Endocan expression is increased in the placenta from obese women with gestational diabetes mellitus

Introduction: Diabetes has become a significant health problem all over the world and its prevalence is increasing rapidly, including in Nepal. Prevalence of gestational diabetes mellitus (GDM) is directly related to the prevalence of type 2 diabetes. Women who areoverweight or obese before they become pregnant are more at risk of GDM irrespective of other factors.Though the risk of developing GDM in shown to be higher in overweight or obese women, there are very few studies done to show such observation in the urban population of Nepal.Methods: This was a hospital based cross-sectional prospective study conducted among the women attending ante partum clinic, in a tertiary level hospital, located at Lalitpur for one-year duration in 2009. All overweight (pre-pregnancy body mass index (BMI)>23) urban women at 24-28 weeks of gestation were enrolled.Fasting blood glucose, screening 50-g oral glucose challenge test(OGTT) and 2-hr OGTT following overnight fastingwas done as per need based on their test results and GDM was diagnosed based on standard guidelines.Results: Out of 256 women majority of women had BMI >25 kg/m2 (n=180),and 151(59%) were multiparous and 105 (41%) were primiparas. Positive screening test was obtained in 51 women (19.9%).The incidence of GDM by ADA and WHO criteria was 10 (3.9%) and 16 (6.3%) respectively. There was statistically non-significant difference in the rate of positive screening test and BMI (p=0.09). The abnormal screening test between primiparous and multiparous was significant (p=0.01).Conclusion: This study showed a high pre-pregnancy BMI and the incidence of GDMamong the patients enrolled. The rate of positive screening test is also higher than the previous studies so, GDM is a growing issue and must be well addressed.

Download Full-text

Promoting Breastfeeding Among Obese Women and Women with Gestational Diabetes Mellitus

Current Diabetes Reports ◽

10.1007/s11892-010-0159-6 ◽

2010 ◽

Vol 11 (1) ◽

pp. 7-12 ◽

Cited By ~ 19

Author(s):

Kimberly K. Trout ◽

Tali Averbuch ◽

Meghan Barowski

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Obese Women

Download Full-text

Defective insulin signaling in placenta from pregnancies complicated by gestational diabetes mellitus

Acta Endocrinologica ◽

10.1530/eje-09-0031 ◽

2009 ◽

Vol 160 (4) ◽

pp. 567-578 ◽

Cited By ~ 107

Author(s):

Michelle Colomiere ◽

Michael Permezel ◽

Clyde Riley ◽

Gernot Desoye ◽

Martha Lappas

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Signaling Pathway ◽

Insulin Signaling ◽

Placental Tissue ◽

Insulin Signaling Pathway ◽

Obese Patients ◽

Obese Women ◽

Normal Controls

ObjectiveStudies in adipose tissue and skeletal muscle suggest that impaired insulin action is due to defects in the insulin signaling pathway and may play a role in the pathophysiology of insulin resistance associated with gestational diabetes mellitus (GDM) and obesity. The present study tested the hypothesis that endogenous expression levels in the human term placenta of insulin signaling components are altered in placental tissue from GDM women in comparison with normal controls and maternal obesity.Design and methodsPlacental tissue was collected from normal, diet-controlled GDM, and insulin-controlled GDM in both non-obese and obese women (n=6–7 per group). Western blotting and quantitative RT-PCR was performed to determine the level of expression in the insulin signaling pathway.ResultsThere was a significant increase in insulin receptor (IR) substrate (IRS)-1 protein expression with a concurrent decrease in IRS-2 protein expression in non-obese women with insulin-controlled GDM compared with diet-controlled GDM and normal controls. Furthermore, a decrease in both protein and mRNA expression of phosphatidyl-inositol-3-kinase (PI3-K) p85α and glucose transporter (GLUT)-4 was observed in non-obese and obese women with insulin controlled GDM compared with normal controls. When comparing non-obese to obese patients, significant decreases in mRNA expression of IR-β, PI3K p85α and GLUT-4 was found in obese patients.ConclusionOur results suggest that post receptor defects are present in the insulin signaling pathway in placenta of women with pregnancies complicated by diabetes and obesity. In addition, expression studies demonstrate post receptor alterations in insulin signaling possibly under selective maternal regulation and not fetal regulation.

