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Kracht CL, Neshteruk CD, Moding KJ, Rolke LJ, Wagner BE, Kielb E, Ferrante MJ, Robinson C, Keinsley J, Colella J, Speirs KE, Luecking CT. Community-based diet and obesity-related policy, system, and environmental interventions for obesity prevention during the first 1000 days: A scoping review. Obes Rev 2024; 25:e13815. [PMID: 39159998 DOI: 10.1111/obr.13815] [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: 11/21/2023] [Revised: 04/19/2024] [Accepted: 07/25/2024] [Indexed: 08/21/2024]
Abstract
Community-based policy, systems, and environmental interventions have the potential to reduce modifiable risk factors for obesity early in life. The purpose of this scoping review was to characterize the breadth, generalizability, and methodological quality of community-based diet and obesity-related policy, system, and environmental interventions during the first 1000 days of life, from pregnancy to 24 months of age. Eight databases were searched, and 83 studies (122 references) were included. Data were extracted for breadth (intervention characteristics), generalizability (reach, effectiveness, adoption, implementation, and maintenance), and study quality (Downs and Black Checklist). Systems and environmental approaches were common (> 80%), relative to policy approaches (39%). The majority (60-69%) occurred in the prenatal period and early infancy (0-3 months), assessed breastfeeding or child growth/obesity (53% for both), and included people with lower income (80%) or racial and/or ethnic minority groups (63%). Many interventions reported positive outcomes (i.e., in the expected direction) for child diet, breastfeeding, and feeding practices (> 62%). Few reported intervention maintenance or spanned the full 1000 days. Most studies were classified as good (32%) or fair (56%) methodological quality. The interventions mainly addressed pregnancy and early infancy. Rigorous and representative investigation is needed to improve intervention reach, sustainability, and application in toddlerhood.
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Affiliation(s)
- Chelsea L Kracht
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
- University of Kansas Medical Center, Kansas City, KS, USA
| | - Cody D Neshteruk
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
- Duke Center for Childhood Obesity Research, Duke University School of Medicine, Durham, NC, USA
| | - Kameron J Moding
- Department of Human Development and Family Science, Purdue University, West Lafayette, IN, USA
| | - Laura J Rolke
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
- Duke Center for Childhood Obesity Research, Duke University School of Medicine, Durham, NC, USA
| | - Brooke E Wagner
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
- Duke Center for Childhood Obesity Research, Duke University School of Medicine, Durham, NC, USA
| | - Elizabeth Kielb
- Department of Human Development and Family Science, Purdue University, West Lafayette, IN, USA
| | - Mackenzie J Ferrante
- Department of Nutritional Sciences, School of Environmental and Biological Sciences, Rutgers University, New Brunswick, NJ, USA
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
| | - Cayla Robinson
- Department of Dietetics and Human Nutrition, Martin-Gatton College of Agriculture, Food and Environment, University of Kentucky, Lexington, KY, USA
| | - Jason Keinsley
- Department of Dietetics and Human Nutrition, Martin-Gatton College of Agriculture, Food and Environment, University of Kentucky, Lexington, KY, USA
| | - Jordan Colella
- Department of Dietetics and Human Nutrition, Martin-Gatton College of Agriculture, Food and Environment, University of Kentucky, Lexington, KY, USA
| | - Katherine E Speirs
- Human Development and Family Science, John and Doris Norton School of Human Ecology, University of Arizona, Tucson, AZ, USA
| | - Courtney T Luecking
- Department of Dietetics and Human Nutrition, Martin-Gatton College of Agriculture, Food and Environment, University of Kentucky, Lexington, KY, USA
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Gao M, Wang H, Li N, Qiao Y, Liu H, Li W, Wang S, Li J, Yu Z, Hu G, Leng J, Yang X. Serum CD44 levels in early pregnancy and its genetic variants for increased risk of gestational diabetes mellitus in Chinese pregnant women. J Proteomics 2024; 307:105268. [PMID: 39097228 DOI: 10.1016/j.jprot.2024.105268] [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: 03/26/2024] [Revised: 07/29/2024] [Accepted: 07/30/2024] [Indexed: 08/05/2024]
Abstract
This study aimed to explore associations of serum cluster of differentiation 44 (CD44) levels and its genetic variants in early pregnancy with gestational diabetes mellitus (GDM). We conducted a 1:1 case-control study (n = 414) nested in a prospective cohort of 22,302 pregnant women recruited from 2010 to 2012 in Tianjin, China. Blood samples were collected at the first antenatal care visit (at a median of 10th gestational week). Binary conditional logistic regressions were performed to examine associations of serum CD44 levels and its genetic variants with increased risk of GDM. In this study, we found that serum CD44 levels in early pregnancy was associated with GDM risk in a U-shaped manner. High serum CD44 levels and its genetic risk score in early pregnancy were associated with markedly increased risk of GDM after adjustment for traditional confounders (OR: 1.95, 95%CI: 1.12-3.40 & 1.95, 1.05-3.61). Furthermore, after adjustment for serum CD44 levels, the OR of CD44 genetic risk score for GDM was slightly attenuated but not significant (1.84, 0.98-3.48). In conclusion, serum CD44 levels and its genetic variants in early pregnancy were associated with GDM risk in Chinese pregnant women, with the effect of CD44 genetic variants being accounted for by serum CD44. SIGNIFICANCE: Recent studies suggested that pregnant women with GDM may have abnormal levels of CD44 and abnormal expression of CD44 gene, but it is uncertain whether abnormal CD44 plays a causal role in occurrence of GDM. Specifically, it remains unknown whether serum CD44 levels in early pregnancy and its genetic variants can predict the later occurrence of GDM. In this study, we found that high serum CD44 levels in early pregnancy and its genetic variants were associated with markedly increased risk of GDM in Chinese pregnant women, with the effect of CD44 genetic variants being largely accounted for by serum CD44 levels. Our study is the first reporting that serum CD44 levels and its genetic variants were associated with markedly increased risk of GDM. These multi-omics risk markers may be useful for identification of women at high risk of GDM in early pregnancy. Our findings also provide new insights into the disease mechanisms.
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Affiliation(s)
- Ming Gao
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Hui Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin 300070, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin 300070, China; Tianjin Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin 300070, China
| | - Ninghua Li
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Yijuan Qiao
- Department of Children's Health, Tianjin Women and Children's Health Center, Tianjin 300070, China
| | - Hongyan Liu
- Department of Children's Health, Tianjin Women and Children's Health Center, Tianjin 300070, China
| | - Weiqin Li
- Department of Children's Health, Tianjin Women and Children's Health Center, Tianjin 300070, China
| | - Shuting Wang
- Department of Children's Health, Tianjin Women and Children's Health Center, Tianjin 300070, China
| | - Jing Li
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin 300070, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin 300070, China; Tianjin Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin 300070, China
| | - Zhijie Yu
- Population Cancer Research Program and Department of Pediatrics, Dalhousie University, Halifax 15000, Canada
| | - Gang Hu
- Chronic Disease Epidemiology Laboratory, Pennington Biomedical Research Center, Baton Rouge, Louisiana 70808, USA
| | - Junhong Leng
- Department of Children's Health, Tianjin Women and Children's Health Center, Tianjin 300070, China.
| | - Xilin Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin 300070, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin 300070, China; Tianjin Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin 300070, China.
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Benhalima K, Geerts I, Calewaert P, Van Rijsselberghe M, Lee D, Bochanen N, Verstraete S, Buyse L, Lewi L, Caron R, Tency I, Staquet M, Vermeersch P, Wens J. The 2024 Flemish consensus on screening for gestational diabetes mellitus early and later in pregnancy. Acta Clin Belg 2024:1-8. [PMID: 39068500 DOI: 10.1080/17843286.2024.2384258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2024] [Accepted: 07/19/2024] [Indexed: 07/30/2024]
Abstract
BACKGROUND Screening for gestational diabetes mellitus (GDM) is important to improve pregnancy outcomes and to prevent type 2 diabetes after pregnancy. Due to a lack of evidence, the 2019 Flemish consensus did not recommend screening for GDM in early pregnancy. Recently, a large randomized controlled trial (TOBOGM) demonstrated that screening for GDM before 20 weeks reduces the risk of neonatal complications in women with risk factors when using higher cut-offs to define GDM compared to the criteria used later in pregnancy. METHODS Based on this new evidence, members of the Diabetes Liga, the Flemish associations of general physicians (Domus Medica), obstetricians (VVOG), midwives (VBOV), diabetes nurse educators (BVVDV), dieticians (VBVD) and clinical chemists (RBSLM) have adapted the Flemish consensus on screening for GDM. BACKGROUND Recommendations: As in 2019, this new consensus recommends universal screening for overt diabetes in early pregnancy preferably by measuring fasting plasma glucose by using the same diagnostic criteria as in the non-pregnant state. Based on the new evidence, women with fasting plasma glucose 95-125 mg/dL (5.3-6.9 mmol/L) before 20 weeks gestation should be diagnosed as early GDM. In addition, in women with obesity and/or a history of GDM, it is advised to perform already a 75 g oral glucose tolerance test (OGTT) between 6 and 20 weeks gestation using higher cut-offs to diagnose early GDM [fasting ≥95 mg/dL (5.3 mmol/L), 1 hour ≥ 19 mg/dL (10.6 mmol/L) and/or 2 hour ≥ 162 mg/dL (9.0 mmol/L))]. The recommendation concerning screening for GDM between 24 and 28 weeks remains unchanged with a diagnosis of GDM based on the 75 g OGTT and IADPSG criteria [fasting ≥ 92 mg/dL (5.1 mmol/L), 1 hour ≥ 180 mg/dL (10.0 mmol/L) and/or 2 hour ≥ 153 mg/dL (8.5 mmol/L)].
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Affiliation(s)
- Katrien Benhalima
- Department of Endocrinology, University hospital Gasthuisberg, KU Leuven, Leuven, Belgium
| | - Ina Geerts
- Department of Endocrinology, University hospital Gasthuisberg, KU Leuven, Leuven, Belgium
| | - Peggy Calewaert
- Department of Endocrinology, University hospital Gasthuisberg, KU Leuven, Leuven, Belgium
| | | | - Dahae Lee
- Department of Endocrinology, Imelda ziekenhuis, Bonheiden, Belgium
| | - Niels Bochanen
- Department of Endocrinology-Diabetology-Metabolism, Antwerp University Hospital, Edegem, Belgium
| | | | | | - Liesbeth Lewi
- Vlaamse Vereniging voor Obstetrie en Gynaecologie (VVOG) and Department of Obstetrics & Gynecology, University hospital Gasthuisberg, KU Leuven, Leuven, Belgium
| | - Rudi Caron
- Beroepsvereniging voor Vlaamse diabetesverpleegkundigen (BVVDV) and Department of Endocrinology, University hospital Gasthuisberg, KU Leuven, Leuven, Belgium
| | - Inge Tency
- Department of Midwifery and Vlaamse Beroepsorganisatie van Vroedvrouwen (VBOV) Werkgroep Wetenschappelijk Onderzoek, Odisee University of Applied Sciences, Sint-Niklaas, Belgium
| | | | - Pieter Vermeersch
- Royal Belgian Society of Laboratory Medicine (RBSLM) and Clinical Biology, University hospital Gasthuisberg, KU Leuven, Leuven, Belgium
| | - Johan Wens
- Domus Medica and Department of Primary and Interdisciplinary Care, University of Antwerp, Wilrijk, Belgium
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Hivert MF, Backman H, Benhalima K, Catalano P, Desoye G, Immanuel J, McKinlay CJD, Meek CL, Nolan CJ, Ram U, Sweeting A, Simmons D, Jawerbaum A. Pathophysiology from preconception, during pregnancy, and beyond. Lancet 2024; 404:158-174. [PMID: 38909619 DOI: 10.1016/s0140-6736(24)00827-4] [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: 01/30/2024] [Revised: 04/07/2024] [Accepted: 04/19/2024] [Indexed: 06/25/2024]
Abstract
Gestational diabetes is the most common medical complication in pregnancy. Historically, gestational diabetes was considered a pregnancy complication involving treatment of rising glycaemia late in the second trimester. However, recent evidence challenges this view. Pre-pregnancy and pregnancy-specific factors influence gestational glycaemia, with open questions regarding roles of non-glycaemic factors in the aetiology and consequences of gestational diabetes. Varying patterns of insulin secretion and resistance in early and late pregnancy underlie a heterogeneity of gestational diabetes in the timing and pathophysiological subtypes with clinical implications: early gestational diabetes and insulin resistant gestational diabetes subtypes are associated with a higher risk of pregnancy complications. Metabolic perturbations of early gestational diabetes can affect early placental development, affecting maternal metabolism and fetal development. Fetal hyperinsulinaemia can affect the development of multiple fetal tissues, with short-term and long-term consequences. Pregnancy complications are prevented by managing glycaemia in early and late pregnancy in some, but not all women with gestational diabetes. A better understanding of the pathophysiology and heterogeneity of gestational diabetes will help to develop novel management approaches with focus on improved prevention of maternal and offspring short-term and long-term complications, from pre-conception, throughout pregnancy, and beyond.
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Affiliation(s)
- Marie-France Hivert
- Division of Chronic Disease Research Across the Lifecourse (CoRAL), Department of Population Medicine, Harvard Medical School, Harvard Pilgrim Health Care Institute, Boston, MA, USA; Diabetes Unit, Massachusetts General Hospital, Boston, MA, USA
| | - Helena Backman
- Faculty of Medicine and Health, Department of Obstetrics and Gynecology, Örebro University, Örebro, Sweden
| | - Katrien Benhalima
- Endocrinology, University Hospital Gasthuisberg, KU Leuven, Leuven, Belgium
| | - Patrick Catalano
- Maternal Infant Research Institute, Obstetrics and Gynecology Research, Tufts Medical Center, Boston, MA, USA; School of Medicine, Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Gernot Desoye
- Department of Obstetrics and Gynaecology, Medical University of Graz, Graz, Austria
| | - Jincy Immanuel
- School of Medicine, Western Sydney University, Sydney, NSW, Australia; Institute for Women's Health, College of Nursing, Texas Woman's University, Denton, TX, USA
| | - Christopher J D McKinlay
- Department of Paediatrics Child and Youth Health, University of Auckland, Auckland, New Zealand; Kidz First Neonatal Care, Te Whatu Ora Counties Manukau, Auckland, New Zealand
| | - Claire L Meek
- Leicester Diabetes Centre, Leicester General Hospital, University of Leicester, Leicester, UK
| | - Christopher J Nolan
- School of Medicine and Psychology, College of Health and Medicine, Australian National University, Canberra, ACT, Australia; Department of Endocrinology, Canberra Health Services, Woden, ACT, Australia
| | - Uma Ram
- Department of Obstetrics and Gynecology, Seethapathy Clinic and Hospital, Chennai, Tamilnadu, India
| | - Arianne Sweeting
- Department of Endocrinology, Royal Prince Alfred Hospital and University of Sydney, Sydney, NSW, Australia
| | - David Simmons
- School of Medicine, Western Sydney University, Sydney, NSW, Australia.
| | - Alicia Jawerbaum
- Facultad de Medicina, Universidad de Buenos Aires (UBA)-CONICET, Buenos Aires, Argentina; Laboratory of Reproduction and Metabolism, CEFYBO-CONICET, Buenos Aires, Argentina
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Malik N, Ahmad A, Ashraf H. Metabolic Profile of Offspring of Mothers with Gestational Diabetes Mellitus. Indian J Endocrinol Metab 2024; 28:192-196. [PMID: 38911115 PMCID: PMC11189277 DOI: 10.4103/ijem.ijem_211_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 09/24/2023] [Accepted: 10/13/2023] [Indexed: 06/25/2024] Open
Abstract
Introduction Gestational diabetes mellitus (GDM) is defined as diabetes diagnosed in the second or third trimester of pregnancy that was not clearly overt diabetes before gestation. Unrecognized and untreated GDM confers significantly greater maternal and fetal risk, which is largely related to the degree of hyperglycemia. The specific risks of diabetes in pregnancy include but are not limited to, spontaneous abortion, pre-eclampsia, fetal anomalies, macrosomia, neonatal hypoglycemia, hyperbilirubinemia, and respiratory distress syndrome. Additionally, GDM is also implicated in long-term metabolic derangements in the offspring in the form of obesity/overweight, hypertension, dysglycemia, insulin resistance, and dyslipidemias later in life. To determine the prevalence of anthropometric and metabolic derangements in children between 1 and 5 years of age, born to women with GDM. Methods This hospital-based cross-sectional study was conducted between November 2019 and November 2021 at our Pediatric Endocrine Clinic. Women were diagnosed as having GDM based on the American Diabetes Association Criteria (2019). History regarding the treatment of the GDM (diet only/diet and medical treatment) and detailed physical examination, including anthropometry and blood pressure, were recorded. Blood samples were collected from children for the estimation of their metabolic profile. Results Overweight, obesity, and severe obesity were present in 18 (11.3%), 2 (1.3%), and 2 (1.3%) children, respectively. Hypertension was found in 21 (19.4%) children. Elevated LDL, triglyceride, and total cholesterol were seen in 3 (1.9%), 84 (52.5%), and 1 (0.6%) children, respectively. Impaired fasting glucose (IFG) was found in 6 (3.8%) children, while 27 (16.9%) subjects were found to be having impaired glucose tolerance after OGTT. Insulin resistance was found in 30 (18.8%) children. GDM mothers with a higher BMI tended to have children with a higher BMI (correlation coefficient, r = .414, P < .001). Higher serum triglyceride levels (r = -0.034, P = 0.672) were recorded in children, irrespective of the BMI of their mothers. There was no significant correlation of maternal BMI with blood pressure (r = -0.134, P = 0.091) or with HOMA-IR (r = 0.00, P = 0.996) in children. However, mothers with a higher BMI had children with statistically higher fasting blood glucose (r = +0.339, P = <0.001) as well as blood glucose 2 hours after OGTT (r = +0.297, P = <0.001). This positive correlation of maternal BMI with the glucose metabolism of their offspring was observed for both male and female genders. Conclusion Children of women with GDM had a higher BMI, and the mode of treatment for GDM did not lead to differences in childhood BMI. The higher BMI of a GDM mother is associated with altered glucose metabolism in their offspring. Deranged levels of triglyceride across the gender were not found to be statistically significant. This has implications for future metabolic and cardiovascular risks in targeting this group for intervention studies to prevent obesity and disorders of glucose metabolism as one potential strategy to prevent adverse metabolic health outcomes.
