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Schoonejans JM, Fan HM, Mitchell AL, Lövgren-Sandblom A, Sukumar N, Periyathambi N, Weldeselassie Y, Seed PT, Molinaro A, Marschall HU, Saravanan P, Williamson C. Serum bile acid measurements in women of European and South Asian ethnicity with or without gestational diabetes mellitus: A cohort study. BJOG 2024. [PMID: 38424005 DOI: 10.1111/1471-0528.17798] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 02/13/2024] [Accepted: 02/16/2024] [Indexed: 03/02/2024]
Abstract
OBJECTIVE Investigation of serum bile acid profiles in pregnancies complicated by gestational diabetes mellitus (GDM) in a multi-ethnic cohort of women who are lean or obese. DESIGN Prospective cohort study. SETTING UK multicentre study. POPULATION Fasting serum from participants of European or South Asian self-reported ethnicity from the PRiDE study, between 23 and 31 weeks of gestation. METHODS Bile acids were measured using ultra-performance liquid chromatography-tandem mass spectrometry. Log-transformed data were analysed using linear regression in STATA/IC 15.0. MAIN OUTCOME MEASURES Total bile acids (TBAs), C4, fasting glucose and insulin. RESULTS The TBAs were 1.327-fold (1.105-1.594) increased with GDM in European women (P = 0.003). Women with GDM had 1.162-fold (1.002-1.347) increased levels of the BA synthesis marker C4 (P = 0.047). In South Asian women, obesity (but not GDM) increased TBAs 1.522-fold (1.193-1.942, P = 0.001). Obesity was associated with 1.420-fold (1.185-1.702) increased primary/secondary BA ratio (P < 0.001) related to 1.355-fold (1.140-1.611) increased primary BA concentrations (P = 0.001). TBAs were positively correlated with fasting glucose (P = 0.039) in all women, and with insulin (P = 0.001) and the Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) (P = 0.001) in women with GDM. CONCLUSIONS Serum BA homeostasis in late gestation depends on body mass index and GDM in ethnicity-specific ways. This suggests ethnicity-specific aetiologies may contribute to metabolic risk in European and South Asian women, with the relationship between BAs and insulin resistance of greater importance in European women. Further studies into ethnicity-specific precision medicine for GDM are required.
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Affiliation(s)
- Josca M Schoonejans
- Department of Women and Children's Health, School of Life Course Sciences, King's College London, London, UK
- Department of Metabolism, Digestion & Reproduction, Institute of Reproductive and Developmental Biology, Imperial College London, London, UK
| | - Hei Man Fan
- Department of Women and Children's Health, School of Life Course Sciences, King's College London, London, UK
| | - Alice L Mitchell
- Department of Women and Children's Health, School of Life Course Sciences, King's College London, London, UK
- Department of Metabolism, Digestion & Reproduction, Institute of Reproductive and Developmental Biology, Imperial College London, London, UK
| | | | - Nithya Sukumar
- Department of Diabetes, Endocrinology and Metabolism, George Eliot Hospital, Nuneaton, UK
- Populations, Evidence and Technologies, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Nishanthi Periyathambi
- Department of Diabetes, Endocrinology and Metabolism, George Eliot Hospital, Nuneaton, UK
- Populations, Evidence and Technologies, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Yonas Weldeselassie
- Department of Diabetes, Endocrinology and Metabolism, George Eliot Hospital, Nuneaton, UK
- Populations, Evidence and Technologies, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Paul T Seed
- Department of Women and Children's Health, School of Life Course Sciences, King's College London, London, UK
| | - Antonio Molinaro
- Department of Molecular and Clinical Medicine, Wallenberg Laboratory, University of Gothenburg, Gothenburg, Sweden
| | - Hanns-Ulrich Marschall
- Department of Molecular and Clinical Medicine, Wallenberg Laboratory, University of Gothenburg, Gothenburg, Sweden
| | - Ponnusamy Saravanan
- Department of Diabetes, Endocrinology and Metabolism, George Eliot Hospital, Nuneaton, UK
- Populations, Evidence and Technologies, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Catherine Williamson
- Department of Women and Children's Health, School of Life Course Sciences, King's College London, London, UK
