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Arnoriaga-Rodríguez M, Serrano I, Paz M, Barabash A, Valerio J, del Valle L, O’Connors R, Melero V, de Miguel P, Diaz Á, Familiar C, Moraga I, Pazos-Guerra M, Martínez-Novillo M, Rubio MA, Marcuello C, Ramos-Leví A, Matia-Martín P, Calle-Pascual AL. A Simplified Screening Model to Predict the Risk of Gestational Diabetes Mellitus in Caucasian and Latin American Pregnant Women. Genes (Basel) 2024; 15:482. [PMID: 38674416 PMCID: PMC11049498 DOI: 10.3390/genes15040482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Revised: 04/07/2024] [Accepted: 04/09/2024] [Indexed: 04/28/2024] Open
Abstract
The pathophysiology of gestational diabetes mellitus (GDM) comprises clinical and genetic factors. In fact, GDM is associated with several single nucleotide polymorphisms (SNPs). This study aimed to build a prediction model of GDM combining clinical and genetic risk factors. A total of 1588 pregnant women from the San Carlos Cohort participated in the present study, including 1069 (67.3%) Caucasian (CAU) and 519 (32.7%) Latin American (LAT) individuals, and 255 (16.1%) had GDM. The incidence of GDM was similar in both groups (16.1% CAU and 16.0% LAT). Genotyping was performed via IPLEX Mass ARRAY PCR, selecting 110 SNPs based on literature references. SNPs showing the strongest likelihood of developing GDM were rs10830963, rs7651090, and rs1371614 in CAU and rs1387153 and rs9368222 in LAT. Clinical variables, including age, pre-pregnancy body mass index, and fasting plasma glucose (FPG) at 12 gestational weeks, predicted the risk of GDM (AUC 0.648, 95% CI 0.601-0.695 in CAU; AUC 0.688, 95% CI 0.628-9.748 in LAT), and adding SNPs modestly improved prediction (AUC 0.722, 95%CI 0.680-0.764 in CAU; AUC 0.769, 95% CI 0.711-0.826 in LAT). In conclusion, adding genetic variants enhanced the prediction model of GDM risk in CAU and LAT pregnant women.
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Affiliation(s)
- María Arnoriaga-Rodríguez
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (M.A.-R.); (A.B.); (J.V.); (L.d.V.); (V.M.); (P.d.M.); (Á.D.); (C.F.); (I.M.); (M.P.-G.); (M.A.R.); (C.M.); (A.R.-L.)
| | - Irene Serrano
- Unidad de Apoyo a la Investigación, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Biomedical Research Networking Center in Cancer (CIBERONC), 28040 Madrid, Spain; (I.S.); (M.P.)
| | - Mateo Paz
- Unidad de Apoyo a la Investigación, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Biomedical Research Networking Center in Cancer (CIBERONC), 28040 Madrid, Spain; (I.S.); (M.P.)
| | - Ana Barabash
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (M.A.-R.); (A.B.); (J.V.); (L.d.V.); (V.M.); (P.d.M.); (Á.D.); (C.F.); (I.M.); (M.P.-G.); (M.A.R.); (C.M.); (A.R.-L.)
- Facultad de Medicina, Medicina II Department, Universidad Complutense de Madrid, 28040 Madrid, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), 28029 Madrid, Spain
| | - Johanna Valerio
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (M.A.-R.); (A.B.); (J.V.); (L.d.V.); (V.M.); (P.d.M.); (Á.D.); (C.F.); (I.M.); (M.P.-G.); (M.A.R.); (C.M.); (A.R.-L.)
| | - Laura del Valle
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (M.A.-R.); (A.B.); (J.V.); (L.d.V.); (V.M.); (P.d.M.); (Á.D.); (C.F.); (I.M.); (M.P.-G.); (M.A.R.); (C.M.); (A.R.-L.)
| | - Rocio O’Connors
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (M.A.-R.); (A.B.); (J.V.); (L.d.V.); (V.M.); (P.d.M.); (Á.D.); (C.F.); (I.M.); (M.P.-G.); (M.A.R.); (C.M.); (A.R.-L.)
| | - Verónica Melero
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (M.A.-R.); (A.B.); (J.V.); (L.d.V.); (V.M.); (P.d.M.); (Á.D.); (C.F.); (I.M.); (M.P.-G.); (M.A.R.); (C.M.); (A.R.-L.)
| | - Paz de Miguel
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (M.A.-R.); (A.B.); (J.V.); (L.d.V.); (V.M.); (P.d.M.); (Á.D.); (C.F.); (I.M.); (M.P.-G.); (M.A.R.); (C.M.); (A.R.-L.)
- Facultad de Medicina, Medicina II Department, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Ángel Diaz
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (M.A.-R.); (A.B.); (J.V.); (L.d.V.); (V.M.); (P.d.M.); (Á.D.); (C.F.); (I.M.); (M.P.-G.); (M.A.R.); (C.M.); (A.R.-L.)
- Facultad de Medicina, Medicina II Department, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Cristina Familiar
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (M.A.-R.); (A.B.); (J.V.); (L.d.V.); (V.M.); (P.d.M.); (Á.D.); (C.F.); (I.M.); (M.P.-G.); (M.A.R.); (C.M.); (A.R.-L.)
| | - Inmaculada Moraga
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (M.A.-R.); (A.B.); (J.V.); (L.d.V.); (V.M.); (P.d.M.); (Á.D.); (C.F.); (I.M.); (M.P.-G.); (M.A.R.); (C.M.); (A.R.-L.)
| | - Mario Pazos-Guerra
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (M.A.-R.); (A.B.); (J.V.); (L.d.V.); (V.M.); (P.d.M.); (Á.D.); (C.F.); (I.M.); (M.P.-G.); (M.A.R.); (C.M.); (A.R.-L.)
| | - Mercedes Martínez-Novillo
- Clinical Laboratory Department, Hospital Clínico Universitario San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain;
| | - Miguel A. Rubio
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (M.A.-R.); (A.B.); (J.V.); (L.d.V.); (V.M.); (P.d.M.); (Á.D.); (C.F.); (I.M.); (M.P.-G.); (M.A.R.); (C.M.); (A.R.-L.)
- Facultad de Medicina, Medicina II Department, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Clara Marcuello
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (M.A.-R.); (A.B.); (J.V.); (L.d.V.); (V.M.); (P.d.M.); (Á.D.); (C.F.); (I.M.); (M.P.-G.); (M.A.R.); (C.M.); (A.R.-L.)
| | - Ana Ramos-Leví
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (M.A.-R.); (A.B.); (J.V.); (L.d.V.); (V.M.); (P.d.M.); (Á.D.); (C.F.); (I.M.); (M.P.-G.); (M.A.R.); (C.M.); (A.R.-L.)
| | - Pilar Matia-Martín
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (M.A.-R.); (A.B.); (J.V.); (L.d.V.); (V.M.); (P.d.M.); (Á.D.); (C.F.); (I.M.); (M.P.-G.); (M.A.R.); (C.M.); (A.R.-L.)
- Facultad de Medicina, Medicina II Department, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Alfonso L. Calle-Pascual
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (M.A.-R.); (A.B.); (J.V.); (L.d.V.); (V.M.); (P.d.M.); (Á.D.); (C.F.); (I.M.); (M.P.-G.); (M.A.R.); (C.M.); (A.R.-L.)
- Facultad de Medicina, Medicina II Department, Universidad Complutense de Madrid, 28040 Madrid, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), 28029 Madrid, Spain
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Arnoriaga-Rodriguez M, Melero V, Barabash A, Valerio J, del Valle L, O’Connor RM, de Miguel P, Diaz JA, Familiar C, Moraga I, Duran A, Jimenez I, Cuesta M, Torrejon MJ, Martinez-Novillo M, Runkle I, Pazos M, Rubio MA, Matia-Martín P, Calle-Pascual AL. Modifiable Risk Factors and Trends in Changes in Glucose Regulation during the First Three Years Postdelivery: The St Carlos Gestational Diabetes Mellitus Prevention Cohort. Nutrients 2023; 15:4995. [PMID: 38068853 PMCID: PMC10707889 DOI: 10.3390/nu15234995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 11/18/2023] [Accepted: 11/29/2023] [Indexed: 12/18/2023] Open
Abstract
OBJECTIVE Evaluation of the influence of potential risk factors (RFs) on glycemic changes at 3 years postpartum. METHODS The glycemic status of 1400 women, in absence of a new pregnancy, was evaluated at 3 months (3 m) and 3 years (3 y) postpartum, after participation in the St. Carlos Gestational Study (2228 normoglycemic pregnant women followed from before gestational week 12 to delivery, from 2015-2017). Abnormal glucose regulation (AGR) was defined as fasting serum glucose ≥ 100 mg/dL and/or HbA1c ≥ 5.7% and/or 2 h 75 g OGTT glucose ≥ 140 mg/dL. In total, 12 modifiable and 3 unmodifiable RFs were analyzed. RESULTS 3 m postpartum, 110/1400 (7.9%) women had AGR; 3 y postpartum, 137 (9.8%) women exhibited AGR (110 with 3 m normal glucose tolerance [NGT]); 1263 (90.2%) had NGT (83 with 3 m AGR). More women with gestational diabetes mellitus (GDM) progressed to AGR at 3 y (OR: 1.60 [1.33-1.92]) than women without GDM. Yet, most women with 3 m and/or 3 y AGR had no GDM history. Having ≥2 unmodifiable RFs was associated with increased risk for progression to AGR (OR: 1.90 [1.28-2.83]) at 3 y postpartum. Having >5/12 modifiable RFs was associated with increased progression from NGT to AGR (OR: 1.40 [1.00-2.09]) and AGR persistence (OR: 2.57 [1.05-6.31]). Pregestational BMI ≥ 25 kg/m2 (OR: 0.59 [0.41-0.85]), postdelivery weight gain (OR: 0.53 [0.29-0.94]), and waist circumference > 89.5 cm (OR: 0.54 [0.36-0.79]) reduced the likelihood of NGT persisting at 3 y. CONCLUSIONS 3-month and/or 3-year postpartum AGR can be detected if sought in women with no prior GDM. Modifiable and unmodifiable RF predictors of AGR at 3 y postpartum were identified. Universal screening for glycemic alterations should be considered in all women following delivery, regardless of prior GDM. These findings could be useful to design personalized strategies in women with risk factors for 3 y AGR.
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Affiliation(s)
- Maria Arnoriaga-Rodriguez
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (M.A.-R.); (V.M.); (A.B.); (J.V.); (L.d.V.); (R.M.O.); (P.d.M.); (J.A.D.); (C.F.); (I.M.); (A.D.); (I.J.); (M.C.); (I.R.); (M.P.); (M.A.R.)
| | - Verónica Melero
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (M.A.-R.); (V.M.); (A.B.); (J.V.); (L.d.V.); (R.M.O.); (P.d.M.); (J.A.D.); (C.F.); (I.M.); (A.D.); (I.J.); (M.C.); (I.R.); (M.P.); (M.A.R.)
| | - Ana Barabash
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (M.A.-R.); (V.M.); (A.B.); (J.V.); (L.d.V.); (R.M.O.); (P.d.M.); (J.A.D.); (C.F.); (I.M.); (A.D.); (I.J.); (M.C.); (I.R.); (M.P.); (M.A.R.)