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Affiliation(s)
- Nazish Malik
- Department of Pediatrics, Jawaharlal Nehru Medical College and Hospital Faculty of Medicine, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - Ayesha Ahmad
- Department of Pediatrics, Jawaharlal Nehru Medical College and Hospital Faculty of Medicine, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - Hamid Ashraf
- Department of Pediatrics, Rajiv Gandhi Centre for Endocrinology, Jawaharlal Nehru Medical College and Hospital Faculty of Medicine, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
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Du H, Li D, Molive LM, Wu N. Advances in free fatty acid profiles in gestational diabetes mellitus. J Transl Med 2024; 22:180. [PMID: 38374136 PMCID: PMC10875910 DOI: 10.1186/s12967-024-04922-4] [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: 11/26/2023] [Accepted: 01/21/2024] [Indexed: 02/21/2024] Open
Abstract
The morbidity of gestational diabetes mellitus (GDM) is increasing and is associated with adverse perinatal outcomes and long-term maternal and infant health. The exact mechanism underlying changes in plasma free fatty acid (FFA) profiles in patients with GDM is unknown. However, it is believed that changes in diet and lipid metabolism may play a role. Fatty acids contain many specific FFAs, and the type of FFA has different impacts on physiological processes; hence, determining changes in FFAs in individual plasma is essential. Alterations in FFA concentration or profile may facilitate insulin resistance. Additionally, some FFAs show potential to predict GDM in early pregnancy and are strongly associated with the growth and development of the fetus and occurrence of macrosomia. Here, we aimed to review changes in FFAs in women with GDM and discuss the relationship of FFAs with GDM incidence and adverse outcomes.
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Affiliation(s)
- Haoyi Du
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, 110004, People's Republic of China
| | - Danyang Li
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, 110004, People's Republic of China
| | - Laura Monjowa Molive
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, 110004, People's Republic of China
| | - Na Wu
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, 110004, People's Republic of China.
- Medical Department, Shengjing Hospital of China Medical University, Liaoning Province, Shenyang, People's Republic of China.
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Chen S, Zhao Z, Luo M, Gao Y, Zhou T, Hu J, Luo L, Liu W, Zhang G. Environmental tobacco smoke increased risk of gestational diabetes mellitus: A birth cohort study in Sichuan, China. Diabetes Metab Res Rev 2024; 40:e3724. [PMID: 37727006 DOI: 10.1002/dmrr.3724] [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: 03/22/2023] [Revised: 06/11/2023] [Accepted: 08/07/2023] [Indexed: 09/21/2023]
Abstract
INTRODUCTION Studies on the relationship between environmental tobacco smoke (ETS) and gestational diabetes mellitus (GDM) are limited. In this study, we aimed to clarify the association between ETS at different trimesters of pregnancy and the risk of GDM among non-smoking pregnant women. METHODS A total of 16,893 non-smoking mothers from the Southwest Birth Cohort, China, were included in the final analyses. Exposure and outcome measures included self-reported ETS status at different trimesters of pregnancy and GDM diagnosis. Multivariable logistic regression models were constructed to estimate the association between ETS and GDM. RESULTS The prevalence of ETS exposure was 25.7%. Compared with no ETS, ever ETS had an increased risk of GDM, with an adjusted odds ratio (95% confidence intervals) of 1.21 (1.09, 1.33). The association remained consistent at different trimesters of pregnancy ETS exposure. In the last trimester and with continuous ETS exposure, the risk of GDM increased significantly with the increase in the duration of the exposure. The risk of GDM associated with ever ETS during pregnancy significantly increased in mothers over 30 years old and pre-pregnancy overweight (P for interaction <0.05). CONCLUSIONS ETS exposure at different trimesters of pregnancy was associated with an increased risk of GDM among non-smoking pregnant women. These findings emphasise the importance of preventing ETS exposure during pregnancy.
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Affiliation(s)
- Shiqi Chen
- Department of Obstetrics, Sichuan Provincial Maternity and Child Health Care Hospital (The Affiliated Women's and Children's Hospital of Chengdu Medical College), Chengdu, Sichuan, China
| | - Ziling Zhao
- Department of Obstetrics, Sichuan Provincial Maternity and Child Health Care Hospital (The Affiliated Women's and Children's Hospital of Chengdu Medical College), Chengdu, Sichuan, China
| | - Min Luo
- Department of Obstetrics, Sichuan Provincial Maternity and Child Health Care Hospital (The Affiliated Women's and Children's Hospital of Chengdu Medical College), Chengdu, Sichuan, China
| | - Yan Gao
- Department of Obstetrics, Sichuan Provincial Maternity and Child Health Care Hospital (The Affiliated Women's and Children's Hospital of Chengdu Medical College), Chengdu, Sichuan, China
| | - Tianjin Zhou
- Department of Obstetrics, Sichuan Provincial Maternity and Child Health Care Hospital (The Affiliated Women's and Children's Hospital of Chengdu Medical College), Chengdu, Sichuan, China
| | - Jinnuo Hu
- Department of Obstetrics, Sichuan Provincial Maternity and Child Health Care Hospital (The Affiliated Women's and Children's Hospital of Chengdu Medical College), Chengdu, Sichuan, China
| | - Liwei Luo
- Department of Obstetrics, Sichuan Provincial Maternity and Child Health Care Hospital (The Affiliated Women's and Children's Hospital of Chengdu Medical College), Chengdu, Sichuan, China
| | - Weixin Liu
- Department of Obstetrics, Sichuan Provincial Maternity and Child Health Care Hospital (The Affiliated Women's and Children's Hospital of Chengdu Medical College), Chengdu, Sichuan, China
| | - Gang Zhang
- Department of Obstetrics, Sichuan Provincial Maternity and Child Health Care Hospital (The Affiliated Women's and Children's Hospital of Chengdu Medical College), Chengdu, Sichuan, China
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Tarry-Adkins JL, Robinson IG, Pantaleão LC, Armstrong JL, Thackray BD, Holzner LMW, Knapton AE, Virtue S, Jenkins B, Koulman A, Murray AJ, Ozanne SE, Aiken CE. The metabolic response of human trophoblasts derived from term placentas to metformin. Diabetologia 2023; 66:2320-2331. [PMID: 37670017 PMCID: PMC10627909 DOI: 10.1007/s00125-023-05996-3] [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: 04/17/2023] [Accepted: 07/18/2023] [Indexed: 09/07/2023]
Abstract
AIMS/HYPOTHESIS Metformin is increasingly used therapeutically during pregnancy worldwide, particularly in the treatment of gestational diabetes, which affects a substantial proportion of pregnant women globally. However, the impact on placental metabolism remains unclear. In view of the association between metformin use in pregnancy and decreased birthweight, it is essential to understand how metformin modulates the bioenergetic and anabolic functions of the placenta. METHODS A cohort of 55 placentas delivered by elective Caesarean section at term was collected from consenting participants. Trophoblasts were isolated from the placental samples and treated in vitro with clinically relevant doses of metformin (0.01 mmol/l or 0.1 mmol/l) or vehicle. Respiratory function was assayed using high-resolution respirometry to measure oxygen concentration and calculated [Formula: see text]. Glycolytic rate and glycolytic stress assays were performed using Agilent Seahorse XF assays. Fatty acid uptake and oxidation measurements were conducted using radioisotope-labelled assays. Lipidomic analysis was conducted using LC-MS. Gene expression and protein analysis were performed using RT-PCR and western blotting, respectively. RESULTS Complex I-supported oxidative phosphorylation was lower in metformin-treated trophoblasts (0.01 mmol/l metformin, 61.7% of control, p<0.05; 0.1 mmol/l metformin, 43.1% of control, p<0.001). The proton efflux rate arising from glycolysis under physiological conditions was increased following metformin treatment, up to 23±5% above control conditions following treatment with 0.1 mmol/l metformin (p<0.01). There was a significant increase in triglyceride concentrations in trophoblasts treated with 0.1 mmol/l metformin (p<0.05), particularly those of esters of long-chain polyunsaturated fatty acids. Fatty acid oxidation was reduced by ~50% in trophoblasts treated with 0.1 mmol/l metformin compared with controls (p<0.001), with no difference in uptake between treatment groups. CONCLUSIONS/INTERPRETATION In primary trophoblasts derived from term placentas metformin treatment caused a reduction in oxidative phosphorylation through partial inactivation of complex I and potentially by other mechanisms. Metformin-treated trophoblasts accumulate lipids, particularly long- and very-long-chain polyunsaturated fatty acids. Our findings raise clinically important questions about the balance of risk of metformin use during pregnancy, particularly in situations where the benefits are not clear-cut and alternative therapies are available.
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Affiliation(s)
- Jane L Tarry-Adkins
- Department of Obstetrics and Gynaecology, the Rosie Hospital and NIHR Cambridge Biomedical Research Centre, University of Cambridge, Cambridge, UK
| | - India G Robinson
- Department of Obstetrics and Gynaecology, the Rosie Hospital and NIHR Cambridge Biomedical Research Centre, University of Cambridge, Cambridge, UK
| | - Lucas C Pantaleão
- Wellcome-MRC Institute of Metabolic Science and Medical Research Council Metabolic Diseases Unit, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK
| | - Jenna L Armstrong
- Department of Physiology, Neuroscience and Development, University of Cambridge, Cambridge, UK
| | - Benjamin D Thackray
- Department of Physiology, Neuroscience and Development, University of Cambridge, Cambridge, UK
| | - Lorenz M W Holzner
- Department of Physiology, Neuroscience and Development, University of Cambridge, Cambridge, UK
| | - Alice E Knapton
- Department of Physiology, Neuroscience and Development, University of Cambridge, Cambridge, UK
| | - Sam Virtue
- Wellcome-MRC Institute of Metabolic Science and Medical Research Council Metabolic Diseases Unit, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK
| | - Benjamin Jenkins
- Wellcome-MRC Institute of Metabolic Science and Medical Research Council Metabolic Diseases Unit, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK
| | - Albert Koulman
- Wellcome-MRC Institute of Metabolic Science and Medical Research Council Metabolic Diseases Unit, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK
| | - Andrew J Murray
- Department of Physiology, Neuroscience and Development, University of Cambridge, Cambridge, UK
- Centre for Trophoblast Research, University of Cambridge, Cambridge, UK
| | - Susan E Ozanne
- Wellcome-MRC Institute of Metabolic Science and Medical Research Council Metabolic Diseases Unit, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK
- Centre for Trophoblast Research, University of Cambridge, Cambridge, UK
| | - Catherine E Aiken
- Department of Obstetrics and Gynaecology, the Rosie Hospital and NIHR Cambridge Biomedical Research Centre, University of Cambridge, Cambridge, UK.
- Wellcome-MRC Institute of Metabolic Science and Medical Research Council Metabolic Diseases Unit, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK.
- Centre for Trophoblast Research, University of Cambridge, Cambridge, UK.
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9
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Nawsherwan, Liu Z, Le Z, Mubarik S, Sun Y, Naeem S, Li H. The adverse effect of gestational diabetes mellitus and hypertensive disorders of pregnancy on maternal-perinatal outcomes among singleton and twin pregnancies: a retrospective cohort study (2011-2019). Front Endocrinol (Lausanne) 2023; 14:1267338. [PMID: 38098860 PMCID: PMC10720659 DOI: 10.3389/fendo.2023.1267338] [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: 08/07/2023] [Accepted: 11/06/2023] [Indexed: 12/17/2023] Open
Abstract
Background Gestational diabetes mellitus (GDM) and hypertensive disorders of pregnancy (HDP) are the predominant pregnancy complications among singleton and twin pregnancies worldwide. Our primary objective was to explore the adverse effect of GDM and HDP on maternal-perinatal outcomes compared with non-GDM and non-HDP in singleton and twin pregnancies. The secondary objective was to find the risk of adverse maternal-perinatal outcomes in twin pregnancies compared with singleton pregnancies complicated with GDM and HDP in Hubei, China. Methods A tertiary hospital-based retrospective study was conducted at Wuhan University Renmin Hospital, Hubei Province, China, from 2011 to 2019. A chi-square test was used to determine the difference in adverse maternal-perinatal outcomes between singleton and twin pregnancies. A multiple binary logistic regression model and a joinpoint regression model were used to determine the association of GDM and HDP with adverse maternal-perinatal outcomes and GDM and HDP temporal trend among singleton and twin pregnancies. Results The trend of HDP [average annual percentage change (AAPC) 15.1% (95% confidence interval (95%CI): 5.3, 25.7)] among singleton pregnancies and GDM [AAPC 50.4% (95%CI: 19.9, 88.7)] among twin pregnancies significantly increased from 2011 to 2019. After adjusting for confounding factors, GDM is associated with an increased risk of C-section (adjusted odds ratio (aOR), 1.5; 95%CI: 1.3, 1.6) and macrosomia (aOR, 1.3; 95%CI: 1.1, 1.6) in singleton and preterm birth (PTB) (aOR, 2.1; 95%CI: 1.2, 3.3) in twin pregnancies compared with non-GDM. HDP was associated with a higher risk of C-section, PTB, perinatal mortality, and low birth weight (LBW) in both singleton and twin pregnancies compared with the non-HDP. Compared with singleton pregnancies complicated with GDM and HDP, twin pregnancies showed higher odds of C-section [(aOR, 1.7; 95%CI: 1.1, 2.7), (aOR, 4.6; 95%CI: 2.5, 8.7), respectively], PTB [(aOR, 22.9; 95%CI: 14.1, 37.3), (aOR, 8.1; 95%CI: 5.3, 12.3), respectively], LBW [(aOR, 12.1; 95%CI: 8.2, 18.1), (aOR, 5.1; 95%CI: 3.6, 7.4), respectively], and low Apgar score [(aOR, 8.2; 95%CI: 4.4, 15.1), (aOR, 3.8; 95%CI: 2.4, 5.8), respectively] complicated with GDM and HDP. Conclusion In conclusion, GDM showed an increased risk of a few adverse maternal-perinatal outcomes and HDP is associated with a higher risk of several adverse maternal-perinatal outcomes in singleton and twin pregnancies compared to non-GDM and non-HDP. Moreover, twin pregnancies complicated with GDM and HDP showed higher odds of adverse maternal-neonatal outcomes compared with singleton pregnancies complicated with GDM and HDP.
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Affiliation(s)
- Nawsherwan
- Xiamen Cardiovascular Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
| | - Zhiyi Liu
- Clinical College of Traditional Chinese Medicine, Hubei University of Chinese Medicine, Hubei, China
| | - Zhang Le
- Xiamen Cardiovascular Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
| | - Sumaira Mubarik
- PharmacoTherapy, -Epidemiology and -Economics, Groningen Research Institute of Pharmacy, University of Groningen, Groningen, Netherlands
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, Wuhan, China
| | - Yanmei Sun
- Department of Obstetrics and Gynecology, Renmin Hospital, Wuhan University, Wuhan, Hubei, China
| | - Shafaq Naeem
- Department of Preventive Medicine, School of Public Health, Wuhan University, Wuhan, China
| | - Hui Li
- Department of Medicine, Taixing People Hospital, Taizhou, Jiangsu, China
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10
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Thøgersen M, Nielsen KK, Wibaek R, Damm P, Jensen RB, Nielsen H, Maindal HT, Andersen GS. Body Mass Index Trajectories in Children Exposed to Gestational Diabetes in Utero: A Nationwide Register-based Study. J Clin Endocrinol Metab 2023; 108:e1551-e1559. [PMID: 37379575 DOI: 10.1210/clinem/dgad384] [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: 05/10/2023] [Revised: 06/19/2023] [Accepted: 06/26/2023] [Indexed: 06/30/2023]
Abstract
CONTEXT Children exposed to gestational diabetes mellitus (GDM) in utero are at high risk of developing overweight and obesity, but their postnatal growth trajectories and risk profiles remain unclear. OBJECTIVE We aimed to identify distinct body mass index (BMI) trajectories from birth to 10 years of age in children exposed to GDM and to explore their associations with infant and maternal characteristics. METHODS This nationwide cohort study linked data from Danish registries on 15 509 children exposed to GDM in utero, born in Denmark from January 2008 to October 2019. We applied latent class trajectory modeling to identify distinct BMI trajectories. Associations of BMI trajectories with infant and maternal characteristics were analyzed using multiple linear regression. RESULTS We identified 3 distinct BMI trajectories characterized by a "normal" (60%), a "late accelerating" (28%) and an "early accelerating" (12%) BMI trajectory, the 2 latter at risk of overweight and obesity, respectively, at age 10 years, relative to World Health Organization child growth standards. Children in the "late accelerating" BMI trajectory were more often born large for gestational age (P < .001). More children in the "early accelerating" BMI trajectory were boys, born small for gestational age, and had mothers with a higher pre-pregnancy BMI compared to the other groups (P < .001). CONCLUSION Children exposed to GDM in utero differ widely in their BMI trajectory. The detection of risk profiles based on early BMI growth and infant and maternal characteristics provides an opportunity for future targeted care and prevention.
