medicine (TCM)formulas related to treating GDM were collected, then the proteins corresponding to the key genes were molecularly docked with the small molecular structures of clinically proven effective herbal tonics, and molecular dynamic simulations were performed to select the best candidates for pharmacological compounds. Results Elevated ferritin levels in patients with GDM were verified using clinical data. The presence of ferroptosis in placental tissues of patients with GDM was confirmed using electron microscopy and western blotting. Ninety-nine key genes with the highest correlation with ferroptosis were identified from DEGs and weighted gene co-expression network analysis (WGCNA). Analysis using the Kyoto Encyclopedia of Genes and Genomes demonstrated that the DEGs were primarily involved in the oxidative phosphorylation pathway. The key genes were further screened by PPI; two key genes, SF3B14 and BABAM1, were identified by combining the gene corresponding to protein structure and function, followed by molecular docking and molecular dynamic simulation. Coptis chinensis was proposed as the best candidate for herbal treatment at the molecular level. Conclusion This data revealed the presence of ferroptosis in patients with GDM and identified possible modulatory roles of ferroptosis-related genes involved in the molecular mechanisms of GDM, providing new insights into the pathogenesis of GDM, which also provided new directions for the systematic optimization of TCM formulas for the management and targeted treatment of GDM.
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Affiliation(s)
- Yan Zhao
- Department of Obstetrics and Gynaecology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Qianqian Gao
- Department of Obstetrics, Weifang People’s Hospital, Weifang, ShanDong, China
| | - Baoxuan Li
- Department of Obstetrics and Gynaecology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Yang Wang
- Department of Obstetrics and Gynaecology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Yue Wang
- Department of Obstetrics and Gynaecology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
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24
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Gao Y, Hu Y, Xiang L. Remnant cholesterol, but not other cholesterol parameters, is associated with gestational diabetes mellitus in pregnant women: a prospective cohort study. J Transl Med 2023; 21:531. [PMID: 37544989 PMCID: PMC10405385 DOI: 10.1186/s12967-023-04322-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 07/01/2023] [Indexed: 08/08/2023] Open
Abstract
OBJECTIVE No evidence has been found of a relationship between remnant cholesterol (RC) and the likelihood of gestational diabetes mellitus (GDM) in pregnant women. The aim of our study was to investigate the link between serum RC at 12-14 weeks of gestation and the risk of GDM. METHODS This was a secondary analysis with data from a prospective cohort study in Korea. A total of 590 single pregnant women attending two hospitals in Korea, up to 14 weeks gestation, from November 2014 to July 2016 were included in the study. The formula used to calculate RC in detail was RC (mg/dL) = TC (mg/dL)-HDL-c (mg/dL)-LDL-c (mg/dL). Logistic regression models were employed to examine the relationship between RC and GDM and explore the association between other lipoprotein cholesterol parameters and the risk of GDM. Furthermore, receiver operating characteristic (ROC) analysis was performed to assess the ability of RC to identify GDM. Additionally, sensitivity and subgroup analyses were conducted. RESULTS The mean age of participants was 32.06 ± 3.80 years. The median of RC was 34.66 mg/dL. 37 pregnant women (6.27%) were eventually diagnosed with GDM. Multivariate adjusted logistic regression analysis showed that RC was positively associated with the risk of GDM (OR = 1.458, 95% CI 1.221, 1.741). There was no significant association between other lipoprotein cholesterols (including TC, LDL-c, HDL-c) and the risk of GDM. The area under the ROC curve for RC as a predictor of GDM was 0.8038 (95% CI 0.7338-0.8738), and the optimal RC cut-off was 24.30 mg/dL. Our findings were demonstrated to be robust by performing a series of sensitivity analyses. CONCLUSION Serum RC levels at 12-14 weeks of gestation are positively associated with GDM risk in pregnant women. RC in early pregnancy is an early warning indicator of GDM in pregnant women, especially those with normal HDL-c, LDL-c, and TC that are easily overlooked. There is a high risk of developing GDM in pregnant women whose RC is more than 24.30 mg/dL. This study may help optimize GDM prevention in pregnant women and facilitate communication between physicians, pregnant patients, and their families.
