Higher Levels of Triglyceride, Fatty Acid Translocase, and Toll-Like Receptor 4 and Lower Level of HDL-C in Pregnant Women with GDM and Their Close Correlation with Neonatal Weight

Zhou, Jiayi; Bai, Jie; Guo, Yue; Fu, Lijun; Xing, Jinchun

doi:10.1159/000510032

Cited by 11 publications

(8 citation statements)

References 24 publications

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“…Compared with insulin, glyburide was associated with higher neonatal BW, while metformin was with lower BW of infants, in which the results were the same as a previous study [14]. Zhou et al [61] suggested that the level of triglyceride in maternal blood was positively correlated with neonatal BW. Metformin is also confirmed to reduce the level of triglyceride in nonobese type 2 diabetes mellitus patients [62].…”

Section: Comparison With Other Studiessupporting

confidence: 80%

Comparison of Insulin, Metformin, and Glyburide on Perinatal Complications of Gestational Diabetes Mellitus: A Systematic Review and Meta-Analysis

Xian

Liu

Chen

et al. 2021

Gynecol Obstet Invest

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Aim: This systematic and meta-analysis was conducted to evaluate the efficacy and safety of insulin, metformin, and glyburide on perinatal complications for gestational diabetes mellitus (GDM). Methods: Medline (PubMed), EMBASE, The Cochrane Library (Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials [CENTRAL], and Cochrane Methodology Register), Web of Science (Science and Social Science Citation Index), and ClinicalTrials (Clinicaltrials.gov) were searched, as well as manual searching. We included randomized controlled trials comparing efficacy and safety of metformin versus glyburide, metformin versus insulin, and glyburide versus insulin in patients with GDM. Results: We included 32 articles including 5,964 patients published from inception to July 2020. Compared with insulin, metformin was more effective at lower incidence of macrosomia (RR: 0.66, 95% CI: 0.50–0.88, p = 0.005), lower incidence of neonatal intensive care unit admission (RR: 0.78, 95% CI: 0.67–0.91, p = 0.002), less neonatal hypoglycemia (RR: 0.67, 95% CI: 0.56–0.80, p < 0.0001), decreased birth weight (BW) (SMD: −0.37, 95% CI: −0.62 to −0.12, p = 0.004), lower incidence of large for gestational age (RR: 0.76, 95% CI: 0.50–0.90, p = 0.002), shorter gestation age at delivery (MD: −0.22, 95% CI: −0.34 to −0.10, p = 0.0002), lower maternal weight gain (MD: −1.41, 95% CI: −2.28 to −0.55, p = 0.001), less incidence of caesarean section delivery (RR: 0.86, 95% CI: 0.78–0.95, p = 0.0004), lower maternal postprandial blood glucose (SMD: −0.41, 95% CI: −0.72 to −0.11, p = 0.008), and lower incidence of pregnancy-induced hypertension (RR: 0.47, 95% CI: 0.27–0.83, p = 0.01). However, glyburide, compared with insulin, was associated with higher BW (MD: 54.95, 95% CI: 3.87–106.03, p = 0.03) and increased the incidence of neonatal hypoglycemia (RR: 1.52, 95% CI: 1.12–2.07, p = 0.007). Meanwhile, compared to glyburide, metformin was associated with higher maternal fasting blood glucose (SMD: 0.20, 95% CI: 0.05–0.36, p = 0.01) and lower incidence of induction of labor (RR: 0.76, 95% CI: 0.59–0.97, p = 0.03). Conclusions: This review suggests that metformin can decrease the incidence of perinatal complications, and it should be considered as a generally safe alternative to insulin.

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Section: Comparison With Other Studiessupporting

confidence: 80%

Comparison of Insulin, Metformin, and Glyburide on Perinatal Complications of Gestational Diabetes Mellitus: A Systematic Review and Meta-Analysis

Xian

Liu

Chen

et al. 2021

Gynecol Obstet Invest

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“…There was also no difference in HDL between the groups analyzed. Other studies found low HDL levels and high triglyceride levels in patients with preeclampsia when compared to controls ( Dong et al, 2021 ; Zhou et al, 2021 ). In our study, triglyceride levels were higher in patients with preeclampsia than in the control group.…”