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Affiliation(s)
- Maja Thøgersen
- Health Promotion Research, Copenhagen University Hospital-Steno Diabetes Center Copenhagen, 2730 Herlev, Denmark
- Department of Public Health, Faculty of Health, Aarhus University, 8000 Aarhus, Denmark
| | - Karoline Kragelund Nielsen
- Health Promotion Research, Copenhagen University Hospital-Steno Diabetes Center Copenhagen, 2730 Herlev, Denmark
| | - Rasmus Wibaek
- Clinical Research, Copenhagen University Hospital-Steno Diabetes Center Copenhagen, 2730 Herlev, Denmark
| | - Peter Damm
- Center for Pregnant Women with Diabetes, Department of Obstetrics, Copenhagen University Hospital-Rigshospitalet, 2100 Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark
| | - Rikke Beck Jensen
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark
- Department of Growth and Reproduction, Copenhagen University Hospital-Rigshospitalet, 2100 Copenhagen, Denmark
| | - Helene Nielsen
- Clinical Research, Copenhagen University Hospital-Steno Diabetes Center Copenhagen, 2730 Herlev, Denmark
| | - Helle Terkildsen Maindal
- Health Promotion Research, Copenhagen University Hospital-Steno Diabetes Center Copenhagen, 2730 Herlev, Denmark
- Department of Public Health, Faculty of Health, Aarhus University, 8000 Aarhus, Denmark
| | - Gregers Stig Andersen
- Clinical Research, Copenhagen University Hospital-Steno Diabetes Center Copenhagen, 2730 Herlev, Denmark
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11
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Busso D, González A, Santander N, Saavedra F, Quiroz A, Rivera K, González J, Olmos P, Marette A, Bazinet L, Illanes S, Enrione J. A Quinoa Protein Hydrolysate Fractionated by Electrodialysis with Ultrafiltration Membranes Improves Maternal and Fetal Outcomes in a Mouse Model of Gestational Diabetes Mellitus. Mol Nutr Food Res 2023; 67:e2300047. [PMID: 37667444 DOI: 10.1002/mnfr.202300047] [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: 01/27/2023] [Revised: 05/08/2023] [Indexed: 09/06/2023]
Abstract
SCOPE Quinoa intake exerts hypoglycemic and hypolipidemic effects in animals and humans. Although peptides from quinoa inhibit key enzymes involved in glucose homeostasis in vitro, their in vivo antidiabetic properties have not been investigated. METHODS AND RESULTS This study evaluated the effect of oral administration of a quinoa protein hydrolysate (QH) produced through enzymatic hydrolysis and fractionation by electrodialysis with ultrafiltration membrane (EDUF) (FQH) on the metabolic and pregnancy outcomes of Lepdb/+ pregnant mice, a preclinical model of gestational diabetes mellitus. The 4-week pregestational consumption of 2.5 mg mL-1 of QH in water prevented glucose intolerance and improves hepatic insulin signaling in dams, also reducing fetal weights. Sequencing and bioinformatic analyses of the defatted FQH (FQHD) identified 11 peptides 6-10 amino acids long that aligned with the quinoa proteome and exhibited putative anti-dipeptidyl peptidase-4 (DPP-IV) activity, confirmed in vitro in QH, FQH, and FDQH fractions. Peptides homologous to mouse and human proteins enriched for biological processes related to glucose metabolism are also identified. CONCLUSION Processing of quinoa protein may be used to develop a safe and effective nutritional intervention to control glucose intolerance during pregnancy. Further studies are required to confirm if this nutritional intervention is applicable to pregnant women.
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Affiliation(s)
- Dolores Busso
- Program of Reproductive Biology, Research and Innovation Center, School of Medicine, Faculty of Medicine, Universidad de los Andes, Santiago, 7550000, Chile
- Center of Interventional Medicine for Precision and Advanced Cellular Therapy (IMPACT), Universidad de los Andes, Santiago, 7550000, Chile
| | - Adrián González
- Biopolymer Research and Engineering Lab (BiopREL), Research and Innovation Center, School of Nutrition and Dietetics, Faculty of Medicine, Universidad de los Andes, Santiago, 7550000, Chile
| | - Nicolás Santander
- Health Science Institute, Universidad de O´Higgins, Rancagua, 2841959, Chile
| | - Fujiko Saavedra
- Program of Reproductive Biology, Research and Innovation Center, School of Medicine, Faculty of Medicine, Universidad de los Andes, Santiago, 7550000, Chile
| | - Alonso Quiroz
- PhD Program in Medical Sciences, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, 8320000, Chile
| | - Katherine Rivera
- PhD Program in Medical Sciences, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, 8320000, Chile
| | - Javier González
- Immersion in Science Program, School of Medicine, Faculty of Medicine, Universidad de los Andes, Santiago, 7550000, Chile
| | - Pablo Olmos
- Department of Nutrition, Diabetes and Metabolism, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, 8320000, Chile
| | - André Marette
- Institute of Nutrition and Functional Foods (INAF), Université Laval, Québec, Québec G1V 0A6, Canada
- Department of Anatomy and Physiology, Faculty of Medicine, Laval Hospital Research Center, Université Laval, Québec, Québec G1V 4G5, Canada
| | - Laurent Bazinet
- Department of Anatomy and Physiology, Faculty of Medicine, Laval Hospital Research Center, Université Laval, Québec, Québec G1V 4G5, Canada
- Department of Food Science and Nutrition, Laboratoire de Transformation Alimentaire et Procédés ÉlectroMembranaire (LTAPEM, Laboratory of Food Processing and Electro-Membrane Processes) Université Laval, Québec, Québec G1V 0A6, Canada
| | - Sebastián Illanes
- Program of Reproductive Biology, Research and Innovation Center, School of Medicine, Faculty of Medicine, Universidad de los Andes, Santiago, 7550000, Chile
- Center of Interventional Medicine for Precision and Advanced Cellular Therapy (IMPACT), Universidad de los Andes, Santiago, 7550000, Chile
| | - Javier Enrione
- Center of Interventional Medicine for Precision and Advanced Cellular Therapy (IMPACT), Universidad de los Andes, Santiago, 7550000, Chile
- Biopolymer Research and Engineering Lab (BiopREL), Research and Innovation Center, School of Nutrition and Dietetics, Faculty of Medicine, Universidad de los Andes, Santiago, 7550000, Chile
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12
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Escalona R, Larqué C, Cortes D, Vilchis R, Granados-Delgado E, Sánchez A, Sánchez-Bringas G, Lugo-Martínez H. High-fat diet impairs glucose homeostasis by increased p16 beta-cell expression and alters glucose homeostasis of the progeny in a parental-sex dependent manner. Front Endocrinol (Lausanne) 2023; 14:1246194. [PMID: 37876538 PMCID: PMC10591070 DOI: 10.3389/fendo.2023.1246194] [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: 06/24/2023] [Accepted: 09/21/2023] [Indexed: 10/26/2023] Open
Abstract
Introduction Obesity consists in the accumulation of adipose tissue accompanied by low grade chronic inflammation and is considered a pandemic disease. Recent studies have observed that obesity affects females and males in a sex-dependent manner. In addition, several works have demonstrated that parental obesity increases the risk to develop obesity, insulin resistance, diabetes, and reproductive disorders. Considering that intergenerational effects of obesity may occur in a sex-dependent manner, we studied male Wistar rat progeny (F1) obtained from mothers or fathers (F0) fed on a high-fat diet (HFD). Methods Five-week-old female and male Wistar rats were fed on a HFD (with 60% of calories provided by fat) for 18 weeks (F0). At the end of the treatment, animals were mated with young rats to obtain their progeny (F1). After weaning, F1 animals were fed on standard chow until 18 weeks of age. Body weight gain, fasting plasma glucose, insulin and leptin levels, glucose tolerance, insulin sensitivity, and adiposity were evaluated. In addition, beta-cell expression of nuclear p16 was assessed by immunofluorescence. Results and conclusions HFD altered plasma fasting glucose, insulin and leptin levels, glucose tolerance, adiposity, and beta-cell expression of p16 in F0 rats. Particularly, HFD showed sexual dimorphic effects on body weight gain and insulin sensitivity. Moreover, we observed that parental HFD feeding exerts parental-sex-specific metabolic impairment in the male progeny. Finally, parental metabolic dysfunction could be in part attributed to the increased beta-cell expression of p16; other mechanisms could be involved in the offspring glucose homeostasis.
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Affiliation(s)
| | | | | | | | | | | | | | - Haydée Lugo-Martínez
- Laboratory of Embryology and Genetics, Departamento de Embriología y Genética, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de México, Mexico
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13
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Li N, Li J, Wang H, Qiao Y, Li W, Gao M, Liu E, Yu Z, Hu G, Fang Z, Leng J, Yang X. Serum Sulfur-Containing Amino Acids and Risk of Maternal Gestational Diabetes and Adverse Growth Patterns in Offspring. Nutrients 2023; 15:4089. [PMID: 37764871 PMCID: PMC10537007 DOI: 10.3390/nu15184089] [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: 08/17/2023] [Revised: 09/15/2023] [Accepted: 09/20/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND To estimate associations of sulfur-containing amino acids (SAAs) in the early trimester of pregnancy and gestational diabetes mellitus (GDM) and estimate associations of maternal SAAs with adverse growth patterns in offspring. METHODS We established a 1:1 matched case-control study (n = 486) from our cohort of pregnant women, and 401 children were followed up at ages 1 to 8 years. We conducted binary conditional logistic regression to estimate the risk associations of serum SAAs with GDM. Multinomial logistic regression was implemented to explore associations of maternal SAAs with adverse growth patterns in the offspring. RESULTS High serum methionine and cystine were independently associated with increased GDM risk (OR: 1.92, 95%CI: 1.18-3.13 and 2.69, 1.59-4.53). Conversely, a low level of serum taurine was independently associated with increased GDM risk (2.61, 1.64-4.16). Maternal high cystine and low taurine were also associated with an increased risk of persistent obesity growth pattern (POGP) in offspring (OR: 2.79, 95%CI: 1.09-7.17 and 3.92, 1.11-13.89) and the effect was largely independent of GDM. CONCLUSIONS High serum methionine, cystine and low serum taurine in the early trimester of pregnancy were associated with a greatly increased risk of GDM. Maternal high cystine and low taurine were associated with elevated risk of offspring POGP, largely independent of GDM.
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Affiliation(s)
- Ninghua Li
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin 300070, China; (N.L.); (J.L.); (H.W.); (M.G.)
| | - Jing Li
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin 300070, China; (N.L.); (J.L.); (H.W.); (M.G.)
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin 300070, China;
- Tianjin Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin 300070, China
| | - Hui Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin 300070, China; (N.L.); (J.L.); (H.W.); (M.G.)
| | - Yijuan Qiao
- Project Office, Tianjin Women and Children’s Health Center, Tianjin 300070, China; (Y.Q.); (W.L.); (E.L.)
| | - Weiqin Li
- Project Office, Tianjin Women and Children’s Health Center, Tianjin 300070, China; (Y.Q.); (W.L.); (E.L.)
| | - Ming Gao
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin 300070, China; (N.L.); (J.L.); (H.W.); (M.G.)
| | - Enqing Liu
- Project Office, Tianjin Women and Children’s Health Center, Tianjin 300070, China; (Y.Q.); (W.L.); (E.L.)
| | - Zhijie Yu
- Population Cancer Research Program and Department of Pediatrics, Dalhousie University, Halifax, NS 15000, Canada;
| | - Gang Hu
- Chronic Disease Epidemiology Laboratory, Pennington Biomedical Research Center, Baton Rouge, LA 70808, USA;
| | - Zhongze Fang
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin 300070, China;
- Tianjin Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin 300070, China
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Junhong Leng
- Project Office, Tianjin Women and Children’s Health Center, Tianjin 300070, China; (Y.Q.); (W.L.); (E.L.)
| | - Xilin Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin 300070, China; (N.L.); (J.L.); (H.W.); (M.G.)
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin 300070, China;
- Tianjin Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin 300070, China
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Molitor J, Sun Y, Rubio VG, Benmarhnia T, Chen JC, Avila C, Sacks DA, Chiu V, Slezak J, Getahun D, Wu J. Modeling spatially varying compliance effects of PM 2.5 exposure reductions on gestational diabetes mellitus in southern California: Results from electronic health record data of a large pregnancy cohort. ENVIRONMENTAL RESEARCH 2023; 231:116091. [PMID: 37182828 PMCID: PMC10405446 DOI: 10.1016/j.envres.2023.116091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 03/06/2023] [Accepted: 05/09/2023] [Indexed: 05/16/2023]
Abstract
Gestational diabetes mellitus (GDM) is a major pregnancy complication affecting approximately 14.0% of pregnancies around the world. Air pollution exposure, particularly exposure to PM2.5, has become a major environmental issue affecting health, especially for vulnerable pregnant women. Associations between PM2.5 exposure and adverse birth outcomes are generally assumed to be the same throughout a large geographical area. However, the effects of air pollution on health can very spatially in subpopulations. Such spatially varying effects are likely due to a wide range of contextual neighborhood and individual factors that are spatially correlated, including SES, demographics, exposure to housing characteristics and due to different composition of particulate matter from different emission sources. This combination of elevated environmental hazards in conjunction with socioeconomic-based disparities forms what has been described as a "double jeopardy" for marginalized sub-populations. In this manuscript our analysis combines both an examination of spatially varying effects of a) unit-changes in exposure and examines effects of b) changes from current exposure levels down to a fixed compliance level, where compliance levels correspond to the Air Quality Standards (AQS) set by the U.S. Environmental Protection Agency (EPA) and World Health Organization (WHO) air quality guideline values. Results suggest that exposure reduction policies should target certain "hotspot" areas where size and effects of potential reductions will reap the greatest rewards in terms of health benefits, such as areas of southeast Los Angeles County which experiences high levels of PM2.5 exposures and consist of individuals who may be particularly vulnerable to the effects of air pollution on the risk of GDM.
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Affiliation(s)
- John Molitor
- College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, 97331, USA.
| | - Yi Sun
- Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Department of Environmental and Occupational Health, Program in Public Health, University of California, Irvine, CA, USA
| | | | - Tarik Benmarhnia
- Scripps Institution of Oceanography, University of California, San Diego, CA, USA
| | - Jiu-Chiuan Chen
- Departments of Population & Public Health Sciences and Neurology, University of Southern California, Keck School of Medicine, Los Angeles, CA, USA
| | - Chantal Avila
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
| | - David A Sacks
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA; Department of Obstetrics and Gynecology, University of Southern California, Keck School of Medicine, Los Angeles, CA, USA
| | - Vicki Chiu
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
| | - Jeff Slezak
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
| | - Darios Getahun
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA; Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, USA
| | - Jun Wu
- Department of Environmental and Occupational Health, Program in Public Health, University of California, Irvine, CA, USA.
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15
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Li N, Li J, Wang H, Liu J, Li W, Yang K, Huo X, Leng J, Yu Z, Hu G, Fang Z, Yang X. Aromatic Amino Acids and Their Interactions with Gut Microbiota-Related Metabolites for Risk of Gestational Diabetes: A Prospective Nested Case-Control Study in a Chinese Cohort. ANNALS OF NUTRITION & METABOLISM 2023; 79:291-300. [PMID: 37339616 DOI: 10.1159/000531481] [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: 07/07/2022] [Accepted: 06/05/2023] [Indexed: 06/22/2023]
Abstract
INTRODUCTION The aim of this study was to explore associations of aromatic amino acids (AAA) in early pregnancy with gestational diabetes mellitus (GDM), and whether high AAA and gut microbiota-related metabolites had interactive effects on GDM risk. METHODS We conducted a 1:1 case-control study (n = 486) nested in a prospective cohort of pregnant women from 2010 to 2012. According to the International Association of Diabetes and Pregnancy Study Group's criteria, 243 women were diagnosed with GDM. Binary conditional logistic regression was performed to examine associations of AAA with GDM risk. Interactions between AAA and gut microbiota-related metabolites for GDM were examined using additive interaction measures. RESULTS High phenylalanine and tryptophan were associated with increased GDM risk (OR: 1.72, 95% CI: 1.07-2.78 and 1.66, 1.02-2.71). The presence of high trimethylamine (TMA) markedly increased the OR of high phenylalanine alone up to 7.95 (2.79-22.71), while the presence of low glycoursodeoxycholic acid (GUDCA) markedly increased the OR of high tryptophan alone up to 22.88 (5.28-99.26), both with significant additive interactions. Furthermore, high lysophosphatidylcholines (LPC18:0) mediated both interactive effects. CONCLUSIONS High phenylalanine may have an additive interaction with high TMA, while high tryptophan may have an additive interaction with low GUDCA toward increased risk of GDM, both being mediated via LPC18:0.