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Affiliation(s)
- Yajing Gao
- Department of Anesthesiology, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, 518028, China
| | - Yanhua Hu
- College of Information Science and Engineering, Liuzhou Institute of Technology, No. 99, Xinliu Avenue, Yufeng District, Liuzhou, 545616, Guangxi Zhuang Autonomous Region, China.
| | - Lan Xiang
- School of Medical Technology and Nursing, Shenzhen Polytechnic, No.113, Tongfa Road 113, Nanshan District, Shenzhen, 518055, Guangdong, China.
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25
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Zhao G, Zhang F, Zhong Y, Zhang Y, Zhang X, Zhu S, Zhang X, Li T, Zhu W, Li D. Independent and interactive effects of ozone and thermal inversion exposure on the risk of gestational diabetes mellitus in Wuhan, China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:91315-91323. [PMID: 37477814 DOI: 10.1007/s11356-023-28855-5] [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: 02/23/2023] [Accepted: 07/14/2023] [Indexed: 07/22/2023]
Abstract
The adverse effects of exposure to thermal inversion (TI) and ozone (O3) on human health have been reported; however, there are few studies have explored the independent and potential interactive effects of them on gestational diabetes mellitus (GDM). A total of 31,262 pregnant women from the Wuhan Children's Hospital covering the period from 2017 to 2021 were included in this study. The logistic regression adjusted for the covariates was applied to explore the independent effect of exposure to O3 and TI on GDM. The relative excess risk due to the interaction (RERI) analysis was applied to assess the possible interactive effect. Per 10 μg/m3 increased in O3 (OR = 1.069, 95% CI: 1.049, 1.089) during the first trimester and per 10 days increased in TI (OR = 1.041, 95% CI: 1.005, 1.080) in the second trimester were significantly associated with the risk of GDM. The synergistic effect of exposure to TI and O3 was larger than their sum effect (RERI = 0.330, 95% CI: 0.170, 0.476). This study added further support for public health-related policy to improve maternal health by curbing TI and O3.
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Affiliation(s)
- Gaichan Zhao
- Department of Obstetrics and Gynecology, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430014, China
- Yuhua District Center for Disease Control and Prevebtion, Shijiazhuang, 050021, China
| | - Faxue Zhang
- Department of Occupational and Environmental Health, School of Public Health, Wuhan University, Wuhan, 430071, China
| | - Yuanyuan Zhong
- Department of Obstetrics and Gynecology, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430014, China
| | - Yan Zhang
- Department of Obstetrics and Gynecology, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430014, China
| | - Xupeng Zhang
- Department of Public Health, School of Public Health, Wuhan University, Wuhan, 430071, China
| | - Shijie Zhu
- Department of Occupational and Environmental Health, School of Public Health, Wuhan University, Wuhan, 430071, China
| | - Xiaowei Zhang
- Department of Public Health, School of Public Health, Wuhan University, Wuhan, 430071, China
| | - Tianzhou Li
- Department of Occupational and Environmental Health, School of Public Health, Wuhan University, Wuhan, 430071, China
| | - Wei Zhu
- Department of Obstetrics and Gynecology, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430014, China.
- Department of Occupational and Environmental Health, School of Public Health, Wuhan University, Wuhan, 430071, China.
| | - Dejia Li
- Department of Occupational and Environmental Health, School of Public Health, Wuhan University, Wuhan, 430071, China
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26
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Alipour N, Fallahnezhad S, Bagheri J, Babaloo H, Tahmasebi F, Sazegar G, Haghir H. Increased Apoptosis in Subcortical Regions of The Visual Pathway in Offspring Born to Diabetic Rats. CELL JOURNAL 2023; 25:564-569. [PMID: 37641418 PMCID: PMC10542209 DOI: 10.22074/cellj.2023.1989649.1232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 06/04/2023] [Accepted: 06/13/2023] [Indexed: 08/31/2023]
Abstract
OBJECTIVE Diabetes in pregnancy is a prevalent disease that can affect the central nervous system of the fetus by hyperglycemia. This study aimed to investigate the impact of maternal diabetes on neuronal apoptosis in the superior colliculus (SC) and the lateral geniculate nucleus (LGN) in male neonates born to diabetic mothers. MATERIALS AND METHODS In this experimental study, female adult rats were separated into three groups: control, diabetic (induced using an intraperitoneal injection of streptozotocin), and insulin-treated diabetic [diabetes controlled by subcutaneous neutral protamine hagedorn (NPH)-insulin injection]. Male neonates from each group were euthanized on 0, 7, and 14 postnatal days (P0, P7, and P14, respectively), and apoptotic cells were identified using TUNEL staining. RESULTS The numerical density per unit area (NA) of apoptotic cells was significantly higher in SC and the dorsal LGN (dLGN) in neonates born to the diabetic rats compared to the control group at P0, P7, and P14. However, insulin treatment normalized the number of apoptotic cells. CONCLUSION This study demonstrated that maternal diabetes increased apoptosis in dLGN and SC of male neonates at P0, P7, and P14.