- Department of Metabolism, Digestion & Reproduction, Institute of Reproductive and Developmental Biology, Imperial College London, London, UK
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Fan HM, Mitchell AL, Bellafante E, McIlvride S, Primicheru LI, Giorgi M, Eberini I, Syngelaki A, Lövgren-Sandblom A, Jones P, McCance D, Sukumar N, Periyathambi N, Weldeselassie Y, Hunt KF, Nicolaides KH, Andersson D, Bevan S, Seed PT, Bewick GA, Bowe JE, Fraternali F, Saravanan P, Marschall HU, Williamson C. Sulfated Progesterone Metabolites That Enhance Insulin Secretion via TRPM3 Are Reduced in Serum From Women With Gestational Diabetes Mellitus. Diabetes 2022; 71:837-852. [PMID: 35073578 PMCID: PMC8965673 DOI: 10.2337/db21-0702] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 01/19/2022] [Indexed: 12/02/2022]
Abstract
Serum progesterone sulfates were evaluated in the etiology of gestational diabetes mellitus (GDM). Serum progesterone sulfates were measured using ultra-performance liquid chromatography-tandem mass spectrometry in four patient cohorts: 1) the Hyperglycemia and Adverse Pregnancy Outcomes study; 2) London-based women of mixed ancestry and 3) U.K.-based women of European ancestry with or without GDM; and 4) 11-13 weeks pregnant women with BMI ≤25 or BMI ≥35 kg/m2 with subsequent uncomplicated pregnancies or GDM. Glucose-stimulated insulin secretion (GSIS) was evaluated in response to progesterone sulfates in mouse islets and human islets. Calcium fluorescence was measured in HEK293 cells expressing transient receptor potential cation channel subfamily M member 3 (TRPM3). Computer modeling using Molecular Operating Environment generated three-dimensional structures of TRPM3. Epiallopregnanolone sulfate (PM5S) concentrations were reduced in GDM (P < 0.05), in women with higher fasting plasma glucose (P < 0.010), and in early pregnancy samples from women who subsequently developed GDM with BMI ≥35 kg/m2 (P < 0.05). In islets, 50 µmol/L PM5S increased GSIS by at least twofold (P < 0.001); isosakuranetin (TRPM3 inhibitor) abolished this effect. PM5S increased calcium influx in TRPM3-expressing HEK293 cells. Computer modeling and docking showed identical positioning of PM5S to the natural ligand in TRPM3. PM5S increases GSIS and is reduced in GDM serum. The activation of GSIS by PM5S is mediated by TRPM3 in both mouse and human islets.
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Affiliation(s)
- Hei Man Fan
- School of Life Course Sciences, King’s College London, London, U.K
| | | | - Elena Bellafante
- School of Life Course Sciences, King’s College London, London, U.K
| | - Saraid McIlvride
- School of Life Course Sciences, King’s College London, London, U.K
| | - Laura I. Primicheru
- Wolfson Centre for Age-Related Diseases, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, U.K
| | - Mirko Giorgi
- Randall Division of Cell and Molecular Biophysics, King’s College London, London, U.K
| | - Ivano Eberini
- Department of Pharmacological and Biomolecular Sciences, University of Milan La Statale, Milan, Italy
| | - Argyro Syngelaki
- School of Life Course Sciences, King’s College London, London, U.K
| | | | - Peter Jones
- School of Life Course Sciences, King’s College London, London, U.K
| | - David McCance
- Regional Centre for Endocrinology and Diabetes, Royal Victoria Hospital, Belfast, U.K
| | - Nithya Sukumar
- Department of Diabetes, Endocrinology and Metabolism, George Eliot Hospital, Nuneaton, U.K
- Populations, Evidence and Technologies, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, U.K
| | - Nishanthi Periyathambi
- Department of Diabetes, Endocrinology and Metabolism, George Eliot Hospital, Nuneaton, U.K
- Populations, Evidence and Technologies, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, U.K
| | - Yonas Weldeselassie
- Department of Diabetes, Endocrinology and Metabolism, George Eliot Hospital, Nuneaton, U.K
- Populations, Evidence and Technologies, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, U.K
| | | | | | - David Andersson
- Wolfson Centre for Age-Related Diseases, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, U.K
| | - Stuart Bevan
- Wolfson Centre for Age-Related Diseases, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, U.K
| | - Paul T. Seed
