Diurnal plasma free fatty acid profiles in normal and diabetic pregnancies.

Gillmer, M. D. G.; Beard, R. W.; Oakley, N. W.; Brooke, F. M.; Elphick, Martin; Hull, D

doi:10.1136/bmj.2.6088.670

Cited by 41 publications

(13 citation statements)

References 27 publications

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“…In contrast, other investigators have found no correlation between maternal FFA concentrations and birth weight [38]. In vitro experiments by Dancis et al [39] have shown that transport of FFA across the placenta could not account for fetal fat accretion, although FFA concentrations in the umbilical artery have been reported to be 12% less than in the umbilical vein [40], suggesting that the fetus is a net consumer of FFA.…”

Section: Effects Of Maternal Metabolism On Neonatal Body Compositionmentioning

confidence: 90%

Maternal factors that determine neonatal size and body fat

Catalano

Kirwan

2001

Curr Diab Rep

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These data are a review of previously published data. Initially, body composition was estimated in 186 neonates. Fat- free mass (FFM), which constituted 86% of birth weight, accounted for 83% of the variance in birth weight; fat mass (FM), which constituted 14% of birth weight, accounted for 46% of the variance in birth weight. Male neonates were an average of 175 g heavier than females. FFM was greater among males compared with females (P = 0.0001). Using stepwise logistic regression, 29% of the variance in birth weight, 30% in FFM, and 17% in FM was accounted for. Independent variables included maternal height, pregravid weight, weight gain during pregnancy, education, parity, paternal height and weight, neonatal sex, and gestational age. Including maternal insulin sensitivity explained 48% of the variance in birth weight, 53% in FFM, and 46% in FM. There was a positive correlation between weight gain and birth weight in control subjects but a negative correlation in subjects with gestational diabetes mellitus. Lastly, the roles of insulin, insulin-like growth factors, and leptin were examined in relation to fetoplacental growth and body composition. The assessment of fetal/neonatal body composition may improve the understanding of the effect of differential factors on fetal growth. Factors associated with accretion of fetal adipose tissue in late gestation are less well understood compared with birth weight and FFM. Additional studies of maternal glucose and lipid metabolism are needed to better evaluate fetal growth.

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Section: Effects Of Maternal Metabolism On Neonatal Body Compositionmentioning

confidence: 90%

Maternal factors that determine neonatal size and body fat

Catalano

Kirwan

2001

Curr Diab Rep

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“…In subjects with mild GDM treated with diet alone, mean 24-h plasma glucose concentrations obtained from frequent venous sampling significantly exceed values of nondiabetic control women in late pregnancy (10,11). This occurs even if fasting plasma glucose concentrations are comparable.…”

Section: Maternal Plasma Substrate Abnormalities In Gdmmentioning

confidence: 92%

Impact of Maternal Fuels and Nutritional State on Fetal Growth

Kalkhoff

1991

Diabetes

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Several maternal plasma fuel abnormalities have been described in gestational diabetes mellitus (GDM), and all may contribute to the development of fetal macrosomia, generally because of the surfeit of calories they provide. Elevated maternal plasma glucose and amino acid concentrations represent key disturbances, because they are also well-known fetal pancreatic beta-cell secretagogues. Fetal hyperinsulinemia contributes to macrosomia in a special way by selectively accelerating fuel utilization and storage in insulin-sensitive fetal tissues. Maternal obesity intensifies the insulin resistance already present in late pregnancy and probably exaggerates the metabolic abnormalities attending GDM that impact on fetal growth and development. However, the means by which maternal obesity per se promotes the development of heavy babies in nondiabetic pregnancies remains poorly defined. Significant correlations exist between newborn birth weight and the levels of maternal plasma glucose, amino acids, free fatty acids, and triglycerides in diabetic pregnancies. However, the relative influence of each disturbance on fetal birth weight remains controversial and requires more detailed investigation.

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“…Others [1,2,5,6,7,15,16] have demonstrated fluctuations which will not have been detected using our sampling schedule. Typical is the postprandial morning blood glucose, and postinsulin injection lactate rise found in insulin treated diabetics [1,2].…”

Section: Discussionmentioning

confidence: 74%

“…In most studies blood glucose normalization has been the goal, and only recently have other metabolites been studied [5,6].…”

mentioning

confidence: 99%

Metabolic profiles in closely controlled diabetic pregnancies during the third trimester

et al. 1979

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Summary. In 5 closely controlled pregnant diabetics (duration of pregnancy 237-266 days) and 5 pregnant non-diabetics (duration of pregnancy 210-278 days) 4-hourly blood samples were taken throughout a 24 h period and analyzed for blood glucose, lactate, pyruvate, 3-hydroxybutyrate and acetoacetate, plasma non-esterified fatty acids (NEFA), glucagon and cortisol. 24 h urine specimen was analyzed for total catecholamines and 4-hydroxy-3-methoxymandelic acid. There were few significant differences in concentrations of metabolites and hormones in the two groups at any time, although the variations about the mean was usually greater in the diabetics.Thus for blood glucose in diabetics, mean value was 4.4 mmol/1, coefficient of variation 43%; in non-diabetics 4.1 mmol/1 and 10% respectively. Mean plasma 3-hydroxybutyrate in diabetics was 0.47 mmol/1, coefficient of variation 55%; in non-diabetics 0.44 mmol/1 and 37% respectively. Plasma non-esterified fatty acid levels were significantly higher in the diabetics (0.47 mmol/1) than in the non-diabetics (0.26 mmol/1). Coefficients of variation were 46% and 33% respectively. Two conclusions can be drawn; first, when near normal mean values for blood glucose are achieved, other metabolite and hormone levels are also near normal; second, even when the available means for diabetic control, strict diet and insulin-mixtures twice daily, are used at their maximum, metabolism in diabetics is more unstable than in non-diabetics.

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Diurnal plasma free fatty acid profiles in normal and diabetic pregnancies.

Cited by 41 publications

References 27 publications

Maternal factors that determine neonatal size and body fat

Maternal factors that determine neonatal size and body fat

Impact of Maternal Fuels and Nutritional State on Fetal Growth

Metabolic profiles in closely controlled diabetic pregnancies during the third trimester

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