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Affiliation(s)
- Nasim Alipour
- Department of Anatomy and Cell Biology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Somaye Fallahnezhad
- Nervous System Stem Cell Research Center, Semnan University of Medical Sciences, Semnan, Iran
- Department of Anatomical Sciences, School of Medicine, Semnan University of Medical Sciences, Semnan, Iran
| | - Javad Bagheri
- Department of Anatomy and Cell Biology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hamideh Babaloo
- Department of Advanced Medical Sciences and Technologies, School of Paramedicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Medical Nanotechnology and Tissue Engineering Research Center, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Fatemeh Tahmasebi
- Department of Anatomy and Cell Biology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ghasem Sazegar
- Department of Anatomy and Cell Biology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hossein Haghir
- Department of Anatomy and Cell Biology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
- Medical Genetic Research Center (MGRC), School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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Pełech A, Ruszała M, Niebrzydowska-Tatus M, Bień K, Kimber-Trojnar Ż, Czuba M, Świstowska M, Leszczyńska-Gorzelak B. Do Serum Galectin-9 Levels in Women with Gestational Diabetes and Healthy Ones Differ before or after Delivery? A Pilot Study. Biomolecules 2023; 13:biom13040697. [PMID: 37189444 DOI: 10.3390/biom13040697] [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: 03/19/2023] [Revised: 04/16/2023] [Accepted: 04/19/2023] [Indexed: 05/17/2023] Open
Abstract
Gestational diabetes mellitus (GDM) is a common metabolic disease that occurs during pregnancy, with the placenta playing an important role in its pathophysiology. Currently, the role of galectin-9 in the development of GDM is unknown. The aim of this study was to compare galectin-9 concentrations in healthy pregnant women and those with GDM. Galectin-9 levels were assessed in serum samples taken both just before and after delivery, as well as in urine samples collected in the postpartum period. Maternal body composition and hydration status were evaluated using the bioelectrical impedance analysis (BIA) method. There were no statistically significant differences in the concentration of galectin-9 in women with GDM compared to healthy pregnant women in their serum samples taken just before delivery, nor in their serum and urine samples collected in the early postpartum period. However, serum galectin-9 concentrations taken before delivery were positively correlated with BMI and parameters related to the amount of adipose tissue assessed in the early postpartum period. Additionally, there was a correlation between serum galectin-9 concentrations taken before and after delivery. Galectin-9 is unlikely to become a diagnostic marker for GDM. However, this subject requires further clinical research in larger groups.