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Affiliation(s)
- Ninghua Li
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Jing Li
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China
- Tianjin Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China
| | - Hui Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Jinnan Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Weiqin Li
- Project Office, Tianjin Women and Children's Health Center, Tianjin, China
| | - Kai Yang
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Xiaoxu Huo
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China
- Tianjin Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China
| | - Junhong Leng
- Project Office, Tianjin Women and Children's Health Center, Tianjin, China
| | - Zhijie Yu
- Population Cancer Research Program and Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Gang Hu
- Chronic Disease Epidemiology Laboratory, Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
| | - Zhongze Fang
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China
- Tianjin Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Xilin Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China
- Tianjin Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China
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16
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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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17
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Biomarkers of oxidative stress and reproductive complications. Adv Clin Chem 2023; 113:157-233. [PMID: 36858646 DOI: 10.1016/bs.acc.2022.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Oxidative stress is the result of an imbalance between the formation of reactive oxygen species (ROS) and the levels of enzymatic and non-enzymatic antioxidants. The assessment of biological redox status is performed by the use of oxidative stress biomarkers. An oxidative stress biomarker is defined as any physical structure or process or chemical compound that can be assessed in a living being (in vivo) or in solid or fluid parts thereof (in vitro), the determination of which is a reproducible and reliable indicator of oxidative stress. The use of oxidative stress biomarkers allows early identification of the risk of developing diseases associated with this process and also opens up possibilities for new treatments. At the end of the last century, interest in oxidative stress biomarkers began to grow, due to evidence of the association between the generation of free radicals and various pathologies. Up to now, a significant number of studies have been carried out to identify and apply different oxidative stress biomarkers in clinical practice. Among the most important oxidative stress biomarkers, it can be mentioned the products of oxidative modifications of lipids, proteins, nucleic acids, and uric acid as well as the measurement of the total antioxidant capacity of fluids in the human body. In this review, we aim to present recent advances and current knowledge on the main biomarkers of oxidative stress, including the discovery of new biomarkers, with emphasis on the various reproductive complications associated with variations in oxidative stress levels.
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18
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Raets L, Van Hoorenbeeck K, Maes T, Vercammen C, De Block C, Dirinck E, Van Pottelbergh I, Wierckx K, Laenen A, Bogaerts A, Mathieu C, Benhalima K. The Belgian Diabetes in Pregnancy Follow-Up Study (BEDIP-FUS): A Multi-Centric Prospective Cohort Study on the Long-Term Metabolic Risk across Different Degrees of Gestational Glucose Intolerance: Methodology and Design. J Clin Med 2023; 12:jcm12031025. [PMID: 36769669 PMCID: PMC9917817 DOI: 10.3390/jcm12031025] [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] [Received: 12/19/2022] [Revised: 01/16/2023] [Accepted: 01/26/2023] [Indexed: 01/31/2023] Open
Abstract
The Belgian Diabetes in Pregnancy follow-up study (BEDIP-FUS) aims to investigate the impact of body mass index (BMI), adiposity and different degrees of glucose intolerance on the metabolic profile and future risk for type 2 diabetes (T2D) in women and offspring five years after delivery in the BEDIP study. The BEDIP study was a prospective cohort study to evaluate different screening strategies for gestational diabetes (GDM) based on the 2013 WHO criteria. The aim of the BEDIP-FUS is to recruit 375 women-offspring pairs, stratified according to three different subgroups based on the antenatal result of the glucose challenge test (GCT) and oral glucose tolerance test (OGTT) during the BEDIP pregnancy. The follow-up visit consists of a 75 g OGTT, anthropometric measurements and questionnaires for the mothers, and a fasting blood sample with anthropometric measurements for the child. Primary outcome for the mother is glucose intolerance defined by the American Diabetes Association criteria and for the offspring the BMI z-score. Recruitment began in January 2021. The BEDIP-FUS study will help to better individualize follow-up in women with different degrees of hyperglycemia in pregnancy and their offspring.
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Affiliation(s)
- Lore Raets
- Department of Endocrinology, University Hospital Gasthuisberg, KU Leuven, Herestraat 49, 3000 Leuven, Belgium
- Correspondence: ; Tel.: +32-1634-7296
| | - Kim Van Hoorenbeeck
- Department of Pediatrics, Antwerp University Hospital, Drie Eikenstraat 655, 2650 Edegem, Belgium
| | - Toon Maes
- Department of Endocrinology, Imelda Ziekenhuis, Imeldalaan 9, 2820 Bonheiden, Belgium
| | - Chris Vercammen
- Department of Endocrinology, Imelda Ziekenhuis, Imeldalaan 9, 2820 Bonheiden, Belgium
| | - Christophe De Block
- Department of Endocrinology-Diabetology-Metabolism, Antwerp University Hospital, Drie Eikenstraat 655, 2650 Edegem, Belgium
| | - Eveline Dirinck
- Department of Endocrinology-Diabetology-Metabolism, Antwerp University Hospital, Drie Eikenstraat 655, 2650 Edegem, Belgium
| | - Inge Van Pottelbergh
- Department of Endocrinology, OLV-Ziekenhuis Aalst-Asse-Ninove, Moorselbaan 164, 9300 Aalst, Belgium
| | - Katrien Wierckx
- Department of Endocrinology, OLV-Ziekenhuis Aalst-Asse-Ninove, Moorselbaan 164, 9300 Aalst, Belgium
| | - Annouschka Laenen
- Center of Biostatics and Statistical Bioinformatics, KU Leuven, Kapucijnenvoer 35 bloc d-box 7001, 3000 Leuven, Belgium
| | - Annick Bogaerts
- Department of Development & Regeneration, REALIFE Research Group KU Leuven, Herestraat 49, 3000 Leuven, Belgium
| | - Chantal Mathieu
- Department of Endocrinology, University Hospital Gasthuisberg, KU Leuven, Herestraat 49, 3000 Leuven, Belgium
| | - Katrien Benhalima
- Department of Endocrinology, University Hospital Gasthuisberg, KU Leuven, Herestraat 49, 3000 Leuven, Belgium
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Association of placental PPARα/γ and miR-27b expression with macrosomia in healthy pregnancy. Pediatr Res 2023; 93:267-273. [PMID: 35459765 DOI: 10.1038/s41390-022-02072-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 02/06/2022] [Accepted: 03/26/2022] [Indexed: 01/28/2023]
Abstract
BACKGROUND Peroxisomal proliferator-activated receptors (PPARs) and microRNAs (miRNAs) play important roles in the development of fetuses, whereas expression changes of PPARs and three miRNAs (miR-17, miR-27b and miR-34a) and whether these miRNAs regulate PPARs in non-GDM macrosomia placenta is unclear. METHODS A case-control study was performed to collect information and placental tissues on mothers and newborns of non-GDM macrosomia and normal-birth-weight infants. In vitro HTR8-SVneo cellular model was used to detect the effects of miRNAs on PPARs expression. Quantitative real-time PCR (qRT-PCR) and western blot was applied to examine the expression levels of PPARs, miR-17, miR-27b, and miR-34a in placental tissues and cells. RESULTS The PPARα/γ mRNA and protein levels were significantly up-regulated and miR-27b was down-regulated in the placenta of macrosomia group compared with in the control group, while no difference was observed in PPARβ, miR-17, and miR-34a. After adjusting for confounding factors, low miR-27b and high PPARα/γ mRNA expression still increased the risk of macrosomia. The PPARα/γ protein levels presented a corresponding decrease or increase when cells were transfected with miR-27b mimic or inhibitor. CONCLUSIONS Placental PPARα/γ and miR-27b expression were associated with non-GDM macrosomia and miR-27b probably promotes the occurrence of non-GDM macrosomia by regulating PPARα/γ protein. IMPACT Low miR-27b and high PPARα/γ mRNA expression in the placenta were associated with higher risk of macrosomia. In vitro HTR8-SVneo cell experiment supported that miR-27b could negatively regulate the expression of PPARα and PPARγ protein. MiR-27b was probably involved in non-GDM macrosomia through negative regulation of PPARα/γ protein.
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20
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Placental extracellular vesicles in maternal-fetal communication during pregnancy. Biochem Soc Trans 2022; 50:1785-1795. [DOI: 10.1042/bst20220734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 11/25/2022] [Accepted: 11/28/2022] [Indexed: 12/13/2022]
Abstract
For several years, a growing number of studies have highlighted the pivotal role of placental extracellular vesicles (EVs) throughout pregnancy. These membrane nanovesicles, heterogeneous in nature, composition and origin, are secreted by several trophoblastic cell types and are found in both the maternal and fetal compartments. They can be uptaken by recipient cells and drive a wide variety of physiological and pathological processes. In this review, we provide an overview of the different described roles of placental EVs in various aspects of normal pregnancy, from placenta establishment to maternal immune tolerance towards the fetus and protection against viral infections. In the second part, we present selected examples of pathological pregnancies in which placental EVs are involved, such as gestational diabetes mellitus, pre-eclampsia, and congenital infections. Since the abundance and/or composition of placental EVs is deregulated in maternal serum during pathological pregnancies, this makes them interesting candidates as non-invasive biomarkers for gestational diseases and opens a wide field of translational perspectives.
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21
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Yao X, Huang S, Li Y, Ge Y, Zhang Z, Ning J, Yang X. Transgenerational effects of zinc, selenium and chromium supplementation on glucose homeostasis in female offspring of gestational diabetes rats. J Nutr Biochem 2022; 110:109131. [PMID: 36028097 DOI: 10.1016/j.jnutbio.2022.109131] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 07/26/2022] [Accepted: 08/01/2022] [Indexed: 01/13/2023]
Abstract
Clinical studies have demonstrated that maternal gestational diabetes mellitus (GDM) increases the offspring's risk of developing glucose intolerance. Our previous study reported that co-supplementation with zinc, selenium, and chromium improved insulin resistance in diet-induced GDM rats. Here, Transgenerational effects of supplementation with zinc (10 mg/kg.bw), selenium (20 μg/kg.bw), and chromium (20 μg/kg.bw) in F1 female offspring of both zinc, selenium and chromium (ZnSeCr)-treated, and untreated GDM rats daily by gavage from weaning to the postpartum were investigated in the present study. Glucose homeostasis in the F1 female offspring of GDM at different stages were evaluated. Maternal GDM did increase the birth mass of newborn F1 female offspring, as well as the serum glucose and insulin levels. Zinc, selenium and chromium supplementation attenuated the GDM-induced mass gain, increased serum glucose and insulin levels in the female neonates. The high fat and sucrose (HFS) diet-fed GDM-F1 offspring developed GDM, with glucose intolerance, hyperglycemia and insulin resistance during pregnancy. Moreover, endoplasmic reticulum (ER) stress-related protein levels were increased and the activation of insulin signaling pathways were reduced in the liver of HFS-fed GDM-F1 offspring. Whereas glucose homeostasis in parallel with insulin sensitivity was normalized in the female offspring of GDM by supplementation both F0 dams and F1 offspring with zinc, selenium and chromium, not in those either F0 or F1 elements supplemented offspring. Therefore, we speculate that zinc, selenium and chromium supplementation may have a potential beneficial transgenerational effect on the glucose homeostasis in the female offspring of GDM.
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Affiliation(s)
- Xueqiong Yao
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Laboratory of Environment, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Shanshan Huang
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Laboratory of Environment, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yan Li
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Laboratory of Environment, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yanyan Ge
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Laboratory of Environment, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Zhen Zhang
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Laboratory of Environment, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jie Ning
- Department of Endocrinology, Shenzhen Longhua District Central Hospital, Guangdong Medical University Affiliated Longhua Central Hospital, Shenzhen, Guangdong, China.
| | - Xuefeng Yang
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Laboratory of Environment, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
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22
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Sekitoleko I, Tino S, Mubiru M, Nansubuga F, Zaake D, Nakabuye B, Ayiko B, Kalema H, Nakubulwa S, Sekikubo M, Milln J, Nakanga WP, Nakimuli A, Webb EL, Nyirenda MJ. The influence of fasting and post-load glucose levels on maternal and neonatal outcomes in women with hyperglycaemia in pregnancy in Uganda: A prospective observational cohort study. Diabetes Res Clin Pract 2022; 191:110049. [PMID: 36029888 DOI: 10.1016/j.diabres.2022.110049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 06/17/2022] [Accepted: 08/19/2022] [Indexed: 11/03/2022]
Abstract
AIMS The study aims to evaluate the strength of fasting versus post-load glucose levels in predicting adverse outcomes in women with hyperglycaemia in pregnancy (HIP). METHODS Women attending antenatal clinics in urban and peri-urban Uganda had oral glucose tolerance test between 24 and 28 weeks of gestation to screen for HIP, and were followed up to collect data on maternal and neonatal outcomes. Univariable and multivariable Poisson regression models were used to estimate the relative risk adverse outcome associated with fasting hyperglycaemia alone post-load hyperglycaemia alone, or elevation of both fasting and post-load glucose levels. RESULTS We included 3206 participants in the final analysis. HIP was associated with increased risk of Caesarean section, large for gestaional age babies, and neonatal intensive care admission. The risk was highest (2.54-fold compared to normal glycaemic women) when both FBG and post-load glucose levels were elevated. After adjustment for potential confounders, having elevated post-load glucose alone was not associated with increased risk of any of the outcomes, but elevated FBG alone increased the risk of Caesarian section by 1.36-fold. CONCLUSION Fasting hyperglycemia appears to be more strongly associated with adverse pregnancy outcomes than post-load hyperglycaemia, but the risk is even higher in women with elevation of both fasting and post-load glucose levels.
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Affiliation(s)
- Isaac Sekitoleko
- MRC/UVRI and LSHTM Uganda Research Unit, Uganda; London School of Hygiene and Tropical Medicine, London, United Kingdom.
| | - Salome Tino
- MRC/UVRI and LSHTM Uganda Research Unit, Uganda
| | | | | | | | | | - Ben Ayiko
- Entebbe Grade B Hospital, Entebbe, Uganda
| | | | - Sarah Nakubulwa
- Department of Obstetrics and Gynaecology, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda; Kawempe Specialized National Referral Hospital, Kampala, Uganda
| | - Musa Sekikubo
- Department of Obstetrics and Gynaecology, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda; Kawempe Specialized National Referral Hospital, Kampala, Uganda
| | - Jack Milln
- Queen Mary University of London, London, United Kingdom
| | - Wisdom P Nakanga
- National Insititute for Health Research (NIHR), Exeter Clinical Research Faculty, University of Exeter, Exeter, United Kindgom
| | - Annettee Nakimuli
- Department of Obstetrics and Gynaecology, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda; Kawempe Specialized National Referral Hospital, Kampala, Uganda
| | - Emily L Webb
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Moffat J Nyirenda
- MRC/UVRI and LSHTM Uganda Research Unit, Uganda; London School of Hygiene and Tropical Medicine, London, United Kingdom
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23
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Ramirez Zegarra R, Dall’Asta A, Revelli A, Ghi T. COVID-19 and Gestational Diabetes: The Role of Nutrition and Pharmacological Intervention in Preventing Adverse Outcomes. Nutrients 2022; 14:nu14173562. [PMID: 36079820 PMCID: PMC9460671 DOI: 10.3390/nu14173562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 08/14/2022] [Accepted: 08/23/2022] [Indexed: 12/15/2022] Open
Abstract
Pregnant women with GDM affected by COVID-19 seem to be at higher risk of adverse maternal and neonatal outcomes, especially those with overweight or obesity. Good glycemic control seems to be the most effective measure in reducing the risk of GDM and severe COVID-19. For such purposes, the Mediterranean diet, micronutrient supplementation, and physical activity are considered the first line of treatment. Failure to achieve glycemic control leads to the use of insulin, and this clinical scenario has been shown to be associated with an increased risk of adverse maternal and neonatal outcomes. In this review, we explore the current evidence pertaining to the pathogenesis of SARS-CoV-2 leading to the main complications caused by COVID-19 in patients with GDM. We also discuss the incidence of complications caused by COVID-19 in pregnant women with GDM according to their treatment.
