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Wang F, Bao YY, Yu K. The Association of the Triglyceride and Muscle to Fat Ratio During Early Pregnancy with the Development of Gestational Diabetes Mellitus. Diabetes Metab Syndr Obes 2023; 16:3187-3196. [PMID: 37867631 PMCID: PMC10589076 DOI: 10.2147/dmso.s431264] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 10/10/2023] [Indexed: 10/24/2023] Open
Abstract
Objective This study explored the association between metabolic factors and body composition during the first trimester of gestational diabetes mellitus (GDM). Methods This prospective study recruited pregnant women in their first trimester. Clinical information and glucose and lipid measurements were collected, and body composition was assessed using multifrequency bioelectrical impedance analysis. GDM was diagnosed on the basis of an oral glucose tolerance test at 24-28 gestational week. Factors related to GDM were investigated using correlation, and risk ratios (RRs) and 95% CIs of potential risk factors with GDM were estimated using Poisson regression. The area under the receiver operating characteristic (ROC) curve was used to determine predictive effects. Results 59/302 women (19.5%) developed GDM. Older (RR 1.076, 95% CI 1.005-1.152), higher body mass index (BMI) before pregnancy (pre-BMI) (RR 1.012, 95% CI 1.005-1.063), triglycerides (RR 4.052, 95% CI 1.641-6.741), and lower skeletal muscle mass (SMM) to fat mass (FM) ratio (SMM/FM) (RR 0.213, 95% CI 0.051-0890) in the first trimester, and family history of type 2 diabetes (RR 1.496, 95% CI 1.014-2.667) significantly associated with the risk of GDM, but neither fasting plasma glucose nor glycated albumin was associated with GDM. The combined multivariate prediction model achieved good discrimination with an AUC of 0.806 (95% CI 0.737-0.895, P<0.001). According to ROC curve, the cut-off values of TG and SMM/FM were 0.925 mmol/L and 1.305. Conclusion Reduced SMM/FM and elevated triglyceride (TG) levels in the first trimester are associated with GDM development, and should be screened in early pregnancy to identify high-risk subjects for GDM.
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Affiliation(s)
- Fang Wang
- Department of Clinical Nutrition, Peking Union Medical College Hospital (PUMCH), Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing, People's Republic of China
| | - Yuan-Yuan Bao
- Department of Clinical Nutrition, Peking Union Medical College Hospital (PUMCH), Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing, People's Republic of China
| | - Kang Yu
- Department of Clinical Nutrition, Peking Union Medical College Hospital (PUMCH), Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing, People's Republic of China
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Huang O, Wu D, Ji M. Early pregnancy exposure of maternal triglyceride levels and its effects on birth weight. J Pediatr Endocrinol Metab 2023; 36:753-760. [PMID: 37434499 DOI: 10.1515/jpem-2023-0035] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 06/30/2023] [Indexed: 07/13/2023]
Abstract
OBJECTIVES The aim of this study was to evaluate the early pregnancy exposure of maternal triglyceride (mTG) and its effects on birth weight, which was an important indicator for nutritional status of newborns, and even its long-term health. METHODS A retrospective cohort study was designed to investigate the relationship between mTG in early pregnancy and birth weight. Totally 32,982 women who had a singleton pregnancy and underwent serum lipids screening during early pregnancy were included in this study. Logistic regressions were used to evaluate the correlations between mTG levels and small for gestational age (SGA) or large for gestational age (LGA), and the restricted cubic spline models were applied to explore the dose-response relationship. RESULTS The increased mTG levels during early pregnancy decreased the risk of SGA and increased the risk of LGA. The high mTG (>90th, 2.05 mM) was showed associated with higher risk of LGA (AOR, 1.35; 95 %CI, 1.20 to 1.50), and lower risk of SGA (AOR, 0.78; 0.68 to 0.89). Lower risk of LGA (AOR, 0.81; 0.70 to 0.92) was found in those cases of low mTG (<10th, 0.81 mM), but no correlation was found between low mTG levels and the risk of SGA. The results remained robust after excluding women with high or low body mass index (BMI) and pregnancy complications. CONCLUSIONS This study suggested that early pregnancy exposure of mTG were related to the occurrence of SGA and LGA. mTG levels higher than 2.05 mM (>90th) were suggested to be avoid because of its risk for LGA, while mTG lower than 0.81 mM (<10th) showed its benefits for ideal birthweight range.