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Affiliation(s)
- Aleksandra Pełech
- Department of Obstetrics and Perinatology, Medical University of Lublin, 20-090 Lublin, Poland
| | - Monika Ruszała
- Department of Obstetrics and Perinatology, Medical University of Lublin, 20-090 Lublin, Poland
| | | | - Katarzyna Bień
- Department of Obstetrics and Perinatology, Medical University of Lublin, 20-090 Lublin, Poland
| | - Żaneta Kimber-Trojnar
- Department of Obstetrics and Perinatology, Medical University of Lublin, 20-090 Lublin, Poland
| | - Monika Czuba
- Department of Clinical Genetics, Medical University of Lublin, 20-080 Lublin, Poland
| | - Małgorzata Świstowska
- Department of Clinical Genetics, Medical University of Lublin, 20-080 Lublin, Poland
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Pinto S, Croce L, Carlier L, Cosson E, Rotondi M. Thyroid dysfunction during gestation and gestational diabetes mellitus: a complex relationship. J Endocrinol Invest 2023:10.1007/s40618-023-02079-3. [PMID: 37024642 PMCID: PMC10372128 DOI: 10.1007/s40618-023-02079-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 03/24/2023] [Indexed: 04/08/2023]
Abstract
PURPOSE Gestational diabetes mellitus (GDM) and thyroid dysfunction during gestation (GTD) are the two most prevalent endocrinopathies during pregnancy. The aim of the present review is to provide an overview of the peculiar aspects of GDM and GTD, to highlight the potential interactions and clinical consequences of these two frequent clinical conditions. METHODS A literature review regarding GDM and GTD was carried out with particular interest on meta-analyses and human studies dealing with the (i) shared risk factors between GDM and GTD, (ii) the epidemiological link between GTD and GDM, (iii) physiopathologic link between GTD and GDM, (iv) clinical consequences of GDM and GTD, and (v) post-partum implications of GDM and GTD. RESULTS The association between GDM and GTD is common and may be explained by the insulin-resistance state due to maternal GTD, to alterations in the placentation process or to the many shared risk factors. Discrepant results of epidemiologic studies can be explained, at least in part, by the changes in diagnostic criteria and screening strategies throughout the years for both conditions. GDM and GTD impact pregnancy outcome and have post-partum long-term consequences, but more studies are needed to prove an additional adverse effect. CONCLUSIONS Based on the epidemiological and physio-pathological link between GDM and GTD, it could be suggested that a diagnosis of GTD could lead to screen GDM and the other way round.
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Affiliation(s)
- S Pinto
- AP-HP, Department of Endocrinology-Diabetology-Nutrition, Avicenne Hospital, Université Paris 13, Sorbonne Paris Cité, CRNH-IdF, CINFO, Bobigny, France
- AP-HP, Ambulatory Unit of Endocrinology-Diabetology-Nutrition, Jean Verdier Hospital, Université Paris 13, Sorbonne Paris Cité, CRNH-IdF, CINFO, Bondy, France
| | - L Croce
- Department of Internal Medicine and Therapeutics, University of Pavia, 27100, Pavia, PV, Italy
- Unit of Endocrinology and Metabolism, Laboratory for Endocrine Disruptors, Istituti Clinici Scientifici Maugeri IRCCS, Department of Internal Medicine and Therapeutics, University of Pavia, Via S. Maugeri 4, 27100, Pavia, PV, Italy
- NBFC, National Biodiversity Future Center, 90133, Palermo, PA, Italy
| | - L Carlier
- AP-HP, Ambulatory Unit of Endocrinology-Diabetology-Nutrition, Jean Verdier Hospital, Université Paris 13, Sorbonne Paris Cité, CRNH-IdF, CINFO, Bondy, France
| | - E Cosson
- AP-HP, Department of Endocrinology-Diabetology-Nutrition, Avicenne Hospital, Université Paris 13, Sorbonne Paris Cité, CRNH-IdF, CINFO, Bobigny, France
- UMR U1153 INSERM/U11125 INRA/CNAM/Université Paris 13, Unité de Recherche Epidémiologique Nutritionnelle, Bobigny, France
| | - M Rotondi
- Department of Internal Medicine and Therapeutics, University of Pavia, 27100, Pavia, PV, Italy.
- Unit of Endocrinology and Metabolism, Laboratory for Endocrine Disruptors, Istituti Clinici Scientifici Maugeri IRCCS, Department of Internal Medicine and Therapeutics, University of Pavia, Via S. Maugeri 4, 27100, Pavia, PV, Italy.
- NBFC, National Biodiversity Future Center, 90133, Palermo, PA, Italy.
