scholarly journals Association of maternal folate and vitamin B12 in early pregnancy with gestational diabetes mellitus: a prospective cohort study

2020 ◽  
Author(s):  
Xiaotian Chen ◽  
Yi Zhang ◽  
Hongyan Chen ◽  
Yuan Jiang ◽  
Yin Wang ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Cohort Study ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Early Pregnancy ◽  
Tolerance Test ◽  
Folic Acid Supplementation ◽  
Serum Folate ◽  
Oral Glucose ◽  
Vitamin B

<strong>OBJECTIVE</strong> <p>To investigate the association of folate and<b> </b>vitamin B<sub>12 </sub>in early pregnancy with gestational diabetes mellitus (GDM) risk.</p> <p> </p> <p><strong>RESEARCH DESIGN AND METHODS</strong> </p> <p><a></a><a>The data of this study were from a sub-cohort within the Shanghai Preconception Cohort Study. We included pregnancies with red blood cell (RBC) folate and vitamin B<sub>12</sub> measurements at recruitment (between </a><a>9-13 gestational weeks</a>) and those with three samples available for glucose measurements under oral glucose tolerance test (OGTT). GDM was diagnosed between 24-28 weeks gestation. <a>Odds ratio (OR) </a>of having a GDM and 95% confidence interval (CI) was used to quantify the association. </p> <p> </p> <p><strong>RESULTS</strong> </p> <p><a></a><a>A total of 1,058 pregnancies were included and 180 GDM occurred (17.01%).</a> RBC folate and vitamin B<sub>12 </sub>were significantly higher in pregnancies with GDM than those without GDM (<i>P</i> values were 0.045 and 0.002 respectively), and positively correlated with 1-hour and 2-hour serum glucose. Daily folic acid supplementation in early pregnancy increases the risk of GDM, OR (95% CI) was 1.73 (1.19-2.53), <i>P</i>=0.004. Compared with RBC folate <400 ng/mL, pregnancies with RBC folate ³600 ng/mL was associated with approximately 1.60-fold higher odds of GDM, the adjusted OR (95% CI) was 1.58 (1.03-2.41), <i>P</i>=0.033. A significant trend of risk effect on GDM risk across categories of RBC folate was observed (<i>P</i><sub>trend</sub> =0.021). Vitamin B<sub>12</sub> was significantly associated with GDM risk (OR =1.14 per 100 pg/ml, <i>P</i>=0.002). No significant association of serum folate and percentile ratio of RBC folate/vitamin B<sub>12</sub> with GDM was observed.</p> <p> </p> <p><strong>CONCLUSIONS</strong> </p> <p><a>Higher </a>maternal RBC folate and vitamin B<sub>12 </sub>levels<sub> </sub>in early pregnancy are significantly associated with GDM risk, while the balance of folate/vitamin B<sub>12</sub> is not significantly associated with GDM.</p>

scholarly journals Association of maternal folate and vitamin B12 in early pregnancy with gestational diabetes mellitus: a prospective cohort study

2020 ◽  
Author(s):  
Xiaotian Chen ◽  
Yi Zhang ◽  
Hongyan Chen ◽  
Yuan Jiang ◽  
Yin Wang ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Cohort Study ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Early Pregnancy ◽  
Tolerance Test ◽  
Folic Acid Supplementation ◽  
Serum Folate ◽  
Oral Glucose ◽  
Vitamin B

<strong>OBJECTIVE</strong> <p>To investigate the association of folate and<b> </b>vitamin B<sub>12 </sub>in early pregnancy with gestational diabetes mellitus (GDM) risk.</p> <p> </p> <p><strong>RESEARCH DESIGN AND METHODS</strong> </p> <p><a></a><a>The data of this study were from a sub-cohort within the Shanghai Preconception Cohort Study. We included pregnancies with red blood cell (RBC) folate and vitamin B<sub>12</sub> measurements at recruitment (between </a><a>9-13 gestational weeks</a>) and those with three samples available for glucose measurements under oral glucose tolerance test (OGTT). GDM was diagnosed between 24-28 weeks gestation. <a>Odds ratio (OR) </a>of having a GDM and 95% confidence interval (CI) was used to quantify the association. </p> <p> </p> <p><strong>RESULTS</strong> </p> <p><a></a><a>A total of 1,058 pregnancies were included and 180 GDM occurred (17.01%).</a> RBC folate and vitamin B<sub>12 </sub>were significantly higher in pregnancies with GDM than those without GDM (<i>P</i> values were 0.045 and 0.002 respectively), and positively correlated with 1-hour and 2-hour serum glucose. Daily folic acid supplementation in early pregnancy increases the risk of GDM, OR (95% CI) was 1.73 (1.19-2.53), <i>P</i>=0.004. Compared with RBC folate <400 ng/mL, pregnancies with RBC folate ³600 ng/mL was associated with approximately 1.60-fold higher odds of GDM, the adjusted OR (95% CI) was 1.58 (1.03-2.41), <i>P</i>=0.033. A significant trend of risk effect on GDM risk across categories of RBC folate was observed (<i>P</i><sub>trend</sub> =0.021). Vitamin B<sub>12</sub> was significantly associated with GDM risk (OR =1.14 per 100 pg/ml, <i>P</i>=0.002). No significant association of serum folate and percentile ratio of RBC folate/vitamin B<sub>12</sub> with GDM was observed.</p> <p> </p> <p><strong>CONCLUSIONS</strong> </p> <p><a>Higher </a>maternal RBC folate and vitamin B<sub>12 </sub>levels<sub> </sub>in early pregnancy are significantly associated with GDM risk, while the balance of folate/vitamin B<sub>12</sub> is not significantly associated with GDM.</p>