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Affiliation(s)
- Ou Huang
- Department of General Surgery, Comprehensive Breast Health Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China
| | - Dandan Wu
- Department of General Surgery, Comprehensive Breast Health Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China
- School of Medicine, The International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University, Shanghai, P.R. China
- Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, P.R. China
| | - Min Ji
- Department of General Surgery, Comprehensive Breast Health Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China
- School of Medicine, The International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University, Shanghai, P.R. China
- Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, P.R. China
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Jiang XF, Wang H, Wu DD, Zhang JL, Gao L, Chen L, Zhang J, Fan JX, Huang HF, Wu YT, Lin XH. The Impact of Gestational Weight Gain on the Risks of Adverse Maternal and Infant Outcomes among Normal BMI Women with High Triglyceride Levels during Early Pregnancy. Nutrients 2021; 13:nu13103454. [PMID: 34684457 PMCID: PMC8540674 DOI: 10.3390/nu13103454] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 08/28/2021] [Revised: 09/23/2021] [Accepted: 09/27/2021] [Indexed: 11/16/2022] Open
Abstract
A high maternal triglyceride (mTG) level during early pregnancy is linked to adverse pregnancy outcomes, but the use of specific interventions has been met with limited success. A retrospective cohort study was designed to investigate the impact of gestational weight gain (GWG) on the relationship between high levels of mTG and adverse pregnancy outcomes in normal early pregnancy body mass index (BMI) women. The patients included 39,665 women with normal BMI who had a singleton pregnancy and underwent serum lipids screening during early pregnancy. The main outcomes were adverse pregnancy outcomes, including gestational hypertension, preeclampsia, gestational diabetes, cesarean delivery, preterm birth, and large or small size for gestational age (LGA or SGA) at birth. As a result, the high mTG (≥2.05mM) group had increased risks for gestational hypertension ((Adjusted odds ratio (AOR), 1.80; 95% CI, 1.46 to 2.24)), preeclampsia (1.70; 1.38 to 2.11), gestational diabetes (2.50; 2.26 to 2.76), cesarean delivery (1.22; 1.13 to 1.32), preterm birth (1.42, 1.21 to 1.66), and LGA (1.49, 1.33 to 1.68) compared to the low mTG group, after adjustment for potential confounding factors. Additionally, the risks of any adverse outcome were higher in each GWG subgroup among women with high mTG than those in the low mTG group. High mTG augmented risks of gestational hypertension, preeclampsia, preterm birth, and LGA among women with 50th or greater percentile of GWG. Interestingly, among women who gained less than the 50th percentile of GWG subgroups, there was no relationship between high mTG level and risks for those pregnancy outcomes when compared to low mTG women. Therefore, weight control and staying below 50th centile of the suggested GWG according to gestational age can diminish the increased risks of adverse pregnancy outcomes caused by high mTG during early pregnancy.
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Affiliation(s)
- Xia-Fei Jiang
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200030, China; (X.-F.J.); (D.-D.W.); (L.C.); (J.Z.); (J.-X.F.)
- Shanghai Key Laboratory of Embryo Original Diseases, Shanghai 200030, China
| | - Hui Wang
- Department of Obstetrics and Gynecology, Maternity and Child Health Hospital of Songjiang District, Shanghai 201620, China;
| | - Dan-Dan Wu
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200030, China; (X.-F.J.); (D.-D.W.); (L.C.); (J.Z.); (J.-X.F.)
- Shanghai Key Laboratory of Embryo Original Diseases, Shanghai 200030, China
| | - Jian-Lin Zhang
- Obstetrics and Gynecology Hospital, Institute of Reproduction and Development, Fudan University, Shanghai 200011, China; (J.-L.Z.); (L.G.)
| | - Ling Gao
- Obstetrics and Gynecology Hospital, Institute of Reproduction and Development, Fudan University, Shanghai 200011, China; (J.-L.Z.); (L.G.)
| | - Lei Chen
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200030, China; (X.-F.J.); (D.-D.W.); (L.C.); (J.Z.); (J.-X.F.)
| | - Jian Zhang
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200030, China; (X.-F.J.); (D.-D.W.); (L.C.); (J.Z.); (J.-X.F.)
| | - Jian-Xia Fan
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200030, China; (X.-F.J.); (D.-D.W.); (L.C.); (J.Z.); (J.-X.F.)
| | - He-Feng Huang
- Shanghai Key Laboratory of Embryo Original Diseases, Shanghai 200030, China
- Correspondence: (X.-H.L.); (Y.-T.W.); (H.-F.H.); Tel.: +86-21- 64070434 (X.-H.L.); +86-21-63455050 (Y.-T.W.); +86-21-63455050 (H.-F.H.)
| | - Yan-Ting Wu
- Obstetrics and Gynecology Hospital, Institute of Reproduction and Development, Fudan University, Shanghai 200011, China; (J.-L.Z.); (L.G.)
- Correspondence: (X.-H.L.); (Y.-T.W.); (H.-F.H.); Tel.: +86-21- 64070434 (X.-H.L.); +86-21-63455050 (Y.-T.W.); +86-21-63455050 (H.-F.H.)
| | - Xian-Hua Lin
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200030, China; (X.-F.J.); (D.-D.W.); (L.C.); (J.Z.); (J.-X.F.)