- UCM School of Medicine, Medicina II Department, Universidad Complutense de Madrid, 28040 Madrid, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), 28029 Madrid, Spain
| | - Johanna Valerio
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (M.A.-R.); (V.M.); (A.B.); (J.V.); (L.d.V.); (R.M.O.); (P.d.M.); (J.A.D.); (C.F.); (I.M.); (A.D.); (I.J.); (M.C.); (I.R.); (M.P.); (M.A.R.)
| | - Laura del Valle
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (M.A.-R.); (V.M.); (A.B.); (J.V.); (L.d.V.); (R.M.O.); (P.d.M.); (J.A.D.); (C.F.); (I.M.); (A.D.); (I.J.); (M.C.); (I.R.); (M.P.); (M.A.R.)
| | - Rocio Martin O’Connor
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (M.A.-R.); (V.M.); (A.B.); (J.V.); (L.d.V.); (R.M.O.); (P.d.M.); (J.A.D.); (C.F.); (I.M.); (A.D.); (I.J.); (M.C.); (I.R.); (M.P.); (M.A.R.)
| | - Paz de Miguel
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (M.A.-R.); (V.M.); (A.B.); (J.V.); (L.d.V.); (R.M.O.); (P.d.M.); (J.A.D.); (C.F.); (I.M.); (A.D.); (I.J.); (M.C.); (I.R.); (M.P.); (M.A.R.)
- UCM School of Medicine, Medicina II Department, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - José A. Diaz
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (M.A.-R.); (V.M.); (A.B.); (J.V.); (L.d.V.); (R.M.O.); (P.d.M.); (J.A.D.); (C.F.); (I.M.); (A.D.); (I.J.); (M.C.); (I.R.); (M.P.); (M.A.R.)
- UCM School of Medicine, Medicina II Department, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Cristina Familiar
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (M.A.-R.); (V.M.); (A.B.); (J.V.); (L.d.V.); (R.M.O.); (P.d.M.); (J.A.D.); (C.F.); (I.M.); (A.D.); (I.J.); (M.C.); (I.R.); (M.P.); (M.A.R.)
| | - Inmaculada Moraga
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (M.A.-R.); (V.M.); (A.B.); (J.V.); (L.d.V.); (R.M.O.); (P.d.M.); (J.A.D.); (C.F.); (I.M.); (A.D.); (I.J.); (M.C.); (I.R.); (M.P.); (M.A.R.)
| | - Alejandra Duran
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (M.A.-R.); (V.M.); (A.B.); (J.V.); (L.d.V.); (R.M.O.); (P.d.M.); (J.A.D.); (C.F.); (I.M.); (A.D.); (I.J.); (M.C.); (I.R.); (M.P.); (M.A.R.)
- UCM School of Medicine, Medicina II Department, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Inés Jimenez
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (M.A.-R.); (V.M.); (A.B.); (J.V.); (L.d.V.); (R.M.O.); (P.d.M.); (J.A.D.); (C.F.); (I.M.); (A.D.); (I.J.); (M.C.); (I.R.); (M.P.); (M.A.R.)
| | - Martín Cuesta
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (M.A.-R.); (V.M.); (A.B.); (J.V.); (L.d.V.); (R.M.O.); (P.d.M.); (J.A.D.); (C.F.); (I.M.); (A.D.); (I.J.); (M.C.); (I.R.); (M.P.); (M.A.R.)
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), 28029 Madrid, Spain
| | - María José Torrejon
- Clinical Laboratory Department, Hospital Clínico Universitario San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (M.J.T.); (M.M.-N.)
| | - Mercedes Martinez-Novillo
- Clinical Laboratory Department, Hospital Clínico Universitario San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (M.J.T.); (M.M.-N.)
| | - Isabelle Runkle
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (M.A.-R.); (V.M.); (A.B.); (J.V.); (L.d.V.); (R.M.O.); (P.d.M.); (J.A.D.); (C.F.); (I.M.); (A.D.); (I.J.); (M.C.); (I.R.); (M.P.); (M.A.R.)
- UCM School of Medicine, Medicina II Department, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Mario Pazos
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (M.A.-R.); (V.M.); (A.B.); (J.V.); (L.d.V.); (R.M.O.); (P.d.M.); (J.A.D.); (C.F.); (I.M.); (A.D.); (I.J.); (M.C.); (I.R.); (M.P.); (M.A.R.)
| | - Miguel A. Rubio
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (M.A.-R.); (V.M.); (A.B.); (J.V.); (L.d.V.); (R.M.O.); (P.d.M.); (J.A.D.); (C.F.); (I.M.); (A.D.); (I.J.); (M.C.); (I.R.); (M.P.); (M.A.R.)
- UCM School of Medicine, Medicina II Department, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Pilar Matia-Martín
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (M.A.-R.); (V.M.); (A.B.); (J.V.); (L.d.V.); (R.M.O.); (P.d.M.); (J.A.D.); (C.F.); (I.M.); (A.D.); (I.J.); (M.C.); (I.R.); (M.P.); (M.A.R.)
- UCM School of Medicine, Medicina II Department, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Alfonso L. Calle-Pascual
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (M.A.-R.); (V.M.); (A.B.); (J.V.); (L.d.V.); (R.M.O.); (P.d.M.); (J.A.D.); (C.F.); (I.M.); (A.D.); (I.J.); (M.C.); (I.R.); (M.P.); (M.A.R.)
- UCM School of Medicine, Medicina II Department, Universidad Complutense de Madrid, 28040 Madrid, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), 28029 Madrid, Spain
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Lima FA, Otte F, Vakili M, Ardana-Lamas F, Biednov M, Dall’Antonia F, Frankenberger P, Gawelda W, Gelisio L, Han H, Huang X, Jiang Y, Kloos M, Kluyver T, Knoll M, Kubicek K, Bermudez Macias IJ, Schulz J, Turkot O, Uemura Y, Valerio J, Wang H, Yousef H, Zalden P, Khakhulin D, Bressler C, Milne C. Experimental capabilities for liquid jet samples at sub-MHz rates at the FXE Instrument at European XFEL. J Synchrotron Radiat 2023; 30:1168-1182. [PMID: 37860937 PMCID: PMC10624029 DOI: 10.1107/s1600577523008159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 09/18/2023] [Indexed: 10/21/2023]
Abstract
The Femtosecond X-ray Experiments (FXE) instrument at the European X-ray Free-Electron Laser (EuXFEL) provides an optimized platform for investigations of ultrafast physical, chemical and biological processes. It operates in the energy range 4.7-20 keV accommodating flexible and versatile environments for a wide range of samples using diverse ultrafast X-ray spectroscopic, scattering and diffraction techniques. FXE is particularly suitable for experiments taking advantage of the sub-MHz repetition rates provided by the EuXFEL. In this paper a dedicated setup for studies on ultrafast biological and chemical dynamics in solution phase at sub-MHz rates at FXE is presented. Particular emphasis on the different liquid jet sample delivery options and their performance is given. Our portfolio of high-speed jets compatible with sub-MHz experiments includes cylindrical jets, gas dynamic virtual nozzles and flat jets. The capability to perform multi-color X-ray emission spectroscopy (XES) experiments is illustrated by a set of measurements using the dispersive X-ray spectrometer in von Hamos geometry. Static XES data collected using a multi-crystal scanning Johann-type spectrometer are also presented. A few examples of experimental results on ultrafast time-resolved X-ray emission spectroscopy and wide-angle X-ray scattering at sub-MHz pulse repetition rates are given.
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Affiliation(s)
- F. A. Lima
- European XFEL, Holzkoppel 4, 22869 Schenefeld, Germany
| | - F. Otte
- European XFEL, Holzkoppel 4, 22869 Schenefeld, Germany
- Fakultät für Physik, Technical University Dortmund, Dortmund, Germany
| | - M. Vakili
- European XFEL, Holzkoppel 4, 22869 Schenefeld, Germany
- Center for Free-Electron Laser Science CFEL, Deutsches Elektronen-Synchrotron DESY, Notkestr. 85, 22607 Hamburg, Germany
| | | | - M. Biednov
- European XFEL, Holzkoppel 4, 22869 Schenefeld, Germany
| | | | | | - W. Gawelda
- European XFEL, Holzkoppel 4, 22869 Schenefeld, Germany
- Faculty of Physics, Adam Mickiewicz University, 61-614 Poznań, Poland
| | - L. Gelisio
- European XFEL, Holzkoppel 4, 22869 Schenefeld, Germany
| | - H. Han
- European XFEL, Holzkoppel 4, 22869 Schenefeld, Germany
| | - X. Huang
- European XFEL, Holzkoppel 4, 22869 Schenefeld, Germany
| | - Y. Jiang
- European XFEL, Holzkoppel 4, 22869 Schenefeld, Germany
| | - M. Kloos
- European XFEL, Holzkoppel 4, 22869 Schenefeld, Germany
| | - T. Kluyver
- European XFEL, Holzkoppel 4, 22869 Schenefeld, Germany
| | - M. Knoll
- European XFEL, Holzkoppel 4, 22869 Schenefeld, Germany
| | - K. Kubicek
- European XFEL, Holzkoppel 4, 22869 Schenefeld, Germany
- The Hamburg Centre for Ultrafast Imaging, 22761 Hamburg, Germany
- Institut für Experimentalphysik, Universität Hamburg, 22607 Hamburg, Germany
| | | | - J. Schulz
- European XFEL, Holzkoppel 4, 22869 Schenefeld, Germany
| | - O. Turkot
- European XFEL, Holzkoppel 4, 22869 Schenefeld, Germany
| | - Y. Uemura
- European XFEL, Holzkoppel 4, 22869 Schenefeld, Germany
| | - J. Valerio
- European XFEL, Holzkoppel 4, 22869 Schenefeld, Germany
| | - H. Wang
- European XFEL, Holzkoppel 4, 22869 Schenefeld, Germany
| | - H. Yousef
- European XFEL, Holzkoppel 4, 22869 Schenefeld, Germany
| | - P. Zalden
- European XFEL, Holzkoppel 4, 22869 Schenefeld, Germany
| | - D. Khakhulin
- European XFEL, Holzkoppel 4, 22869 Schenefeld, Germany
| | - C. Bressler
- European XFEL, Holzkoppel 4, 22869 Schenefeld, Germany
- The Hamburg Centre for Ultrafast Imaging, 22761 Hamburg, Germany
- Institut für Experimentalphysik, Universität Hamburg, 22607 Hamburg, Germany
| | - C. Milne
- European XFEL, Holzkoppel 4, 22869 Schenefeld, Germany
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4
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Melero V, Arnoriaga M, Barabash A, Valerio J, Del Valle L, Martin O'Connor R, de Miguel MP, Diaz JA, Familiar C, Moraga I, Duran A, Cuesta M, Torrejon MJ, Martinez-Novillo M, Moreno M, Romera G, Runkle I, Pazos M, Rubio MA, Matia-Martín P, Calle-Pascual AL. An Early Mediterranean-Based Nutritional Intervention during Pregnancy Reduces Metabolic Syndrome and Glucose Dysregulation Rates at 3 Years Postpartum. Nutrients 2023; 15:3252. [PMID: 37513670 PMCID: PMC10383706 DOI: 10.3390/nu15143252] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 07/17/2023] [Accepted: 07/19/2023] [Indexed: 07/30/2023] Open
Abstract
A Mediterranean diet (MedDiet)-based intervention reduces the rate of immediate postpartum maternal metabolic disorders. Whether these effects persist long-term remains to be determined. A total of 2526 normoglycemic women were randomized before the 12th gestational week (GW). IG women followed a MedDiet with extra virgin olive oil (EVOO) (>40 mL/day) and a handful of nuts daily, whereas CG women had to restrict all kinds of dietary fat. At 3 months postpartum, a motivational lifestyle interview was held. The endpoint of the study evaluated the rate of abnormal glucose regulation (AGR) and metabolic syndrome (MetS) at 3 years postpartum in women of the San Carlos cohort. A total of 369/625 (59%) CG women and 1031/1603 (64.3%) IG women were finally analyzed. At 3 months and 3 years postdelivery, the IG women showed higher adherence to the MedDiet, which was associated with lower values of body mass index (BMI) and lipid and glycemic profiles. Body weight change and waist circumference were lower in the IG women. After applying multiple regression analysis, the ORs (95%CI) resulted in AGR (3.18 (2.48-4.08); p < 0.001)/MetS (3.79 (1.81-7.95); p = 0.001) for women with GDM and higher OR for development of MetS in CG women (3.73 (1.77-7.87); p = 0.001). A MedDiet-based intervention early in pregnancy demonstrated persistent beneficial effects on AGR and MetS rates at 3 years postpartum.
