Early Subclinical Atherosclerosis in Gestational Diabetes: The Predictive Role of Routine Biomarkers and Nutrigenetic Variants

Gestational diabetes mellitus (GDM) can be considered a silent risk for out-of-pregnancy diabetes mellitus (DM) and cardiovascular disease (CVD) later in life. We aimed to assess the predictive role of 3rd trimester lipid profile during pregnancy for the susceptibility to markers of subclinical atherosclerosis (CVD susceptibility) at 3 years in a cohort of women with history of GDM. A secondary aim is to evaluate the usefulness of novel nutrigenetic markers, in addition to traditional parameters, for predicting early subclinical atherosclerosis in such women in order to plan adequate early prevention interventions. We assessed 28 consecutive GDM women in whom we collected socio-demographic characteristics and clinical and anthropometric parameters at the 3rd trimester of pregnancy. In a single blood sample, from each patient, we assessed 9 single nucleotide polymorphisms (SNPs) from 9 genes related to nutrients and metabolism, which were genotyped by High Resolution Melting analysis. All women then attended a 3-year-postpartum follow-up and on that occasion performed an oral glucose tolerance test (OGTT, with 75 g oral glucose), the measurement of carotid artery intima-media thickness (cIMT), and analyses of metabolic parameters. In addition, we evaluated the physical activity level and the adherence to Mediterranean diet (MedDiet) using the International Physical Activity Questionnaire (IPAQ-short version) and PREDIMED questionnaires. We found an association between 3rd trimester triglycerides and cIMT (p=0.014). We also found significant associations between the APOA5 CC genotype and cIMT after adjustments for age and body mass index (p=0.045) and between the interaction CC APOA5/CC LDLR and cIMT (p=0.010). At the follow-up, the cohort also featured a mean BMI in the overweight range and a high mean waist circumference. We found no difference in the MedDiet adherence, physical activity, and smoking but an inverse correlation between the PREDIMED and the IPAQ scores with the IMT. In conclusion, this preliminary study provides insight into the predictive role of lipid profile during pregnancy and of some genetic variants on cIMT taken as a parameter of subclinical CVD susceptibility in GDM.

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Gestational Diabetes Mellitus: Perspectives on Lifestyle Changes during Pregnancy and Post-partum, Physical Activity and the Prevention of Future Type 2 Diabetes

Australian Journal of Primary Health ◽

10.1071/py08040 ◽

2008 ◽

Vol 14 (3) ◽

pp. 85 ◽

Cited By ~ 12

Author(s):

Frances Doran

Keyword(s):

Physical Activity ◽

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Post Partum ◽

Oral Glucose ◽

The Impact

This paper reports on a mixed methods study which sought to explore the role of physical activity in relation to the management of gestational diabetes mellitus (GDM); the impact of a diagnosis of GDM on a woman?s life; follow-up support and factors that both hinder and support women to engage in physical activity post-partum in order to reduce their risk of developing future type 2 diabetes. Thirty-eight women who had a pregnancy complicated by GDM completed surveys. In-depth interviews were then conducted with a subset of eight women who completed these surveys, to further explore their experiences. Women reported making changes to their lifestyle to improve diet and engage in physical activity during pregnancy. These changes were harder to sustain after the baby was born. In this study few women underwent the recommended six-weekly oral glucose tolerance testing, and post-partum follow-up support was virtually non-existent. There is a clear role for health promotion across a number of sectors to support sustained behaviour change in this high-risk group of women. Factors are identified that could enhance follow-up support, particularly for lifestyle change.

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Abstract P281: All-cause and Cardiovascular Mortality in Men With High Levels of Physical Activity and Coronary Artery Calcification

Circulation ◽

10.1161/circ.137.suppl_1.p281 ◽

2018 ◽

Vol 137 (suppl_1) ◽

Author(s):

Laura F Defina ◽

Nina B Radford ◽

David Leonard ◽

Stephen W Farrell ◽

Andjelka Pavlovic ◽

...

