BackgroundGestational diabetes mellitus (GDM) is a form of diabetes that occurs during pregnancy. GDM is a well known risk factor for foetal overgrowth, termed macrosomia which is influenced by maternal hypergycemia and endocrine status through placental circulation. The study was undertaken to investigate the implication of growth factors and their receptors in GDM and macrosomia, and to discuss the role of the materno-foeto-placental axis in the in-utero regulation of foetal growth.Methods30 women with GDM and their 30 macrosomic babies (4.75 ± 0.15 kg), and 30 healthy age-matched pregnant women and their 30 newborns (3.50 ± 0.10 kg) were recruited in the present study. Serum concentrations of GH and growth factors, i.e., IGF-I, IGF-BP3, FGF-2, EGF and PDGF-B were determined by ELISA. The expression of mRNA encoding for GH, IGF-I, IGF-BP3, FGF-2, PDGF-B and EGF, and their receptors, i.e., GHR, IGF-IR, FGF-2R, EGFR and PDGFR-β were quantified by using RT-qPCR.ResultsThe serum concentrations of IGF-I, IGF-BP3, EGF, FGF-2 and PDGF-B were higher in GDM women and their macrosomic babies as compared to their respective controls. The placental mRNA expression of the growth factors was either upregulated (FGF-2 or PDGF-B) or remained unaltered (IGF-I and EGF) in the placenta of GDM women. The mRNA expression of three growth factor receptors, i.e., IGF-IR, EGFR and PDGFR-β, was upregulated in the placenta of GDM women. Interestingly, serum concentrations of GH were downregulated in the GDM women and their macrosomic offspring. Besides, the expression of mRNAs encoding for GHR was higher, but that encoding for GH was lower, in the placenta of GDM women than control women.ConclusionsOur results demonstrate that growth factors might be implicated in GDM and, in part, in the pathology of macrosomia via materno-foeto-placental axis.

No abstract

Background: Data on overweight and obesity in general population in Benin is scarce. This study aimed therefore to assess prevalence and risk factors of overweight and obesity in Benin. Methods:The study consisted of a cross-sectional survey, using the World Health Organisation (WHO)'s instrument for stepwise surveillance (STEPS) of non-communicable diseases risk factors. A five stage random sample of 25 to 64 years old male and female adults living in Benin participated in structured interviews and their size, weight and blood pressure were measured according to standardized procedures. Prevalence and means were computed with their 95% confidence interval and standard error respectively, taking into account the sampling design. Prevalence was compared by Khi2 and means by Student's t test. Univariate and stratified by gender multivariate polytomous logistic regressions were performed to identify socio-demographic and physical risk factors of overweight and obesity. Results: A total of 6,773 adults participated in the study. About 50.50% of the participants were male. The overall prevalence of overweight and obesity was 19.20% (95% CI 17.91; 20.66) and 7.25% (95% CI 6.34; 8.14) respectively. The prevalence of high risk abdominal obesity was 15.48% (95% CI 15.45; 15.50). The prevalence of overweight (22.41% vs. 15.99%) and obesity (10.68% vs. 3.61%) was significantly higher in females than males. Likewise, the prevalence of abdominal obesity was significantly higher in women (27.39%) than in men (2.73%). After controlling for confounding factors, risk factors of overweight and obesity in both women and men were older age, primary and high school/university education levels, occupation, dwelling and department. Conclusion: Our findings suggested that overweight and obesity are common in Benin. However, some differences were noted between women and men as regards socio-demographic variables. These findings call for more in-depth studies. Moreover, policies and programmes targeting the identified risk factors and high risk abdominal obesity may prove helpful in reducing the prevalence of overweight and obesity in Benin.

The study provided objective evidence for the exorbitant medical cost of diabetes considering that no medical insurance is available in the study countries. Although the calculator only estimates the cost of inaction, it is innovative and of interest for several stakeholders.