1
|
Lis-Kuberka J, Berghausen-Mazur M, Orczyk-Pawiłowicz M. Gestational Diabetes Mellitus and Colostral Appetite-Regulating Adipokines. Int J Mol Sci 2024; 25:3853. [PMID: 38612666 PMCID: PMC11011253 DOI: 10.3390/ijms25073853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2024] [Revised: 03/25/2024] [Accepted: 03/26/2024] [Indexed: 04/14/2024] Open
Abstract
Gestational diabetes mellitus (GDM) is a complex metabolic disorder that has short- and long-term effects on maternal and offspring health. This study aimed to assess the impact of maternal hyperglycemia severity, classified as GDM-G1 (diet treatment) and GDM-G2 (insulin treatment) on colostral appetite-regulating molecules. Colostrum samples were collected from hyperglycemic (N = 30) and normoglycemic (N = 21) mothers, and the concentrations of milk hormones were determined by immunoenzymatic assay. A difference was found for milk ghrelin, but not for molecules such as adiponectin, leptin, resistin, or IGF-I levels, in relation to maternal hyperglycemia. The colostral ghrelin in the GDM-G1 cohort (0.21 ng/mL) was significantly lower than for GDM-G2 (0.38 ng/mL) and non-GDM groups (0.36 ng/mL). However, colostral resistin was higher, but not significantly, for GDM-G1 (13.33 ng/mL) and GDM-G2 (12.81 ng/mL) cohorts than for normoglycemic mothers (7.89 ng/mL). The lack of difference in relation to hyperglycemia for milk leptin, adiponectin, leptin-adiponectin ratio, resistin, and IGF-I levels might be the outcome of effective treatment of GDM during pregnancy. The shift between ghrelin and other appetite-regulating hormones might translate into altered ability to regulate energy balance, affecting offspring's metabolic homeostasis.
Collapse
Affiliation(s)
- Jolanta Lis-Kuberka
- Division of Chemistry and Immunochemistry, Department of Biochemistry and Immunochemistry, Wroclaw Medical University, M. Skłodowskiej-Curie 48/50, 50-369 Wroclaw, Poland;
| | - Marta Berghausen-Mazur
- Department of Neonatology, J. Gromkowski Provincial Specialist Hospital, Koszarowa 5, 51-149 Wroclaw, Poland
- Faculty of Medicine, Wroclaw University of Science and Technology, Hoene-Wrońskiego 13c, 58-376 Wroclaw, Poland
| | - Magdalena Orczyk-Pawiłowicz
- Division of Chemistry and Immunochemistry, Department of Biochemistry and Immunochemistry, Wroclaw Medical University, M. Skłodowskiej-Curie 48/50, 50-369 Wroclaw, Poland;
| |
Collapse
|
2
|
Mohandas S, Milan KL, Anuradha M, Ramkumar KM. Exploring Lactoferrin as a novel marker for disease pathology and ferroptosis regulation in gestational diabetes. J Reprod Immunol 2024; 161:104182. [PMID: 38159430 DOI: 10.1016/j.jri.2023.104182] [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: 10/15/2023] [Revised: 11/30/2023] [Accepted: 12/12/2023] [Indexed: 01/03/2024]
Abstract
Iron overload is linked to heightened susceptibility to ferroptosis, a process increasingly implicated in diabetes pathogenesis. This present study aims to assess the utility of Lactoferrin in predicting different stages of GDM and explore its association with disease pathology and ferroptosis. In this observational study, 72 pregnant women were recruited and categorized into three groups: healthy pregnant women without diabetes (NGDM, n = 24), early gestational diabetes (eGDM, n = 24), and established gestational diabetes (GDM, n = 24), all receiving standard antenatal care at 12 weeks of gestation. Circulating levels of ferritin, soluble transferrin receptor (sTFR), and Lactoferrin using multiplexed bead-based cytokine immunoassay. Gene expression analysis focused on analyzing crucial ferroptosis regulators, SLC7A11 and GPX4, in isolated peripheral blood mononuclear cells (PBMCs). A significant elevation in ferritin levels and a decrease in the sTFR: Ferritin ratio supported iron overload and disrupted iron homeostasis in GDM subjects. Notably, Lactoferrin levels were significantly lower in women with GDM than in the control group and those with eGDM. This decline in Lactoferrin correlated with increased hyperglycemia indicators and reduced expression of ferroptosis regulators among GDM patients. Furthermore ROC curve analysis demonstrated that Lactoferrin shows promise as a valuable marker for distinguishing individuals with GDM from those with eGDM. Lactoferrin shows promise as a biomarker for detecting GDM. These findings indicate its role as a potential biomarker and highlight Lactoferrin as a critical regulator of hyperglycemia and ferroptosis in women with GDM.