Keyword(s):

Physical Activity ◽

Coronary Artery ◽

Coronary Artery Calcification ◽

Proportional Hazards ◽

Subclinical Atherosclerosis ◽

Activity Level ◽

Mortality Hazard ◽

Hazard Ratios ◽

All Cause Mortality

Introduction: Recent studies have suggested that extreme levels of physical activity (endurance athletes) are associated with subclinical atherosclerosis as well as increased mortality. The safety of continuing high levels of physical activity is uncertain once coronary artery calcification (CAC) is discovered. Hypothesis: We hypothesized that men performing &ge3000 MET·minutes/week of physical activity would have greater all-cause and cardiovascular (CV) mortality compared to those with &lt1500 or 1500-&lt3000 MET·minutes/week of physical activity and that mortality risk would be greater in those with CAC&ge100 compared to &lt100 Agatston units. Methods: The cohort studied included 16,109 men without prevalent CV disease who reported physical activity levels and underwent EBT or MDCT scan. Physical activity was categorized into &ge3000 (n=1,266), 1500-3000 (n=3,027), and &lt1500 (n=11,816) MET·minutes/week. CAC scanning included EBT scans (1997-2007) or MDCT scans (2007-2013), and CAC score was categorized into &ge100 (n=3,547) and &lt100 (n=12,562) Agatston units. We fit separate proportional hazards regression models to follow-up times for all-cause and CV mortality. The models included all combinations of CAC and physical activity categories and were adjusted for baseline age, smoking, BMI, cholesterol, HDLc, and systolic blood pressure. Results: The average age of participants at baseline was 51.3±8.3 years. Men with the highest activity level had a lower BMI and higher HDLc. After an average follow-up of 8.9 years, there were 329 all-cause and 60 CV deaths, including 174 all-cause and 38 CV deaths in those with CAC&ge100. The sample had 80% power to detect all-cause mortality hazard ratios &ge 1.9 and 1.8 for physical activity &ge3000 versus &lt1500 in those with CAC&lt100 and &ge100, respectively. The corresponding minimum detectable CV mortality hazard ratios were 3.5 and 2.8. Comparing physical activity &ge3000 to &lt1500 in those with CAC&ge100, the hazard ratios (95% CI) were 0.9 (0.5, 1.5) for all-cause mortality and 0.9 (0.3, 3.1) for CV mortality. Hazard ratios were similar when comparing physical activity &ge3000 to 1500-&lt3000 in those with CAC &ge100. Finally, when comparing physical activity categories, there was no evidence that hazard ratios varied by CAC category, p&gt0.7. Conclusions: This sample offers no evidence that levels of activity &ge3000 MET·minutes/week are associated with increased all-cause or CV mortality compared to those with &lt1500 or 1500- &lt3000 MET·minutes/week, regardless of CAC level.

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Incidence of Risk Factors on the Onset of Gestational Diabetes Mellitus

International Journal on Measurement Technologies and Instrumentation Engineering ◽

10.4018/ijmtie.2012070102 ◽

2012 ◽

Vol 2 (3) ◽

pp. 8-22

Author(s):

E. De Franchis ◽

A. Ferramosca ◽

V. Zara ◽

L. Piper

Keyword(s):

Physical Activity ◽

Diabetes Mellitus ◽

Risk Factors ◽

Family History ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Close Association ◽

Tolerance Test ◽

Oral Glucose ◽

Total Period

In this study the authors evaluated the prevalence of Gestational Diabetes Mellitus (GDM) and the incidence in determining the occurrence thereof, given by the following risk factors: age, family history for Diabetes Mellitus (DM), Body Mass Index (BMI), smoking, diet, macrosomia in previous pregnancies and physical activity. To this end, they investigated a cohort of 61 pregnant women, who had at least one risk factor, in a total period of nine months, during which women checked in the Clinic of Endocrinology and Diabetology of the Hospital “F. Ferrari” in Casarano (Lecce) Italy, and were subjected to an anamnestic investigation and then to a diagnostic test (Oral Glucose Tolerance Test, OGTT 75 g). The anamnesis has allowed to identify the type of risk factors that are present in the population, while the OGTT has allowed to diagnose gestational diabetes. Later, an analysis of the cross-collected data was performed in order to evaluate the percentage incidence of the disease, in relation to risk factors observed. The authors’ results confirmed a prevalence of GDM of 26.23% and the existence of a close association between risk factors and GDM. In particular, the risk factors, macrosomia, BMI = 25 kg/m2, a hypercaloric diet, light physical activity, and age = 35 years, seem to have more influence than smoking and family history for DM, inducing the onset of the illness.

