Comparison of multiple methods to measure maternal fat mass in late gestation

Marshall, Nicole; Murphy, Elizabeth J.; King, Janet C.; Haas, E; Lim, Jeong Youn; Wiedrick, Jack; Thornburg, Kent L.; Purnell, Jonathan Q.

doi:10.3945/ajcn.115.113464

Cited by 37 publications

(39 citation statements)

References 41 publications

(44 reference statements)

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“…Using the applied methods, we are limited in our ability to distinguish between maternal and fetal components to gestational weight gain or to specify fetal adiposity, which is likely small (< 0.5 kg) . Thoracic gas volume was estimated, but not measured, because in this cohort of women with obesity, only half of the measurements produced reliable data (73/162, 45%), while this appears to be less problematic in nonobese women (71%‐94%) . We acknowledge that findings on the determinants of weight gain are correlational in nature and causality cannot be inferred.…”

Section: Discussionmentioning

confidence: 99%

Body Composition During Pregnancy Differs by Obesity Class

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Altazan

Hsia

et al. 2019

Obesity

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Objective: The aim of this study is to characterize changes in body composition during pregnancy in women with obesity. Methods: Fifty-four healthy women with obesity (class 1, 30-34.9 kg/m 2 : n = 25; class 2, 35-39.9 kg/m 2 : n = 21; class 3, ≥ 40.0 kg/m 2 : n = 8) expecting a singleton pregnancy were studied. Body composition was measured in early pregnancy (13-16 weeks), midpregnancy (24-27 weeks), and late pregnancy (35-37 weeks) using air displacement plethysmography, stable isotopes, and skinfold thickness measurements. Fasting glucose, insulin, and leptin were measured. Results: The gain in fat-free mass was lower in the second trimester compared with the third (2.7 ± 0.2 to 5.3 ± 0.2 kg; P < 0.001), whereas fat mass accumulation declined over time (0.6 ± 0.3 to −0.7 ± 0.4 kg; P = 0.005). Women with class 1 and 2 obesity gained 1.1 ± 0.7 kg of fat mass during pregnancy, while women with class 3 obesity lost 4.1 ± 0.6 kg (both P < 0.001). The difference in fat accumulation between obesity classes was observed only in the second trimester (P = 0.02). Gestational weight gain was associated positively with changes in plasma concentrations of insulin, leptin, and insulin resistance (all P < 0.01). Conclusions: Gestational weight gain in pregnancy differs by obesity class and trimester. Women with class 3 obesity gain less body weight and fat mass. Fat mass gain is most likely preventable in the second trimester.Obesity (2020) 28, 268-276. Study ImportanceWhat is already known? ► Healthy gestational weight gain is inversely related to body size. ► Fat mass is the most variable component of gestational weight gain in nonobese pregnancy.What does this study add?► Weight and body composition changes during pregnancy differ by obesity class. ► Fat mass is gained during the second trimester but not the third. ► "Inadequate" weight gain is the result of fat loss.

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Section: Discussionmentioning

confidence: 99%

Body Composition During Pregnancy Differs by Obesity Class

Most

Altazan

Hsia

et al. 2019

Obesity

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“…Total DNA was extracted from placental tissue ( n = 7–8/group) using PowerSoil DNA Isolation Kit (MO BIO Laboratories, Carlsbad, CA, United States). PCR and custom primers were used to amplify the V4–V5 region of the 16S rRNA gene as previously described ( Marshall et al, 2016 ), and sequenced on the Illumina MiSeq platform.…”

