Objective: to estimate the role of adipose tissue in gestational weight gain (GWG) and preferential fat deposition among normal-weight women. Subjects and methods: prospective cohort study of 84 pregnancies: maternal body mass index 18,5–24,9 kg/m2, singleton term pregnancy, nondiabetic women, somatically well. GWG and skinfold thickness were evaluated in the 1st, 2nd, 3d trimesters, on the 3d day after delivery. Results: fat mass gain in low GWG was similar to recommended GWG and in the high-GWG group was greater one. Women with recommended and low GWG returned to their initial fat level on the 3d day after delivery, in excessive weight gain fat significantly increased (р=0,025). Compared to initial recommended GWG resulted in triceps skinfold thicknesses loss (р=0,001), in abdominal skinfold gained nothing and in thighs skinfold thicknesses increasing (р=0,021). Inadequate GWG leads to fat loss in arms (р=0,017), fat of abdominal area and thighs return to initial level. In excessive GWG fat in the upper trunk and arms not changed, in the lower area (thighs) significantly increased compared to initial level (р=0,001) or other groups (р=0,001). Conclusion: excessive GWG was associated with greater adipose tissue cumulation and its deposition preferentially over the thighs. Inadequate GWG was clearly linked to low fat-free mass gain.
BACKGROUND: It has been proven that vitamin D plays an important role in pregnancy. Deficiency of this element may be associated with the risk of developing gestational diabetes mellitus, preeclampsia, placentar insufficiency, low birth weight and premature birth.AIMS: To conduct an epidemiological analysis of vitamin D supply in women at different stages of pregnancy, living in Russia.MATERIALS AND METHODS: We included 1198 pregnant women living in 3 regions of Russia in the observational, multicenter, cross-sectional, continuous study. All pregnant women were tested for serum 25(OH)D levels. We collected biomaterial from August 2018 to December 2019. The end point of the study was the indicator of vitamin D supply in pregnant women and its level depending on the trimester of pregnancy and region of Russia. Statistical analysis included counting and grouping according to vitamin D levels, and calculating the median vitamin D concentration in each region.RESULTS: We confirmed vitamin D deficiency in all regions. The optimum level of this element is present in less than 7% of women. Insufficiency of this element is present in 20,62% of all women. The largest percentage of them is in a deficit of this element — 46,66%. We found that the lowest rates are in Smolensk, where the median was 12,75 ng/ml. In addition, we found changes in vitamin D concentration: with an increase in gestational age revealed a decrease in its level.CONCLUSIONS: In our study, we confirmed the presence of a 25(OH)D deficiency in most of the examined pregnant women, which is consistent with international epidemiological data. We should remember about these both at the stage of pre-gravid preparation and at the stage of pregnancy itself in order to achieve the optimal level of vitamin D.
Aim. To elucidate the character of the relationship between gestational body weight gain (GBWG) and carbohydrate/lipid metabolism during pregnancy. Material and methods. This prospective cohort study enrolled 85 women with full-term sigleton pregnancy in the absence of signs of diabetes mellitus or severe somatic pathology including 15 ones with subnormal GBWG, 35 with excessive GBWG, and 36 with recommended GBWG. Detection of gestational body weight gain, carbohydrate tolerance test, measurement of baseline and stimulated insulin secreation, lipidograms obtained in the first, second, and third trimesters. Results. The biochemical profile in the patients with pathological GBWG has the following peculiarities in comparison with that of the women with recommended GBWG during pregnancy. The women with excessive GBWG in the second and third trimesters are characterized by enhanced levels of baseline and stimulated insulin secretion, high HOMO-IR index and LDLP concentration (p<0.05). The women with subnormal GBWG in the first trimester have a higher fasting blood glucose level whereas in the third trimester both fasting glycemia and insulin concentration in response to standard carbohydrate loading decrease to below the respective normal values (p<0.05). The biochemical and hormonal characteristics of carbohydrate and lipid metabolism undergo secondary changes following body mass variations. Conclusion. The results of this study show that changes in sensitivity to insulin are in all probability the consequence of pathological enhancement of body mass rather than its cause.
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