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Zeng Q, Zou D, Liu N, Wei Y, Yang J, Wu W, Han F, He R, Guo R. Association of miR-196a2 and miR-27a polymorphisms with gestational diabetes mellitus susceptibility in a Chinese population. Front Endocrinol (Lausanne) 2023; 14:1127336. [PMID: 37113490 PMCID: PMC10127250 DOI: 10.3389/fendo.2023.1127336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 03/20/2023] [Indexed: 04/08/2023] Open
Abstract
IntroductionMiR-196a2 and miR-27a play a key role in the regulation of the insulin signaling pathway. Previous studies have indicated that miR-27a rs895819 and miR-196a2 rs11614913 have a strong association with type 2 diabetes (T2DM), but very few studies have investigated their role in gestational diabetes mellitus (GDM).MethodsA total of 500 GDM patients and 502 control subjects were enrolled in this study. Using the SNPscan™ genotyping assay, rs11614913 and rs895819 were genotyped. In the data treatment process, the independent sample t test, logistic regression and chi-square test were used to evaluate the differences in genotype, allele, and haplotype distributions and their associations with GDM risk. One-way ANOVA was conducted to determine the differences in genotype and blood glucose level.ResultsThere were obvious differences in prepregnancy body mass index (pre-BMI), age, systolic blood pressure (SBP), diastolic blood pressure (DBP) and parity between GDM and healthy subjects (P < 0.05). After adjusting for the above factors, the miR-27a rs895819 C allele was still associated with an increased risk of GDM (C vs. T: OR=1.245; 95% CI: 1.011-1.533; P = 0.039) and the TT-CC genotype of rs11614913-rs895819 was related to an increased GDM risk (OR=3.989; 95% CI: 1.309-12.16; P = 0.015). In addition, the haplotype T-C had a positive interaction with GDM (OR=1.376; 95% CI: 1.075-1.790; P=0.018), especially in the 18.5 ≤ pre-BMI < 24 group (OR=1.403; 95% CI: 1.026-1.921; P=0.034). Moreover, the blood glucose level of the rs895819 CC genotype was significantly higher than that of the TT and TC genotypes (P < 0.05). The TT-CC genotype of rs11614913-rs895819 showed that the blood glucose level was significantly higher than that of the other genotypes.DiscussionOur findings suggest that miR-27a rs895819 is associated with increased GDM susceptibility and higher blood glucose levels.
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Affiliation(s)
- Qiaoli Zeng
- Department of Internal Medicine, Shunde Women and Children’s Hospital (Maternity and Child Healthcare Hospital of Shunde Foshan), Guangdong Medical University, Foshan, Guangdong, China
- State Key Laboratory of Quality Research in Chinese Medicine, School of Pharmacy, Macau University of Science and Technology, Taipa, Macau, China
- Guangdong Engineering Research Center of Chinese Medicine & Disease Susceptibility, Jinan University, Guangzhou, Guangdong, China
- Key Laboratory of Research in Maternal and Child Medicine and Birth Defects, Guangdong Medical University, Foshan, Guangdong, China
- Matenal and Child Research Institute, Shunde Women and Children’s Hospital (Maternity and Child Healthcare Hospital of Shunde Foshan), Guangdong Medical University, Foshan, Guangdong, China
| | - Dehua Zou
- State Key Laboratory of Quality Research in Chinese Medicine, School of Pharmacy, Macau University of Science and Technology, Taipa, Macau, China
- Guangdong Engineering Research Center of Chinese Medicine & Disease Susceptibility, Jinan University, Guangzhou, Guangdong, China
| | - Na Liu
- Department of Pediatrics, Shunde Women and Children’s Hospital (Maternity and Child Healthcare Hospital of Shunde Foshan), Guangdong Medical University, Foshan, Guangdong, China
| | - Yue Wei
- Department of Ultrasound, Shunde Women and Children’s Hospital (Maternity and Child Healthcare Hospital of Shunde Foshan), Guangdong Medical University, Foshan, Guangdong, China
- Department of Ultrasound, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China
| | - Jing Yang
- Department of Obstetric, Shunde Women and Children’s Hospital (Maternity and Child Healthcare Hospital of Shunde Foshan), Guangdong Medical University, Foshan, Guangdong, China
| | - Weibiao Wu
- Medical Genetics Laboratory, Shunde Women and Children’s Hospital (Maternity and Child Healthcare Hospital of Shunde Foshan), Guangdong Medical University, Foshan, Guangdong, China
| | - Fengqiong Han
- Department of Obstetric, Shunde Women and Children’s Hospital (Maternity and Child Healthcare Hospital of Shunde Foshan), Guangdong Medical University, Foshan, Guangdong, China
- *Correspondence: Fengqiong Han, ; Rongrong He, ; Runmin Guo,
| | - Rongrong He
- State Key Laboratory of Quality Research in Chinese Medicine, School of Pharmacy, Macau University of Science and Technology, Taipa, Macau, China
- Guangdong Engineering Research Center of Chinese Medicine & Disease Susceptibility, Jinan University, Guangzhou, Guangdong, China
- *Correspondence: Fengqiong Han, ; Rongrong He, ; Runmin Guo,
| | - Runmin Guo
- Department of Internal Medicine, Shunde Women and Children’s Hospital (Maternity and Child Healthcare Hospital of Shunde Foshan), Guangdong Medical University, Foshan, Guangdong, China
- Key Laboratory of Research in Maternal and Child Medicine and Birth Defects, Guangdong Medical University, Foshan, Guangdong, China