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Physical activity level in women with gestational diabetes mellitus: Lifestyle INtervention for Diabetes prevention After pregnancy (LINDA‐Brasil) study

Journal of Diabetes ◽

10.1111/1753-0407.12872 ◽

2018 ◽

Vol 11 (6) ◽

pp. 457-465

Author(s):

Leony M. Galliano ◽

Anelita H. M. Del Vecchio ◽

Juliana Silvani ◽

Cristina Façanha ◽

Fabrício B. Del Vecchio

Keyword(s):

Physical Activity ◽

Diabetes Mellitus ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Lifestyle Intervention ◽

Physical Activity Level ◽

Diabetes Prevention ◽

Activity Level

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The important role of physical activity in the prevention and management of gestational diabetes mellitus

Diabetes/Metabolism Research and Reviews ◽

10.1002/dmrr.2402 ◽

2013 ◽

Vol 29 (5) ◽

pp. 334-346 ◽

Cited By ~ 42

Author(s):

Stephanie-May Ruchat ◽

Michelle F. Mottola

Keyword(s):

Physical Activity ◽

Diabetes Mellitus ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus

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Lipid Profile in Pregnant Women with and without Gestational Diabetes Mellitus: A Case-Control Study

hormozgan medical journal ◽

10.5812/hmj.102063 ◽

2020 ◽

Vol In Press (In Press) ◽

Author(s):

Zeynab Farsangi ◽

Ghazal Zoghi ◽

Masoumeh Kheirandish ◽

Roghayeh Shahbazi ◽

Masoumeh Mahmoudi ◽

...

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Pregnant Women ◽

Lipid Profile ◽

Gestational Age ◽

Demographic Data ◽

Density Lipoprotein ◽

Tolerance Test ◽

Oral Glucose

Background: Gestational diabetes mellitus (GDM), the most common metabolic disorder of pregnancy, is associated with alterations in circulating lipids. Objectives: The aim of this study was to compare lipid profiles in women with and without GDM. Methods: This study was performed on 84 pregnant women at 26 - 30 weeks of gestation (42 pregnant women with GDM as cases and 42 healthy pregnant women as controls). After obtaining informed consent and gathering demographic data, subjects underwent a 75 g oral glucose tolerance test, and lipid profile was also measured in all subjects. Results: We found that high-density lipoprotein (HDL) levels were significantly higher in the GDM group (53.10 ± 1.72 vs. 46.64 ± 1.70 mg/dL, P = 0.008). Total cholesterol (228.96 ± 52.03 vs. 211.59 ± 41.83 mg/dL) and triglyceride (TG) levels (225.58 ± 89.84 vs 208.38 ± 80.66 mg/dL) were also higher in the GDM group; however, the differences were not statistically significant (P = 0.770 and P = 0.327, respectively). On the contrary, low-density lipoprotein was found to be non-significantly higher in the healthy group (144.54 ± 26.01 vs 122.41 ± 4.82 mg/dL, P = 0.709). Besides, there was a significant association between HDL levels and GDM (OR 1.049; CI 95% (1.009 - 1.090), P = 0.015). This association remained significant when adjusted for age, BMI, and gestational age (OR 1.010; CI 95% (1.002 - 1.017), P = 0.009). No significant association was found between GDM and TG, cholesterol, and LDL levels. Conclusions: HDL levels are significantly higher in pregnant women with GDM compared to pregnant women without GDM. HDL level is significantly associated with GDM even after adjustment for age, BMI, and gestational age.