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Affiliation(s)
- Ruben Ramirez Zegarra
- Obstetrics and Gynaecology Unit, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
- Department of Obstetrics and Gynaecology, University Hospital Rechts der Isar, Technical University of Munich, 81675 Munich, Germany
| | - Andrea Dall’Asta
- Obstetrics and Gynaecology Unit, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
| | - Alberto Revelli
- Sant’Anna Hospital, Department of Surgical Sciences, University of Turin, 10126 Turin, Italy
| | - Tullio Ghi
- Obstetrics and Gynaecology Unit, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
- Correspondence:
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24
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Effects of Probiotic Supplementation during Pregnancy on the Future Maternal Risk of Metabolic Syndrome. Int J Mol Sci 2022; 23:ijms23158253. [PMID: 35897822 PMCID: PMC9330652 DOI: 10.3390/ijms23158253] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 07/21/2022] [Accepted: 07/23/2022] [Indexed: 12/12/2022] Open
Abstract
Probiotics are live microorganisms that induce health benefits in the host. Taking probiotics is generally safe and well tolerated by pregnant women and their children. Consumption of probiotics can result in both prophylactic and therapeutic effects. In healthy adult humans, the gut microbiome is stable at the level of the dominant taxa: Bacteroidetes, Firmicutes and Actinobacteria, and has a higher presence of Verrucomicrobia. During pregnancy, an increase in the number of Proteobacteria and Actinobacteria phyla and a decrease in the beneficial species Roseburia intestinalis and Faecalibacterium prausnitzii are observed. Pregnancy is a "window" to the mother's future health. The aim of this paper is to review studies assessing the potentially beneficial effects of probiotics in preventing the development of diseases that appear during pregnancy, which are currently considered as risk factors for the development of metabolic syndrome, and consequently, reducing the risk of developing maternal metabolic syndrome in the future. The use of probiotics in gestational diabetes mellitus, preeclampsia and excessive gestational weight gain is reviewed. Probiotics are a relatively new intervention that can prevent the development of these disorders during pregnancy, and thus, would reduce the risk of metabolic syndrome resulting from these disorders in the mother's future.
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25
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Lin D, Fan D, Li P, Chen G, Rao J, Zhou Z, Zhang H, Luo X, Ma H, Feng J, Lu D, Wang L, Lan S, Luo C, Guo X, Liu Z. Perinatal outcomes among twin pregnancies with gestational diabetes mellitus: A nine-year retrospective cohort study. Front Public Health 2022; 10:946186. [PMID: 35958858 PMCID: PMC9358001 DOI: 10.3389/fpubh.2022.946186] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 07/06/2022] [Indexed: 11/15/2022] Open
Abstract
Objective To compare the outcomes between gestational diabetes mellitus (GDM) vs. non-GDM twin gestations. Methods A retrospective cohort study of 2,151 twin pregnancies was performed in a tertiary hospital in Foshan, China, 2012–2020. Pregnancy and neonatal outcomes were compared between women with vs. without GDM using 1:1 propensity score matching (PSM) and multivariable logistic models. For neonatal outcomes, generalized estimating equation (GEE) approach was used to address the intertwin correlation. Results Of the 2,151 participants, 472 women (21.9%) were diagnosed with GDM. Women with GDM were older and more likely to be overweight or obese, and more likely have chronic hypertension, assisted pregnancies and dichorionic twins. In the PSM cohort of 942 pregnancies, there was no statistical difference when comparing GDM twin pregnancies and non-GDM in any of the perinatal outcomes, especially in terms of preterm birth (PTB) <37 weeks (P = 0.715), large for gestational age (LGA) (P = 0.521) and neonatal respiratory distress (NRDS) (P = 0.206). In the entire cohort, no significant adjusted ORs for these outcomes were obtained from logistic regression models adjusted for confounders (aOR for PTB < 37 weeks: 1.25, 95% CI: 0.98–1.58; aOR for LGA: 1.26, 95% CI: 0.88–1.82; and aOR for NRDS, 1.05, 95% CI: 0.68–1.64). Conclusion Twin pregnancies with GDM and adequate prenatal care have comparable perinatal outcomes to those without.
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Affiliation(s)
- Dongxin Lin
- Foshan Institute of Fetal Medicine, Southern Medical University Affiliated Maternal and Child Health Hospital of Foshan, Foshan, China
- Department of Obstetrics, Southern Medical University Affiliated Maternal and Child Health Hospital of Foshan, Foshan, China
| | - Dazhi Fan
- Foshan Institute of Fetal Medicine, Southern Medical University Affiliated Maternal and Child Health Hospital of Foshan, Foshan, China
- Department of Obstetrics, Southern Medical University Affiliated Maternal and Child Health Hospital of Foshan, Foshan, China
| | - Pengsheng Li
- Foshan Institute of Fetal Medicine, Southern Medical University Affiliated Maternal and Child Health Hospital of Foshan, Foshan, China
- Department of Obstetrics, Southern Medical University Affiliated Maternal and Child Health Hospital of Foshan, Foshan, China
| | - Gengdong Chen
- Foshan Institute of Fetal Medicine, Southern Medical University Affiliated Maternal and Child Health Hospital of Foshan, Foshan, China
- Department of Obstetrics, Southern Medical University Affiliated Maternal and Child Health Hospital of Foshan, Foshan, China
| | - Jiaming Rao
- Foshan Institute of Fetal Medicine, Southern Medical University Affiliated Maternal and Child Health Hospital of Foshan, Foshan, China
- Department of Obstetrics, Southern Medical University Affiliated Maternal and Child Health Hospital of Foshan, Foshan, China
| | - Zixing Zhou
- Foshan Institute of Fetal Medicine, Southern Medical University Affiliated Maternal and Child Health Hospital of Foshan, Foshan, China
- Department of Obstetrics, Southern Medical University Affiliated Maternal and Child Health Hospital of Foshan, Foshan, China
| | - Huishan Zhang
- Foshan Institute of Fetal Medicine, Southern Medical University Affiliated Maternal and Child Health Hospital of Foshan, Foshan, China
- Department of Obstetrics, Southern Medical University Affiliated Maternal and Child Health Hospital of Foshan, Foshan, China
| | - Xin Luo
- Foshan Institute of Fetal Medicine, Southern Medical University Affiliated Maternal and Child Health Hospital of Foshan, Foshan, China
- Department of Obstetrics, Southern Medical University Affiliated Maternal and Child Health Hospital of Foshan, Foshan, China
| | - Huiting Ma
- Foshan Institute of Fetal Medicine, Southern Medical University Affiliated Maternal and Child Health Hospital of Foshan, Foshan, China
- Department of Obstetrics, Southern Medical University Affiliated Maternal and Child Health Hospital of Foshan, Foshan, China
| | - Jingping Feng
- Department of Obstetrics, Southern Medical University Affiliated Maternal and Child Health Hospital of Foshan, Foshan, China
| | - Demei Lu
- Department of Obstetrics, Southern Medical University Affiliated Maternal and Child Health Hospital of Foshan, Foshan, China
| | - Lijuan Wang
- Department of Obstetrics, Southern Medical University Affiliated Maternal and Child Health Hospital of Foshan, Foshan, China
| | - Shiyan Lan
- Department of Obstetrics, Southern Medical University Affiliated Maternal and Child Health Hospital of Foshan, Foshan, China
| | - Caihong Luo
- Department of Obstetrics, Southern Medical University Affiliated Maternal and Child Health Hospital of Foshan, Foshan, China
| | - Xiaoling Guo
- Foshan Institute of Fetal Medicine, Southern Medical University Affiliated Maternal and Child Health Hospital of Foshan, Foshan, China
- Department of Obstetrics, Southern Medical University Affiliated Maternal and Child Health Hospital of Foshan, Foshan, China
- *Correspondence: Xiaoling Guo
| | - Zhengping Liu
- Foshan Institute of Fetal Medicine, Southern Medical University Affiliated Maternal and Child Health Hospital of Foshan, Foshan, China
- Department of Obstetrics, Southern Medical University Affiliated Maternal and Child Health Hospital of Foshan, Foshan, China
- Zhengping Liu
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Fu Y, Yang Y, Zhu L, Chen J, Yu N, Zhao M. Effect of dietary n-6: n-3 Poly-Unsaturated fatty acids ratio on gestational diabetes mellitus: a prospective cohort. Gynecol Endocrinol 2022; 38:583-587. [PMID: 35549805 DOI: 10.1080/09513590.2022.2073995] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
OBJECTIVE The aim of this study was to investigate the relationship between dietary n-6: n-3 poly-unsaturated fatty acids (PUFA) ratio and the risk of developing gestational diabetes mellitus (GDM). MATERIALS AND METHODS A total of 100 pregnant women were prospectively included for detailed information on dietary intake at 16-18 weeks evaluated using a three-day food record, and subsequent GDM diagnosis at 24-28 weeks. Participants were divided into two groups for analysis: GDM group (n = 22) and control group (n = 78) based on oral glucose tolerance test results performed between 24 and 28 weeks. RESULTS The average dietary n-6: n-3 PUFA ratio in the control group was 5.63 ± 2.12 and that in the GDM group was 8.35 ± 3.45, within a significant difference (p < .05). A significant difference was associated with a higher dietary n-6: n-3 PUFA ratio and GDM (adjusted odds ratio = 4.29, 95%confidence interval:1.303, 14.124). CONCLUSIONS Higher dietary n-6: n-3 PUFA ratio was associated with higher odds of GDM. Given the small sample, further studies are required to confirm this hypothesis.
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Affiliation(s)
- Yueqi Fu
- School of Nursing, Anhui Medical University, Hefei, Anhui, China
| | - Ya Yang
- Anhui No.2 Provincial People's Hospital, Hefei, Anhui, China
| | - Liyuan Zhu
- School of Nursing, Anhui Medical University, Hefei, Anhui, China
| | - Jing Chen
- School of Nursing, Anhui Medical University, Hefei, Anhui, China
| | - Ningning Yu
- School of Nursing, Anhui Medical University, Hefei, Anhui, China
| | - Mei Zhao
- School of Nursing, Anhui Medical University, Hefei, Anhui, China
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Tehrani FR, Naz MSG, Bidhendi-Yarandi R, Behboudi-Gandevani S. Effect of Different Types of Diagnostic Criteria for Gestational Diabetes Mellitus on Adverse Neonatal Outcomes: A Systematic Review, Meta-Analysis, and Meta-Regression. Diabetes Metab J 2022; 46:605-619. [PMID: 35255550 PMCID: PMC9353558 DOI: 10.4093/dmj.2021.0178] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 10/02/2021] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Evidence supporting various diagnostic criteria for diagnose gestational diabetes mellitus (GDM) are consensus-based, needs for additional evidence related to outcomes. Therefore, the aim of this systematic-review and meta-analysis was to assess the impact of different GDM diagnostic-criteria on the risk of adverse-neonatal-outcomes. METHODS Electronic databases including Scopus, PubMed, and Web of Sciences were searched to retrieve English original, population-based studies with the universal GDM screening approach, up to January-2020. GDM diagnostic criteria were classified in seven groups and International Association of the Diabetes and Pregnancy Study Groups (IADPSG) was considered as reference one. We used the Mantel-Haenszel method to calculate the pooled odds of events. The possibility of publication bias was examined by Begg's test. RESULTS A total of 55 population-based studies consisting of 1,604,391 pregnant women with GDM and 7,770,855 non-GDM counterparts were included. Results showed that in all diagnostic-criteria subgroups, the risk of adverse neonatal outcomes including macrosomia, hyperbilirubinemia, respiratory distress syndrome, neonatal hypoglycemia, neonatal intensive care unit admission, preterm birth, and birth-trauma were significantly higher than the non-GDM counterparts were significantly higher than non-GDM counterparts. Meta-regression analysis revealed that the magnitude of neonatal risks in all diagnostic-criteria subgroups are similar. CONCLUSION Our results showed that the risk of adverse-neonatal-outcome increased among women with GDM, but the magnitude of risk was not different among those women who were diagnosed through more or less intensive strategies. These findings may help health-care-providers and policy-makers to select the most cost-effective approach for the screening of GDM among pregnant women.
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Affiliation(s)
- Fahimeh Ramezani Tehrani
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran,
Iran
| | - Marzieh Saei Ghare Naz
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran,
Iran
| | - Razieh Bidhendi-Yarandi
- Department of Biostatistics, University of Social Welfare and Rehabilitation Sciences, Tehran,
Iran
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28
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Ochoa‐Moreno I, Hanson M. Obesity and diabetes in pregnancy: a perfect storm for transgenerational health. PRACTICAL DIABETES 2022. [DOI: 10.1002/pdi.2403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Ivan Ochoa‐Moreno
- Institute of Developmental Sciences, School of Human Development and Health, Faculty of Medicine, University of Southampton Southampton UK
| | - Mark Hanson
- Institute of Developmental Sciences, School of Human Development and Health, Faculty of Medicine, University of Southampton Southampton UK
- Southampton NIHR Biomedical Research Centre University Hospital Southampton UK
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Li N, Li J, Wang H, Liu J, Li W, Yang K, Huo X, Leng J, Yu Z, Hu G, Fang Z, Yang X. Branched-Chain Amino Acids and Their Interactions With Lipid Metabolites for Increased Risk of Gestational Diabetes. J Clin Endocrinol Metab 2022; 107:e3058-e3065. [PMID: 35271718 PMCID: PMC9891107 DOI: 10.1210/clinem/dgac141] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Indexed: 02/04/2023]
Abstract
OBJECTIVE We aimed to explore associations of branched-chain amino acids (BCAA) in early pregnancy with gestational diabetes mellitus (GDM), and whether high BCAAs and lipidomics markers had interactive effects on the risk of GDM. METHODS We conducted a 1:1 case-control study (n = 486) nested in a prospective cohort of pregnant women in Tianjin, China. Blood samples were collected at their first antenatal care visit (median 10 gestational weeks). Serum BCAAs, saturated fatty acids (SFA) and lysophosphatidylcholines (LPC) were measured by liquid chromatography-tandem mass spectrometry analysis. Conditional logistic regression was performed to examine associations of BCAAs with the risk of GDM. Interactions between high BCAAs and high SFA16:0 for GDM were examined using additive interaction measures. RESULTS High serum valine, leucine, isoleucine, and total BCAAs were associated with markedly increased risk of GDM (OR of top vs bottom tertiles: 1.91 [95% CI, 1.22-3.01]; 1.87 [1.20-2.91]; 2.23 [1.41-3.52]; 1.93 [1.23-3.02], respectively). The presence of high SFA16:0 defined as ≥ 17.1 nmol/mL (ie, median) markedly increased the ORs of high leucine alone and high isoleucine alone up to 4.56 (2.37-8.75) and 4.41 (2.30-8.43) for the risk of GDM, with significant additive interaction. After adjustment for LPCs, the ORs were greatly elevated (6.33, 2.25-17.80 and 6.53, 2.39-17.86) and the additive interactions became more significant. CONCLUSION BCAAs in early pregnancy were positively associated with the risk of GDM, and high levels of leucine and isoleucine enhanced the risk association of high SFA16:0 with GDM, independent of LPCs.
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Affiliation(s)
| | | | - Hui Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Jinnan Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Weiqin Li
- Project Office, Tianjin Women and Children’s Health Center, Tianjin, China
| | - Kai Yang
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Xiaoxu Huo
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China
- Tianjin Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China
| | - Junhong Leng
- Project Office, Tianjin Women and Children’s Health Center, Tianjin, China
| | - Zhijie Yu
- Population Cancer Research Program and Department of Pediatrics, Dalhousie University
Halifax, Canada
| | - Gang Hu
- Chronic Disease Epidemiology Laboratory, Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
| | - Zhongze Fang
- Prof. Zhongze Fang, Department of Toxicology, School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin 300070, China.
| | - Xilin Yang
- Correspondence: Prof. Xilin Yang, P.O. Box 154, School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin 300070, China. ; or
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30
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Antoniou MC, Gilbert L, Gross J, Rossel JB, Fumeaux CJF, Vial Y, Puder JJ. Sex-dependent influence of maternal predictors on fetal anthropometry in pregnancies with gestational diabetes mellitus. BMC Pregnancy Childbirth 2022; 22:460. [PMID: 35650561 PMCID: PMC9158189 DOI: 10.1186/s12884-022-04767-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 05/06/2022] [Indexed: 11/25/2022] Open
Abstract
Background Third trimester fetal anthropometric parameters are known to predict neonatal complications. A better understanding of predictors of adverse fetal parameters might help to personalize the use and frequency of fetal ultrasound. The objectives of this study were: (a) to evaluate the utility of maternal sociodemographic, anthropometric and metabolic predictors to predict 3rd trimester fetal anthropometric parameters in women with gestational diabetes mellitus (GDM), (b) to assess whether the impact of these maternal predictors is fetal sex-dependent, and (c) to provide a risk stratification for markers of fetal overgrowth (fetal weight centile (FWC) and fetal abdominal circumference centile (FACC) depending on prepregnancy BMI and gestational weight gain (GWG) until the 1st GDM visit. Methods This prospective study included 189 women with GDM. Maternal predictors were age, ethnicity, prepregnancy BMI, GWG and excessive weight gain until the 1st GDM visit, fasting, 1-hour and 2-hour blood glucose oral glucose tolerance test values, HbA1c at the 1st visit and medical treatment requirement. Fetal outcomes included FWC, FWC >90% and <10%, FACC, FACC >90% and <10%, at 29 0/7 to 35 6/7 weeks of gestational age. We performed univariate and multivariate regression analyses and probability analyses. Results In multivariate analyses, prepregnancy BMI was associated with FWC, FWC > 90% and FACC. GWG until the 1st GDM visit was associated with FWC, FACC and FACC > 90% (all p ≤ 0.045). Other maternal parameters were not significantly associated with fetal anthropometry in multivariate analyses (all p ≥ 0.054). In female fetuses, only GWG was associated with FACC (p= 0.044). However, in male fetuses, prepregnancy BMI was associated with FWC, FWC > 90% and FACC and GWG with FWC in multivariate analyses (all p ≤ 0.030). In women with a prepregnancy BMI of ≥ 25 kg/m2 and a GWG until the 1st GDM visit ≥ 10.3 kg (mean GWG), the risk for FWC > 90% and FACC > 90% was 5.3 and 4 times higher than in their counterparts. Conclusions A personalized fetal ultrasound surveillance guided by fetal sex, prepregnancy BMI and GWG may be beneficial in reducing adverse fetal and neonatal outcomes. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-022-04767-z.