- School of Life Course Sciences, King’s College London, London, U.K
| | - Gavin A. Bewick
- School of Life Course Sciences, King’s College London, London, U.K
| | - James E. Bowe
- School of Life Course Sciences, King’s College London, London, U.K
| | - Franca Fraternali
- Randall Division of Cell and Molecular Biophysics, King’s College London, London, U.K
| | - Ponnusamy Saravanan
- Department of Diabetes, Endocrinology and Metabolism, George Eliot Hospital, Nuneaton, U.K
- Populations, Evidence and Technologies, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, U.K
| | - Hanns-Ulrich Marschall
- Department of Molecular and Clinical Medicine/Wallenberg Laboratory, University of Gothenburg, Gothenburg, Sweden
| | - Catherine Williamson
- School of Life Course Sciences, King’s College London, London, U.K
- Corresponding author: Catherine Williamson,
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Periyathambi N, Sukumar N, Weldeselassie Y, Saravanan P. Impact of maternal HbA 1c on offspring glucose at 4-7 years of age: role of childhood adiposity and other potential confounders. Diabetologia 2021; 64:1447-1448. [PMID: 33754157 DOI: 10.1007/s00125-021-05433-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 02/09/2021] [Indexed: 10/21/2022]
Affiliation(s)
- Nishanthi Periyathambi
- Population, Evidence and Technologies, Division of Health Sciences, University of Warwick, Coventry, UK
| | - Nithya Sukumar
- Population, Evidence and Technologies, Division of Health Sciences, University of Warwick, Coventry, UK
- Academic Department of Diabetes, Endocrinology and Metabolism, George Eliot Hospital, Nuneaton, UK
| | - Yonas Weldeselassie
- Population, Evidence and Technologies, Division of Health Sciences, University of Warwick, Coventry, UK
| | - Ponnusamy Saravanan
- Population, Evidence and Technologies, Division of Health Sciences, University of Warwick, Coventry, UK.
- Academic Department of Diabetes, Endocrinology and Metabolism, George Eliot Hospital, Nuneaton, UK.
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Bagias C, Sukumar N, Weldeselassie Y, Oyebode O, Saravanan P. Cord Blood Adipocytokines and Body Composition in Early Childhood: A Systematic Review and Meta-Analysis. Int J Environ Res Public Health 2021; 18:ijerph18041897. [PMID: 33669328 PMCID: PMC7920289 DOI: 10.3390/ijerph18041897] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [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] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Revised: 02/07/2021] [Accepted: 02/12/2021] [Indexed: 01/02/2023]
Abstract
Childhood obesity is a growing epidemic. Early identification of high-risk groups will allow for the development of prevention strategies. Cord blood adipocytokines have been previously examined as biomarkers predicting future obesity. We conducted a systematic review looking at the association between cord blood leptin and adiponectin with adiposity up to 5 years of age. A literature review was performed between January 1994 and August 2020 using two bibliographic databases (Medline/Pubmed and EMBASE) and was registered on PROSPERO (CRD42017069024). Studies using skinfold thickness and direct methods of assessing body composition in full term neonates were considered. Partial correlation and multiple regression models were used to present the results. Meta-analysis was performed, were possible, using a random effects model. Cochran’s Q test was used to assess heterogeneity and I2 statistics to calculate the percentage of variation across studies. The potential for publication bias was assessed using funnel plots. Data from 22 studies were retrieved and reviewed by two independent reviewers. Cord blood leptin was positively associated with adiposity at birth (r = 0.487; 95% CI: 0.444, 0.531) but was inversely related to adiposity up to 3 years of age. The association was not sustained at 5 years. There was a weak positive association between adiponectin in cord blood and adiposity at birth (r = 0.201; 95% CI: 0.125, 0.277). No correlation was found between cord blood adiponectin in young children, but data were limited. This review supports that cord blood leptin and adiponectin are associated with adiposity at birth. The results of this study provide insight into the role of adipocytokines at birth on future metabolic health and their potential use as risk stratification tools.