Section: Discussionmentioning

confidence: 86%

Association of LEPTIN and other inflammatory markers with preeclampsia: A systematic review

et al. 2022

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Background: Preeclampsia is a serious pregnancy complication that affects 5%–10% of the obstetric population.Objective: To study inflammatory markers associated with preeclampsia.Search Strategy: Searches of articles on the topic published over a 10-year period (2009–2019) were performed in three databases (PubMed, Cochrane, and Embase) using the keywords preeclampsia and inflammatory markers. The PubMed search using 10 years and humans as filters retrieved 124 articles. Using an advanced search strategy, 0 articles were identified in Embase and 10 articles in Cochrane. After screening and eligibility assessment, 13 articles were included in the systematic review and meta-analysis. Meta-analysis and quality assessment of the studies were performed using the Review Manager 5.3 program.Results: For meta-analysis, women with preeclampsia were compared to control women, i.e., pregnancies without arterial hypertension. Leptin levels were significantly higher (p < 0.0002) in women with preeclampsia compared to controls. Total cholesterol was also significantly elevated in women with preeclampsia (p < 0.0001). There was no significant difference in HDL between groups, but women with preeclampsia had significantly increased LDL (p < 0.01). The same was observed for triglycerides, which were significantly increased in women with preeclampsia (p < 0.04) compared to controls. Analysis of TNF-alpha, an important inflammatory marker, showed higher levels in women with preeclampsia (p < 0.03) compared to controls. The same was observed for another important inflammatory marker, interleukin 6, which was significantly increased in women with preeclampsia (p < 0.0002). There was a significant increase of C-reactive protein in women with preeclampsia (p < 0.003) compared to controls.Conclusion: Women with preeclampsia have increased levels of inflammatory markers compared to control women.

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“…However, one unanticipated finding was that there was no significant difference between the intramuscular triglyceride contents in the chronic DMSO treatment group and the forskolin treatment group. This result may be explained by the hypothesis that a self-protection mechanism might be activated to prevent fatty acids from being hydrolyzed ( Zhou et al, 2021a ) when the intramuscular abundance of triglycerides was not elevated by external intervention, and further investigation is suggested to validate it.…”

Section: Discussionmentioning

confidence: 99%

The Role of cAMP-PKA Pathway in Lactate-Induced Intramuscular Triglyceride Accumulation and Mitochondria Content Increase in Mice

et al. 2021

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The glycolytic product of exercise, lactate, has long been recognized to promote lipid accumulation by activation of G-protein-coupled receptor 81 (GPR81) and inhibition of the cyclic adenosine monophosphate-protein kinase A (cAMP –PKA) pathway in adipose tissue. Whether lactate causes a similar process in skeletal muscle is unclear. Lactate might also improve mitochondria content in skeletal muscle; however, the mechanism is not clarified either. In this study, using intramuscular injection of lactate to the gastrocnemius and intraperitoneal injection of forskolin (activator of cAMP-PKA pathway), we identified the role of the cAMP-PKA pathway in lactate-induced intramuscular triglyceride accumulation and mitochondrial content increase. The intramuscular triglyceride level in the gastrocnemius increased after 5weeks of lactate injection (p<0.05), and this effect was blocked by forskolin injection (p<0.05). Corresponding expression level changes of GPR81, P-PKA/PKA, P-CREB/cAMP-response element binding protein (CREB), and proteins related to lipid metabolism suggest that lactate could induce intramuscular triglyceride accumulation partly through the inhibition of the cAMP-PKA pathway. Meanwhile, the intramuscular expression of citrate synthase (CS) and the activity of CS increased after 5weeks of lactate injection (p<0.05), but the change of CS expression was not blocked by forskolin injection, suggesting other mechanisms might exist. Consequently, exploration for other potential mechanisms that might contribute to the lactate-induced mitochondria content increase was conducted. We found an increase in the contents of lactate-related metabolites in skeletal muscle mitochondria after acute lactate injection (the p-value of each analysis is less than 0.05). LHDA was also validated to exist in mitochondria in this study. These results provide a possibility for metabolism-related mechanisms of lactate-induced mitochondria content increase. Future study is needed to validate this hypothesis. In conclusion, lactate-induced intramuscular triglyceride accumulation is achieved by inhibition of lipolysis, and this process is regulated by the cAMP-PKA pathway. Promoted lipogenesis also contributes to lactate-induced triglyceride accumulation, and this process might also be regulated by the cAMP-PKA pathway. Lactate injection might increase mitochondria content and cAMP-PKA pathway might have a limited contribution, while other metabolism-related mechanisms might play a prominent role.

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Higher Levels of Triglyceride, Fatty Acid Translocase, and Toll-Like Receptor 4 and Lower Level of HDL-C in Pregnant Women with GDM and Their Close Correlation with Neonatal Weight

Cited by 11 publications

References 24 publications

Comparison of Insulin, Metformin, and Glyburide on Perinatal Complications of Gestational Diabetes Mellitus: A Systematic Review and Meta-Analysis

Comparison of Insulin, Metformin, and Glyburide on Perinatal Complications of Gestational Diabetes Mellitus: A Systematic Review and Meta-Analysis

Association of LEPTIN and other inflammatory markers with preeclampsia: A systematic review

The Role of cAMP-PKA Pathway in Lactate-Induced Intramuscular Triglyceride Accumulation and Mitochondria Content Increase in Mice

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