scholarly journals Dietary Patterns during Pregnancy Are Associated with the Risk of Gestational Diabetes Mellitus: Evidence from a Chinese Prospective Birth Cohort Study

Nutrients ◽  
2019 ◽  
Vol 11 (2) ◽  
pp. 405 ◽  
Author(s):  
Jiajin Hu ◽  
Emily Oken ◽  
Izzuddin Aris ◽  
Pi-I Lin ◽  
Yanan Ma ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Cohort Study ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Dietary Patterns ◽  
Tolerance Test ◽  
Dietary Guidelines ◽  
Birth Cohort Study ◽  
Oral Glucose ◽  
Traditional Pattern

Dietary patterns during pregnancy have been shown to influence the development of gestational diabetes mellitus (GDM). However, evidence from Asian populations is limited and inconsistent. We conducted a prospective cohort study in China to assess the relationship between dietary patterns and GDM. We administered three-day food diaries (TFD) and food frequency questionnaires (FFQ) at the second trimester. GDM was diagnosed with a 75 g 2-h oral glucose tolerance test at 24–28 weeks of gestation. We identified dietary patterns using principal components analysis and used multivariable logistic regression to investigate associations of dietary patterns with GDM. Of the 1014 participants, 23.5% were diagnosed with GDM. Both the TFD and FFQ identified a “traditional pattern”, consisting of high vegetable, fruit, and rice intake, which was associated with a lower GDM risk (odds ratio (OR) for quartile 4 versus quartile 1: 0.40, 95% CI: 0.23–0.71 for traditional pattern (TFD); OR: 0.44, CI: 0.27–0.70 for traditional pattern (FFQ)). The protective associations were more pronounced among women ≥35 years old. A whole grain–seafood TFD pattern was associated with higher risk of GDM (OR: 1.73, 95% CI: 1.10–2.74). These findings may provide evidence for making dietary guidelines among pregnant women in Chinese populations to prevent GDM.

The Association between Maternal/Fetal Insulin Receptor Substrate 1 Gene Polymorphism rs1801278 and Gestational Diabetes Mellitus in a Chinese Population

2021 ◽  
pp. 1-8
Author(s):  
Lingling Wu ◽  
Changping Fang ◽  
Jun Zhang ◽  
Yanchou Ye ◽  
Haiyan Zhao
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gene Polymorphism ◽  
Gestational Diabetes Mellitus ◽  
Insulin Receptor ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Insulin Receptor Substrate ◽  
Single Center ◽  
Insulin Receptor Substrate 1

<b><i>Objectives:</i></b> Insulin receptor substrate 1 (IRS1) is a crucial factor in the insulin signaling pathway. IRS1 gene polymorphism rs1801278 in mothers has been reported to be associated with gestational diabetes mellitus (GDM). However, it is not clear whether IRS1 gene polymorphism rs1801278 in fetuses is associated with their mothers’ GDM morbidity. The purpose of this study is to analyze the association between maternal, fetal, or maternal/fetal <i>IRS1</i> gene polymorphism rs1801278 and GDM risk. <b><i>Design:</i></b> The study was a single-center, prospective cohort study. In total, 213 pairs of GDM mothers/fetuses and 191 pairs of control mothers/fetuses were included in this study. They were recruited after they underwent oral glucose tolerance test during 24–28 weeks of gestation and followed up until delivery. All participants received the conventional interventions (diet and exercise), and no special therapy except routine treatment. <b><i>Methods:</i></b> A total of 213 pairs of GDM mothers/fetuses and 191 pairs of normal blood glucose pregnant mothers/fetuses were ge­notyped using PCR and DNA sequencing from January 2015 to September 2016. Maternal/fetal <i>IRS1</i> gene polymorphism rs1801278 was analyzed and compared between 2 groups. <b><i>Results:</i></b> There were no significant differences in the frequency of individual mothers’ or fetuses’ <i>IRS1</i> rs1801278 polymorphisms between 2 groups; if both the mothers and fetuses carried A allele, significantly lower GDM morbidity was observed in the mothers. <b><i>Limitations:</i></b> The sample size was relatively small as a single-center study. <b><i>Conclusions:</i></b> Our study suggested that maternal/fetal rs1801278 polymorphism of <i>IRS1</i> is a modulating factor in GDM; both mothers/fetuses carrying the A allele of rs1801278 may protect the mothers against the development of GDM.