Collapse
Affiliation(s)
- Sundhar Mohandas
- Department of Biotechnology, School of Bioengineering, SRM Institute of Science and Technology, Kattankulathur 603203, Tamil Nadu, India
| | - Kunnath Lakshmanan Milan
- Department of Biotechnology, School of Bioengineering, SRM Institute of Science and Technology, Kattankulathur 603203, Tamil Nadu, India
| | - Murugesan Anuradha
- Department of Obstetrics & Gynecology, SRM Medical College Hospital and Research Centre, Kattankulathur 603203, Tamil Nadu, India
| | - Kunka Mohanram Ramkumar
- Department of Biotechnology, School of Bioengineering, SRM Institute of Science and Technology, Kattankulathur 603203, Tamil Nadu, India.
| |
Collapse
|
3
|
Kulesza-Brończyk B, Bień A, Sobieraj P, Orczyk-Pawiłowicz M, Lis-Kuberka J, Czosnykowska-Łukacka M, Bzikowska-Jura A. Factors affecting total protein and lactoferrin in human milk. Sci Rep 2023; 13:22434. [PMID: 38104179 PMCID: PMC10725433 DOI: 10.1038/s41598-023-50124-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 12/15/2023] [Indexed: 12/19/2023] Open
Abstract
The aim of this study was to investigate factors affecting total, true protein and lactoferrin (Lf) concentrations in human milk (HM) and to evaluate the changes in protein concentrations over the course of lactation (first to sixth month postpartum). HM samples were collected from exclusively breastfeeding mothers during six time periods (1-6 months postpartum); 198 breast milk samples were collected in total. The concentrations of total and true protein in HM were determined using the MIRIS human milk analyzer (HMA). The assessment of HM protein content was also performed in skim HM samples and quantified by bicinchoninic methods with the Bicinchoninic Acid Protein Assay Kit. In turn, Lf content in skim HM samples was determined by the enzyme-linked immunosorbent assay (ELISA) in accordance with a slightly modified procedure. In the first month of lactation total protein concentration was negatively correlated with maternal pre-pregnancy BMI (r = - 0.397; p = 0.022), whereas in the third month postpartum, positive correlation with maternal age was found (r = 0.399; p = 0.021). Considering Lf concentration, in the first month of lactation, it was positively correlated with baby's birth weight (r = 0.514; p = 0.002). In the next months (from second to sixth) no relationships between Lf concentration and maternal and infants' factors were observed. The concentration of protein and Lf in HM changes dynamically throughout lactation. Maternal and infant characteristics may impact the HM protein and Lf content, especially in the first month postpartum.
Collapse
Affiliation(s)
- Bożena Kulesza-Brończyk
- Department of Obstetrics, Gynecology and Maternity Care, Faculty of Health Sciences, Medical University of Bialystok, Białystok, Poland
| | - Agnieszka Bień
- Chair of Obstetrics Development, Faculty of Health Sciences, Medical University of Lublin, Lublin, Poland.