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Affiliation(s)
- Verónica Melero
- Endocrinology and Nutrition Department, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Hospital Clínico Universitario San Carlos, 28040 Madrid, Spain
| | - Maria Arnoriaga
- Endocrinology and Nutrition Department, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Hospital Clínico Universitario San Carlos, 28040 Madrid, Spain
| | - Ana Barabash
- Endocrinology and Nutrition Department, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Hospital Clínico Universitario San Carlos, 28040 Madrid, Spain
- Facultad de Medicina, Medicina II Department, Universidad Complutense de Madrid, 28040 Madrid, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), 28029 Madrid, Spain
| | - Johanna Valerio
- Endocrinology and Nutrition Department, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Hospital Clínico Universitario San Carlos, 28040 Madrid, Spain
| | - Laura Del Valle
- Endocrinology and Nutrition Department, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Hospital Clínico Universitario San Carlos, 28040 Madrid, Spain
| | - Rocio Martin O'Connor
- Endocrinology and Nutrition Department, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Hospital Clínico Universitario San Carlos, 28040 Madrid, Spain
| | - Maria Paz de Miguel
- Endocrinology and Nutrition Department, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Hospital Clínico Universitario San Carlos, 28040 Madrid, Spain
- Facultad de Medicina, Medicina II Department, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Jose Angel Diaz
- Endocrinology and Nutrition Department, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Hospital Clínico Universitario San Carlos, 28040 Madrid, Spain
- Facultad de Medicina, Medicina II Department, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Cristina Familiar
- Endocrinology and Nutrition Department, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Hospital Clínico Universitario San Carlos, 28040 Madrid, Spain
| | - Inmaculada Moraga
- Endocrinology and Nutrition Department, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Hospital Clínico Universitario San Carlos, 28040 Madrid, Spain
| | - Alejandra Duran
- Endocrinology and Nutrition Department, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Hospital Clínico Universitario San Carlos, 28040 Madrid, Spain
- Facultad de Medicina, Medicina II Department, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Martín Cuesta
- Endocrinology and Nutrition Department, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Hospital Clínico Universitario San Carlos, 28040 Madrid, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), 28029 Madrid, Spain
| | - María José Torrejon
- Clinical Laboratory Department, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Hospital Clínico Universitario San Carlos, 28040 Madrid, Spain
| | - Mercedes Martinez-Novillo
- Clinical Laboratory Department, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Hospital Clínico Universitario San Carlos, 28040 Madrid, Spain
| | - Maria Moreno
- Clinical Laboratory Department, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Hospital Clínico Universitario San Carlos, 28040 Madrid, Spain
| | - Gisela Romera
- Clinical Laboratory Department, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Hospital Clínico Universitario San Carlos, 28040 Madrid, Spain
| | - Isabelle Runkle
- Endocrinology and Nutrition Department, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Hospital Clínico Universitario San Carlos, 28040 Madrid, Spain
- Facultad de Medicina, Medicina II Department, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Mario Pazos
- Endocrinology and Nutrition Department, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Hospital Clínico Universitario San Carlos, 28040 Madrid, Spain
| | - Miguel A Rubio
- Endocrinology and Nutrition Department, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Hospital Clínico Universitario San Carlos, 28040 Madrid, Spain
- Facultad de Medicina, Medicina II Department, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Pilar Matia-Martín
- Endocrinology and Nutrition Department, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Hospital Clínico Universitario San Carlos, 28040 Madrid, Spain
- Facultad de Medicina, Medicina II Department, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Alfonso Luis Calle-Pascual
- Endocrinology and Nutrition Department, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Hospital Clínico Universitario San Carlos, 28040 Madrid, Spain
- Facultad de Medicina, Medicina II Department, Universidad Complutense de Madrid, 28040 Madrid, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), 28029 Madrid, Spain
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Markmann V, Walther M, Dartsch M, Valerio J, Frenzel L, Lokteva I, Westermeier F, Grübel G, Lehmkühler F. A versatile chamber for x-ray scattering on liquid jets with sample recycling. Rev Sci Instrum 2022; 93:125106. [PMID: 36586895 DOI: 10.1063/5.0105529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 11/11/2022] [Indexed: 06/17/2023]
Abstract
We introduce the setup of a versatile sample chamber for x-ray scattering experiments on liquids delivered by μ-jets. The simple implementation at x-ray light sources, adaptability to different nozzle types, and the availability of a microscope for observation of the jet flow allow for its broad application. In combination with an inbuilt recycling circle, a continuous flow operation is provided. Functionality of the system was demonstrated in a rheology study at PETRA III.
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Affiliation(s)
- V Markmann
- Deutsches Elektronen-Synchrotron DESY, Notkestrasse 85, 22607 Hamburg, Germany
| | - M Walther
- Deutsches Elektronen-Synchrotron DESY, Notkestrasse 85, 22607 Hamburg, Germany
| | - M Dartsch
- Deutsches Elektronen-Synchrotron DESY, Notkestrasse 85, 22607 Hamburg, Germany
| | - J Valerio
- Deutsches Elektronen-Synchrotron DESY, Notkestrasse 85, 22607 Hamburg, Germany
| | - L Frenzel
- Deutsches Elektronen-Synchrotron DESY, Notkestrasse 85, 22607 Hamburg, Germany
| | - I Lokteva
- Deutsches Elektronen-Synchrotron DESY, Notkestrasse 85, 22607 Hamburg, Germany
| | - F Westermeier
- Deutsches Elektronen-Synchrotron DESY, Notkestrasse 85, 22607 Hamburg, Germany
| | - G Grübel
- Deutsches Elektronen-Synchrotron DESY, Notkestrasse 85, 22607 Hamburg, Germany
| | - F Lehmkühler
- Deutsches Elektronen-Synchrotron DESY, Notkestrasse 85, 22607 Hamburg, Germany
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6
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Ramos-Levi A, Barabash A, Valerio J, García de la Torre N, Mendizabal L, Zulueta M, de Miguel MP, Diaz A, Duran A, Familiar C, Jimenez I, del Valle L, Melero V, Moraga I, Herraiz MA, Torrejon MJ, Arregi M, Simón L, Rubio MA, Calle-Pascual AL. Genetic variants for prediction of gestational diabetes mellitus and modulation of susceptibility by a nutritional intervention based on a Mediterranean diet. Front Endocrinol (Lausanne) 2022; 13:1036088. [PMID: 36313769 PMCID: PMC9612917 DOI: 10.3389/fendo.2022.1036088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Accepted: 09/20/2022] [Indexed: 11/13/2022] Open
Abstract
HYPOTHESIS Gestational diabetes mellitus (GDM) entails a complex underlying pathogenesis, with a specific genetic background and the effect of environmental factors. This study examines the link between a set of single nucleotide polymorphisms (SNPs) associated with diabetes and the development of GDM in pregnant women with different ethnicities, and evaluates its potential modulation with a clinical intervention based on a Mediterranean diet. METHODS 2418 women from our hospital-based cohort of pregnant women screened for GDM from January 2015 to November 2017 (the San Carlos Cohort, randomized controlled trial for the prevention of GDM ISRCTN84389045 and real-world study ISRCTN13389832) were assessed for evaluation. Diagnosis of GDM was made according to the International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria. Genotyping was performed by IPLEX MassARRAY PCR using the Agena platform (Agena Bioscience, SanDiego, CA). 110 SNPs were selected for analysis based on selected literature references. Statistical analyses regarding patients' characteristics were performed in SPSS (Chicago, IL, USA) version 24.0. Genetic association tests were performed using PLINK v.1.9 and 2.0 software. Bioinformatics analysis, with mapping of SNPs was performed using STRING, version 11.5. RESULTS Quality controls retrieved a total 98 SNPs and 1573 samples, 272 (17.3%) with GDM and 1301 (82.7%) without GDM. 1104 (70.2%) were Caucasian (CAU) and 469 (29.8%) Hispanic (HIS). 415 (26.4%) were from the control group (CG), 418 (26.6%) from the nutritional intervention group (IG) and 740 (47.0%) from the real-world group (RW). 40 SNPs (40.8%) presented some kind of significant association with GDM in at least one of the genetic tests considered. The nutritional intervention presented a significant association with GDM, regardless of the variant considered. In CAU, variants rs4402960, rs7651090, IGF2BP2; rs1387153, rs10830963, MTNR1B; rs17676067, GLP2R; rs1371614, DPYSL5; rs5215, KCNJ1; and rs2293941, PDX1 were significantly associated with an increased risk of GDM, whilst rs780094, GCKR; rs7607980, COBLL1; rs3746750, SLC17A9; rs6048205, FOXA2; rs7041847, rs7034200, rs10814916, GLIS3; rs3783347, WARS; and rs1805087, MTR, were significantly associated with a decreased risk of GDM, In HIS, variants significantly associated with increased risk of GDM were rs9368222, CDKAL1; rs2302593, GIPR; rs10885122, ADRA2A; rs1387153, MTNR1B; rs737288, BACE2; rs1371614, DPYSL5; and rs2293941, PDX1, whilst rs340874, PROX1; rs2943634, IRS1; rs7041847, GLIS3; rs780094, GCKR; rs563694, G6PC2; and rs11605924, CRY2 were significantly associated with decreased risk for GDM. CONCLUSIONS We identify a core set of SNPs in their association with diabetes and GDM in a large cohort of patients from two main ethnicities from a single center. Identification of these genetic variants, even in the setting of a nutritional intervention, deems useful to design preventive and therapeutic strategies.