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Affiliation(s)
- Maria-Christina Antoniou
- Pediatric Service, Department Woman Mother Child, University Hospital of Lausanne, 1011, Lausanne, Switzerland.
| | - Leah Gilbert
- Obstetric Service, Department Woman Mother Child, University Hospital of Lausanne, 1011, Lausanne, Switzerland
| | - Justine Gross
- Obstetric Service, Department Woman Mother Child, University Hospital of Lausanne, 1011, Lausanne, Switzerland.,Service of Endocrinology, Diabetes and Metabolism, University Hospital of Lausanne, 1011, Lausanne, Switzerland
| | - Jean-Benoît Rossel
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Céline Julie Fischer Fumeaux
- Clinic of Neonatology, Department Woman Mother Child, University Hospital of Lausanne, 1011, Lausanne, Switzerland
| | - Yvan Vial
- Obstetric Service, Department Woman Mother Child, University Hospital of Lausanne, 1011, Lausanne, Switzerland
| | - Jardena Jacqueline Puder
- Obstetric Service, Department Woman Mother Child, University Hospital of Lausanne, 1011, Lausanne, Switzerland
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31
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Muglia L, Tong S, Ozanne S, Benhalima K. Maternal factors during pregnancy influencing maternal, fetal and childhood outcomes: Meet the Guest Editors. BMC Med 2022; 20:114. [PMID: 35264147 PMCID: PMC8908555 DOI: 10.1186/s12916-022-02294-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 02/09/2022] [Indexed: 01/04/2023] Open
Affiliation(s)
- Louis Muglia
- Burroughs Wellcome Fund, Research Triangle Park, NC, USA.
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, OH, USA.
| | - Stephen Tong
- Department of Obstetrics and Gynaecology, University of Melbourne and Mercy Perinatal, Mercy Hospital for Women, Melbourne, Australia
| | - Susan Ozanne
- Wellcome-MRC Institute of Metabolic Science and Medical Research Council Metabolic Diseases Unit, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK
| | - Katrien Benhalima
- Department of Endocrinology, University Hospital Gasthuisberg, KU Leuven, Herestraat 49, 3000, Leuven, Belgium
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32
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Zhang Y, Lan X, Li F, Sun H, Zhang J, Li R, Gao Y, Dong H, Cai C, Zeng G. Dietary cholesterol and egg intake are associated with the risk of gestational diabetes: a prospective study from Southwest China. BMC Pregnancy Childbirth 2022; 22:45. [PMID: 35038995 PMCID: PMC8764826 DOI: 10.1186/s12884-022-04382-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 01/05/2022] [Indexed: 12/24/2022] Open
Abstract
Background An increasing body of evidence suggests that cholesterol intake increases during pregnancy and may influence the risk of gestational diabetes mellitus (GDM). However, existing evidence remains controversial and limited. The present study aimed to determine the relation among dietary cholesterol, specifically egg consumption, in pregnant Chinese women and their risk of GDM. Methods A population-based study that included 1617 pregnant women was conducted in 2017. At baseline, dietary information was collected by 24-hour dietary recalls over three days. GDM was diagnosed by a 75 g 2-hr oral glucose tolerance test (OGTT) at 24-28 weeks of gestation. Logistic regression models were used to examine the associations of dietary cholesterol and egg intake with GDM. In addition, path analysis including cholesterol intake, plasma lipid profiles and GDM risk was conducted. Results The average total cholesterol intake was 340.8 mg/d, and cholesterol from eggs accounted for 59.2%. The odds ratio (OR) of GDM risk was 1.48 for the highest quartile of total cholesterol intake compared to the lowest quartile (95% CI 1.10-2.00; Ptrend = 0.015) after adjustment for potential risk factors for GDM. Moreover, cholesterol from eggs rather than from other foods was positively associated with incident GDM (OR=1.09, 95% CI 1.03-1.17). Each additional egg consumed per day was positively correlated with a higher risk of GDM (OR=1.32, 95% CI 1.11-1.58). Path analysis indicated that cholesterol intake not only increased the risk of GDM by elevating plasma total cholesterol (TC), but also increased the risk of GDM through other non hyperlipidemia pathways. Conclusions Maternal dietary cholesterol intake was significantly associated with incident GDM, and egg consumption was a major driver of the association in this population. More studies are needed to substantiate these findings and to explore the underlying mechanisms. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-022-04382-y.
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Affiliation(s)
- Yiqi Zhang
- Department of Nutrition and Food Safety, West China School of Public Health and West China Fourth Hospital, Sichuan University, No. 16, Section 3, Renmin Nan Road, Chengdu, 610041, Sichuan, China
| | - Xi Lan
- Department of Nutrition and Food Safety, West China School of Public Health and West China Fourth Hospital, Sichuan University, No. 16, Section 3, Renmin Nan Road, Chengdu, 610041, Sichuan, China
| | - Fei Li
- Department of Nutrition and Food Safety, West China School of Public Health and West China Fourth Hospital, Sichuan University, No. 16, Section 3, Renmin Nan Road, Chengdu, 610041, Sichuan, China
| | - Hong Sun
- Department of Nutrition and Food Safety, West China School of Public Health and West China Fourth Hospital, Sichuan University, No. 16, Section 3, Renmin Nan Road, Chengdu, 610041, Sichuan, China
| | - Ju Zhang
- Department of Clinical Nutrition, Sichuan Provincial Hospital for Women and Children, Chengdu, 610000, Sichuan, China
| | - Run Li
- Department of Clinical Nutrition, Sichuan Provincial Hospital for Women and Children, Chengdu, 610000, Sichuan, China
| | - Yan Gao
- Department of Obstetrics, Sichuan Provincial Hospital for Women and Children, Chengdu, 610000, Sichuan, China
| | - Hongli Dong
- Department of Nutrition and Food Safety, West China School of Public Health and West China Fourth Hospital, Sichuan University, No. 16, Section 3, Renmin Nan Road, Chengdu, 610041, Sichuan, China
| | - Congjie Cai
- Department of Nutrition and Food Safety, West China School of Public Health and West China Fourth Hospital, Sichuan University, No. 16, Section 3, Renmin Nan Road, Chengdu, 610041, Sichuan, China
| | - Guo Zeng
- Department of Nutrition and Food Safety, West China School of Public Health and West China Fourth Hospital, Sichuan University, No. 16, Section 3, Renmin Nan Road, Chengdu, 610041, Sichuan, China.
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Sun Y, Li X, Benmarhnia T, Chen JC, Avila C, Sacks DA, Chiu V, Slezak J, Molitor J, Getahun D, Wu J. Exposure to air pollutant mixture and gestational diabetes mellitus in Southern California: Results from electronic health record data of a large pregnancy cohort. ENVIRONMENT INTERNATIONAL 2022; 158:106888. [PMID: 34563749 PMCID: PMC9022440 DOI: 10.1016/j.envint.2021.106888] [Citation(s) in RCA: 46] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 09/07/2021] [Accepted: 09/17/2021] [Indexed: 05/14/2023]
Abstract
BACKGROUND Epidemiological findings are inconsistent regarding the associations between air pollution exposure during pregnancy and gestational diabetes mellitus (GDM). Several limitations exist in previous studies, including potential outcome and exposure misclassification, unassessed confounding, and lack of simultaneous consideration of air pollution mixtures and particulate matter (PM) constituents. OBJECTIVES To assess the association between GDM and maternal residential exposure to air pollution, and the joint effect of the mixture of air pollutants and PM constituents. METHODS Detailed clinical data were obtained for 395,927 pregnancies in southern California (2008-2018) from Kaiser Permanente Southern California (KPSC) electronic health records. GDM diagnosis was based on KPSC laboratory tests. Monthly average concentrations of fine particulate matter < 2.5 μm (PM2.5), <10 μm (PM10), nitrogen dioxide (NO2), and ozone (O3) were estimated using kriging interpolation of Environmental Protection Agency's routine monitoring station data, while PM2.5 constituents (i.e., sulfate, nitrate, ammonium, organic matter and black carbon) were estimated using a fine-resolution geoscience-derived model. A multilevel logistic regression was used to fit single-pollutant models; quantile g-computation approach was applied to estimate the joint effect of air pollution and PM component mixtures. Main analyses adjusted for maternal age, race/ethnicity, education, median family household income, pre-pregnancy BMI, smoking during pregnancy, insurance type, season of conception and year of delivery. RESULTS The incidence of GDM was 10.9% in the study population. In single-pollutant models, we observed an increased odds for GDM associated with exposures to PM2.5, PM10, NO2 and PM2.5 constituents. The association was strongest for NO2 [adjusted odds ratio (OR) per interquartile range: 1.176, 95% confidence interval (CI): 1.147-1.205)]. In multi-pollutant models, increased ORs for GDM in association with one quartile increase in air pollution mixtures were found for both kriging-based regional air pollutants (NO2, PM2.5, and PM10, OR = 1.095, 95% CI: 1.082-1.108) and PM2.5 constituents (i.e., sulfate, nitrate, ammonium, organic matter and black carbon, OR = 1.258, 95% CI: 1.206-1.314); NO2 (78%) and black carbon (48%) contributed the most to the overall mixture effects among all krigged air pollutants and all PM2.5 constituents, respectively. The risk of GDM associated with air pollution exposure were significantly higher among Hispanic mothers, and overweight/obese mothers. CONCLUSION This study found that exposure to a mixture of ambient PM2.5, PM10, NO2, and PM2.5 chemical constituents was associated with an increased risk of GDM. NO2 and black carbon PM2.5 contributed most to GDM risk.
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Affiliation(s)
- Yi Sun
- Department of Environmental and Occupational Health, Program in Public Health, University of California, Irvine, CA, USA
| | - Xia Li
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
| | - Tarik Benmarhnia
- Herbert Wertheim School of Public Health and Scripps Institution of Oceanography, University of California, San Diego, 9500 Gilman Drive #0725, CA La Jolla 92093, USA
| | - Jiu-Chiuan Chen
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Chantal Avila
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
| | - David A Sacks
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA; Department of Obstetrics and Gynecology, University of Southern California, Keck School of Medicine, Los Angeles, CA, USA
| | - Vicki Chiu
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
| | - Jeff Slezak
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
| | - John Molitor
- College of Public Health and Human Sciences, Oregon State University, Corvallis, OR 97331, USA
| | - Darios Getahun
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA; Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, USA.
| | - Jun Wu
- Department of Environmental and Occupational Health, Program in Public Health, University of California, Irvine, CA, USA.
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Olerich K, Soper D, Delaney S, Sterrett M. Pregnancy Care for Patients With Super Morbid Obesity. Front Pediatr 2022; 10:839377. [PMID: 35928678 PMCID: PMC9343711 DOI: 10.3389/fped.2022.839377] [Citation(s) in RCA: 4] [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: 12/19/2021] [Accepted: 06/22/2022] [Indexed: 11/13/2022] Open
Abstract
The patient with obesity represents unique challenges to the medical community and, in the setting of pregnancy, additional risks to both mother and fetus. This document will focus on the risks and considerations needed to care for the women with obesity and her fetus during the antepartum, intrapartum, and immediate postpartum stages of pregnancy. Specific attention will be given to pregnancy in the setting of class III and super morbid obesity.
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Affiliation(s)
- Kelsey Olerich
- Department of Obstetrics and Gynecology, University of Washington, Seattle, WA, United States
| | - David Soper
- Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, SC, United States
| | - Shani Delaney
- Department of Obstetrics and Gynecology, University of Washington, Seattle, WA, United States
| | - Mary Sterrett
- Department of Obstetrics and Gynecology, University of Washington, Seattle, WA, United States.,Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, SC, United States
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Zanardo V, Tortora D, Sandri A, Severino L, Mesirca P, Straface G. COVID-19 pandemic: Impact on gestational diabetes mellitus prevalence. Diabetes Res Clin Pract 2022; 183:109149. [PMID: 34808282 PMCID: PMC8665826 DOI: 10.1016/j.diabres.2021.109149] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Revised: 10/29/2021] [Accepted: 11/17/2021] [Indexed: 12/17/2022]
Abstract
AIM Although an increased risk of gestational diabetes mellitus (GDM) has been noted in women exposed to stressful conditions and traumatic events, limited information is available about such risk in the context of the COVID-19 pandemic. METHODS The study was designed as a non-concurrent case-control study on the prevalence of GDM, defined according to IADPSG 2010, in women giving birth during the COVID-19 pandemic in the hot spot of Northeast Italy from March 9th to May 18th, 2020, with an antecedent puerperae-matched group whose women had given birth in 2019. RESULTS Analysis revealed that during the COVID-19 pandemic in 2020, GDM prevalence was significantly higher than in 2019 (GDM, 48/533, 9 vs 86/637, 13.5%, p = 0.01), as illustrated by a higher GDM prevalence in 5/6 months of the final semester of 2020. In addition, logistic regression analysisconfirmed a statistically significant temporal relationship between experiencing the lockdown during the first trimester of gestation and later GDM incidence (t = 2.765, P = 0.012), with an 34% increase in mean number of GDM diagnoses per month (antilog of the parameter = 1.34). CONCLUSION The COVID-19 pandemic negatively impacted GDM prevalence in 2020 compared to 2019, especially for pregnant women in the 1st trimester of gestation.
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Affiliation(s)
- Vincenzo Zanardo
- Division of Perinatal Medicine, Policlinico Abano Terme, Abano Terme, Italy.
| | | | | | - Lorenzo Severino
- Division of Perinatal Medicine, Policlinico Abano Terme, Abano Terme, Italy
| | - Paolo Mesirca
- Division of Perinatal Medicine, Policlinico Abano Terme, Abano Terme, Italy
| | - Gianluca Straface
- Division of Perinatal Medicine, Policlinico Abano Terme, Abano Terme, Italy
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Ashraf SA, Elkhalifa AEO, Ahmad MF, Patel M, Adnan M, Sulieman AME. Probiotic Fermented Foods and Health Promotion. AFRICAN FERMENTED FOOD PRODUCTS- NEW TRENDS 2022:59-88. [DOI: 10.1007/978-3-030-82902-5_6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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37
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Triceps skinfold thickness and body mass index and the risk of gestational diabetes mellitus: Evidence from a multigenerational cohort study. Obes Res Clin Pract 2021; 16:44-49. [PMID: 34973921 DOI: 10.1016/j.orcp.2021.12.005] [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: 10/06/2021] [Revised: 12/10/2021] [Accepted: 12/21/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND Pre-pregnancy obesity is a well-recognized risk factor for gestational diabetes mellitus (GDM). There is a continuity of obesity from childhood to adolescence and then adulthood. However, it is unknown whether early childhood obesity predicts GDM. METHODS We investigated the prospective association of childhood triceps skinfold thickness and body mass index (BMI) with GDM risk among women from the Mater-University of Queensland Study of Pregnancy (MUSP), a multigenerational cohort study. A multiple logistic regression model was applied to estimate the odds of experiencing GDM by childhood skinfold thickness and BMI. RESULTS Out of 552 women in the study for whom data were available on triceps skinfold thickness and BMI at average age 5 (range 3-7) years old, 52 (9.42%) developed GDM by average age 30 (range 28-33) years. We found that the risk of developing GDM was greater among women who had greater skinfold thickness but not greater BMI at age 5 years. Women who were classified as overweight or obese based on skinfold thickness at age 5 years had an increased odds ratio of GDM compared to women who had normal skinfold thickness. This association remained significant after adjustment for the potential confounders (OR 2.74; 95% confidence interval=1.28-5.86). CONCLUSION The risk of developing GDM was associated with higher skinfold thickness at age 5 years.