| | - Piotr Sobieraj
- Department of Internal Medicine, Hypertension and Vascular Diseases, Faculty of Medicine, Medical University of Warsaw, Warsaw, Poland
| | - Magdalena Orczyk-Pawiłowicz
- Division of Chemistry and Immunochemistry, Department of Biochemistry and Immunochemistry, Wroclaw Medical University, Wrocław, Poland
| | - Jolanta Lis-Kuberka
- Division of Chemistry and Immunochemistry, Department of Biochemistry and Immunochemistry, Wroclaw Medical University, Wrocław, Poland
| | | | - Agnieszka Bzikowska-Jura
- Department of Medical Biology, Laboratory of Human Milk and Lactation Research at Regional Human Milk Bank in Holy Family Hospital, Medical University of Warsaw, Warsaw, Poland
| |
Collapse
|
4
|
Froń A, Orczyk-Pawiłowicz M. Understanding the Immunological Quality of Breast Milk in Maternal Overweight and Obesity. Nutrients 2023; 15:5016. [PMID: 38140275 PMCID: PMC10746120 DOI: 10.3390/nu15245016] [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: 11/14/2023] [Revised: 11/30/2023] [Accepted: 12/01/2023] [Indexed: 12/24/2023] Open
Abstract
Maternal obesity, affecting many pregnant women globally, not only poses immediate health risks but also modulates breast milk composition. Obesity is linked to inflammation and oxidative stress, impacting breast milk's immune properties. This paper explores the intricate relationship between maternal metabolic disorders, such as obesity, and breast milk's immunological components. We conducted a thorough search for original and review articles published until 17 October 2023 in the PUBMED/Scopus database. This search included several terms related to human breast milk, immunological properties, and obesity. Articles were selected with the consensus of all authors. Maternal metabolic disorders have discernible effects on the composition of immune-related components in breast milk, such as immunoglobulins, lactoferrin, leptin, ghrelin, adiponectin, C-reactive protein, growth factors, extracellular vesicles, and lymphocytes. These changes in breast milk composition can significantly impact the newborn's immune system, with potential long-term health implications beyond the immediate postnatal period. Maternal metabolic health is a critical factor in shaping the health trajectory of the neonate through breastfeeding, although the full advantages of breastfeeding for children of mothers with obesity remain uncertain. Ongoing research aims to understand and unravel these links.
Collapse
Affiliation(s)
- Anita Froń
- Division of Chemistry and Immunochemistry, Department of Biochemistry and Immunochemistry, Wroclaw Medical University, M. Skłodowskiej-Curie 48/50, 50-369 Wroclaw, Poland
| | - Magdalena Orczyk-Pawiłowicz
- Division of Chemistry and Immunochemistry, Department of Biochemistry and Immunochemistry, Wroclaw Medical University, M. Skłodowskiej-Curie 48/50, 50-369 Wroclaw, Poland
| |
Collapse
|
5
|
Li X, Ning X, Rui B, Wang Y, Lei Z, Yu D, Liu F, Deng Y, Yuan J, Li W, Yan J, Li M. Alterations of milk oligosaccharides in mothers with gestational diabetes mellitus impede colonization of beneficial bacteria and development of RORγt + Treg cell-mediated immune tolerance in neonates. Gut Microbes 2023; 15:2256749. [PMID: 37741825 PMCID: PMC10519364 DOI: 10.1080/19490976.2023.2256749] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 09/05/2023] [Indexed: 09/25/2023] Open
Abstract
Gestational diabetes mellitus (GDM) is an increasing public health concern that significantly increases the risk of early childhood allergic diseases. Altered maternal milk glycobiome may strongly affect gut microbiota and enteric-specific Treg cell-mediated development of immune tolerance in GDM infants. In this study, we found that, compared with healthy Chinese mothers, mothers with GDM had significantly lower levels of total and specific human milk oligosaccharides (HMOs) in their colostrum that subsequently increased with extension of lactation. This alteration in HMO profiles significantly delayed colonization of Lactobacillus and Bifidobacterium spp. in their breast-fed infants, resulting in a distinct gut microbial structure and metabolome. Further experiments in GDM mouse models indicated that decreased contents of milk oligosaccharides, mainly 3'-sialyllactose (3'-SL), in GDM maternal mice reduced colonization of bacteria, such as L. reuteri and L. johnsonii, in the neonatal gut, which impeded development of RORγt+ regulatory T (Treg) cell-mediated immune tolerance. Treatment of GDM neonates with 3'-SL, Lactobacillus reuteri (L. reuteri) and L. johnsonii promoted the proliferation of enteric Treg cells and expression of transcription factor RORγt, which may have contributed to compromising ovalbumin (OVA)-induced allergic responses. In vitro experiments showed that 3'-SL, metabolites of L. johnsonii, and lysates of L. reuteri stimulated differentiation of mouse RORγt+ Treg cells through multiple regulatory effects on Toll-like receptor, MAPK, p53, and NOD-like receptor signaling pathways. This study provides new ideas for the development of gut microbiota and immune tolerance in GDM newborns.