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Affiliation(s)
- Ana Ramos-Levi
- Endocrinology and Nutrition Department, Hospital Universitario de la Princesa, Instituto de Investigación Princesa, Universidad Autónoma de Madrid, Madrid, Spain
| | - Ana Barabash
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
- Facultad de Medicina. Medicina II Department, Universidad Complutense de Madrid, Madrid, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain
| | - Johanna Valerio
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Nuria García de la Torre
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain
- *Correspondence: Alfonso L. Calle-Pascual, ; Nuria García de la Torre,
| | | | | | - Maria Paz de Miguel
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
- Facultad de Medicina. Medicina II Department, Universidad Complutense de Madrid, Madrid, Spain
| | - Angel Diaz
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
- Facultad de Medicina. Medicina II Department, Universidad Complutense de Madrid, Madrid, Spain
| | - Alejandra Duran
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
- Facultad de Medicina. Medicina II Department, Universidad Complutense de Madrid, Madrid, Spain
| | - Cristina Familiar
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Inés Jimenez
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Laura del Valle
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Veronica Melero
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Inmaculada Moraga
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Miguel A. Herraiz
- Gynecology and Obstetrics Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - María José Torrejon
- Clinical Laboratory Department Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Maddi Arregi
- Patia Europe, Clinical Laboratory, San Sebastián, Spain
| | | | - Miguel A. Rubio
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
- Facultad de Medicina. Medicina II Department, Universidad Complutense de Madrid, Madrid, Spain
| | - Alfonso L. Calle-Pascual
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
- Facultad de Medicina. Medicina II Department, Universidad Complutense de Madrid, Madrid, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain
- *Correspondence: Alfonso L. Calle-Pascual, ; Nuria García de la Torre,
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7
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Melero V, Runkle I, Garcia de la Torre N, De Miguel P, Valerio J, del Valle L, Barabash A, Sanabria C, Moraga I, Familiar C, Durán A, Torrejón MJ, Diaz JA, Cuesta M, Ruiz JG, Jiménez I, Pazos M, Herraiz MA, Izquierdo N, Pérez N, Matia P, Perez-Ferre N, Marcuello C, Rubio MA, Calle-Pascual AL. The Consumption of Food-Based Iodine in the Immediate Pre-Pregnancy Period in Madrid Is Insufficient. San Carlos and Pregnancy Cohort Study. Nutrients 2021; 13:nu13124458. [PMID: 34960010 PMCID: PMC8707458 DOI: 10.3390/nu13124458] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 12/12/2021] [Accepted: 12/12/2021] [Indexed: 12/01/2022] Open
Abstract
A pre-gestational thyroid reserve of iodine is crucial to guarantee the increased demand for thyroid hormone production of early pregnancy. An iodine intake ≥150 µg/day is currently recommended. The objective of this study was to assess average pre-gestational food-based iodine consumption in pregnant women at their first prenatal visit (<12 gestational weeks), and its association with adverse materno-fetal events (history of miscarriages, early fetal losses, Gestational Diabetes, prematurity, caesarean sections, and new-borns large/small for gestational age). Between 2015–2017, 2523 normoglycemic women out of 3026 eligible had data in the modified Diabetes Nutrition and Complication Trial (DNCT) questionnaire permitting assessment of pre-gestational food-based iodine consumption, and were included in this study. Daily food-based iodine intake was 123 ± 48 µg, with 1922 (76.1%) not reaching 150 µg/day. Attaining this amount was associated with consuming 8 weekly servings of vegetables (3.84; 3.16–4.65), 1 of shellfish (8.72; 6.96–10.93) and/or 2 daily dairy products (6.43; 5.27–7.86). Women who reached a pre-gestational intake ≥150 µg had lower rates of hypothyroxinemia (104 (17.3%)/384 (21.4%); p = 0.026), a lower miscarriage rate, and a decrease in the composite of materno-fetal adverse events (0.81; 0.67–0.98). Reaching the recommended iodine pre-pregnancy intake with foods could benefit the progression of pregnancy.
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Affiliation(s)
- Verónica Melero
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (V.M.); (I.R.); (N.G.d.l.T.); (P.D.M.); (J.V.); (L.d.V.); (A.B.); (C.S.); (I.M.); (C.F.); (A.D.); (J.A.D.); (M.C.); (J.G.R.); (I.J.); (M.P.); (P.M.); (N.P.-F.); (C.M.); (M.A.R.)
| | - Isabelle Runkle
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (V.M.); (I.R.); (N.G.d.l.T.); (P.D.M.); (J.V.); (L.d.V.); (A.B.); (C.S.); (I.M.); (C.F.); (A.D.); (J.A.D.); (M.C.); (J.G.R.); (I.J.); (M.P.); (P.M.); (N.P.-F.); (C.M.); (M.A.R.)
| | - Nuria Garcia de la Torre
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (V.M.); (I.R.); (N.G.d.l.T.); (P.D.M.); (J.V.); (L.d.V.); (A.B.); (C.S.); (I.M.); (C.F.); (A.D.); (J.A.D.); (M.C.); (J.G.R.); (I.J.); (M.P.); (P.M.); (N.P.-F.); (C.M.); (M.A.R.)
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), 28029 Madrid, Spain
| | - Paz De Miguel
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (V.M.); (I.R.); (N.G.d.l.T.); (P.D.M.); (J.V.); (L.d.V.); (A.B.); (C.S.); (I.M.); (C.F.); (A.D.); (J.A.D.); (M.C.); (J.G.R.); (I.J.); (M.P.); (P.M.); (N.P.-F.); (C.M.); (M.A.R.)
- Medicina II Department, Facultad de Medicina, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Johanna Valerio
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (V.M.); (I.R.); (N.G.d.l.T.); (P.D.M.); (J.V.); (L.d.V.); (A.B.); (C.S.); (I.M.); (C.F.); (A.D.); (J.A.D.); (M.C.); (J.G.R.); (I.J.); (M.P.); (P.M.); (N.P.-F.); (C.M.); (M.A.R.)
| | - Laura del Valle
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (V.M.); (I.R.); (N.G.d.l.T.); (P.D.M.); (J.V.); (L.d.V.); (A.B.); (C.S.); (I.M.); (C.F.); (A.D.); (J.A.D.); (M.C.); (J.G.R.); (I.J.); (M.P.); (P.M.); (N.P.-F.); (C.M.); (M.A.R.)
| | - Ana Barabash
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (V.M.); (I.R.); (N.G.d.l.T.); (P.D.M.); (J.V.); (L.d.V.); (A.B.); (C.S.); (I.M.); (C.F.); (A.D.); (J.A.D.); (M.C.); (J.G.R.); (I.J.); (M.P.); (P.M.); (N.P.-F.); (C.M.); (M.A.R.)
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), 28029 Madrid, Spain
- Medicina II Department, Facultad de Medicina, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Concepción Sanabria
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (V.M.); (I.R.); (N.G.d.l.T.); (P.D.M.); (J.V.); (L.d.V.); (A.B.); (C.S.); (I.M.); (C.F.); (A.D.); (J.A.D.); (M.C.); (J.G.R.); (I.J.); (M.P.); (P.M.); (N.P.-F.); (C.M.); (M.A.R.)
| | - Inmaculada Moraga
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (V.M.); (I.R.); (N.G.d.l.T.); (P.D.M.); (J.V.); (L.d.V.); (A.B.); (C.S.); (I.M.); (C.F.); (A.D.); (J.A.D.); (M.C.); (J.G.R.); (I.J.); (M.P.); (P.M.); (N.P.-F.); (C.M.); (M.A.R.)
| | - Cristina Familiar
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (V.M.); (I.R.); (N.G.d.l.T.); (P.D.M.); (J.V.); (L.d.V.); (A.B.); (C.S.); (I.M.); (C.F.); (A.D.); (J.A.D.); (M.C.); (J.G.R.); (I.J.); (M.P.); (P.M.); (N.P.-F.); (C.M.); (M.A.R.)
| | - Alejandra Durán
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (V.M.); (I.R.); (N.G.d.l.T.); (P.D.M.); (J.V.); (L.d.V.); (A.B.); (C.S.); (I.M.); (C.F.); (A.D.); (J.A.D.); (M.C.); (J.G.R.); (I.J.); (M.P.); (P.M.); (N.P.-F.); (C.M.); (M.A.R.)
- Medicina II Department, Facultad de Medicina, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Maria Jose Torrejón
- Clinical Laboratory Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain;
| | - Jose Angel Diaz
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (V.M.); (I.R.); (N.G.d.l.T.); (P.D.M.); (J.V.); (L.d.V.); (A.B.); (C.S.); (I.M.); (C.F.); (A.D.); (J.A.D.); (M.C.); (J.G.R.); (I.J.); (M.P.); (P.M.); (N.P.-F.); (C.M.); (M.A.R.)
- Medicina II Department, Facultad de Medicina, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Martin Cuesta
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (V.M.); (I.R.); (N.G.d.l.T.); (P.D.M.); (J.V.); (L.d.V.); (A.B.); (C.S.); (I.M.); (C.F.); (A.D.); (J.A.D.); (M.C.); (J.G.R.); (I.J.); (M.P.); (P.M.); (N.P.-F.); (C.M.); (M.A.R.)
| | - Jorge Grabiel Ruiz
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (V.M.); (I.R.); (N.G.d.l.T.); (P.D.M.); (J.V.); (L.d.V.); (A.B.); (C.S.); (I.M.); (C.F.); (A.D.); (J.A.D.); (M.C.); (J.G.R.); (I.J.); (M.P.); (P.M.); (N.P.-F.); (C.M.); (M.A.R.)
| | - Inés Jiménez
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (V.M.); (I.R.); (N.G.d.l.T.); (P.D.M.); (J.V.); (L.d.V.); (A.B.); (C.S.); (I.M.); (C.F.); (A.D.); (J.A.D.); (M.C.); (J.G.R.); (I.J.); (M.P.); (P.M.); (N.P.-F.); (C.M.); (M.A.R.)
| | - Mario Pazos
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (V.M.); (I.R.); (N.G.d.l.T.); (P.D.M.); (J.V.); (L.d.V.); (A.B.); (C.S.); (I.M.); (C.F.); (A.D.); (J.A.D.); (M.C.); (J.G.R.); (I.J.); (M.P.); (P.M.); (N.P.-F.); (C.M.); (M.A.R.)
| | - Miguel Angel Herraiz
- Gynecology and Obstetrics Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (M.A.H.); (N.I.); (N.P.)
| | - Nuria Izquierdo
- Gynecology and Obstetrics Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (M.A.H.); (N.I.); (N.P.)
| | - Noelia Pérez
- Gynecology and Obstetrics Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (M.A.H.); (N.I.); (N.P.)
| | - Pilar Matia
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (V.M.); (I.R.); (N.G.d.l.T.); (P.D.M.); (J.V.); (L.d.V.); (A.B.); (C.S.); (I.M.); (C.F.); (A.D.); (J.A.D.); (M.C.); (J.G.R.); (I.J.); (M.P.); (P.M.); (N.P.-F.); (C.M.); (M.A.R.)
- Medicina II Department, Facultad de Medicina, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Natalia Perez-Ferre
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (V.M.); (I.R.); (N.G.d.l.T.); (P.D.M.); (J.V.); (L.d.V.); (A.B.); (C.S.); (I.M.); (C.F.); (A.D.); (J.A.D.); (M.C.); (J.G.R.); (I.J.); (M.P.); (P.M.); (N.P.-F.); (C.M.); (M.A.R.)
- Medicina II Department, Facultad de Medicina, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Clara Marcuello
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (V.M.); (I.R.); (N.G.d.l.T.); (P.D.M.); (J.V.); (L.d.V.); (A.B.); (C.S.); (I.M.); (C.F.); (A.D.); (J.A.D.); (M.C.); (J.G.R.); (I.J.); (M.P.); (P.M.); (N.P.-F.); (C.M.); (M.A.R.)
- Medicina II Department, Facultad de Medicina, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Miguel Angel Rubio
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (V.M.); (I.R.); (N.G.d.l.T.); (P.D.M.); (J.V.); (L.d.V.); (A.B.); (C.S.); (I.M.); (C.F.); (A.D.); (J.A.D.); (M.C.); (J.G.R.); (I.J.); (M.P.); (P.M.); (N.P.-F.); (C.M.); (M.A.R.)
- Medicina II Department, Facultad de Medicina, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Alfonso Luis Calle-Pascual
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (V.M.); (I.R.); (N.G.d.l.T.); (P.D.M.); (J.V.); (L.d.V.); (A.B.); (C.S.); (I.M.); (C.F.); (A.D.); (J.A.D.); (M.C.); (J.G.R.); (I.J.); (M.P.); (P.M.); (N.P.-F.); (C.M.); (M.A.R.)