- Matenal and Child Research Institute, Shunde Women and Children’s Hospital (Maternity and Child Healthcare Hospital of Shunde Foshan), Guangdong Medical University, Foshan, Guangdong, China
- Department of endocrinology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China
- *Correspondence: Fengqiong Han, ; Rongrong He, ; Runmin Guo,
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Li X, Li TT, Tian RX, Fei JJ, Wang XX, Yu HH, Yin ZZ. Gestational diabetes mellitus: The optimal time of delivery. World J Diabetes 2023; 14:179-187. [PMID: 37035228 PMCID: PMC10075038 DOI: 10.4239/wjd.v14.i3.179] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Revised: 01/17/2023] [Accepted: 02/23/2023] [Indexed: 03/15/2023] Open
Abstract
Gestational diabetes mellitus (GDM) is a common pregnancy complication strongly associated with poor maternal-fetal outcomes. Its incidence and prevalence have been increasing in recent years. Women with GDM typically give birth through either vaginal delivery or cesarean section, and the maternal-fetal outcomes are related to several factors such as cervical level, fetal lung maturity, the level of glycemic control still present, and the mode of treatment for the condition. We categorized women with GDM based on the latter two factors. GDM that is managed without medication when it is responsive to nutrition- and exercise-based therapy is considered diet- and exercise-controlled GDM, or class A1 GDM, and GDM managed with medication to achieve adequate glycemic control is considered class A2 GDM. The remaining cases in which neither medical nor nutritional treatment can control glucose levels or patients who do not control their blood sugar are categorized as class A3 GDM. We investigated the optimal time of delivery for women with GDM according to the classification of the condition. This review aimed to address the benefits and harms of giving birth at different weeks of gestation for women with different classes of GDM and attempted to provide an analytical framework and clearer advice on the optimal time for labor.
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Affiliation(s)
- Xuan Li
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, Anhui Province, China
| | - Teng-Teng Li
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, Anhui Province, China
| | - Rui-Xian Tian
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, Anhui Province, China
| | - Jia-Jia Fei
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, Anhui Province, China
| | - Xing-Xing Wang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, Anhui Province, China
| | - Hui-Hui Yu
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, Anhui Province, China
| | - Zong-Zhi Yin
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, Anhui Province, China
- NHC Key Laboratory of the Study of Abnormal Gametes and the Reproductive Tract, Anhui Medical University, Hefei 230022, Anhui Province, China
- Key Laboratory of Population Health Across Life Cycle, Anhui Medical University, Hefei 230022, Anhui Province, China
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Yanachkova V, Staynova R, Stankova T, Kamenov Z. Placental Growth Factor and Pregnancy-Associated Plasma Protein-A as Potential Early Predictors of Gestational Diabetes Mellitus. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59020398. [PMID: 36837599 PMCID: PMC9961527 DOI: 10.3390/medicina59020398] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 01/29/2023] [Accepted: 02/14/2023] [Indexed: 02/22/2023]
Abstract
Gestational diabetes mellitus (GDM) is one of the most common pregnancy complications and one of the main causes of adverse pregnancy outcomes. An early diagnosis of GDM is of fundamental importance in clinical practice. However, the major professional organizations recommend universal screening for GDM, using a 75 g oral glucose tolerance test at 24-28 weeks of gestation. A selective screening at an early stage of pregnancy is recommended only if there are maternal risk factors for diabetes. As a result, the GDM diagnosis is often delayed and established after the appearance of complications. The manifestation of GDM is directly related to insulin resistance, which is closely associated with endothelial dysfunction. The placenta, the placental peptides and hormones play a pivotal role in the manifestation and progression of insulin resistance during pregnancy. Recently, the placental growth factor (PlGF) and plasma-associated protein-A (PAPP-A), have been shown to significantly affect both insulin sensitivity and endothelial function. The principal function of PAPP-A appears to be the cleavage of circulating insulin-like growth factor binding protein-4 while PlGF has been shown to play a central role in the development and maturation of the placental vascular system and circulation. On one hand, these factors are widely used as early predictors (11-13 weeks of gestation) of complications during pregnancy, such as preeclampsia and fetal aneuploidies, in most countries. On the other hand, there is increasing evidence for their predictive role in the development of carbohydrate disorders, but some studies are rather controversial. Therefore, this review aims to summarize the available literature about the potential of serum levels of PlGF and PAPP-A as early predictors in the diagnosis of GDM.