Section: Methodsmentioning

confidence: 99%

Inflammatory Determinants of Pregravid Obesity in Placenta and Peripheral Blood

et al. 2018

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Pre-pregnancy (pregravid) obesity has been linked to several adverse health outcomes for both mother and offspring. Complications during pregnancy include increased risk for gestational diabetes, hypertension, preeclampsia, placental abruption, and difficulties during delivery. Several studies suggest that these negative outcomes are mediated by heightened systemic inflammation as well as changes in placental development and function. However, the molecular mechanisms by which pregravid obesity affects these processes are poorly understood. In this study, we aimed to address this question by carrying out a comprehensive analysis of the systemic maternal immune system coupled with placental gene expression and microbial profiling at term delivery (11 lean and 14 obese). Specifically, we examined the impact of pregravid obesity on circulating cytokines, chemokine, adipokines, and growth factors using multiplex Luminex assay. Innate and adaptive immune cell frequencies and their cytokine production in response to stimuli were measured using flow cytometry. Finally, changes in placental transcriptome and microbiome were profiled using RNA- and 16S-sequencing, respectively. Pregravid obesity is characterized by insulin and leptin resistance, high levels of circulating inflammatory markers IL-6 and CRP, in addition to chemokine IL-8 (p < 0.01). Moreover, pregravid obesity was associated with lower frequency of naïve CD4+ T-cells (p < 0.05), increased frequency of memory CD4+ T-cells (p < 0.01), and a shift towards Th2 cytokine production (p = 0.05). Myeloid cells from the obese cohort produced higher levels of pro-inflammatory cytokines but lower levels of chemokines following TLR stimulation (p < 0.05). Lastly, pregravid obesity is associated with increased abundance of Bacteroides and changes in the expression of genes important for nutrient transport and immunity (FDR < 0.05). Collectively, these data indicate that pregravid obesity is associated with heightened systemic inflammation and of dysregulated nutrient transport in the placenta and provide insight into the basis of fetal reprogramming.

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“…ADP with equations adjusted for FFM densities according to van Raaij et al (ADP vR ) [7] was used as our reference method. The reason for using ADP vR as reference method was that pregnancy-adjusted densitometry has been validated for use in late pregnancy [11] and for assessing FM changes during pregnancy [12], and provided the best estimate of maternal FM compared with post-pregnancy DXA values in an evaluation of two-and three-compartment models [13]. These studies also showed that mean FM in trimester 3 and FM gain during pregnancy were higher in the Siri densitometry twocomponent model than in the four-component model, whereas the densitometry two-component model with van Raaij correction was accurate [11,12].…”

Section: Study Design and Participantsmentioning

confidence: 99%

“…ADP is a user-friendly densitometry method and safe during pregnancy. Although few validation studies of ADP during pregnancy have been performed, it implements the same densitometry theories as hydrodensitometry/underwater weighing to assess a twocomponent body composition model and a comparative study of two and three-compartment models deemed ADP with adjustments for FFM hydration as the best model for use in late pregnancy [13].…”

Section: Introductionmentioning

confidence: 99%

Body Composition During Pregnancy: Longitudinal Changes and Method Comparisons

et al. 2020

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The Pregnancy Obesity Nutrition and Child Health study is a longitudinal study of reproductive health. Here we analyzed body composition of normal-weight and obese Swedish women by three methods during each trimester of pregnancy. Cross-sectional and longitudinal fat mass estimates using quantitative magnetic resonance (QMR) and bioelectrical impedance analysis (BIA) (Tanita MC-180MA-III) were compared with fat mass determined by air displacement plethysmography (ADP) in pregnancy weeks 8-12, 24-26, and 35-37 in normal-weight women (n = 122, BMI = 22.1 ± 1.6 kg/m 2) and obese women (n = 29, BMI = 34.6 ± 3.6 kg/m 2). ADP results were calculated from pregnancy-adjusted fat-free mass densities. Mean fat mass by QMR and ADP were similar in obese women, although with wide limits of agreement. In normal-weight women, QMR overestimated mean fat mass in all trimesters, with systematic overestimation at low fat mass values in trimesters 1 and 3. In obese women, fat mass by BIA was grossly underestimated and imprecise in all trimesters, especially at higher values in trimester 2. In normalweight women, fat mass by BIA was moderately lower than by ADP in trimester 1, similar in trimester 2, and moderately higher in trimester 3. QMR and ADP assessed fat mass changes similarly in obese women, whereas BIA overestimated fat mass changes in normal-weight women. Mean fat mass and fat mass changes by QMR and pregnancy-adjusted ADP were similar in pregnant obese women. Mean fat mass by QMR and fat mass changes by BIA were higher than corresponding values determined by pregnancy-adjusted ADP in normal-weight women.

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Comparison of multiple methods to measure maternal fat mass in late gestation

Cited by 37 publications

References 41 publications

Body Composition During Pregnancy Differs by Obesity Class

Body Composition During Pregnancy Differs by Obesity Class

Inflammatory Determinants of Pregravid Obesity in Placenta and Peripheral Blood

Body Composition During Pregnancy: Longitudinal Changes and Method Comparisons

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