Maternal triglyceride levels and newborn weight in pregnant women with normal glucose tolerance

Cianni, Graziano Di; Miccoli, Roberto; Volpe, L; Lencioni, Cristina; Ghio, Alessandra; Giovannitti, M. G.; Cuccuru, Ilaria; Pellegrini, Giovanni; Chatzianagnostou, Kyriazoula; Boldrini, Antonio; Prato, Stefano Del

doi:10.1111/j.1464-5491.2004.01336.x

Cited by 222 publications

(169 citation statements)

References 31 publications

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“…Moreover, lipid profiles for OAV and GDM are not distinguishable. High triglyceride concentrations have been previously reported in women with GDM (24,25). The same is true for women with OAV, whose triglyceride levels were higher than those for women with NGT and similar to those for women with GDM, suggesting that similar pathogenetic mechanisms (i.e., impaired insulin action) may be at work in both conditions.…”

Section: Discussionsupporting

confidence: 58%

Normal Glucose Tolerance and Gestational Diabetes Mellitus

et al. 2007

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OBJECTIVE -The aim of this article was to define the metabolic phenotype of pregnant women with one abnormal value (OAV) during an oral glucose tolerance test (OGTT) and to test whether OAV could be considered metabolically comparable to gestational diabetes mellitus (GDM) or a specific entity between GDM and normal pregnancy. RESEARCH DESIGN AND METHODS-After 100-g 3-h OGTTs, 4,053 pregnant women were classified as having GDM, OAV, or normal glucose tolerance (NGT). Those with OAV were subdivided into three subgroups: fasting hyperglycemia (one abnormal value at fasting during an OGTT), 1-h hyperglycemia (one abnormal value at 1 h during an OGTT [1h-OAV]), or 2-or 3-h hyperglycemia (one abnormal value at 2 or 3 h during an OGTT). As derived from the OGTT, we measured insulin sensitivity (insulin sensitivity index [ISI] Matsuda) and insulin secretion (homeostasis model assessment for the estimation of ␤-cell secretion [HOMA-B], first-and second-phase insulin secretion). The product of the first-phase index and the ISI was calculated to obtain the insulin secretion-sensitivity index (ISSI).RESULTS -GDM was diagnosed in 17.9% and OAV in 18.7% of pregnant women; women with GDM and OAV were older and had higher BMI and serum triglyceride levels than those with NGT (all P Ͻ 0.05). Women with NGT had the highest ISI followed by those with OAV (Ϫ21.7%) and GDM (Ϫ32.1%). HOMA-B results were comparable with those for OAV and GDM but significantly (P Ͻ 0.01) lower than those for NGT; first-and second-phase insulin secretion appeared progressively reduced from that in women with NGT to that in women with OAV and GDM (P Ͻ 0.01). ISSI was higher in women with NGT than in women with either OAV (Ϫ34%) or GDM (Ϫ51.7%) (P Ͻ 0.001). Among OAV subgroups, the 1h-OAV subgroup showed the lowest ISSI (P Ͻ 0.05).CONCLUSIONS -OAV and GDM are clinically indistinguishable, and both groups are different from women with NGT. Women with GDM and OAV showed impaired insulin secretion and insulin sensitivity, although these defects are more pronounced in women with GDM. Compared with other OAV subgroups, 1h-OAV could be considered a more severe condition.

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Section: Discussionsupporting

confidence: 58%

Normal Glucose Tolerance and Gestational Diabetes Mellitus

et al. 2007

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“…In women with preexisting diabetes, elevated maternal triglycerides and low HDL-C in the third trimester are associated with an increased risk of LGA infants (15). In GDM, maternal triglyceride levels measured post-oral glucose tolerance testing correlate with birth weight to the same extent as 1-and 2-h glucose measures (30). Further, in women with good glycemic control, maternal fasting free fatty acids and triglycerides at oral glucose tolerance test and delivery are independently related to the rate of LGA (7,28).…”

Section: Maternal Obesitymentioning

confidence: 78%

Normalizing Metabolism in Diabetic Pregnancy: Is It Time to Target Lipids?