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Affiliation(s)
- Vesselina Yanachkova
- Department of Endocrinology, Specialized Hospital for Active Treatment of Obstetrics and Gynaecology “Dr Shterev”, 1330 Sofia, Bulgaria
| | - Radiana Staynova
- Department of Pharmaceutical Sciences, Faculty of Pharmacy, Medical University of Plovdiv, 4002 Plovdiv, Bulgaria
| | - Teodora Stankova
- Department of Medical Biochemistry, Faculty of Pharmacy, Medical University of Plovdiv, 4002 Plovdiv, Bulgaria
- Correspondence:
| | - Zdravko Kamenov
- Department of Internal Medicine, Medical University of Sofia, 1431 Sofia, Bulgaria
- Clinic of Endocrinology, University Hospital “Alexandrovska”, 1431 Sofia, Bulgaria
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Zyukov OL, Оshyvalova ОО, Biloshytska OK. MATHEMATICAL MODEL FOR PREDICTING FASTING BLOOD GLUCOSE LEVEL IN DIABETES MELLITUS PATIENTS. WIADOMOSCI LEKARSKIE (WARSAW, POLAND : 1960) 2023; 76:2295-2301. [PMID: 37948729 DOI: 10.36740/wlek202310125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2023]
Abstract
OBJECTIVE The aim: To substantiate the use of data on patients' lifestyle, parameters of blood glucose, heart rate, blood pressure and bread units to build a mathematical model for predicting fasting blood glucose level in diabetes mellitus patients to improve existing measures for diabetes prevention. PATIENTS AND METHODS Materials and methods: An open database consisting of the studied parameters of 359 people was used in the research. The linear regression method was used to predict fasting blood glucose level in diabetes mellitus patients. The statistical software IBM SPSS Statistics Version 23 was chosen for calculations. RESULTS Results: To calculate the coefficients of the linear regression equation, stepwise elimination of parameters was chosen. The analysis of the coefficients of influence of independent variables on dependent showed that the greatest effect on the change in glucose level had value of consumed bread units. The model for women diagnosed with type 2 diabetes showed the highest accuracy. CONCLUSION Conclusions: Mathematical modeling made it clear that any malnutrition or health disorders can lead to a significant change in glucose levels. The obtained models consist of a number of parameters, some of which might depend on the presence of concomitant diseases. Further studies should focus on the optimal combination of various parameters taking into account methods of treating comorbidities.
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Affiliation(s)
- Oleg L Zyukov
- STATE INSTITUTION OF SCIENCE «RESEARCH AND PRACTICAL CENTER OF PREVENTIVE AND CLINICAL MEDICINE» STATE ADMINISTRATIVE DEPARTMENT, KYIV, UKRAINE
| | - Оlena О Оshyvalova
- STATE INSTITUTION OF SCIENCE «RESEARCH AND PRACTICAL CENTER OF PREVENTIVE AND CLINICAL MEDICINE» STATE ADMINISTRATIVE DEPARTMENT, KYIV, UKRAINE
| | - Oksana K Biloshytska
- STATE INSTITUTION OF SCIENCE «RESEARCH AND PRACTICAL CENTER OF PREVENTIVE AND CLINICAL MEDICINE» STATE ADMINISTRATIVE DEPARTMENT, KYIV, UKRAINE; NATIONAL TECHNICAL UNIVERSITY OF UKRAINE «IGOR SIKORSKY KYIV POLYTECHNIC INSTITUTE», KYIV, UKRAINE
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