First-Trimester Follistatin-Like-3 Levels in Pregnancies Complicated by Subsequent Gestational Diabetes Mellitus

Thadhani, Ravi; Powe, Camille E.; Tjoa, May Lee; Khankin, Eliyahu V.; Ye, Jun; Ecker, Jeffrey L.; Schneyer, Alan L.; Karumanchi, S. Ananth

doi:10.2337/dc09-1745

Cited by 38 publications

(31 citation statements)

References 26 publications

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“…In contrast, the concentration of visfatin, which is produced by adipose tissue, is increased by about 30% [70] . There is contradictory evidence that the serum concentration of follistatin-like-3 may also be reduced at 11-13 weeks [68,71] .…”

Section: Biochemical Markersmentioning

confidence: 99%

Turning the Pyramid of Prenatal Care

2011

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The current approach to prenatal care, which involves visits at 16, 24, 28, 30, 32, 34 and 36 weeks and then weekly until delivery, was established 80 years ago. The high concentration of visits in the third trimester implies, firstly, that most complications occur at this late stage of pregnancy and, secondly, that most adverse outcomes are unpredictable during the first or even second trimester. This review presents evidence that many pregnancy complications can now be predicted at an integrated first hospital visit at 11–13 weeks by combining data from maternal characteristics and history with findings of biophysical and biochemical tests. It is therefore proposed that the traditional pyramid of care should be inverted with the main emphasis placed in the first rather than third trimester of pregnancy.

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Section: Biochemical Markersmentioning

confidence: 99%

Turning the Pyramid of Prenatal Care

2011

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“…However, prior efforts to identify first-trimester biomarkers and risk algorithms for subsequent GDM diagnosis have been limited. Associations have been found between levels of the following first-trimester biomarkers and increased risk of GDM: low follistatin-3 [7]; low sex hormone-binding globulin [8, 9]; high C-reactive protein [9, 10]; and high tissue plasminogen activator and low HDL-cholesterol [11]. Although these models had variable degrees of predictive power based on the choice of clinical variables or biochemical surrogates of adiposity, none explored first-trimester metabolites to identify women at risk of GDM.…”

Section: Introductionmentioning

confidence: 99%

A systematic review of metabolite profiling in gestational diabetes mellitus

2014

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Aims/hypothesis Gestational diabetes mellitus is associated with adverse maternal and fetal outcomes during, as well as subsequent to, pregnancy, including increased risk of type 2 diabetes and cardiovascular disease. Because of the importance of early risk stratification in preventing these complications, improved first-trimester biomarker determination for diagnosing gestational diabetes would enhance our ability to optimise both maternal and fetal health. Metabolomic profiling, the systematic study of small molecule products of biochemical pathways, has shown promise in the identification of key metabolites associated with the pathogenesis of several metabolic diseases, including gestational diabetes. This article provides a systematic review of the current state of research on biomarkers and gestational diabetes and discusses the clinical relevance of metabolomics in the prediction, diagnosis and management of gestational diabetes. Methods We conducted a systematic search of MEDLINE (PubMed) up to the end of February 2014 using the key term combinations of 'metabolomics,' 'metabonomics,' 'nuclear magnetic spectroscopy,' 'mass spectrometry,' 'metabolic profiling' and 'amino acid profile' combined (AND) with 'gestational diabetes'. Additional articles were identified through searching the reference lists from included studies. Quality assessment of included articles was conducted through the use of QUADOMICS. Results This systematic review included 17 articles. The biomarkers most consistently associated with gestational diabetes were asymmetric dimethylarginine and NEFAs. After QUADOMICS analysis, 13 of the 17 included studies were classified as 'high quality'. Conclusions/interpretation Existing metabolomic studies of gestational diabetes present inconsistent findings regarding metabolite profile characteristics. Further studies are needed in larger, more racially/ethnically diverse populations.

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“…Aunque en 2010 Thadhani et al demostraron concentraciones más bajas en primer trimestre en mujeres que desarrollaron DG 50 ; estos resultados no han podido ser reproducidos en estudios posteriores 40 .…”

Section: Marcadores Bioquímicosunclassified

Cribado precoz de diabetes gestacional y macrosomía

Maíz

Plasencia

2014

Progresos de Obstetricia y Ginecología

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Recibido el 7 de julio de 2014; aceptado el 10 de julio de 2014 Disponible en Internet el 11 de septiembre de 2014 PALABRAS CLAVE Diabetes gestacional; Macrosomía fetal; Cribado; Primer trimestreResumen La diabetes gestacional (DG), con una prevalencia de un 9%, se asocia a una elevada morbilidad materna y perinatal. El diagnóstico y el tratamiento precoz de la hiperglucemia materna reducen el riesgo de macrosomía fetal y sus complicaciones intraparto. En el primer trimestre se puede identificar factores de riesgo de DG de la historia materna (edad, obesidad, macrosomía o DG en gestaciones previas, antecedente familiar de diabetes), marcadores bioquímicos (adiponectina, sex hormone-binding globuline y otros) y marcadores biofísicos (arteriografía, adiposidad visceral). Entre los factores de riesgo de macrosomía destacan la obesidad y la diabetes en la historia materna, pregnancy associated plasma protein-A y fracción libre de la subunidad beta de la gonadotropina coriónica humana como marcadores bioquímicos y la translucencia nucal y Doppler de arterias uterinas como marcadores biofísicos. Combinando los marcadores mediante modelos de predicción, y con una tasa de falsos positivos del 10%, se puede alcanzar una tasa de detección del 65 y el 35% para DG y macrosomía, respectivamente. ß 2014 SEGO. Publicado por Elsevier España, S.L.U. Todos los derechos reservados. Early screening of gestational diabetes and macrosomyAbstract Gestational diabetes (GD), which has a prevalence of 9%, is associated with high maternal and perinatal morbidity. Early diagnosis and treatment of maternal hyperglycemia reduce the risk of macrosomia and the associated intrapartum complications. Risk factors for GD can be identified in the first trimester from maternal history (age, obesity, previous macrosomia or GD, family history of diabetes), biochemical markers (adiponectin, sex hormone-binding globuline and others), and biophysical markers (arteriography, visceral adiposity). Risk factors for macrosomia include obesity and diabetes in the maternal history, pregnancy associated plasma protein-A and free b subunit of human chorionic gonadotropin as biochemical markers, and nuchal translucency and uterine artery Doppler as biophysical markers. Prediction models

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First-Trimester Follistatin-Like-3 Levels in Pregnancies Complicated by Subsequent Gestational Diabetes Mellitus

Cited by 38 publications

References 26 publications

Turning the Pyramid of Prenatal Care

Turning the Pyramid of Prenatal Care

A systematic review of metabolite profiling in gestational diabetes mellitus

Cribado precoz de diabetes gestacional y macrosomía

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