Collapse
Affiliation(s)
- Xinke Li
- Department of Microecology, College of Basic Medical Science, Dalian Medical University, Dalian, China
| | - Xixi Ning
- Department of Microecology, College of Basic Medical Science, Dalian Medical University, Dalian, China
| | - Binqi Rui
- Department of Microecology, College of Basic Medical Science, Dalian Medical University, Dalian, China
| | - Yushuang Wang
- Department of Microecology, College of Basic Medical Science, Dalian Medical University, Dalian, China
| | - Zengjie Lei
- Department of Microecology, College of Basic Medical Science, Dalian Medical University, Dalian, China
| | - Da Yu
- Department of Obstetrics, Dalian Women and Children Medical Center (Group), Dalian, China
| | - Feitong Liu
- H&H Group, H&H Research, China Research and Innovation Center, Guangzhou, China
| | - Yanjie Deng
- Department of Obstetrics, Dalian Women and Children Medical Center (Group), Dalian, China
| | - Jieli Yuan
- Department of Microecology, College of Basic Medical Science, Dalian Medical University, Dalian, China
| | - Wenzhe Li
- Department of Microecology, College of Basic Medical Science, Dalian Medical University, Dalian, China
| | - Jingyu Yan
- Key Laboratory of Separation Science for Analytical Chemistry, Dalian Institute of Chemical Physics, Chinese Academy of Sciences, Dalian, China
| | - Ming Li
- Department of Microecology, College of Basic Medical Science, Dalian Medical University, Dalian, China
| |
Collapse
|
6
|
Rafaqat S, Sattar A, Khalid A, Rafaqat S. Role of liver parameters in diabetes mellitus - a narrative review. Endocr Regul 2023; 57:200-220. [PMID: 37715985 DOI: 10.2478/enr-2023-0024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/18/2023] Open
Abstract
Diabetes mellitus is characterized by hyperglycemia and abnormalities in insulin secretion and function. This review article focuses on various liver parameters, including albumin, alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), alpha fetoprotein (AFP), alpha 1 antitrypsin (AAT), ammonia, bilirubin, bile acid, gamma-glutamyl transferase (GGT), immunoglobulin, lactate dehydrogenase (LDH), and total protein. These parameters play significant roles in the development of different types of diabetes such as type 1 diabetes (T1DM), type 2 diabetes (T2DM) and gestational diabetes (GDM). The article highlights that low albumin levels may indicate inflammation, while increased ALT and AST levels are associated with liver inflammation or injury, particularly in non-alcoholic fatty liver disease (NAFLD). Elevated ALP levels can be influenced by liver inflammation, biliary dysfunction, or bone metabolism changes. High bilirubin levels are independently linked to albuminuria in T1DM and an increased risk of T2DM. Elevated GGT levels are proposed as markers of oxidative stress and liver dysfunction in T2DM. In GDM, decreased serum AFP levels may indicate impaired embryo growth. Decreased AFP levels in T2DM can hinder the detection of hepatocellular carcinoma. Hyperammonemia can cause encephalopathy in diabetic ketoacidosis, and children with T1DM and attention deficit hyperactivity disorder often exhibit higher ammonia levels. T2DM disrupts the regulation of nitrogen-related metabolites, leading to increased blood ammonia levels. Bile acids affect glucose regulation by activating receptors on cell surfaces and nuclei, and changes in bile acid metabolism are observed in T2DM. Increased LDH activity reflects metabolic disturbances in glucose utilization and lactate production, contributing to diabetic complications. Poor glycemic management may be associated with elevated levels of IgA and IgG serum antibodies, and increased immunoglobulin levels are also associated with T2DM.