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), 28029 Madrid, Spain
- Medicina II Department, Facultad de Medicina, Universidad Complutense de Madrid, 28040 Madrid, Spain
- Correspondence:
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8
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Torres T, Puig L, Vender R, Lynde C, Piaserico S, Carrascosa JM, Gisondi P, Daudén E, Conrad C, Mendes-Bastos P, Ferreira P, Leite L, Lu JD, Valerio J, Bruni M, Messina F, Nidegger A, Llamas-Velasco M, Del Alcazar E, Mufti A, White K, Caldarola G, Teixeira L, Romanelli P, Desai K, Gkalpakiotis S, Romanelli M, Yeung J, Nogueira M, Chiricozzi A. Drug Survival of IL-12/23, IL-17 and IL-23 Inhibitors for Psoriasis Treatment: A Retrospective Multi-Country, Multicentric Cohort Study. Am J Clin Dermatol 2021; 22:567-579. [PMID: 33786754 DOI: 10.1007/s40257-021-00598-4] [Citation(s) in RCA: 62] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/06/2021] [Indexed: 01/05/2023]
Abstract
BACKGROUND Drug survival analysis of biologic agents in psoriasis is of extreme importance, as it allows not only the evaluation of objective clinical outcomes (such as effectiveness and safety) but also of factors that are associated with patients' adherence to treatment. The aim of this study was to evaluate and compare the drug survival of the most recent biologic agents approved for the treatment of moderate-to-severe psoriasis-ustekinumab, secukinumab, ixekizumab, brodalumab, guselkumab, and risankizumab-and to identify clinical predictors that can influence the drug survival of these drugs. METHODS This retrospective multicentric cohort study from 16 dermatology centers in Portugal, Spain, Italy, Switzerland, Czech Republic, Canada, and the United States included patients that started IL-12/23, IL-17 (IL-17A and IL-17R) and IL-23 inhibitors for the treatment of psoriasis between January 1, 2012 and December 31, 2019. Survival analysis was performed using a Kaplan-Meier estimator, to obtain descriptive survival curves, and proportional hazard Cox regression models. RESULTS A total of 3312 treatment courses (total patients: 3145) were included in the study; 1118 (33.8%) with an IL-12/23 inhibitor (ustekinumab), 1678 (50.7%) with an IL-17 inhibitor [911 (27.5%) on secukinumab, 651 (19.7%) on ixekizumab, 116 (3.5%) on brodalumab], and 516 (15.5%) with an IL-23 inhibitor [398 (12.0%) on guselkumab, 118 (3.5%) on risankizumab]. At 18 months, the cumulative probability of survival was 96.4% for risankizumab, 91.1% for guselkumab, 86.3% for brodalumab, 86.1% for ustekinumab, 82.0% for ixekizumab, and 79.9% for secukinumab. Using ustekinumab as reference, drug survival of guselkumab was higher (HR 0.609; 95% CI 0.418-0.887) and that of secukinumab was lower (HR 1.490; 95% CI 1.257-1.766). In the final multivariable model, secukinumab, female sex, higher BMI, and prior exposure to biologic agents significantly increased the risk of drug discontinuation, whereas risankizumab was protective. CONCLUSION In this multinational cohort with 8439 patient-years of follow-up, the cumulative probability of drug survival for all drugs was >79% at 18 months. Prescribed biologic, female sex, higher BMI, and previous exposure to biologic agents were predictors of drug discontinuation. Drug survival of guselkumab and risankizumab was higher than that of ustekinumab, and secukinumab was lower.
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Affiliation(s)
- Tiago Torres
- Department of Dermatology, Centro Hospitalar Universitário do Porto, Porto, Portugal.
- Instituto de Ciências Biomédicas Abel Salazar, University of Porto, Porto, Portugal.
| | - Luis Puig
- Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Ron Vender
- McMaster University, Hamilton, Ontario, Canada
| | - Charles Lynde
- Lynde Institute for Dermatology, Markham, Ontario, Canada
| | - Stefano Piaserico
- Dermatology Unit, Department of Medicine, University of Padua, 35128, Padua, Italy
| | - Jose M Carrascosa
- Department of Dermatology, Germans Trias i Pujol University Hospital (HUGTP), Autonomous University of Barcelona (UAB), Badalona, Spain
| | - Paolo Gisondi
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, 37126, Verona, Italy
| | - Esteban Daudén
- Dermatology Department, Hospital Universitario de la Princesa, Instituto de Investigación Sanitaria La Princesa (IIS-IP), Madrid, Spain
| | - Curdin Conrad
- Department of Dermatology, Lausanne University Hospital CHUV, University of Lausanne, Lausanne, Switzerland
| | | | | | | | - Justin D Lu
- Michael G. DeGroote School of Medicine, Faculty of Medicine, Hamilton, Ontario, Canada
| | - J Valerio
- Clínica Médica Belém, Lisbon, Portugal
| | - M Bruni
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, 37126, Verona, Italy
| | - F Messina
- Dermatology Unit, Department of Medicine, University of Padua, 35128, Padua, Italy
| | - A Nidegger
- Department of Dermatology, Lausanne University Hospital CHUV, University of Lausanne, Lausanne, Switzerland
| | - M Llamas-Velasco
- Dermatology Department, Hospital Universitario de la Princesa, Instituto de Investigación Sanitaria La Princesa (IIS-IP), Madrid, Spain
| | - E Del Alcazar
- Department of Dermatology, Germans Trias i Pujol University Hospital (HUGTP), Autonomous University of Barcelona (UAB), Badalona, Spain
| | - A Mufti
- Division of Dermatology, Department of Medicine, University of Toronto, Probity Medical Research, Waterloo, Ontario, Canada
| | - Kyra White
- Lynde Institute for Dermatology, Markham, Ontario, Canada
| | - G Caldarola
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Università Cattolica del Sacro Cuore, Largo Agostino Gemelli, 8, 00168, Rome, Italy
| | - Laetitia Teixeira
- Center for Health Technology and Services Research (CINTESIS), Institute of Biomedical Sciences Abel Salazar, University of Porto (ICBAS.UP), Porto, Portugal
| | - Paolo Romanelli
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami, Miller School of Medicine, Miami, Florida, USA
| | - K Desai
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami, Miller School of Medicine, Miami, Florida, USA
| | - Spyridon Gkalpakiotis
- Department of Dermatovenereology, Third Faculty of Medicine, Charles University and Kralovske Vinohrady University Hospital, Prague, Czech Republic
| | | | - Jensen Yeung
- Division of Dermatology, Department of Medicine, University of Toronto, Probity Medical Research, Waterloo, Ontario, Canada
| | - Miguel Nogueira
- Department of Dermatology, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Andrea Chiricozzi
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Università Cattolica del Sacro Cuore, Largo Agostino Gemelli, 8, 00168, Rome, Italy
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Runkle I, de Miguel MP, Barabash A, Cuesta M, Diaz Á, Duran A, Familiar C, de la Torre NG, Herraiz MÁ, Izquierdo N, Diaz Á, Marcuello C, Matia P, Melero V, Montañez C, Moraga I, Perez-Ferre N, Perez N, Assaf-Balut C, Rubio MÁ, Ruiz-Sanchez JG, Sanabria C, Torrejon MJ, Valerio J, Del Valle L, Calle-Pascual A. Early Levothyroxine Treatment for Subclinical Hypothyroidism or Hypothyroxinemia in Pregnancy: The St Carlos Gestational and Thyroid Protocol. Front Endocrinol (Lausanne) 2021; 12:743057. [PMID: 34737722 PMCID: PMC8560890 DOI: 10.3389/fendo.2021.743057] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Accepted: 09/22/2021] [Indexed: 11/17/2022] Open
Abstract
UNLABELLED The optimal maternal levels of thyroid hormones (TH) during the first trimester of gestation have not been established, nor has the ideal moment to initiate levothyroxine treatment (LT) to improve the evolution of gestation and fetal development. Cut-off points for Thyroid-stimulating hormone (TSH) <2.5 µIU/mL and free thyroxine (FT4)>7.5 pg/mL have been recommended. There are no data on whether initiation of LT <9th Gestational Week (GW) can have a favourable impact. OBJECTIVE To define the TSH/FT4 percentiles corresponding with 2.5 µIU/mL and 7.5 pg/mL levels, respectively, at GW8 (Study 1), and evaluate the effects of protocol-based LT before GW9 on gestation evolution, in women with TSH ≥2.5 µIU/mL and/or FT4≤ 7.5 pg/mL (study 2). SUBJECTS 2768 consecutive pregnant women attending the first gestational visit from 2013-2014 and 3026 from 2015-2016 were eligible for Study I and 2 respectively. A final 2043 (study 1) and 2069 (study 2) women were assessed in these studies. RESULTS Study 1: The FT4 level of 7.5 pg/mL corresponds with the 17.9th percentile, a TSH level of 2.5 µIU/mL with the 75.8th. Women with TSH ≥2.5 µIU/mL had a history of fetal losses more frequently than those <2.5 (OR 2.33 (95%CI): 1.58-3.12), as did those with FT4 ≤7.5 pg/ml compared to those >7.5 (OR 4.81; 3.25-8.89). Study 2: A total of 1259 women had optimal TSH/FT4 levels (Group 1), 672 (32.4%, Group 2) had suboptimal TSH or T4l, and 138 (6.7%, Group 3) had suboptimal values of both. 393 (58.5%) in Group 2 and 88 (63.8%) in Group 3 started LT before GW9. Mean (SD) GW24 levels were TSH: 1.96 ± 1.22 µIU/mL and FT4: 7.07 ± 1.25 pg/mL. The highest FT4 value was 12.84 pg/mL. The adjusted risk for an adverse event if LT was started early was 0.71 (0.43-0.91) for Group 2 and 0.80 (0.66-0.94) for Group 3. CONCLUSIONS Early LT in women with suboptimum levels of TSH/FT4 (≥2.5µIU/mL/≤7.5 pg/ml) at or before GW9 is safe and improves gestation progression. These data support the recommendation to adopt these cut-off points for LT initiation, which should be started as early as possible.
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Affiliation(s)
- Isabelle Runkle
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
- Medicina II Department, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - María Paz de Miguel
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
- Medicina II Department, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - Ana Barabash
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
- Medicina II Department, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain
| | - Martin Cuesta
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain
| | - Ángel Diaz
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
- Medicina II Department, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - Alejandra Duran
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
- Medicina II Department, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - Cristina Familiar
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Nuria García de la Torre
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain
| | - Miguel Ángel Herraiz
- Medicina II Department, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
- Gynecology and Obstetrics Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Nuria Izquierdo
- Medicina II Department, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
- Gynecology and Obstetrics Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Ángel Diaz
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Clara Marcuello
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Pilar Matia
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
- Medicina II Department, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - Verónica Melero
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Carmen Montañez
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Inmaculada Moraga
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Natalia Perez-Ferre
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Noelia Perez
- Gynecology and Obstetrics Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Carla Assaf-Balut
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
- Medicina II Department, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - Miguel Ángel Rubio
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
- Medicina II Department, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - Jorge Gabriel Ruiz-Sanchez
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Concepción Sanabria
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - María José Torrejon
- Clinical Laboratory Department Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Johanna Valerio
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Laura Del Valle
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Alfonso Calle-Pascual
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
- Medicina II Department, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain
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Markmann V, Dartsch M, Valerio J, Frenzel L, Lokteva I, Walther M, Westermeier F, Grübel G, Lehmkühler F. Shear-induced ordering in liquid microjets seen by x-ray cross correlation analysis. Struct Dyn 2020; 7:054901. [PMID: 33094129 PMCID: PMC7568674 DOI: 10.1063/4.0000038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 10/01/2020] [Indexed: 05/13/2023]
Abstract
We applied shear to a silica nanoparticle dispersion in a microfluidic jet device and observed direction-dependent structure along and across the flow direction. The asymmetries of the diffraction patterns were evaluated by x-ray cross correlation analysis. For different Rayleigh nozzle sizes and shapes, we measured the decay of the shear-induced ordering after the cessation of the shear. At large tube sizes and small shear rates, the characteristic times of the decay become longer, but Péclet-weighted times do not scale linearly with Péclet numbers. By modeling particle distributions with the corresponding diffraction patterns and comparing measured shape asymmetry to simulations, we determined the variation of volume fraction over the azimuthal angle for the maximum ordered state in the jet.
