Interaction between MTNR1B polymorphisms and lifestyle intervention on pregnancy outcomes

Background

Interactions between polymorphisms of the melatonin receptor 1B gene (MTNR1B) and lifestyle intervention for gestational diabetes have been described. Whether these are specific for physical activity or healthy eating intervention is unknown.

Objectives

To assess the interaction between MTNR1B rs10830962 and rs10830963 polymorphisms and lifestyle interventions during pregnancy.

Methods

Women with a BMI of ≥ 29 kg/m2 (n = 436) received counseling on healthy eating (HE), physical activity (PA) or both. The control group received usual care. The analysis had a factorial design with comparison of HE versus no HE and PA versus no PA. Maternal outcomes at 24-28 weeks were gestational weight gain (GWG), maternal fasting glucose, insulin, insulin resistance (HOMA-IR), and development of GDM. Interaction between receiving either HE or PA intervention and genotypes of both rs10830962 and rs10830963 was assessed using multilevel regression analysis.

Results

GDM risk was increased in women homozygous for the G allele of rs10830962 or rs10830963 (OR 2.60 [95% CI 1.34, 5.06] and 2.83 [1.24, 6.47], respectively). Significant interactions between rs10830962 and interventions were found: In women homozygous for the G allele, but not in the other genotypes, the PA intervention reduced maternal fasting insulin (beta -0.16 [95%CI -0.33, 0.02], p = 0.08) and HOMA-IR (-0.17 [-0.35, 0.01], p = 0.06). In heterozygous women, HE intervention had no effect, whereas in women homozygous for the C allele, HE intervention reduced GWG (-1.6 kg [-2.4, -0.8]).

Discussion

In women homozygous for the risk allele of MTNR1B rs10830962, GDM risk was increased and PA intervention might be more beneficial than HE intervention for reducing maternal insulin resistance.

Key messages

Associations of Body Mass Index (Maternal BMI) and Gestational Diabetes Mellitus with Neonatal and Maternal Pregnancy Outcomes in a Multicentre European Database (Diabetes and Pregnancy Vitamin D and Lifestyle Intervention for Gestational Diabetes Mellitus Prevention)

Objective. Assess the impact of Gestational Diabetes Mellitus (GDM) and obesity on neonatal and maternal pregnancy outcomes. Methods. Cross-sectional data (3343 pregnancies) from seven European centres were included in a multilevel analysis of the association between GDM/obesity and caesarean section, macrosomia and neonatal morbidities. Results. Comparison of databases identified reporting differences between countries due to the inclusion of true population based samples or pregnancies from specialised tertiary centres, resulting in higher prevalences of GDM for some countries. The analysis showed that obesity and GDM were independent risk factors of perinatal complications. Only BMI had a dose-dependent effect on the risk of macrosomia and caesarean section. Both obesity (BMI > 30 kg/m²) and GDM were independent risk factors of neonatal morbidities. Conclusions. Obesity and GDM were independent risk factors of perinatal complications. The effect of the worldwide obesity and diabetes epidemic is extending to the next generation.

The effect of a topical insecticide containing permethrin on the number of Culicoides midges caught near horses with and without insect bite hypersensitivity in the Netherlands

Insect bite hypersensitivity (IBH) in horses is most likely caused by Culicoides species, although other insects may also play a role. Until now no effective cure has been found for this condition, although numerous therapeutic and preventive measures have been used to control insect hypersensitivity. One such method is to apply a topical insecticide to horses. In this study, the effect of a topical insecticide containing permethrin (3.6%) was examined in seven pairs of horses. The horses were placed inside a tent trap to collect Culicoides spp. and other insects attracted to the horses on two subsequent evenings. On the first evening, both horses were untreated. After the end of this session, one horse of each pair was treated with the pour-on insecticide; treated horses were kept separate from untreated horses. The next evening the pairs of horses were again placed inside the tent trap and insects were collected. Similar percentages of Culicoides were trapped as in earlier studies (C. obsoletus 95.34% and C. pulicaris 4.54%), with healthy horses attracting more Culicoides than horses affected by IBH. The number of Culicoides, the percentage of blood-fed Culicoides obsoletus, and the total number of insects attracted to horses 24 hours after treatment with permethrin were reduced but the reduction was not statistically significant. No negative side effects of permethrin administration were observed.

The possession of technical aids among persons with a somatic chronic disease

PURPOSE

Previous research has highlighted disability as a determinant of the need for technical aids; surprisingly, disease as a potential determinant has been ignored. The goal of the present study was to determine whether the possession of technical aids is dependent on the type of chronic disease, illness duration, co-morbidity, disability, age, and several other factors.

METHODS

The study was performed in a representative sample of persons with a somatic chronic disease (n=2262). Type of chronic disease, time post-diagnosis and co-morbidity were assessed by the patient's general practitioner. Disability was assessed with the Sickness Impact Profile. The possession of technical aids and other characteristics were assessed by questionnaire.

RESULTS

Type of chronic disease (osteoarthritis, rheumatoid arthritis, diabetes and COPD), disability, age and gender were significantly and independently associated with the possession of technical aids.

CONCLUSIONS

Apart from disability, disease-, age-, and gender-related characteristics determine the possession of technical aids. A detailed assessment of these characteristics is required in order to ensure that technical aids meet personal needs.