Collapse
Affiliation(s)
- Sana Rafaqat
- 1Department of Biotechnology, Lahore College for Women University, Lahore, Punjab, Pakistan
| | - Aqsa Sattar
- 2Department of Zoology, Lahore College for Women University, Lahore, Punjab, Pakistan
| | - Amber Khalid
- 3Department of Zoology, University of Narowal, Punjab, Pakistan
| | - Saira Rafaqat
- 2Department of Zoology, Lahore College for Women University, Lahore, Punjab, Pakistan
| |
Collapse
|
7
|
Almhanna MGH, Easa ZO, Alatwani SHA. Morbidity and mortality among infants of diabetic mothers admitted to a neonatal care unit in Karbala pediatric teaching hospital. J Med Life 2022; 15:994-999. [PMID: 36188641 PMCID: PMC9514828 DOI: 10.25122/jml-2022-0073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 05/31/2022] [Indexed: 11/21/2022] Open
Abstract
This study aimed to determine the morbidity and mortality patterns among infants of diabetic mothers admitted to the neonatal care unit in Karbala pediatric teaching hospital. The study enrolled fifty diabetic infants (pregestational and gestational) admitted to the ward from the 1st of October 2013 to the 30th of January 2014. Data on delivery mode, gestational age, birth weight, other associated morbidities, investigation results, therapy, length of hospital stay, and outcome were collected and compared to infants of non-diabetic mothers admitted during the same period. A retrospective analysis of maternal data was performed. 62% of infants were born to mothers with gestational diabetes, and 38% were born to mothers with pre-gestational diabetes. 86% were born by caesarian section, of which 35% were by emergency cesarean section. The mean gestational age of infants of diabetic mothers was 37w1d±1.88, and 29 (64%) had macrosomia. The most typical morbidities were hypoglycemia (significantly higher in infants of diabetic mothers (IDMs) than infants of non-diabetic mothers) and hyperbilirubinemia in 36 (72%) and 24 (48%), respectively. There was no difference in morbidity patterns between infants of pregestational and gestational diabetic mothers except for macrosomia, and transient tachypnea of newborns was higher in gestational diabetes. The mortality rate was not significantly higher in IDMs. Diabetes during pregnancy has a serious effect on neonates and their mothers. The commenced morbidities in IDMs were hypoglycemia, macrosomia, and hyperbilirubinemia, so strict control of blood glucose level during pregnancy and education of diabetic women is essential before and during gestation.
Collapse
Affiliation(s)
| | - Zuhair Omran Easa
- Department of Pediatrics, College of Medicine, University of Karbala, Karbala, Iraq,Corresponding Author: Zuhair Omran Easa, Department of Pediatrics, College of Medicine, University of Karbala, Karbala, Iraq. E-mail:
| | | |
Collapse
|
8
|
Dekker PM, Boeren S, van Goudoever JB, Vervoort JJM, Hettinga KA. Exploring Human Milk Dynamics: Interindividual Variation in Milk Proteome, Peptidome, and Metabolome. J Proteome Res 2022; 21:1002-1016. [PMID: 35104145 PMCID: PMC8981310 DOI: 10.1021/acs.jproteome.1c00879] [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] [Indexed: 01/02/2023]
Abstract
![]()
Human milk is a dynamic
biofluid, and its detailed composition
receives increasing attention. While most studies focus on changes
over time or differences between maternal characteristics, interindividual
variation receives little attention. Nevertheless, a comprehensive
insight into this can help interpret human milk studies and help human
milk banks provide targeted milk for recipients. This study aimed
to map interindividual variation in the human milk proteome, peptidome,
and metabolome and to investigate possible explanations for this variation.
A set of 286 milk samples was collected from 29 mothers in the third
month postpartum. Samples were pooled per mother, and proteins, peptides,
and metabolites were analyzed. A substantial coefficient of variation
(>100%) was observed for 4.6% and 36.2% of the proteins and peptides,
respectively. In addition, using weighted correlation network analysis
(WGCNA), 5 protein and 11 peptide clusters were obtained, showing
distinct characteristics. With this, several associations were found
between the different data sets and with specific sample characteristics.
This study provides insight into the dynamics of human milk protein,
peptide, and metabolite composition. In addition, it will support
future studies that evaluate the effect size of a parameter of interest
by enabling a comparison with natural variability.
Collapse
Affiliation(s)
- Pieter M Dekker
- Food Quality and Design Group, Wageningen University & Research, Bornse Weilanden 9, 6708 WG Wageningen, The Netherlands.,Laboratory of Biochemistry, Wageningen University & Research, Stippeneng 4, 6708 WE Wageningen, The Netherlands
| | - Sjef Boeren
- Laboratory of Biochemistry, Wageningen University & Research, Stippeneng 4, 6708 WE Wageningen, The Netherlands
| | - Johannes B van Goudoever
- Department of Pediatrics, Amsterdam UMC Vrije Universiteit Emma Children's Hospital, 1081 Amsterdam, The Netherlands
| | - Jacques J M Vervoort
- Laboratory of Biochemistry, Wageningen University & Research, Stippeneng 4, 6708 WE Wageningen, The Netherlands
| | - Kasper A Hettinga
- Food Quality and Design Group, Wageningen University & Research, Bornse Weilanden 9, 6708 WG Wageningen, The Netherlands
| |
Collapse
|