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Affiliation(s)
- Christos Bagias
- Division of Health Sciences, Department of Population Evidence and Technologies, Warwick Medical School, University of Warwick, Coventry CV7 7HL, UK; (C.B.); (N.S.); (Y.W.); (O.O.)
- Department of Endocrinology and Diabetes, University Hospital of Ioannina, 45500 Ioannina, Greece
| | - Nithya Sukumar
- Division of Health Sciences, Department of Population Evidence and Technologies, Warwick Medical School, University of Warwick, Coventry CV7 7HL, UK; (C.B.); (N.S.); (Y.W.); (O.O.)
- Academic Department of Diabetes, Endocrinology and Metabolism, George Eliot Hospital NHS Trust, Nuneaton CV10 7DJ, UK
| | - Yonas Weldeselassie
- Division of Health Sciences, Department of Population Evidence and Technologies, Warwick Medical School, University of Warwick, Coventry CV7 7HL, UK; (C.B.); (N.S.); (Y.W.); (O.O.)
| | - Oyinlola Oyebode
- Division of Health Sciences, Department of Population Evidence and Technologies, Warwick Medical School, University of Warwick, Coventry CV7 7HL, UK; (C.B.); (N.S.); (Y.W.); (O.O.)
| | - Ponnusamy Saravanan
- Division of Health Sciences, Department of Population Evidence and Technologies, Warwick Medical School, University of Warwick, Coventry CV7 7HL, UK; (C.B.); (N.S.); (Y.W.); (O.O.)
- Academic Department of Diabetes, Endocrinology and Metabolism, George Eliot Hospital NHS Trust, Nuneaton CV10 7DJ, UK
- Correspondence:
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Mozdiak E, Weldeselassie Y, McFarlane M, Tabuso M, Widlak MM, Dunlop A, Tsertsvadze A, Arasaradnam RP. Systematic review with meta-analysis of over 90 000 patients. Does fast-track review diagnose colorectal cancer earlier? Aliment Pharmacol Ther 2019; 50:348-372. [PMID: 31286552 DOI: 10.1111/apt.15378] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 03/13/2019] [Accepted: 05/27/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND National UK data on colorectal cancer (CRC) stage at diagnosis is incomplete. Site-specific fast-track (2-week wait) cancer data are not collected directly by NHS England. Policy making based on these data alone can lead to inaccuracy. AIMS To review available data on key outcomes (cancer conversion rate and stage at diagnosis) for the UK's lower gastrointestinal 2-week wait pathway. METHODS A comprehensive literature search was conducted between 2000 and 2017. Primary outcomes were cancer conversion rate and cancer stage at diagnosis. Results were expressed as proportions with 95% CIs. A random effects model was used for meta-analysis; heterogeneity was assessed by I2 . RESULTS Of 95 papers reviewed, 49 were included in analysis with a total study population of 93,655. Cancer conversion rate was 7.7% (95% CI: 6.9-8.5). The proportion presenting at Dukes A = 11.2% (95% CI 7.4-15.6), B = 36.7% (95% CI 30.8-42.8), C = 35.7% (95% CI: 30.8-40.8) and D = 11.1% (95% CI 7.3-15.5). No colonic pathology was diagnosed in 54.6% (95% CI: 46.2-62.8). CONCLUSIONS Only 7.7% of patients referred by the 2-week wait pathway were found to have CRC. No beneficial effect on stage at diagnosis was found compared to non-2-week wait referral pathways. Over half of patients had no colonic pathology and detection of adenomas was very low. These results should prompt a reconsideration of the benefits of the 2-week wait pathway in CRC diagnosis and outcomes, with more focus on strategies to improve patient selection.