Download Full-text

Association of gestational diabetes mellitus with offspring weight status across infancy: a prospective birth cohort study in China

10.21203/rs.3.rs-46022/v4 ◽

2020 ◽

Author(s):

Jiajin Hu ◽

Yilin Liu ◽

Xiaotong Wei ◽

Lin Li ◽

Ming Gao ◽

...

Keyword(s):

Diabetes Mellitus ◽

Body Weight ◽

Linear Regression ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Multiple Linear Regression ◽

Normal Weight ◽

Effect Estimate ◽

Obese Women ◽

Z Scores

Abstract Background: The association between gestational diabetes mellitus (GDM) and childhood body weight remains controversial, and additional study is needed, especially in Asian populations.Methods: This prospective study investigated the association between maternal glucose concentration, and GDM status and infant body weight from birth to 12 months of age. Linear mixed effects (LME) models and multiple linear regression were used to assess the longitudinal association of GDM with infant growth measured by weight-for-length z-scores (WFLZ), weight-for-age z-scores (WFAZ), and length-for-age z-scores (LFAZ) at birth, 1, 3, 6, 8, and 12 months of age.Results: Offspring born to mothers with GDM had higher WFLZ [β: 0.26 SD units (95% CI: 0.13–0.40)] across infancy than those of mothers without GDM. When stratified analysis by maternal pre-pregnancy body mass index (BMI) status, the association was pronounced in normal-weight [β:0.28 SD units (95% CI: 0.11–0.45)] and overweight/obese women [β: 0.34 SD units (95% CI: 0.09–0.58)] but not in underweight women (P for interaction <0.05). Multiple linear regression found that the effect estimate of GDM on infant WFLZ was highest at birth [β: 0.36 SD units (95% CI: 0.11– 0.61)], remained significant at 1 [β: 0.22 SD units (95% CI: 0.03–0.41)] and 3 [β:0.19 SD units (95% CI: 0.01–0.37)] months of age and decreased across infancy. Maternal GDM status was not associated with infant WFAZ or LFAZ.Conclusions: Maternal GDM status was associated with infant WFLZ, but not WFAZ or LFAZ. The association between GDM status and offspring WFLZ was more pronounced in early infancy or in normal-weight and overweight/obese women. Increased public health efforts to prevent GDM in normal-weight and overweight/obese pre-pregnancy mothers are recommended to control offspring overweight or obesity.

Download Full-text

Association of gestational diabetes mellitus with offspring weight status across infancy: a prospective birth cohort study in China

10.21203/rs.3.rs-46022/v2 ◽

2020 ◽

Author(s):

Jiajin Hu ◽

Yilin Liu ◽

Xiaotong Wei ◽

Lin Li ◽

Ming Gao ◽

...

Keyword(s):

Diabetes Mellitus ◽

Body Weight ◽

Linear Regression ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Multiple Linear Regression ◽

Weight Status ◽

Normal Weight ◽

Obese Women ◽

Childhood Weight

Abstract Background: The association between gestational diabetes mellitus (GDM) and childhood body weight remains controversial, and additional study is needed, especially in Asian populations.Methods: This prospective study investigated the association between maternal glucose concentration, and GDM status and infant body weight from birth to 12 months of age. Linear mixed effects (LME) models and multiple linear regression were used to assess the longitudinal association of GDM with infant growth measured by weight-for-length (WFLZ), weight-for-age (WFAZ), and length-for-age (LFAZ) z-scores at birth, 1, 3, 6, 8, and 12 months of age.Results: Offspring born to mothers with GDM had higher WFLZ [β: 0.26 SD units (95% CI: 0.13–0.40)] across infancy than those of mothers without GDM. The association was more pronounced in normal-weight and overweight/obese women (P for interaction< 0.05). Multiple linear regression found that the effect estimate of GDM on infant WFLZ was highest at birth [β: 0.32 SD units (95% CI: 0.07– 0.57)], remained significant at 1 [β: 0.24 SD units (95% CI: 0.05–0.43)] and 3 [β:0.20 SD units (95% CI: 0.01–0.39)] months of age and decreased across infancy. Maternal GDM status was not associated with infant WFAZ or LFAZ.Conclusions: Maternal GDM status was associated with infant WFLZ, but not WFAZ or LFAZ. The association of GDM status with offspring WFLZ was more pronounced in early infancy or in normal-weight and overweight/obese women. The results may help to identify the critical period and specific GDM-risk groups for childhood weight status.

Download Full-text