Preconception dilemma for women with obesity: Is it worth waiting to lose weight?

Kim, Helen H.

doi:10.1016/j.fertnstert.2020.10.033

Cited by 2 publications

(1 citation statement)

References 4 publications

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“…Reducing body weight prior to conception is strongly advocated across multiple national guidelines for women with obesity, although the evidence of bene t remains equivocal [22]. Deferring pregnancy until optimal body weight is achieved is di cult as pregnancy and windows of fertility are time sensitive [23]. We have shown that pre-pregnancy administration of the GLP-1RA, liraglutide, can facilitate weight loss and improve fertility in a mouse model of maternal obesity [24].…”

Section: Introductionmentioning

confidence: 99%

Kidney outcomes are altered by preconception weight modulation in rodent mothers with obesity

Rodrigo,

Chen,

Pollock

et al. 2023

Preprint

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Obesity increases the risk of chronic kidney disease in the mother. We have previously demonstrated the benefits of preconception maternal weight loss on fertility and pregnancy outcomes in a mouse model of maternal obesity. In this study, we aimed to determine if preconception weight loss, either by diet modification or the glucose-like peptide 1 agonist liraglutide, improves maternal kidney outcomes in late gestation. C57BL/6 female mice were fed either a high-fat-diet (HFD) or a standard chow (control) diet for 8 weeks. To induce pre-pregnancy weight loss, HFD-fed dams were either switched to a chow diet pre-pregnancy (4 weeks before mating, HFD-C) or administered liraglutide (0.3mg/kg subcutaneous, for 4weeks) whilst continuing on HFD (HFD-L). Liraglutide was discontinued one week prior to mating. HFD-V mice continued on HFD, with saline injections. Finally, a group of HFD-fed dams were ‘diet switched’ to a chow diet after conception (i.e., post-conception, HFD-PC). Maternal body weight and glucose tolerance were measured at two time points: prior to pregnancy and during late gestation followed by blood, urine and kidney collection. Serum creatinine, urinary creatinine and albumin, and kidney tissue gene expression and protein were measured. In the preconception period, the HFD-L and HFD-C mothers had lower urine albumin: creatinine ratios (UACR) and fatty acid synthase (FAS) protein expression (both P < 0.005 vs HFD-V). At late gestation, the kidneys of HFD-V and HFD-PC dams had increased gene expression of insulin receptor and FAS (both P < 0.05) and higher UACR compared to controls (P < 0.01). In the HFD-PC group, the kidneys showed increased mRNA and protein expression of metabolic and oxidative stress markers (FAS, 8-OHdG vs control, P < 0.05, P < 0.0001 respectively). The preconception intervention groups with liraglutide, or diet change showed reduced renal oxidative stress markers (protein expression of 8-OHdG, P < 0.05 vs HFD), mRNA and protein expression of FAS (P < 0.05 vs HFD), protein expression of fibrosis markers (collagen IV, fibronectin vs HFD, P < 0.05), and UACR (P < 0.05 vs HFD). Preconception weight loss benefits maternal kidney health during pregnancy, superior to diet intervention once pregnancy is established. This study suggests that pre-pregnancy weight reduction is necessary to optimise kidney outcomes in maternal obesity.

show abstract

Section: Introductionmentioning

confidence: 99%

Kidney outcomes are altered by preconception weight modulation in rodent mothers with obesity

Rodrigo,

Chen,

Pollock

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

Kidney outcomes are altered by preconception weight modulation in rodent mothers with obesity

Rodrigo,

Chen,

Pollock

et al. 2024

Sci Rep

View full text Add to dashboard Cite

Obesity increases the risk of chronic kidney disease. We have previously demonstrated the benefits of preconception maternal weight loss on fertility and pregnancy outcomes in a mouse model of maternal obesity. Here, we elucidate if preconception weight loss, either by diet modification or the glucose-like peptide 1 agonist liraglutide, used in the treatment of diabetes and obesity, improves maternal kidney outcomes in late gestation. C57BL/6 female mice were fed either a high-fat-diet (HFD) or a chow (control) diet for 8 weeks. To induce pre-pregnancy weight loss, HFD-fed dams were switched to chow diet (HFD-C) or administered liraglutide (0.3 mg/kg subcutaneous) whilst continuing on HFD (HFD-L). Liraglutide was discontinued one week prior to mating. HFD-V mice continued on HFD, with saline injections. A group of HFD-fed dams were ‘diet switched’ to chow after conception (post-conception, HFD-PC). Maternal body weight and glucose tolerance were measured: (1) preconception and (2) during late gestation followed by blood, urine and kidney collection. Serum creatinine, urinary creatinine and albumin, kidney tissue gene expression and protein were measured. In the preconception period, HFD-L and HFD-C mothers have lower urine albumin:creatinine ratios (UACR) and fatty acid synthase (FAS) protein expression (P < 0.005 vs. HFD-V). At late gestation, kidneys of HFD-V and HFD-PC dams have increased gene expression of insulin receptor and FAS (P < 0.05) and higher UACR compared to controls (P < 0.01). In the HFD-PC group, kidneys show increased mRNA and protein expression of metabolic and oxidative stress markers (FAS, 8-OHdG vs. control, P < 0.05, P < 0.0001 respectively). The preconception intervention groups with liraglutide, or diet change show reduced oxidative stress (protein expression of 8-OHdG, P < 0.05 vs. HFD), mRNA and protein expression of FAS (P < 0.05 vs. HFD), protein expression of fibrosis markers (collagen IV, fibronectin vs. HFD, P < 0.05), and UACR (P < 0.05 vs. HFD). This study suggests that preconception weight loss benefits maternal kidney health during pregnancy, superior to diet intervention once already pregnant.

show abstract

Preconception dilemma for women with obesity: Is it worth waiting to lose weight?

Cited by 2 publications

References 4 publications

Kidney outcomes are altered by preconception weight modulation in rodent mothers with obesity

Kidney outcomes are altered by preconception weight modulation in rodent mothers with obesity

Kidney outcomes are altered by preconception weight modulation in rodent mothers with obesity

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