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Affiliation(s)
- Ella Mozdiak
- University Hospitals Coventry and Warwickshire, Coventry, UK
| | | | | | - Maria Tabuso
- University Hospitals Coventry and Warwickshire, Coventry, UK
| | - Monika M Widlak
- University Hospitals Coventry and Warwickshire, Coventry, UK
| | - Amber Dunlop
- University Hospitals Coventry and Warwickshire, Coventry, UK
| | - Alexander Tsertsvadze
- The University of Warwick, Coventry, UK.,Faculty of Health and Life Sciences, The University of Ottawa, Ottawa, ON, Canada
| | - Ramesh P Arasaradnam
- University Hospitals Coventry and Warwickshire, Coventry, UK.,The University of Warwick, Coventry, UK.,Centre for Applied Biological Sciences, Coventry University, Coventry, UK
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Sukumar N, Bagias C, Goljan I, Weldeselassie Y, Gharanei S, Tan BK, Holst JJ, Saravanan P. Reduced GLP-1 Secretion at 30 Minutes After a 75-g Oral Glucose Load Is Observed in Gestational Diabetes Mellitus: A Prospective Cohort Study. Diabetes 2018; 67:2650-2656. [PMID: 30232211 DOI: 10.2337/db18-0254] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Accepted: 09/06/2018] [Indexed: 11/13/2022]
Abstract
Glucagon-like peptide 1 (GLP-1) levels may be reduced in type 2 diabetes, but whether a similar impairment exists in gestational diabetes mellitus (GDM) has not been established. We studied this in a prospective cohort study of pregnant women (n = 144) during oral glucose tolerance test (OGTT). GLP-1, glucose, and insulin were sampled at 30-min intervals during a 2-h 75-g OGTT, and indices of insulin secretion and sensitivity were calculated. In a nested case-control study, women with GDM (n = 19) had 12% lower total GLP-1 secretion area under the curve (AUC) compared with control subjects matched for age, ethnicity, and gestational age (n = 19), selected from within the lowest quartile of glucose120 min values in our cohort. GDM had lower GLP-1 response in the first 30 min (19% lower GLP-130 min and 17% lower AUC0-30 min) after adjustment for possible confounders. Their glucose levels began to diverge at 30 min of the OGTT with increasing insulin levels, and by 120 min, their insulin levels were three times higher. In a secondary cohort of 57 women that included "high-normal" glucose120 min values, low GLP-1 AUC0-30 min was independently associated with lower indices of insulin secretion and sensitivity. In conclusion, we have observed that women with GDM have lower GLP-1 response at 30 min of an OGTT and hyperglycemia at 120 min despite significant hyperinsulinemia.
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Affiliation(s)
- Nithya Sukumar
- Populations, Evidence and Technologies Group, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, U.K
- Department of Diabetes, Endocrinology and Metabolism, George Eliot Hospital NHS Trust, Nuneaton, U.K
| | - Christos Bagias
- Populations, Evidence and Technologies Group, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, U.K
- Department of Diabetes, Endocrinology and Metabolism, George Eliot Hospital NHS Trust, Nuneaton, U.K
| | - Ilona Goljan
- Department of Diabetes, Endocrinology and Metabolism, George Eliot Hospital NHS Trust, Nuneaton, U.K
| | - Yonas Weldeselassie
- Populations, Evidence and Technologies Group, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, U.K
| | - Seley Gharanei
- Department of Cardiovascular Sciences and Leicester Diabetes Centre, University of Leicester, Leicester, U.K
| | - Bee K Tan
- Department of Cardiovascular Sciences and Leicester Diabetes Centre, University of Leicester, Leicester, U.K
- Cell and Developmental Biology, Division of Biomedical Sciences, Warwick Medical School, University of Warwick, Coventry, U.K
- Department of Obstetrics and Gynaecology, Birmingham University Hospitals of Leicester NHS Trust and University Hospital Birmingham NHS Foundation Trust, Birmingham, U.K
| | - Jens J Holst
- Department of Biomedical Sciences and Novo Nordisk Foundation Centre for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Ponnusamy Saravanan
- Populations, Evidence and Technologies Group, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, U.K.
- Department of Diabetes, Endocrinology and Metabolism, George Eliot Hospital NHS Trust, Nuneaton, U.K
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