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Affiliation(s)
- V. Markmann
- Deutsches Elektronen-Synchrotron DESY, Notkestraße 85, 22607 Hamburg, Germany
- Author to whom correspondence should be addressed:
| | | | | | | | | | - M. Walther
- Deutsches Elektronen-Synchrotron DESY, Notkestraße 85, 22607 Hamburg, Germany
| | - F. Westermeier
- Deutsches Elektronen-Synchrotron DESY, Notkestraße 85, 22607 Hamburg, Germany
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Melero V, Assaf-Balut C, García de la Torre N, Jiménez I, Bordiú E, del Valle L, Valerio J, Familiar C, Durán A, Runkle I, de Miguel MP, Montañez C, Barabash A, Cuesta M, Herraiz MA, Izquierdo N, Rubio MA, Calle-Pascual AL. Benefits of Adhering to a Mediterranean Diet Supplemented with Extra Virgin Olive Oil and Pistachios in Pregnancy on the Health of Offspring at 2 Years of Age. Results of the San Carlos Gestational Diabetes Mellitus Prevention Study. J Clin Med 2020; 9:jcm9051454. [PMID: 32414066 PMCID: PMC7290358 DOI: 10.3390/jcm9051454] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 05/09/2020] [Accepted: 05/11/2020] [Indexed: 12/14/2022] Open
Abstract
The intrauterine environment may be related to the future development of chronic diseases in the offspring. The St. Carlos gestational diabetes mellitus (GDM) prevention study, is a randomized controlled trial that evaluated the influence of the early (before 12th gestational week) Mediterranean diet (MedDiet) on the onset of GDM and adverse gestational outcomes. Out of 874 women assessed after delivery (440 control group (CG)/434 intervention group (IG)), 703 children were followed (365/338; CG/IG), with the aim to assess whether the adherence to a MedDiet during pregnancy induces health benefits for the offspring during the first two years of life. Logistic regression analysis showed that the IG in children of mothers with pre-gestational body mass index (BMI) < 25 kg/m2 and normal glucose tolerance (NGT), was associated with a lower risk (RR(95% CI)) of suffering from severe events requiring hospitalization due to bronchiolitis/asthma (0.75(0.58–0.98) and 0.77(0.59–0.99), respectively) or other diseases that required either antibiotic (0.80(0.65–0.98) and 0.80(0.65–0.99), respectively), corticosteroid treatment (0.73(0.59–0.90) and 0.79(0.62–1.00) respectively) or both (all p < 0.05). A nutritional intervention based on the MedDiet during pregnancy is associated with a reduction in offspring’s hospital admissions, especially in women with pre-gestational BMI < 25 kg/m2 and NGT.
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Affiliation(s)
- Verónica Melero
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (V.M.); (C.A.-B.); (N.G.d.l.T.); (I.J.); (E.B.); (L.d.V.); (J.V.); (C.F.); (A.D.); (I.R.); (M.P.d.M.); (C.M.); (A.B.); (M.C.); (M.A.R.)
- Facultad de Medicina. Medicina II Department, Universidad Complutense de Madrid, 28040 Madrid, Spain; (M.A.H.); (N.I.)
| | - Carla Assaf-Balut
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (V.M.); (C.A.-B.); (N.G.d.l.T.); (I.J.); (E.B.); (L.d.V.); (J.V.); (C.F.); (A.D.); (I.R.); (M.P.d.M.); (C.M.); (A.B.); (M.C.); (M.A.R.)
- Facultad de Medicina. Medicina II Department, Universidad Complutense de Madrid, 28040 Madrid, Spain; (M.A.H.); (N.I.)
| | - Nuria García de la Torre
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (V.M.); (C.A.-B.); (N.G.d.l.T.); (I.J.); (E.B.); (L.d.V.); (J.V.); (C.F.); (A.D.); (I.R.); (M.P.d.M.); (C.M.); (A.B.); (M.C.); (M.A.R.)
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), 28029 Madrid, Spain
| | - Inés Jiménez
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (V.M.); (C.A.-B.); (N.G.d.l.T.); (I.J.); (E.B.); (L.d.V.); (J.V.); (C.F.); (A.D.); (I.R.); (M.P.d.M.); (C.M.); (A.B.); (M.C.); (M.A.R.)
| | - Elena Bordiú
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (V.M.); (C.A.-B.); (N.G.d.l.T.); (I.J.); (E.B.); (L.d.V.); (J.V.); (C.F.); (A.D.); (I.R.); (M.P.d.M.); (C.M.); (A.B.); (M.C.); (M.A.R.)
- Facultad de Medicina. Medicina II Department, Universidad Complutense de Madrid, 28040 Madrid, Spain; (M.A.H.); (N.I.)
| | - Laura del Valle
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (V.M.); (C.A.-B.); (N.G.d.l.T.); (I.J.); (E.B.); (L.d.V.); (J.V.); (C.F.); (A.D.); (I.R.); (M.P.d.M.); (C.M.); (A.B.); (M.C.); (M.A.R.)
| | - Johanna Valerio
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (V.M.); (C.A.-B.); (N.G.d.l.T.); (I.J.); (E.B.); (L.d.V.); (J.V.); (C.F.); (A.D.); (I.R.); (M.P.d.M.); (C.M.); (A.B.); (M.C.); (M.A.R.)
| | - Cristina Familiar
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (V.M.); (C.A.-B.); (N.G.d.l.T.); (I.J.); (E.B.); (L.d.V.); (J.V.); (C.F.); (A.D.); (I.R.); (M.P.d.M.); (C.M.); (A.B.); (M.C.); (M.A.R.)
| | - Alejandra Durán
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (V.M.); (C.A.-B.); (N.G.d.l.T.); (I.J.); (E.B.); (L.d.V.); (J.V.); (C.F.); (A.D.); (I.R.); (M.P.d.M.); (C.M.); (A.B.); (M.C.); (M.A.R.)
- Facultad de Medicina. Medicina II Department, Universidad Complutense de Madrid, 28040 Madrid, Spain; (M.A.H.); (N.I.)
| | - Isabelle Runkle
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (V.M.); (C.A.-B.); (N.G.d.l.T.); (I.J.); (E.B.); (L.d.V.); (J.V.); (C.F.); (A.D.); (I.R.); (M.P.d.M.); (C.M.); (A.B.); (M.C.); (M.A.R.)
- Facultad de Medicina. Medicina II Department, Universidad Complutense de Madrid, 28040 Madrid, Spain; (M.A.H.); (N.I.)
| | - María Paz de Miguel
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (V.M.); (C.A.-B.); (N.G.d.l.T.); (I.J.); (E.B.); (L.d.V.); (J.V.); (C.F.); (A.D.); (I.R.); (M.P.d.M.); (C.M.); (A.B.); (M.C.); (M.A.R.)
- Facultad de Medicina. Medicina II Department, Universidad Complutense de Madrid, 28040 Madrid, Spain; (M.A.H.); (N.I.)
| | - Carmen Montañez
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (V.M.); (C.A.-B.); (N.G.d.l.T.); (I.J.); (E.B.); (L.d.V.); (J.V.); (C.F.); (A.D.); (I.R.); (M.P.d.M.); (C.M.); (A.B.); (M.C.); (M.A.R.)
| | - Ana Barabash
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (V.M.); (C.A.-B.); (N.G.d.l.T.); (I.J.); (E.B.); (L.d.V.); (J.V.); (C.F.); (A.D.); (I.R.); (M.P.d.M.); (C.M.); (A.B.); (M.C.); (M.A.R.)
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), 28029 Madrid, Spain
| | - Martín Cuesta
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (V.M.); (C.A.-B.); (N.G.d.l.T.); (I.J.); (E.B.); (L.d.V.); (J.V.); (C.F.); (A.D.); (I.R.); (M.P.d.M.); (C.M.); (A.B.); (M.C.); (M.A.R.)
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), 28029 Madrid, Spain
| | - Miguel A. Herraiz
- Facultad de Medicina. Medicina II Department, Universidad Complutense de Madrid, 28040 Madrid, Spain; (M.A.H.); (N.I.)
- Gynecology and Obstetrics Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain
| | - Nuria Izquierdo
- Facultad de Medicina. Medicina II Department, Universidad Complutense de Madrid, 28040 Madrid, Spain; (M.A.H.); (N.I.)
- Gynecology and Obstetrics Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain
| | - Miguel A. Rubio
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (V.M.); (C.A.-B.); (N.G.d.l.T.); (I.J.); (E.B.); (L.d.V.); (J.V.); (C.F.); (A.D.); (I.R.); (M.P.d.M.); (C.M.); (A.B.); (M.C.); (M.A.R.)
- Facultad de Medicina. Medicina II Department, Universidad Complutense de Madrid, 28040 Madrid, Spain; (M.A.H.); (N.I.)
| | - Alfonso L. Calle-Pascual
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (V.M.); (C.A.-B.); (N.G.d.l.T.); (I.J.); (E.B.); (L.d.V.); (J.V.); (C.F.); (A.D.); (I.R.); (M.P.d.M.); (C.M.); (A.B.); (M.C.); (M.A.R.)
- Facultad de Medicina. Medicina II Department, Universidad Complutense de Madrid, 28040 Madrid, Spain; (M.A.H.); (N.I.)
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), 28029 Madrid, Spain
- Correspondence:
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Assaf-Balut C, Garcia de la Torre N, Bordiu E, Del Valle L, Valerio J, Jimenez I, Duran A, Fuentes M, Herraiz MA, Izquierdo N, Runkle I, de Miguel P, Familiar C, Montañez MC, Barabash A, Melero V, Cuesta M, Rubio M, Calle-Pascual AL. Consumption of fat-free dairy products is not associated with a lower risk of maternofetal adverse events. BMJ Open Diabetes Res Care 2020; 8:8/1/e001145. [PMID: 32265254 PMCID: PMC7254142 DOI: 10.1136/bmjdrc-2019-001145] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Revised: 01/31/2020] [Accepted: 03/09/2020] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND The consumption of dairy products in pregnancy is widely extended. However, whether the consumption of low or high fat dairy produce is more beneficial for maternofetal health has yet to be established. RESEARCH DESIGN AND METHODS This prospective cohort study evaluated the effect of consumption of dairy products during pregnancy on the frequency of gestational diabetes mellitus (GDM) and a composite of adverse maternofetal outcomes (CMFO). Pregnant women receiving obstetric care between 2014 and 2017 were eligible. Those who consumed ≥3 servings/day of dairy products at 24-28 gestational weeks (GWs) were included and analyzed (n=2004). The population was stratified into three groups according to intake of fat-free dairy products-skimmed milk and fat-free yoghurt and cheese-(days/week): infrequent (1-2), average (3-6) and regular (7). Logistic regression analysis compared ORs (95% CI) for GDM and CMFO between the three groups (where the group of reference was the 'infrequent' intake group). RESULTS After adjusting for confounding factors, no significant associations were found between the degree of consumption of fat-free dairy products and the risk of GDM and a CMFO. Moreover, when categorized by the degree of adherence to the Mediterranean diet (above or below the median score), associations were found between the 'regular' intake group and an increased risk of having a CMFO in women with a high adherence to the Mediterranean diet (OR: 1.50; 95% CI: 1.01 to 2.22; p<0.05). Weight gain during pregnancy did not differ among groups. CONCLUSIONS The consumption of fat-free dairy products during pregnancy does not seem to be beneficial for maternofetal health.