- Shanghai Key Laboratory of Embryo Original Diseases, Shanghai 200030, China
- Obstetrics and Gynecology Hospital, Institute of Reproduction and Development, Fudan University, Shanghai 200011, China; (J.-L.Z.); (L.G.)
- Correspondence: (X.-H.L.); (Y.-T.W.); (H.-F.H.); Tel.: +86-21- 64070434 (X.-H.L.); +86-21-63455050 (Y.-T.W.); +86-21-63455050 (H.-F.H.)
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Samsuddin S, Arumugam PA, Md Amin MS, Yahya A, Musa N, Lim LL, Paramasivam SS, Ratnasingam J, Ibrahim L, Chooi KC, Tan A, Tan PC, Omar SZ, Samingan N, Ahmad Kamar A, Anuar Zaini A, Jalaluddin MY, Vethakkan SR. Maternal lipids are associated with newborn adiposity, independent of GDM status, obesity and insulin resistance: a prospective observational cohort study. BJOG 2019; 127:490-499. [PMID: 31778255 DOI: 10.1111/1471-0528.16031] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/14/2019] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To determine the association between maternal lipaemia and neonatal anthropometrics in Malaysian mother-offspring pairs. DESIGN Prospective observational cohort study. SETTING Single tertiary multidisciplinary antenatal clinic in Malaysia. POPULATION A total of 507 mothers: 145 with gestational diabetes mellitus (GDM); 94 who were obese with normal glucose tolerance (NGT) (pre-gravid body mass index, BMI ≥ 27.5 kg/m2 ), and 268 who were not obese with NGT. METHODS Maternal demographic, anthropometric, and clinical data were collected during an interview/examination using a structured questionnaire. Blood was drawn for insulin, C-peptide, triglyceride (Tg), and non-esterified fatty acid (NEFA) during the 75-g 2-hour oral glucose tolerance test (OGTT) screening, and again at 36 weeks of gestation. At birth, neonatal anthropometrics were assessed and data such as gestational weight gain (GWG) were extracted from the records. MAIN OUTCOME MEASURES Macrosomia, large-for-gestational-age (LGA) status, cohort-specific birthweight (BW), neonatal fat mass (NFM), and sum of skinfold thickness (SSFT) > 90th centile. RESULTS Fasting Tg > 95th centile (3.6 mmol/L) at screening for OGTT was independently associated with LGA (adjusted odds ratio, aOR 10.82, 95% CI 1.26-93.37) after adjustment for maternal glucose, pre-gravid BMI, and insulin sensitivity. Fasting glucose was independently associated with a birthweight ratio (BWR) of >90th centile (aOR 2.06, 95% CI 1.17-3.64), but not with LGA status, in this well-treated GDM cohort with pre-delivery HbA1c of 5.27%. In all, 45% of mothers had a pre-gravid BMI of <23 kg/m2 and 61% had a pre-gravid BMI of ≤ 25 kg/m2 , yet a GWG of >10 kg was associated with a 4.25-fold risk (95% CI 1.71-10.53) of BWR > 90th centile. CONCLUSION Maternal lipaemia and GWG at a low threshold (>10 kg) adversely impact neonatal adiposity in Asian offspring, independent of glucose, insulin resistance and pre-gravid BMI. These may therefore be important modifiable metabolic targets in pregnancy. TWEETABLE ABSTRACT Maternal lipids are associated with adiposity in Asian babies independently of pre-gravid BMI, GDM status, and insulin resistance.
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Affiliation(s)
- S Samsuddin
- Endocrine Unit, Department of Medicine, University Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - P A Arumugam
- Endocrine Unit, Department of Medicine, University Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - Md S Md Amin
- Endocrine Unit, Department of Medicine, University Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - A Yahya
- Department of Social and Preventive Medicine, University Malaya, Kuala Lumpur, Malaysia
| | - N Musa
- Endocrine Unit, Department of Medicine, University Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - L-L Lim
- Endocrine Unit, Department of Medicine, University Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - S S Paramasivam
- Endocrine Unit, Department of Medicine, University Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - J Ratnasingam
- Endocrine Unit, Department of Medicine, University Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - L Ibrahim
- Endocrine Unit, Department of Medicine, University Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - K C Chooi
- Endocrine Unit, Department of Medicine, University Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - Atb Tan
- Endocrine Unit, Department of Medicine, University Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - P C Tan
- Department of Obstetrics and Gynaecology, University Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - S Z Omar
- Department of Obstetrics and Gynaecology, University Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - N Samingan
- Department of Paediatrics, University Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - A Ahmad Kamar
- Department of Paediatrics, University Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - A Anuar Zaini
- Department of Paediatrics, University Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - M Y Jalaluddin
- Department of Paediatrics, University Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - S R Vethakkan
- Endocrine Unit, Department of Medicine, University Malaya Medical Centre, Kuala Lumpur, Malaysia
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