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A low-carbohydrate dietary pattern characterised by high animal fat and protein during the first trimester is associated with an increased risk of gestational diabetes mellitus in Chinese women: a prospective cohort study. Br J Nutr 2021; 126:1872-1880. [PMID: 33597060 DOI: 10.1017/s0007114521000611] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
We aimed to examine the association between low-carbohydrate diet (LCD) scores during the first trimester and gestational diabetes mellitus (GDM) risk in a Chinese population. A total of 1455 women were included in 2017. Dietary information during the first trimester was collected by 24-h dietary recalls for 3 d. The overall, animal and plant LCD scores, which indicated adherence to different low-carbohydrate dietary patterns, were calculated. GDM was diagnosed based on the results of a 75-g, 2-h oral glucose tolerance test at 24-28 weeks gestation. Log-binomial models were used to estimate relative risks (RR) and 95 % CI. The results showed that the multivariable-adjusted RR of GDM from the lowest to the highest quartiles of the overall LCD score were 1·00 (reference), 1·15 (95 % CI 0·92, 1·42), 1·30 (95 % CI 1·06, 1·60) and 1·24 (95 % CI 1·01, 1·52) (P = 0·026 for trend). Multivariable-adjusted RR (95 % CI) of GDM from the lowest to the highest quartiles of the animal LCD score were 1·00 (reference), 1·20 (95 % CI 0·96, 1·50), 1·41 (95 % CI 1·14, 1·73) and 1·29 (95 % CI 1·04, 1·59) (P = 0·002 for trend). After additional adjustment for gestational weight gain before GDM diagnosis, the association of the overall LCD score with GDM risk was non-significant, while the association of animal LCD score with GDM risk remained significant. In conclusion, a low-carbohydrate dietary pattern characterised by high animal fat and protein during the first trimester is associated with an increased risk of GDM in Chinese women.
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Sinha N, Lydia Walker G, Sen A. Looking at the Future Through the Mother's Womb: Gestational Diabetes and Offspring Fertility. Endocrinology 2021; 162:6379047. [PMID: 34597389 PMCID: PMC8520322 DOI: 10.1210/endocr/bqab209] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Indexed: 12/12/2022]
Abstract
Altered nutrition or intrauterine exposure to various adverse conditions during fetal development or earlier in a mother's life can lead to epigenetic changes in fetal tissues, predisposing those tissues to diseases that manifest when offspring become adults. An example is a maternal obesity associated with gestational diabetes (GDM), where fetal exposure to a hyperglycemic, hyperinsulinemic, and/or hyperlipidemic gestational environment can provoke epigenetic changes that predispose offspring to various diseased conditions later in life. While it is now well established that offspring exposed to GDM have an increased risk of developing obesity, metabolic disorders, and/or cardiovascular disease in adult life, there are limited studies assessing the reproductive health of these offspring. This mini-review discusses the long-term effect of in utero exposure to GDM-associated adverse prenatal environment on the reproductive health of the offspring. Moreover, using evidence from various animal models and human epidemiological studies, this review offers molecular insight and understanding of how epigenetic reprogramming of genes culminates in reproductive dysfunction and the development of subfertility or infertility later in adult life.
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Affiliation(s)
- Niharika Sinha
- Reproductive and Developmental Sciences Program, East Lansing, Michigan 48824, USA
- Department of Animal Sciences, Michigan State University, East Lansing, Michigan 48824, USA
| | - Gretchen Lydia Walker
- Reproductive and Developmental Sciences Program, East Lansing, Michigan 48824, USA
- Department of Animal Sciences, Michigan State University, East Lansing, Michigan 48824, USA
| | - Aritro Sen
- Reproductive and Developmental Sciences Program, East Lansing, Michigan 48824, USA
- Department of Animal Sciences, Michigan State University, East Lansing, Michigan 48824, USA
- Correspondence: Aritro Sen, PhD, Reproductive and Developmental Sciences Program, 3013 Interdisciplinary Science & Technology Building, Michigan State University, 766 Service Rd, East Lansing, MI 48824, USA.
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Azab SM, de Souza RJ, Lamri A, Shanmuganathan M, Kroezen Z, Schulze KM, Desai D, Williams NC, Morrison KM, Atkinson SA, Teo KK, Britz-McKibbin P, Anand SS. Metabolite profiles and the risk of metabolic syndrome in early childhood: a case-control study. BMC Med 2021; 19:292. [PMID: 34823524 PMCID: PMC8616718 DOI: 10.1186/s12916-021-02162-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 10/18/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Defining the metabolic syndrome (MetS) in children remains challenging. Furthermore, a dichotomous MetS diagnosis can limit the power to study associations. We sought to characterize the serum metabolite signature of the MetS in early childhood using high-throughput metabolomic technologies that allow comprehensive profiling of metabolic status from a biospecimen. METHODS In the Family Atherosclerosis Monitoring In earLY life (FAMILY) prospective birth cohort study, we selected 228 cases of MetS and 228 matched controls among children age 5 years. In addition, a continuous MetS risk score was calculated for all 456 participants. Comprehensive metabolite profiling was performed on fasting serum samples using multisegment injection-capillary electrophoresis-mass spectrometry. Multivariable regression models were applied to test metabolite associations with MetS adjusting for covariates of screen time, diet quality, physical activity, night sleep, socioeconomic status, age, and sex. RESULTS Compared to controls, thirteen serum metabolites were identified in MetS cases when using multivariable regression models, and using the quantitative MetS score, an additional eight metabolites were identified. These included metabolites associated with gluconeogenesis (glucose (odds ratio (OR) 1.55 [95% CI 1.25-1.93]) and glutamine/glutamate ratio (OR 0.82 [95% CI 0.67-1.00])) and the alanine-glucose cycle (alanine (OR 1.41 [95% CI 1.16-1.73])), amino acids metabolism (tyrosine (OR 1.33 [95% CI 1.10-1.63]), threonine (OR 1.24 [95% CI 1.02-1.51]), monomethylarginine (OR 1.33 [95% CI 1.09-1.64]) and lysine (OR 1.23 [95% CI 1.01-1.50])), tryptophan metabolism (tryptophan (OR 0.78 [95% CI 0.64-0.95])), and fatty acids metabolism (carnitine (OR 1.24 [95% CI 1.02-1.51])). The quantitative MetS risk score was more powerful than the dichotomous outcome in consistently detecting this metabolite signature. CONCLUSIONS A distinct metabolite signature of pediatric MetS is detectable in children as young as 5 years old and may improve risk assessment at early stages of development.
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Affiliation(s)
- Sandi M Azab
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Russell J de Souza
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
- Centre for Metabolism, Obesity and Diabetes Research, McMaster University, Hamilton, ON, Canada
- Population Health Research Institute, Hamilton, ON, Canada
| | - Amel Lamri
- Department of Medicine, McMaster University, Hamilton, ON, Canada
- Population Health Research Institute, Hamilton, ON, Canada
| | - Meera Shanmuganathan
- Department of Chemistry and Chemical Biology, McMaster University, Hamilton, ON, Canada
| | - Zachary Kroezen
- Department of Chemistry and Chemical Biology, McMaster University, Hamilton, ON, Canada
| | | | - Dipika Desai
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
- Population Health Research Institute, Hamilton, ON, Canada
| | | | - Katherine M Morrison
- Centre for Metabolism, Obesity and Diabetes Research, McMaster University, Hamilton, ON, Canada
- Population Health Research Institute, Hamilton, ON, Canada
- Department of Pediatrics, McMaster University, Hamilton, ON, Canada
| | | | - Koon K Teo
- Department of Medicine, McMaster University, Hamilton, ON, Canada
- Population Health Research Institute, Hamilton, ON, Canada
| | - Philip Britz-McKibbin
- Department of Chemistry and Chemical Biology, McMaster University, Hamilton, ON, Canada
| | - Sonia S Anand
- Department of Medicine, McMaster University, Hamilton, ON, Canada.
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada.
- Centre for Metabolism, Obesity and Diabetes Research, McMaster University, Hamilton, ON, Canada.
- Population Health Research Institute, Hamilton, ON, Canada.
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Sharma A, Birkeland KI, Nermoen I, Qvigstad E, Tran AT, Gulseth HL, Sollid ST, Wium C, Varsi C. Understanding mechanisms behind unwanted health behaviours in Nordic and South Asian women and how they affect their gestational diabetes follow-ups: A qualitative study. Diabet Med 2021; 38:e14651. [PMID: 34268812 DOI: 10.1111/dme.14651] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 06/16/2021] [Accepted: 07/13/2021] [Indexed: 12/31/2022]
Abstract
AIMS The type 2 diabetes risk following gestational diabetes mellitus (GDM) is high, particularly among South Asian women in Western countries. Our study aimed to advance the knowledge regarding the mechanisms behind suboptimal follow-up in the Nordic and South Asian women with previous GDM by comparing (1) their experiences, (2) health and disease perceptions and (3) barriers to and facilitators of health-promoting behaviours. METHODS This qualitative study was conducted in three hospital outpatient clinics in Norway, comprising six focus group interviews with 28 women 1-3 years after a pregnancy with GDM. The participants were purposively sampled and grouped according to their ethnicity. The data were analysed using thematic analysis, and a theoretical approach was applied to support the analysis and discuss the study's findings. RESULTS Five main themes were identified: lack of resilience, emotional distress, 'caught between a rock and a hard place', postpartum abandonment and insufficient guidance. The key determinants of the maintenance of unwanted health behaviours after GDM were consistent across the ethnic groups. Although the importance of a culturally sensitive approach was emphasised, it appeared secondary to the need for a more organised public healthcare during and after GDM. CONCLUSIONS Women's real-life constraints, combined with the inadequate healthcare-service implementation, could explain the non-adherence to the lifestyle-changes guidelines essential for preventing diabetes post-GDM. We suggest promoting specific coping strategies and changing the healthcare service approach rather than relying on women's capacity to initiate the necessary changes.
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Affiliation(s)
- Archana Sharma
- Department of Endocrinology, Akershus University Hospital, Lørenskog, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Kåre I Birkeland
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway
| | - Ingrid Nermoen
- Department of Endocrinology, Akershus University Hospital, Lørenskog, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Elisabeth Qvigstad
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway
| | - Anh T Tran
- Institute of Health and Society, Department of General Practice, University of Oslo, Oslo, Norway
| | | | - Stina T Sollid
- Department of Medicine, Drammen Hospital, Vestre Viken Health Trust, Drammen, Norway
| | | | - Cecilie Varsi
- Department of Digital Health Research, Oslo University Hospital, Oslo, Norway
- Faculty of Health and Social Sciences, University of South-Eastern Norway, Drammen, Norway
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Rammah A, Whitworth KW, Amos CI, Estarlich M, Guxens M, Ibarluzea J, Iñiguez C, Subiza-Pérez M, Vrijheid M, Symanski E. Air Pollution, Residential Greenness and Metabolic Dysfunction during Early Pregnancy in the INfancia y Medio Ambiente (INMA) Cohort. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18179354. [PMID: 34501944 PMCID: PMC8430971 DOI: 10.3390/ijerph18179354] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 08/26/2021] [Accepted: 08/31/2021] [Indexed: 12/20/2022]
Abstract
Despite extensive study, the role of air pollution in gestational diabetes remains unclear, and there is limited evidence of the beneficial impact of residential greenness on metabolic dysfunction during pregnancy. We used data from mothers in the Spanish INfancia y Medio Ambiente (INMA) Project from 2003–2008. We obtained spatiotemporally resolved estimates of fine particulate matter (PM2.5) and nitrogen dioxide (NO2) exposures in early pregnancy and estimated residential greenness using satellite-based Normal Difference Vegetation Index (NDVI) within 100, 300 and 500 m buffers surrounding the mother’s residence. We applied logistic regression models to evaluate associations between each of the three exposures of interest and (a) glucose intolerance and (b) abnormal lipid levels. We found limited evidence of associations between increases in PM2.5 and NO2 exposures and the metabolic outcomes. Though not statistically significant, high PM2.5 exposure (≥25 µg/m3) was associated with increased odds of glucose intolerance (OR = 1.16, 95% CI: 0.82, 1.63) and high cholesterol (OR = 1.14, 95% CI: 0.90, 1.44). High NO2 exposure (≥39.8 µg/m3) was inversely associated with odds of high triglycerides (OR = 0.70, 95% CI: 0.45, 1.08). Whereas NDVI was not associated with glucose intolerance, odds of high triglycerides were increased, although the results were highly imprecise. Results were unchanged when the air pollutant variables were included in the regression models. Given the equivocal findings in our study, additional investigations are needed to assess effects of air pollution and residential greenness on metabolic dysfunction during pregnancy.
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Affiliation(s)
- Amal Rammah
- Center for Precision Environmental Health, Baylor College of Medicine, Houston, TX 77030, USA; (A.R.); (K.W.W.)
| | - Kristina W. Whitworth
- Center for Precision Environmental Health, Baylor College of Medicine, Houston, TX 77030, USA; (A.R.); (K.W.W.)
- Department of Medicine, Section of Epidemiology and Population Sciences, Baylor College of Medicine, Houston, TX 77030, USA;
| | - Christopher I. Amos
- Department of Medicine, Section of Epidemiology and Population Sciences, Baylor College of Medicine, Houston, TX 77030, USA;
- Institute of Clinical and Translational Medicine, Baylor College of Medicine, Houston, TX 77030, USA
| | - Marisa Estarlich
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain; (M.E.); (M.G.); (J.I.); (C.I.); (M.S.-P.); (M.V.)
- Department of Nursing, University of Valencia, 46010 Valencia, Spain
- Epidemiology and Environmental Health Joint Research Unit, The Foundation for the Promotion of Health and Biomedical Research of Valencia Region, Universitat Jaume I-Universitat de València, 46010 Valencia, Spain
| | - Mònica Guxens
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain; (M.E.); (M.G.); (J.I.); (C.I.); (M.S.-P.); (M.V.)
- ISGlobal, 08003 Barcelona, Spain
- Department of Experimental and Health Sciences, Pompeu Fabra University, 08003 Barcelona, Spain
- Department of Child and Adolescent Psychiatry, Erasmus University Medical Center (Erasmus MC), 3015 Rotterdam, The Netherlands
| | - Jesús Ibarluzea
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain; (M.E.); (M.G.); (J.I.); (C.I.); (M.S.-P.); (M.V.)
- Group of Environmental Epidemiology and Child Development, Biodonostia Health Research Institute, 20014 San Sebastian, Spain
- Faculty of Psychology, University of the Basque Country UPV/EHU, 20018 San Sebastian, Spain
- Ministry of Health of the Basque Government, Sub Directorate for Public Health and Addictions of Gipuzkoa, 20013 San Sebastián, Spain
| | - Carmen Iñiguez
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain; (M.E.); (M.G.); (J.I.); (C.I.); (M.S.-P.); (M.V.)
- Department of Statistics and Operational Research, University of Valencia, 46010 Valencia, Spain
| | - Mikel Subiza-Pérez
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain; (M.E.); (M.G.); (J.I.); (C.I.); (M.S.-P.); (M.V.)
- Group of Environmental Epidemiology and Child Development, Biodonostia Health Research Institute, 20014 San Sebastian, Spain
- Department of Clinical and Health Psychology and Research Methods, University of the Basque Country UPV/EHU, 20018 San Sebastián, Spain
| | - Martine Vrijheid
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain; (M.E.); (M.G.); (J.I.); (C.I.); (M.S.-P.); (M.V.)
- ISGlobal, 08003 Barcelona, Spain
- Department of Experimental and Health Sciences, Pompeu Fabra University, 08003 Barcelona, Spain
| | - Elaine Symanski
- Center for Precision Environmental Health, Baylor College of Medicine, Houston, TX 77030, USA; (A.R.); (K.W.W.)
- Department of Medicine, Section of Epidemiology and Population Sciences, Baylor College of Medicine, Houston, TX 77030, USA;
- Correspondence:
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Franzago M, Fraticelli F, Marchioni M, Di Nicola M, Di Sebastiano F, Liberati M, Stuppia L, Vitacolonna E. Fat mass and obesity-associated (FTO) gene epigenetic modifications in gestational diabetes: new insights and possible pathophysiological connections. Acta Diabetol 2021; 58:997-1007. [PMID: 33743080 PMCID: PMC8272710 DOI: 10.1007/s00592-020-01668-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 12/26/2020] [Indexed: 12/16/2022]
Abstract
AIMS Gestational diabetes mellitus (GDM) can lead to short- and long-term complications for the child. Epigenetic alterations could contribute to explaining the metabolic disturbances associated with foetal programming. Although the role of the FTO gene remains unclear, it affects metabolic phenotypes probably mediated by epigenetic mechanisms. The aim of this study was to assess whether placental DNA epigenetic modifications at FTO promoter-associated cysteine-phosphate-guanine (CpG) sites are correlated with GDM. A secondary aim was to evaluate the association between the placental FTO DNA methylation and the maternal metabolic traits in women with and without GDM. METHODS Socio-demographic characteristics, clinical parameters at the third trimester of pregnancy, Mediterranean diet adherence, and physical activity were assessed in 33 GDM women and 27 controls. Clinical information about the newborns was registered at birth. The FTO rs9939609 (T > A) was genotyped. RESULTS No association between FTO DNA methylation and GDM was found. DNA methylation on the maternal side at the CpG1 was associated with maternal smoking in GDM (p = 0.034), and DNA methylation at the CpG3 was correlated with smoking or former smoking in controls (p = 0.023). A higher level of TGs was correlated with higher foetal placental DNA methylation at the CpG2 (p = 0.036) in GDM. An inverse association between HDL-C and maternal placental DNA methylation at the CpG3 in controls (p = 0.045) was found. An association between FTO rs9939609 and neonatal birthweight (p = 0.033) was detected. CONCLUSIONS In the awareness that the obesity pathophysiology is complex, the study adds a piece to this intricate mosaic.