scholarly journals Breastfeeding Duration and Development of Dysglycemia in Women Who Had Gestational Diabetes Mellitus: Evidence from the GUSTO Cohort Study

Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 408
Author(s):  
Sumali S. Hewage ◽  
Xin Yu Hazel Koh ◽  
Shu E. Soh ◽  
Wei Wei Pang ◽  
Doris Fok ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Tolerance Test ◽  
Diabetes Risk ◽  
Breastfeeding Duration ◽  
Oral Glucose ◽  
Inverse Association ◽  
Index Pregnancy

(1) Background: Breastfeeding has been shown to support glucose homeostasis in women after a pregnancy complicated by gestational diabetes mellitus (GDM) and is potentially effective at reducing long-term diabetes risk. (2) Methods: Data from the Growing Up in Singapore Towards healthy Outcomes (GUSTO) study were analyzed to understand the influence of breastfeeding duration on long-term dysglycemia (prediabetes and diabetes) risk in women who had GDM in the index pregnancy. GDM and dysglycemia four to seven years postpartum were determined by the oral glucose tolerance test (OGTT). A Poisson regression model with a robust error variance was used to estimate incidence rate ratios (IRRs) for dysglycemia four to seven years post-delivery according to groupings of the duration of any breastfeeding (<1, ≥1 to <6, and ≥6 months). (3) Results: Women who had GDM during the index pregnancy and complete breastfeeding information and OGTT four to seven years postpartum were included in this study (n = 116). Fifty-one women (44%) had postpartum dysglycemia. Unadjusted IRRs showed an inverse association between dysglycemia risk and ≥1 month to <6 months (IRR 0.91; 95% confidence interval [CI] 0.57, 1.43; p = 0.68) and ≥6 months (IRR 0.50; 95% CI 0.27, 0.91; p = 0.02) breastfeeding compared to <1 month of any breastfeeding. After adjusting for key confounders, the IRR for the ≥6 months group remained significant (IRR 0.42; 95% CI 0.22, 0.80; p = 0.008). (4) Conclusions: Our results suggest that any breastfeeding of six months or longer may reduce long-term dysglycemia risk in women with a history of GDM in an Asian setting. Breastfeeding has benefits for mothers beyond weight loss, particularly for those with GDM.

scholarly journals High probability of false-positive gestational diabetes mellitus diagnosis during early pregnancy

2020 ◽  
Vol 8 (1) ◽  
pp. e001234
Author(s):  
Sayuri Nakanishi ◽  
Shigeru Aoki ◽  
Junko Kasai ◽  
Ryosuke Shindo ◽  
Soichiro Obata ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Early Pregnancy ◽  
Therapeutic Intervention ◽  
False Positive ◽  
Early Onset ◽  
Oral Glucose ◽  
Study Cohort ◽  
Iadpsg Criteria

IntroductionThis study aimed to assess the validity of applying the International Association of Diabetes and Pregnancy Study Group (IADPSG) criteria for the diagnosis of gestational diabetes mellitus (GDM) at any time during pregnancy.Research design and methodsThis multicenter cohort study was conducted at five Japanese facilities from January 2018 to April 2019. The study cohort included women at a high risk of GDM who met one or more of the following IADPSG criteria during early pregnancy: fasting plasma glucose (FPG) ≥92 mg/dL and 75 g oral glucose tolerance test (OGTT) value of ≥180 mg/dL at 1 hour, or ≥153 mg/dL at 2 hour (hereafter early-onset GDM). Women diagnosed with early-onset GDM were followed up without therapeutic intervention and underwent the 75 g OGTT again during 24–28 weeks of gestation. Those exhibiting the GDM patterns on the second 75 g OGTT were diagnosed with true GDM and treated, whereas those exhibiting the normal patterns were diagnosed with false positive early GDM and received no therapeutic intervention.ResultsOf the 146 women diagnosed with early-onset GDM, 69 (47%) had normal 75 g OGTT values at 24–28 weeks of gestation, indicating a false-positive result. FPG levels were significantly higher in the first 75 g-OGTT test than in the second 75 g-OGTT test (93 mg/dL and 87.5 mg/dL, respectively; p<0.001). FPG levels were high in 86 (59%) women with early-onset GDM during early pregnancy but in only 39 (27%) women during mid-pregnancy. Compared with false positive early GDM, true GDM was more frequently associated with adverse pregnancy outcomes.ConclusionsAlthough women with early-onset GDM were followed up without treatment, the results of repeated 75 g OGTT during mid-pregnancy were normal in about 50%. Our data did not support the adoption of IADPSG thresholds for the diagnosis of GDM prior to 20 weeks of gestation.

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