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Affiliation(s)
- Carla Assaf-Balut
- Endocrinologia y Nutricion, Hospital Clínico Universitario San Carlos, Madrid, Spain
- Departamento de Medicina II, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - Nuria Garcia de la Torre
- Endocrinologia y Nutricion, Hospital Clínico Universitario San Carlos, Madrid, Spain
- Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain
| | - Elena Bordiu
- Endocrinologia y Nutricion, Hospital Clínico Universitario San Carlos, Madrid, Spain
- Departamento de Medicina II, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - Laura Del Valle
- Endocrinologia y Nutricion, Hospital Clínico Universitario San Carlos, Madrid, Spain
| | - Johanna Valerio
- Endocrinologia y Nutricion, Hospital Clínico Universitario San Carlos, Madrid, Spain
- Departamento de Medicina II, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - Inés Jimenez
- Endocrinologia y Nutricion, Hospital Clínico Universitario San Carlos, Madrid, Spain
| | - Alejandra Duran
- Endocrinologia y Nutricion, Hospital Clínico Universitario San Carlos, Madrid, Spain
| | - Manuel Fuentes
- Preventive Medicine Department, Hospital Clinico Universitario San Carlos, Madrid, Spain
| | - Miguel Angel Herraiz
- Gynecology and Obstetrics Department, Hospital Clinico Universitario San Carlos, Madrid, Spain
| | - Nuria Izquierdo
- Gynecology and Obstetrics Department, Hospital Clinico Universitario San Carlos, Madrid, Spain
| | - Isabelle Runkle
- Endocrinologia y Nutricion, Hospital Clínico Universitario San Carlos, Madrid, Spain
| | - Paz de Miguel
- Endocrinologia y Nutricion, Hospital Clínico Universitario San Carlos, Madrid, Spain
- Departamento de Medicina II, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - Cristina Familiar
- Endocrinologia y Nutricion, Hospital Clínico Universitario San Carlos, Madrid, Spain
| | - Maria Carmen Montañez
- Endocrinologia y Nutricion, Hospital Clínico Universitario San Carlos, Madrid, Spain
| | - Ana Barabash
- Endocrinologia y Nutricion, Hospital Clínico Universitario San Carlos, Madrid, Spain
- Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain
| | - Veronica Melero
- Endocrinologia y Nutricion, Medicina II, UCM, Hospital Clinico Universitario San Carlos, Madrid, Spain
| | - Martín Cuesta
- Endocrinologia y Nutricion, Hospital Clínico Universitario San Carlos, Madrid, Spain
- Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain
| | - Miguel Rubio
- Endocrinologia y Nutricion, Hospital Clínico Universitario San Carlos, Madrid, Spain
| | - Alfonso Luis Calle-Pascual
- Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain
- Endocrinologia y Nutricion, Medicina II, UCM, Hospital Clinico Universitario San Carlos, Madrid, Spain
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Assaf-Balut C, Garcia de la Torre N, Durán A, Bordiu E, Del Valle L, Familiar C, Valerio J, Jimenez I, Herraiz MA, Izquierdo N, Runkle I, de Miguel MP, Montañez C, Barabash A, Cuesta M, Rubio MA, Calle-Pascual AL. An Early, Universal Mediterranean Diet-Based Intervention in Pregnancy Reduces Cardiovascular Risk Factors in the "Fourth Trimester". J Clin Med 2019; 8:jcm8091499. [PMID: 31546914 PMCID: PMC6780735 DOI: 10.3390/jcm8091499] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 09/10/2019] [Accepted: 09/16/2019] [Indexed: 01/15/2023] Open
Abstract
An early antenatal dietary intervention could play an important role in the prevention of metabolic diseases postpartum. The aim of this study is to evaluate whether an early, specific dietary intervention reduces women’s cardiovascular risk in the “fourth trimester”. This prospective cohort study compares 1675 women from the standard-care group (ScG/n = 676), who received standard-care dietary guidelines, with the intervention group (IG/n = 999), who received Mediterranean diet (MedDiet)-based dietary guidelines, supplemented with extra-virgin olive oil and nuts. Cardiovascular risk was determined by the presence of metabolic syndrome (MetS) and insulin resistance syndrome (IrS) (HOMA-IR 3.5) at 12–14 weeks postpartum. MetS was less frequent in the IG (11.3 vs. 19.3%, p < 0.05). The intervention was associated with a reduction in the relative risk of having MetS: 0.74 (95% CI, 0.60–0.90), but not in the risk of IrS. When analyzing the presence of having one or more components of the MetS, the IG had significantly higher rates of having 0 components and lower rates of having ≥1 (p-trend = 0.029). An early MedDiet-based nutritional intervention in pregnancy is associated with reductions in postpartum rates of MetS.
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Affiliation(s)
- Carla Assaf-Balut
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain.
- Facultad de Medicina, Medicina II Department, Universidad Complutense de Madrid, 28040 Madrid, Spain.
| | - Nuria Garcia de la Torre
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain.
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), 28029 Madrid, Spain.
| | - Alejandra Durán
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain.
- Facultad de Medicina, Medicina II Department, Universidad Complutense de Madrid, 28040 Madrid, Spain.
| | - Elena Bordiu
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain.
- Facultad de Medicina, Medicina II Department, Universidad Complutense de Madrid, 28040 Madrid, Spain.
| | - Laura Del Valle
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain.
| | - Cristina Familiar
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain.
| | - Johanna Valerio
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain.
| | - Inés Jimenez
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain.
| | - Miguel Angel Herraiz
- Facultad de Medicina, Medicina II Department, Universidad Complutense de Madrid, 28040 Madrid, Spain.
- Gynecology and Obstetrics Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain.
| | - Nuria Izquierdo
- Facultad de Medicina, Medicina II Department, Universidad Complutense de Madrid, 28040 Madrid, Spain.
- Gynecology and Obstetrics Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain.
| | - Isabelle Runkle
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain.
- Facultad de Medicina, Medicina II Department, Universidad Complutense de Madrid, 28040 Madrid, Spain.
| | - María Paz de Miguel
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain.
- Facultad de Medicina, Medicina II Department, Universidad Complutense de Madrid, 28040 Madrid, Spain.
| | - Carmen Montañez
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain.
| | - Ana Barabash
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain.
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), 28029 Madrid, Spain.
| | - Martín Cuesta
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain.
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), 28029 Madrid, Spain.
| | - Miguel Angel Rubio
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain.
- Facultad de Medicina, Medicina II Department, Universidad Complutense de Madrid, 28040 Madrid, Spain.
| | - Alfonso Luis Calle-Pascual
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain.
- Facultad de Medicina, Medicina II Department, Universidad Complutense de Madrid, 28040 Madrid, Spain.
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), 28029 Madrid, Spain.
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Assaf-Balut C, García de la Torre N, Calle-Pascual AL, Calle-Pascual AL, Torre NGDL, Durán A, Jiménez I, Rubio MÁ, Herraíz MÁ, Izquierdo N, Pérez N, Garcia AS, Dominguez GC, Torrejón MJ, Cuadrado MÁ, Assaf-Balut C, Del Valle L, Bordiú E, Valerio J, Barabash A, Orta MS, Parayuelo MVSD, Muñoz LF, Calzada F. Detection, treatment and prevention programs for gestational diabetes mellitus: The St Carlos experience. ACTA ACUST UNITED AC 2019; 67:342-350. [PMID: 31519528 DOI: 10.1016/j.endinu.2019.06.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Revised: 06/18/2019] [Accepted: 06/26/2019] [Indexed: 01/15/2023]
Abstract
Gestational diabetes mellitus (GDM) increases the risk of adverse events in pregnancy and jeopardizes long-term health of the mother and offspring. There is currently no consensus as to what screening strategies improve the efficiency of GDM diagnosis. Which criteria should be used? Is the one-step or two-step procedure better? There is no agreement as to what the best dietary approach in the treatment of GDM is. In addition, different nutritional interventions have been studied in the prevention of GDM. The Mediterranean diet seems to be effective in preventing GDM and other maternofoetal outcomes. We review herein our experience using the one-step criteria for GDM screening; the treatment and prevention strategies used; and the overall impact of nutrition on maternofoetal health.
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Affiliation(s)
- Carla Assaf-Balut
- Endocrinology and Nutrition Department. Hospital Clínico San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain; Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain
| | - Nuria García de la Torre
- Endocrinology and Nutrition Department. Hospital Clínico San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain; Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain
| | - Alfonso L Calle-Pascual
- Endocrinology and Nutrition Department. Hospital Clínico San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain; Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain; Departamento de Medicina II, Facultad de Medicina, Universidad Complutense de Madrid, Spain.
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15
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Assaf-Balut C, García de la Torre N, Duran A, Fuentes M, Bordiú E, Del Valle L, Familiar C, Valerio J, Jiménez I, Herraiz MA, Izquierdo N, Torrejon MJ, Cuadrado MÁ, Ortega I, Illana FJ, Runkle I, de Miguel P, Moraga I, Montañez C, Barabash A, Cuesta M, Rubio MA, Calle-Pascual AL. A Mediterranean Diet with an Enhanced Consumption of Extra Virgin Olive Oil and Pistachios Improves Pregnancy Outcomes in Women Without Gestational Diabetes Mellitus: A Sub-Analysis of the St. Carlos Gestational Diabetes Mellitus Prevention Study. Ann Nutr Metab 2018; 74:69-79. [PMID: 30554220 DOI: 10.1159/000495793] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Accepted: 11/26/2018] [Indexed: 12/20/2022]
Abstract
AIMS The aim of the study was to evaluate the effect of a Mediterranean diet (MedDiet), enhanced with extra virgin olive oil (EVOO) and nuts, on a composite of adverse maternofoetal outcomes of women with normoglycemia during pregnancy. METHODS This was a sub-analysis of the St Carlos gestational diabetes mellitus Prevention Study. Only normoglycemic women were analysed (697). They were randomized (at 8-12th gestational weeks) to: standard-care control group (337), where fat consumption was limited to 30% of total caloric intake; or intervention group (360), where a MedDiet, enhanced with EVOO and pistachios (40-42% fats of total caloric intake) was recommended. The primary outcome was a composite of maternofoetal outcomes (CMFOs): at least having 1 event of emergency C-section, perineal trauma, pregnancy-induced hypertension and preeclampsia, prematurity, large-for-gestational-age and small-for gestational-age. RESULTS Crude relative risk showed that the intervention was associated with a significant reduction in the risk of CMFOs (0.48 [0.37-0.63]; p = 0.0001), with a number-needed-to-treat = 5. Risk of urinary tract infections, emergency C-sections, perineal trauma, large-for-gestational-age and small-for gestational age new-borns were also significantly reduced. CONCLUSION A MedDiet, enhanced with EVOO and nuts, was associated with a risk reduction of CMFOs in over 50% in normoglycemic pregnant women. Therefore, it might be a potentially adequate diet for pregnant women. TRIAL REGISTRATION Identifier ISRCTN84389045. The study was registered on September 27, 2013. Last edited on September 26, 2018.