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Associations of dietary habits, physical activity and cognitive views with gestational diabetes mellitus among Chinese women

Public Health Nutrition ◽

10.1017/s1368980013001882 ◽

2013 ◽

Vol 17 (8) ◽

pp. 1850-1857 ◽

Cited By ~ 5

Author(s):

Qing Li ◽

Ribo Xiong ◽

Liang Wang ◽

Junying Cui ◽

Linna Shi ◽

...

Keyword(s):

Physical Activity ◽

Diabetes Mellitus ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Dietary Habits ◽

Chinese Women ◽

Multiple Logistic Regression Analysis ◽

Oral Glucose ◽

Morning Sickness ◽

Increased Risk

AbstractObjectiveTo evaluate the relationship between dietary habits, physical activity and cognitive views and the risk of gestational diabetes mellitus (GDM) in Chinese women.DesignA cross-sectional study to explore the potential risk factors of GMD through the International Physical Activity Questionnaire, an FFQ and a self-designed structured questionnaire, respectively.SettingGuangzhou, Guangdong Province, China.SubjectsChinese pregnant women (n 571) who underwent a 75-g oral glucose tolerance test at their 24th to 28th gestational week.ResultsThirteen per cent of the investigated women were identified as having GDM, and an increased intake of local featured foods and lower physical activity were observed in the GDM-positive group v. the GDM-negative group. Women who regarded early-pregnancy morning sickness as relevant to fetal abnormalities and those with unlimited dietary intake after the ending of morning sickness both had an increased risk for GDM (P = 0·018 and P = 0·038, respectively). After multiple logistic regression analysis, cognitive views for unlimited food intake subsequent to morning sickness, increased consumption of energy-dense snack foods and high-glycaemic-index fruits were strongly associated with the risk of GDM (OR = 1·911, P = 0·032; OR = 1·050, P = 0·001; and OR = 1·002, P = 0·017, respectively).ConclusionsLocal featured foods and incorrect cognitive views on pregnancy-related health were closely related to the risk of GDM in Chinese women. Intensive health education about pregnancy physiology and reasonable dietary and physical exercise behaviours should be strengthened for the control of GDM.

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Prospective of study of gestational diabetes mellitus risk in relation to maternal recreation physical activity before and after pregnancy

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20183270 ◽

2018 ◽

Vol 6 (8) ◽

pp. 2785

Author(s):

Sukesh R. S. ◽

Laxmy Rajmohan

Keyword(s):

Physical Activity ◽

Diabetes Mellitus ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Challenge Test ◽

Control Group ◽

Case Group ◽

Oral Glucose ◽

Family History Of Diabetes ◽

Pregnant Females

Background: Gestational diabetes mellitus is common complications of pregnancy. Physical activity is associated with a lower risk of type 2 diabetes mellitus. The present study aimed to know association between physical activity and gestational diabetes mellitus in the first 20 weeks of their pregnancy.Methods: In the current case-control study, 50 pregnant females with gestational diabetes mellitus as the case group and 50 pregnant females as control group were selected. To diagnose gestational diabetes mellitus using diagnostic criteria. Females with abnormal oral glucose challenge test (>140mg/dL) were asked to perform the three-hour 100 g oral glucose tolerance test. The details of physical activity were collected by pregnancy physical activity questionnaire. Anthropometric and other data were recorded for all of the participants.Results: Females with low total physical activity at early pregnancy were at a significantly higher risk of developing gestational diabetes mellitus compared to the ones with higher levels of physical activity. After adjusting for age, body mass index (BMI), gravidity and a family history of diabetes, females with low physical activity during 20 weeks of pregnancy were at a significantly higher risk of developing gestational diabetes mellitus. Females with the low intensity of sedentary, light and moderate physical activity are at a higher risk of developing gestational diabetes mellitus compared to females with a higher intensity of sedentary, light and moderate physical activity.Conclusions: Females should be encouraged to do regular daily physical activity during pregnancy, if there is no specific contraindication to it.

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