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Affiliation(s)
- Marica Franzago
- Department of Medicine and Aging, School of Medicine and Health Sciences, "G. D'Annunzio" University, Chieti-Pescara, Via dei Vestini, 66100, Chieti, Italy
- Center for Advanced Studies and Technology (CAST), "G. D'Annunzio" University, Chieti-Pescara, Chieti, Italy
| | - Federica Fraticelli
- Department of Medicine and Aging, School of Medicine and Health Sciences, "G. D'Annunzio" University, Chieti-Pescara, Via dei Vestini, 66100, Chieti, Italy
| | - Michele Marchioni
- Laboratory of Biostatistics, Department of Medical, Oral and Biotechnological Sciences, "G.D'Annunzio" University, Chieti-Pescara, Chieti, Italy
| | - Marta Di Nicola
- Laboratory of Biostatistics, Department of Medical, Oral and Biotechnological Sciences, "G.D'Annunzio" University, Chieti-Pescara, Chieti, Italy
| | - Francesca Di Sebastiano
- Department of Obstetric and Gynaecology, SS. Annunziata Hospital, "G. D'Annunzio" University, Chieti-Pescara, Chieti, Italy
| | - Marco Liberati
- Department of Medicine and Aging, School of Medicine and Health Sciences, "G. D'Annunzio" University, Chieti-Pescara, Via dei Vestini, 66100, Chieti, Italy
| | - Liborio Stuppia
- Center for Advanced Studies and Technology (CAST), "G. D'Annunzio" University, Chieti-Pescara, Chieti, Italy
- Department of Psychological, Health and Territorial Sciences, School of Medicine and Health Sciences, "G. D'Annunzio" University, Chieti-Pescara, Chieti, Italy
| | - Ester Vitacolonna
- Department of Medicine and Aging, School of Medicine and Health Sciences, "G. D'Annunzio" University, Chieti-Pescara, Via dei Vestini, 66100, Chieti, Italy.
- Center for Advanced Studies and Technology (CAST), "G. D'Annunzio" University, Chieti-Pescara, Chieti, Italy.
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Tryggvadottir EA, Gunnarsdottir I, Birgisdottir BE, Hrolfsdottir L, Landberg R, Hreidarsdottir IT, Hardardottir H, Halldorsson TI. Early pregnancy plasma fatty acid profiles of women later diagnosed with gestational diabetes. BMJ Open Diabetes Res Care 2021; 9:e002326. [PMID: 34348919 PMCID: PMC8340288 DOI: 10.1136/bmjdrc-2021-002326] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 07/04/2021] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Fatty acid (FA) concentrations have previously been associated with gestational diabetes mellitus (GDM). However, few studies on GDM have examined FA profiles in early pregnancy or before diagnosis. This study aimed to compare early pregnancy plasma FA profiles of women with and without GDM diagnoses as well as their reported dietary consumption. RESEARCH DESIGN AND METHODS The subjects comprised 853 women from the prospective study: Pregnant Women in Iceland II (PREWICE II), attending their 11-14 weeks ultrasound appointment in 2017-2018. During the visit, blood samples were collected for plasma FA analysis, and dietary habits were assessed using a short food frequency questionnaire. Information on GDM diagnoses was then later extracted from medical records. Differences in FA profile between GDM cases and non-cases were evaluated using the Mann-Whitney U test. RESULTS GDM was diagnosed in 127 women (14.9%). Concentrations of saturated fatty acids, monounsaturated fatty acids, polyunsaturated fatty acids (PUFA) n-6, PUFA n-3 and total FA were higher in the women who later developed GDM compared with those who did not (p≤0.05). The medians for total FA were 2898 μg/mL for the women with GDM and 2681 μg/mL for those without GDM. Mean adjusted difference for total FA between the groups was 133 μg/mL (95% CI 33 to 233). Similar results were observed in prepregnancy normal-weight women and overweight women/women with obesity. Overall diet quality in early pregnancy appeared to be lower among the women later diagnosed with GDM. CONCLUSION We found that plasma FA profiles in early pregnancy were different for women later diagnosed with GDM compared with those who were not, independent of the women's body mass index.
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Affiliation(s)
- Ellen Alma Tryggvadottir
- Faculty of Food Science and Nutrition, University of Iceland, Reykjavik, Iceland
- Unit for Nutrition Research, Landspitali University Hospital, Reykjavík, Iceland
| | - Ingibjorg Gunnarsdottir
- Faculty of Food Science and Nutrition, University of Iceland, Reykjavik, Iceland
- Unit for Nutrition Research, Landspitali University Hospital, Reykjavík, Iceland
| | - Bryndis Eva Birgisdottir
- Faculty of Food Science and Nutrition, University of Iceland, Reykjavik, Iceland
- Unit for Nutrition Research, Landspitali University Hospital, Reykjavík, Iceland
| | - Laufey Hrolfsdottir
- Faculty of Food Science and Nutrition, University of Iceland, Reykjavik, Iceland
- Department of Education and Science, Akureyri Hospital, Akureyri, Iceland
| | - Rikard Landberg
- Biology and Biological Engineering, Chalmers University of Technology, Goteborg, Sweden
| | - Ingibjorg Th Hreidarsdottir
- Department of Obstetrics and Gynecology, Landspítali University Hospital, Reykjavík, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | | | - Thorhallur Ingi Halldorsson
- Faculty of Food Science and Nutrition, University of Iceland, Reykjavik, Iceland
- Unit for Nutrition Research, Landspitali University Hospital, Reykjavík, Iceland
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Tranidou A, Dagklis T, Tsakiridis I, Siargkas A, Apostolopoulou A, Mamopoulos A, Goulis DG, Chourdakis M. Risk of developing metabolic syndrome after gestational diabetes mellitus - a systematic review and meta-analysis. J Endocrinol Invest 2021; 44:1139-1149. [PMID: 33226626 DOI: 10.1007/s40618-020-01464-6] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Accepted: 10/30/2020] [Indexed: 12/29/2022]
Abstract
PURPOSE A systematic review and meta-analysis were conducted to quantitatively synthesize the current evidence regarding the risk of developing metabolic syndrome (MetS) in women with a personal history of gestational diabetes mellitus (GDM), without pre-existing diabetes, compared with those without a history of GDM. METHODS Four electronic databases [MEDLINE (via PubMed), Scopus, Cochrane Library, PROSPERO] were searched for relevant literature until July 29th 2020. Cochran's Q test was applied for the assessment of heterogeneity. The random-effects model was applied by calculating the odds ratio (OR) and 95% confidence interval (CI) for each study. Publication bias was estimated with Egger's linear regression test. RESULTS The results from 23 studies (10,230 pregnant women; 5169 cases, 5061 controls), indicated that women with a history of GDM had a higher risk of developing MetS compared with those without such a history (OR 3.45; 95% CI 2.80-4.25, p < 0.0001). This risk remained higher, independently of maternal age and ethnicity (although the risk was not as high in Asians; OR 2.11; 95% CI 1.27-3.52). The risk of developing MetS was even higher in studies where women with GDM had increased body mass index (BMI) compared with the controls (OR 4.14; 95% CI 3.18-5.38). CONCLUSIONS The risk for developing MetS following delivery is higher in women with a history of GDM compared with women without such a history. Timely recognition and appropriate intervention are critical to halt progression to MetS and its associated morbidity.
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Affiliation(s)
- A Tranidou
- 3rd Department of Obstetrics and Gynecology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - T Dagklis
- 3rd Department of Obstetrics and Gynecology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - I Tsakiridis
- 3rd Department of Obstetrics and Gynecology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - A Siargkas
- 3rd Department of Obstetrics and Gynecology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - A Apostolopoulou
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - A Mamopoulos
- 3rd Department of Obstetrics and Gynecology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - D G Goulis
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - M Chourdakis
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Department of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.
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Benhalima K. Recent Advances in Gestational Diabetes Mellitus. J Clin Med 2021; 10:jcm10102202. [PMID: 34069666 PMCID: PMC8161167 DOI: 10.3390/jcm10102202] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 05/11/2021] [Indexed: 02/07/2023] Open
Abstract
The incidence of gestational diabetes mellitus (GDM) and overt diabetes in pregnancy is rising globally [...].
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Affiliation(s)
- Katrien Benhalima
- Department of Endocrinology, University Hospital Gasthuisberg, KU Leuven, Herestraat 49, 3000 Leuven, Belgium
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Tryggvadottir EA, Halldorsson TI, Landberg R, Hrolfsdottir L, Birgisdottir BE, Magnusdottir OK, Hreidarsdottir IT, Hardardottir H, Gunnarsdottir I. Higher Alkylresorcinol Concentrations, a Consequence of Whole-Grain Intake, are Inversely Associated with Gestational Diabetes Mellitus in Iceland. J Nutr 2021; 151:1159-1166. [PMID: 33693761 DOI: 10.1093/jn/nxaa449] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 10/12/2020] [Accepted: 12/22/2020] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND A diet rich in whole grains may provide benefits for pregnant women due to whole grains' high nutritional value and dietary fiber content. OBJECTIVES To study the associations of whole-grain consumption, as well as the plasma alkylresorcinol concentration, a whole-grain consumption biomarker, in early pregnancy with gestational diabetes mellitus (GDM) diagnoses. METHODS Subjects were women from the prospective study Pregnant Women in Iceland II (PREWICE II; n = 853) who attended their ultrasound appointment in gestational weeks 11-14 during the period from October 2017 to March 2018. During that visit, whole-grain consumption was estimated using a diet screening questionnaire, and blood samples were collected for analysis of plasma alkylresorcinols (ARs). Information on GDM diagnoses was later extracted from medical records. Multivariate log-binomial regression was used to evaluate the association of dietary whole-grain and AR concentrations with GDM. RESULTS In total, 14.9% of the women adhered to the national food-based dietary guidelines (n = 127), which recommend 2 portions of whole grains daily. GDM was diagnosed in 127 women (14.9%). The frequency of whole-grain consumption was lower in women who were later diagnosed with GDM compared to the women without GDM (median, 5 times/week vs. 6 times/week, respectively; P = 0.02). This difference was reflected in the lower median concentration of total AR in women diagnosed with GDM (163 nmol/L vs. 209 nmol/L, respectively; P < 0.01). The quartile with the highest concentrations of AR had a RR of 0.50 (95% CI: 0.27-0.90) of being diagnosed with GDM, in comparison to the lowest quartile. There was a significant dose response in the GDM risk with higher AR levels. CONCLUSIONS We found that a higher consumption of whole grains, reflected both by reported consumption according to the FFQ and AR biomarkers, was associated with a decreased risk of receiving a GDM diagnosis.
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Affiliation(s)
- Ellen A Tryggvadottir
- Unit for Nutrition Research, Landspitali University Hospital and Faculty of Food Science and Nutrition, University of Iceland, Reykjavik, Iceland
| | - Thorhallur I Halldorsson
- Unit for Nutrition Research, Landspitali University Hospital and Faculty of Food Science and Nutrition, University of Iceland, Reykjavik, Iceland.,Centre for Fetal Programming, Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
| | - Rikard Landberg
- Division of Food and Nutrition Science, Department of Biology and Biological Engineering, Chalmers University of Technology, Gothenburg, Sweden
| | - Laufey Hrolfsdottir
- Unit for Nutrition Research, Landspitali University Hospital and Faculty of Food Science and Nutrition, University of Iceland, Reykjavik, Iceland.,Institution of Health Science Research, University of Akureyri and Akureyri Hospital, Akureyri, Iceland
| | - Bryndis E Birgisdottir
- Unit for Nutrition Research, Landspitali University Hospital and Faculty of Food Science and Nutrition, University of Iceland, Reykjavik, Iceland
| | - Ola K Magnusdottir
- Unit for Nutrition Research, Landspitali University Hospital and Faculty of Food Science and Nutrition, University of Iceland, Reykjavik, Iceland
| | | | - Hildur Hardardottir
- Faculty of Medicine, University of Iceland Reykjavík, Reykjavík, Iceland.,Livio Reykjavík, Reproductive Center in Reykjavík, Reykjavík, Iceland
| | - Ingibjorg Gunnarsdottir
- Unit for Nutrition Research, Landspitali University Hospital and Faculty of Food Science and Nutrition, University of Iceland, Reykjavik, Iceland
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Mishra J, Srivastava SK, Pandey KB. Compromised Renal and Hepatic Functions and Unsteady Cellular Redox State during Preeclampsia and Gestational Diabetes Mellitus. Arch Med Res 2021; 52:635-640. [PMID: 33814206 DOI: 10.1016/j.arcmed.2021.03.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 03/08/2021] [Accepted: 03/17/2021] [Indexed: 12/17/2022]
Abstract
INTRODUCTION To assess renal and hepatic functions along with the redox state in preeclampsia (PE) and gestational diabetes mellitus (GDM) pregnancies. DESIGN AND METHOD The study was conducted on 33 PE (mean age = 30 ± 5 years), 33 GDM (mean age = 30 ± 6 years) and age, gravida, parity, and ethnicity matched 25 normal pregnancies (NP). Biomarkers of redox status, renal and hepatic functions; aspartate transaminase (AST), alanine transaminase (ALT), alkaline phosphatase (ALP), bilirubin, urea, blood urea nitrogen (BUN), creatinine, uric acid, lipid peroxidation (MDA), total thiols (TSH), radical scavenging activities and ferric reducing antioxidant potentials of serum were measured. RESULTS Higher urea, BUN, uric acid, creatinine and overexpressed AST, ALT, ALP was observed in PE (p <0.03-p<0.001), whereas in GDM elevation in creatinine and ALT activity were only statistically significant (p <0.01) in comparison to NP. Diminished antioxidant/radical scavenging potentials, TSH content and increased MDA were noted in both the diseased pregnancies when compared with NP with statistically significant variables ranged from p <0.04-p <0.0001. CONCLUSION Our data suggest that PE has detrimental effects on renal and hepatic functions while GDM are prone to malfunctioned liver and kidney performances. Impaired redox state may be one of the reasons of altered physiological process in PE and GDM pregnancies. Results may be used to monitor the efficiency and efficacy of antioxidant supplementation, recently suggested for PE and GDM patients.
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Affiliation(s)
- Jigeesha Mishra
- Sam Higginbottom University of Agriculture, Technology and Sciences, Prayagraj, India
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Extracellular vesicles and their role in gestational diabetes mellitus. Placenta 2021; 113:15-22. [PMID: 33714611 DOI: 10.1016/j.placenta.2021.02.012] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 01/19/2021] [Accepted: 02/18/2021] [Indexed: 02/07/2023]
Abstract
Gestational diabetes mellitus (GDM) is a complex disorder that is defined by glucose intolerance with onset during pregnancy. The incidence of GDM is increasing worldwide. Pregnancies complicated with GDM have higher rates of maternal and fetal morbidity with short- and long-term consequences, including increased rates of cardiovascular disease and type II diabetes for both the mother and offspring. The pathophysiology of GDM still remains unclear and there has been interest in the role of small extracellular vesicles (sEVs) in the maternal metabolic adaptations that occur in pregnancy and GDM. Small EVs are nanosized particles that contain bioactive content, including miRNAs and proteins, which are released by cells to provide cell-to-cell communication. Pregnancy induces an increase in total and placental-secreted sEVs across gestation, with a further increase in sEV number and changes in the protein and miRNA composition of these sEVs in GDM. Research has suggested that these sEVs have an impact on maternal adaptations during pregnancy, including targeting the pancreas, skeletal muscle and adipose tissue. Consequently, this review will focus on the differences in total and placental sEVs in GDM compared to normal pregnancy, the role of sEVs in the pathophysiology of GDM and their clinical application as potential GDM biomarkers.
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50
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Herath MP, Beckett JM, Hills AP, Byrne NM, Ahuja KDK. Gestational Diabetes Mellitus and Infant Adiposity at Birth: A Systematic Review and Meta-Analysis of Therapeutic Interventions. J Clin Med 2021; 10:jcm10040835. [PMID: 33670645 PMCID: PMC7922793 DOI: 10.3390/jcm10040835] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 02/03/2021] [Accepted: 02/16/2021] [Indexed: 12/16/2022] Open
Abstract
Exposure to untreated gestational diabetes mellitus (GDM) in utero increases the risk of obesity and type 2 diabetes in adulthood, and increased adiposity in GDM-exposed infants is suggested as a plausible mediator of this increased risk of later-life metabolic disorders. Evidence is equivocal regarding the impact of good glycaemic control in GDM mothers on infant adiposity at birth. We systematically reviewed studies reporting fat mass (FM), percent fat mass (%FM) and skinfold thicknesses (SFT) at birth in infants of mothers with GDM controlled with therapeutic interventions (IGDMtr). While treating GDM lowered FM in newborns compared to no treatment, there was no difference in FM and SFT according to the type of treatment (insulin, metformin, glyburide). IGDMtr had higher overall adiposity (mean difference, 95% confidence interval) measured with FM (68.46 g, 29.91 to 107.01) and %FM (1.98%, 0.54 to 3.42) but similar subcutaneous adiposity measured with SFT, compared to infants exposed to normal glucose tolerance (INGT). This suggests that IGDMtr may be characterised by excess fat accrual in internal adipose tissue. Given that intra-abdominal adiposity is a major risk factor for metabolic disorders, future studies should distinguish adipose tissue distribution of IGDMtr and INGT.
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