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Affiliation(s)
- Carla Assaf-Balut
- Department of Endocrinology and Nutrition, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain.,Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - Nuria García de la Torre
- Department of Endocrinology and Nutrition, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain.,Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain
| | - Alejandra Duran
- Department of Endocrinology and Nutrition, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain.,Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - Manuel Fuentes
- Department of Preventive Medicine, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Elena Bordiú
- Department of Endocrinology and Nutrition, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain.,Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - Laura Del Valle
- Department of Endocrinology and Nutrition, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Cristina Familiar
- Department of Endocrinology and Nutrition, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Johanna Valerio
- Department of Endocrinology and Nutrition, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Inés Jiménez
- Department of Endocrinology and Nutrition, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Miguel A Herraiz
- Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain.,Department of Gynecology and Obstetrics, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Nuria Izquierdo
- Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain.,Department of Gynecology and Obstetrics, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - María J Torrejon
- Department of Clinical Laboratory, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Maria Ángeles Cuadrado
- Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain.,Department of Clinical Laboratory, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Isabel Ortega
- Department of Clinical Laboratory, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Francisco J Illana
- Department of Clinical Laboratory, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Isabelle Runkle
- Department of Endocrinology and Nutrition, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain.,Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - Paz de Miguel
- Department of Endocrinology and Nutrition, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain.,Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - Inmaculada Moraga
- Department of Endocrinology and Nutrition, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Carmen Montañez
- Department of Endocrinology and Nutrition, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Ana Barabash
- Department of Endocrinology and Nutrition, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain.,Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain
| | - Martín Cuesta
- Department of Endocrinology and Nutrition, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain.,Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain
| | - Miguel A Rubio
- Department of Endocrinology and Nutrition, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain.,Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - Alfonso L Calle-Pascual
- Department of Endocrinology and Nutrition, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain, .,Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain, .,Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain,
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Assaf-Balut C, Garcia de la Torre N, Durán A, Fuentes M, Bordiú E, del Valle L, Valerio J, Familiar C, Jiménez I, Herraiz MA, Izquierdo N, Torrejón MJ, Runkle I, de Miguel MP, Moraga I, Montañez MC, Barabash A, Cuesta M, Rubio MA, Calle-Pascual AL. Medical nutrition therapy for gestational diabetes mellitus based on Mediterranean Diet principles: a subanalysis of the St Carlos GDM Prevention Study. BMJ Open Diabetes Res Care 2018; 6:e000550. [PMID: 30397489 PMCID: PMC6202993 DOI: 10.1136/bmjdrc-2018-000550] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2018] [Revised: 07/23/2018] [Accepted: 08/13/2018] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES To assess whether Mediterranean Diet (MedDiet)-based medical nutrition therapy facilitates near-normoglycemia in women with gestational diabetes mellitus (GDMw) and observe the effects on adverse pregnancy outcomes. RESEARCH DESIGN AND METHODS This is a secondary analysis of the St Carlos GDM Prevention Study, conducted between January and December 2015 in Hospital Clínico San Carlos (Madrid, Spain). One thousand consecutive women with normoglycemia were included before 12 gestational weeks (GWs), with 874 included in the final analysis. Of these, 177 women were diagnosed with gestational diabetes mellitus (GDM) and 697 had normal glucose tolerance. All GDMw received MedDiet-based medical nutrition therapy with a recommended daily extra virgin olive oil intake ≥40 mL and a daily handful of nuts. The primary goal was comparison of hemoglobin A1c (HbA1c) levels at 36-38 GWs in GDMw and women with normal glucose tolerance (NGTw). RESULTS GDMw as compared with NGTw had higher HbA1c levels at 24-28 GWs (5.1%±0.3% (32±0.9 mmol/mol) vs 4.9%±0.3% (30±0.9 mmol/mol), p=0.001). At 36-38 GWs values were similar between the groups. Similarly, fasting serum insulin and homeostatic model assessment insulin resitance (HOMA-IR) were higher in GDMw at 24-28 GWs (p=0.001) but became similar at 36-38 GWs. 26.6% of GDMw required insulin for glycemic control. GDMw compared with NGTw had higher rates of insufficient weight gain (39.5% vs 22.0%, p=0.001), small for gestational age (6.8% vs 2.6%, p=0.009), and neonatal intensive care unit admission (5.6% vs 1.7%, p=0.006). The rates of macrosomia, large for gestational age, pregnancy-induced hypertensive disorders, prematurity and cesarean sections were comparable with NGTw. CONCLUSIONS Using a MedDiet-based medical nutrition therapy as part of GDM management is associated with achievement of near-normoglycemia, subsequently making most pregnancy outcomes similar to those of NGTw.
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Affiliation(s)
- Carla Assaf-Balut
- Endocrinology and Nutrition Department, Hospital Clínico San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
- Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - Nuria Garcia de la Torre
- Endocrinology and Nutrition Department, Hospital Clínico San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain
| | - Alejandra Durán
- Endocrinology and Nutrition Department, Hospital Clínico San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
- Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - Manuel Fuentes
- Preventive Medicine Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Elena Bordiú
- Endocrinology and Nutrition Department, Hospital Clínico San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
- Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - Laura del Valle
- Endocrinology and Nutrition Department, Hospital Clínico San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Johanna Valerio
- Endocrinology and Nutrition Department, Hospital Clínico San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Cristina Familiar
- Endocrinology and Nutrition Department, Hospital Clínico San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Inés Jiménez
- Endocrinology and Nutrition Department, Hospital Clínico San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Miguel Angel Herraiz
- Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
- Gynecology and Obstetrics Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Nuria Izquierdo
- Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
- Gynecology and Obstetrics Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Maria José Torrejón
- Clinical Laboratory Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Isabelle Runkle
- Endocrinology and Nutrition Department, Hospital Clínico San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
- Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - Maria Paz de Miguel
- Endocrinology and Nutrition Department, Hospital Clínico San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
- Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - Inmaculada Moraga
- Endocrinology and Nutrition Department, Hospital Clínico San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Maria Carmen Montañez
- Endocrinology and Nutrition Department, Hospital Clínico San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Ana Barabash
- Endocrinology and Nutrition Department, Hospital Clínico San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain
| | - Martín Cuesta
- Endocrinology and Nutrition Department, Hospital Clínico San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain
| | - Miguel A Rubio
- Endocrinology and Nutrition Department, Hospital Clínico San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
- Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - Alfonso Luis Calle-Pascual
- Endocrinology and Nutrition Department, Hospital Clínico San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
- Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain
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Abstract
Abstract
We study the effect of the osmolytes, Urea and trimethylamine-N-oxide (TMAO) on POPE (1-palmitoyl-2-oleoyl-sn-glycero-3- phosphoethanolamine) lipid membranes using SAXS/WAXS and DSC. Their antagonist effect is observed with TMAO stabilizing and Urea destabilizing the lipid bilayer, as seen by others in earlier researches.
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Affiliation(s)
- J. Valerio
- Photo Science at DESY, Hamburg , Germany
| | - S. Bernstorff
- Elettra-Sincrotrone Trieste S.C.p.A, Trieste , Italy
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18
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Steinke I, Walther M, Lehmkühler F, Wochner P, Valerio J, Mager R, Schroer MA, Lee S, Roseker W, Jain A, Sikorski M, Song S, Hartmann R, Huth M, Strüder L, Sprung M, Robert A, Fuoss PH, Stephenson GB, Grübel G. A liquid jet setup for x-ray scattering experiments on complex liquids at free-electron laser sources. Rev Sci Instrum 2016; 87:063905. [PMID: 27370468 DOI: 10.1063/1.4953921] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Accepted: 06/01/2016] [Indexed: 05/26/2023]
Abstract
In this paper we describe a setup for x-ray scattering experiments on complex fluids using a liquid jet. The setup supports Small and Wide Angle X-ray Scattering (SAXS/WAXS) geometries. The jet is formed by a gas-dynamic virtual nozzle (GDVN) allowing for diameters ranging between 1 μm and 20 μm at a jet length of several hundred μm. To control jet properties such as jet length, diameter, or flow rate, the instrument is equipped with several diagnostic tools. Three microscopes are installed to quantify jet dimensions and stability in situ. The setup has been used at several beamlines performing both SAXS and WAXS experiments. As a typical example we show an experiment on a colloidal dispersion in a liquid jet at the X-ray Correlation Spectroscopy instrument at the Linac Coherent Light Source free-electron laser.
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Affiliation(s)
- I Steinke
- Deutsches Elektronen-Synchrotron (DESY), Notkestr. 85, 22607 Hamburg, Germany
| | - M Walther
- Deutsches Elektronen-Synchrotron (DESY), Notkestr. 85, 22607 Hamburg, Germany
| | - F Lehmkühler
- Deutsches Elektronen-Synchrotron (DESY), Notkestr. 85, 22607 Hamburg, Germany
| | - P Wochner
- Max Plank-Institut für Festkörperforschung, Heisenbergstr. 1, 70569 Stuttgart, Germany
| | - J Valerio
- Deutsches Elektronen-Synchrotron (DESY), Notkestr. 85, 22607 Hamburg, Germany
| | - R Mager
- Max Plank-Institut für Intelligente Systeme, Heisenbergstr. 3, 70569 Stuttgart, Germany
| | - M A Schroer
- Deutsches Elektronen-Synchrotron (DESY), Notkestr. 85, 22607 Hamburg, Germany
| | - S Lee
- Frontier in Extreme Physics, Korea Research Institute of Standards and Science (KRISS), Daejeon 305-600, South Korea
| | - W Roseker
- Deutsches Elektronen-Synchrotron (DESY), Notkestr. 85, 22607 Hamburg, Germany
| | - A Jain
- Deutsches Elektronen-Synchrotron (DESY), Notkestr. 85, 22607 Hamburg, Germany
| | - M Sikorski
- LCLS, SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - S Song
- LCLS, SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - R Hartmann
- PNSensor GmbH, Sckellstraße 3, 81667 München, Germany
| | - M Huth
- PNSensor GmbH, Sckellstraße 3, 81667 München, Germany
| | - L Strüder
- PNSensor GmbH, Sckellstraße 3, 81667 München, Germany
| | - M Sprung
- Deutsches Elektronen-Synchrotron (DESY), Notkestr. 85, 22607 Hamburg, Germany
| | - A Robert
- LCLS, SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - P H Fuoss
- Argonne National Laboratory, Argonne, Illinois 60439, USA
| | - G B Stephenson
- Argonne National Laboratory, Argonne, Illinois 60439, USA
| | - G Grübel
- Deutsches Elektronen-Synchrotron (DESY), Notkestr. 85, 22607 Hamburg, Germany
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Harrison R, Valerio J, Buffam F, Mezei M. PEO1 Gene (Twinkle) Mutation and Multi-Organ Failure Following Propofol Infusion (P07.205). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p07.205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Harrison R, Valerio J, Buffam F, Mezei M. PEO1 Gene (Twinkle) Mutation and Multi-Organ Failure Following Propofol Infusion (IN7-1.005). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.in7-1.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Allen P, Conradson S, Wilson M, Gottesfeld S, Raistrick I, Valerio J, Lovato M. In situ structural characterization of a platinum electrocatalyst by dispersive x-ray absorption spectroscopy. Electrochim Acta 1994. [DOI: 10.1016/0013-4686(94)e0196-u] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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