et al. 2014

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Outcomes in pregnancies complicated by preexisting diabetes (type 1 and type 2) and gestational diabetes mellitus have improved, but there is still excess morbidity compared with normal pregnancy. Management strategies appropriately focus on maternal glycemia, which demonstrably improves pregnancy outcomes for mother and infant. However, we may be reaching the boundaries of obtainable glycemic control for many women. It has been acknowledged that maternal lipids are important in pregnancies complicated by diabetes. Elevated maternal lipids are associated with preeclampsia, preterm delivery, and large-forgestational-age infants. Despite this understanding, assessment of management strategies targeting maternal lipids has been neglected to date. Consideration needs to be given to whether normalizing maternal lipids would further improve pregnancy outcomes. This review examines the dyslipidemia associated with pregnancy complicated by diabetes, reviews possible therapies, and considers whether it is time to start actively managing this aspect of maternal metabolism.Although rates of adverse outcomes in pregnancies complicated by preexisting diabetes (type 1 and type 2) and gestational diabetes mellitus (GDM) have improved, there is still excess maternal and fetal morbidity compared with normal pregnancy. Current management strategies focus on maternal glycemic control, which demonstrably improves pregnancy outcomes for mother and infant. Truly "normal" glucose levels in pregnancy appear lower than previously thought (1) and achieving currently recommended glucose targets in pregnancy carries a risk of hypoglycemia (2). The challenges in reaching glycemic targets before and after conception raise the question of whether other aspects of maternal metabolism could potentially be addressed to provide benefit to mother and infant.Multiple maternal metabolic, hormonal, and inflammatory factors other than maternal glucose are associated with maternal and fetal outcomes and are altered in pregnancies complicated by prepregnancy diabetes and GDM. These include maternal amino acids, glycerol, ketones, and lipids (3). Lipid management in diabetes is acknowledged as a key therapeutic target in the nonpregnant setting. However, it has not been accorded the same attention in pregnancy. Abnormal maternal lipids in pregnancy have been associated with preeclampsia (4,5), preterm delivery (6), and large-forgestational-age (LGA) infants (7). This review examines the dyslipidemia associated with pregnancy complicated by diabetes, reviews possible therapies, and considers whether there is sufficient evidence to start actively managing lipids in pregnancy. LIPID METABOLISM IN PREGNANCYMaternal metabolism is designed to provide adequate nutrition for fetal growth, in the form of glucose, ketones, lipids, and other fuels. In early pregnancy, maternal

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“…There is compelling evidence that factors in addition to lifestyle (such as excessive energy intake, HFD, low physical activity) contribute to obesity. Recent work suggests that maternal weight and TAG levels before pregnancy are highly correlated with excessive fetal growth (16)(17)(18)(19) . Recent work in the rat indicates that maternal nutritional history predicts obesity in adult offspring independent of postnatal diet (20) .…”

Section: Developmental Origin Of Adult Health and Diseasementioning

confidence: 99%

Nutritional developmental epigenomics: immediate and long-lasting effects

2010

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The phenotype of an individual is the result of complex interactions between genome, epigenome and current, past and ancestral environment leading to a lifelong remodelling of the epigenomes. The genetic information expression contained in the genome is controlled by labile chromatin-associated epigenetic marks. Epigenetic misprogramming during development is widely thought to have a persistent effect on the health of the offspring and may even be transmitted to the next generation. The epigenome serves as an interface between the environment and the genome. Dietary factors, including folate involved in C 1 metabolism, and other social and lifestyle exposures have a profound effect on many aspects of health including ageing and do so, at least partly, through interactions with the genome, which result in altered gene expression with consequences for cell function and health throughout the life course. Depending on the nature and intensity of the environmental insult, the critical spatiotemporal windows and developmental or lifelong processes involved, epigenetic alterations can lead to permanent changes in tissue and organ structure and function or to phenotypic changes that can (or cannot) be reversed using appropriate epigenetic tools. Moreover, the flexibility of epigenetic marks may make it possible for environmental, nutritional and hormonal factors or endocrine disruptors to alter, during a particular spatiotemporal window in a sex-specific manner, the sex-specific methylation or demethylation of specific CpG and/or histone modifications underlying sex-specific expression of a substantial proportion of genes. Moreover, genetic factors, the environment and stochastic events change the epigenetic landscape during the lifetime of an individual. Epigenetic alterations leading to gene expression dysregulation accumulate during ageing and are important in tumorigenesis and age-related diseases. Several encouraging trials suggest that prevention and therapy of age-and lifestyle-related diseases by individualised tailoring to optimal epigenetic diets or drugs are conceivable. However, these interventions will require intense efforts to unravel the complexity of these epigenetic, genetic and environment interactions and to evaluate their potential reversibility with minimal side effects.

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Maternal triglyceride levels and newborn weight in pregnant women with normal glucose tolerance

Cited by 222 publications

References 31 publications

Normal Glucose Tolerance and Gestational Diabetes Mellitus

Normal Glucose Tolerance and Gestational Diabetes Mellitus

Normalizing Metabolism in Diabetic Pregnancy: Is It Time to Target Lipids?

Nutritional developmental epigenomics: immediate and long-lasting effects

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