The alteration of metabolic profiling in the second trimester of GDM and high risk pregnancy, and a nomogram for predicting macrosomia

Abstract Objective Dyslipidemia in the second trimester and associated gestational diabetes are increasing worldwide. Carnitine plays a key role in lipid metabolism. We aim to describe metabolic profiling in the second trimester based on carnitine related metabolomics in GDM and high risk pregnancy, and to find the potential risk factors in GDM and candidate metabolites for diagnosing GDM induced macrosomia.Methods We have randomly investigated 450 pregnant women and their neonates in this retrospective study and 56 (12.4%) GDM cases were diagnosed. We used LC-MS/MS performing metabolic profiling about 12 amino acids and 31 acylcarnitines (containing C0) to assess circulating metabolites concentration in different subgroup according maternal and newborn clinical characteristic. We also calculated the correlation coefficient between maternal and newborn. GDM potential metabolic risk factors were screened by PLS-DA. Multivariate regression analyses were used in identifying independent risk factors for GDM and macrosomia. Based on these carnitine-related factors, a nomogram for estimating macrosomia was developed.Results We found 14 AA (Ala, Arg, Met, BCAA, AAA) and AC (C0, C2, C3, C4DC+C5OH, C5, C16, C18, C18:1) were increased in Age > 35 group, BMI ≥ 30, weight gain > 20 kg group, using assistant reproductive technology group, but the level of C0, Gly were decreased. In fetal clinical data, we obtained AA and AC level in fetuses are higher than their mothers and the metabolic trend was similar with maternal result. PLS-DA showed 15 metabolism(C0, LEU+ILE+PRO-OH, Phe, C18, TYR, etc)play main roles in class separation of GDM. Multivariate analysis showed pre-pregnancy BMI, weight gain, LEU+ILE+PRO-OH, TYR, C0/acylcarnitine, C0, C3, C16, C18 are independent risk factors associated with GDM. Finally, we developed a nomogram predicting macrosomia based on carnitine-related metabolic variables.Conclusion Metabolomics was proved as a powerful tool in identifying the metabolic alteration during the second trimester. These metabolic risk factors in GDM may help understanding of the underlying biochemical pathology of GDM and help physician diagnosing macrosomia.

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Role of second trimester uterine artery doppler for the prediction of preeclampsia in high risk pregnancy

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20190855 ◽

2019 ◽

Vol 8 (3) ◽

pp. 906

Author(s):

Madhuri Thakur ◽

Reeti Mehra

Keyword(s):

Risk Factors ◽

High Risk ◽

Uterine Artery ◽

High Risk Pregnancy ◽

Second Trimester ◽

Uterine Artery Doppler ◽

Risk Pregnancy ◽

Doppler Study ◽

Doppler Indices

Background: The uterine artery Doppler has potentials for screening for complications of impaired placentation. The purpose of study was to assess the role of uterine artery color Doppler waveform analysis in second trimester for the prediction of preeclampsia in a high-risk pregnancy between 18-24 weeks of gestation.Methods: 100 women with moderate or high-risk factors for developing preeclampsia reporting to Obstetrics and Gynaecology department of Government Medical College and Hospital, Sector 32, Chandigarh were enrolled for present study. Transabdominal uterine artery doppler measurements was done at 18-24weeks of gestation in these patients. Doppler . The Doppler indices generated automatically from the machine , the Pulsatility Index (PI), Resistance Index (RI) , presence or absence of diastolic notch and S/D Ratio were recorded, and average was calculated.Results: Out of 100 patients there were 46 primigravidas with no additional risk factors, 22 pateints with two or more risk factors and there were no patients who had three or more risk factors in present study population. Preeclampsia is seen more commonly in primigravida and primigravida is considered as moderate risk factor for preeclampsia. It was found that an elevated second trimester uterine artery RI was significantly associated with developing preeclampsia later in pregnancy. The sensitivity and specificity of uterine artery Doppler velocimetry were found to be 84% and 55% respectively. Receiver operator characteristics (ROC) curves were created to demonstrate the prognostic value of RI and PI of uterine artery doppler indices at 18-24 weeks of gestation for the development preeclampsia. In addition, there were statistically significant positive correlations between mean RI of uterine artery doppler study and patients who developed preeclampsia. With a sensitivity of 84.21% it could identify 31% of the cases of preeclampsia at a false positive rate of 44.4%.Conclusions: Uterine artery doppler study can be used as a predictor of moderate strength for preeclampsia.

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Gestational weight gain in normal weight women and offspring cardio-metabolic risk factors at 20 years of age

International Journal of Obesity ◽

10.1038/ijo.2014.179 ◽

2014 ◽

Vol 39 (4) ◽

pp. 671-676 ◽

Cited By ~ 24

Author(s):

L Hrolfsdottir ◽

D Rytter ◽

S F Olsen ◽

B H Bech ◽

E Maslova ◽

...

Keyword(s):

Risk Factors ◽

Weight Gain ◽

Gestational Weight Gain ◽

Normal Weight ◽

Metabolic Risk Factors ◽

Metabolic Risk ◽

Gestational Weight

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Cardio-Metabolic Benefits of Walnuts in Type 2 Diabetes Mellitus: A Literature Review

European Medical Journal ◽

10.33590/emj/21-00070 ◽

2021 ◽

pp. 111-124

Author(s):

Valentine Y Njike ◽

Genevieve Cecile Kela ◽

Nisar Khan ◽

Rockiy Ayettey ◽

Maxime Tindong ◽

...

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Type 2 Diabetes ◽

At Risk ◽

Type 2 Diabetes Mellitus ◽

Weight Gain ◽

Glycaemic Control ◽

Metabolic Risk Factors ◽

Metabolic Risk

Diabetes and its complications are main causes of morbidity and mortality among adults in the USA. An increase in the number of individuals with diabetes is primarily attributed to changes in dietary patterns including increased consumption of obesogenic foods and beverages. Many individuals who are overweight and obese show signs of insulin resistance and are at increased risk of Type 2 diabetes mellitus (T2DM) and cardiovascular disease. Lifestyle interventions (i.e., physical activity and nutrition) are the cornerstone of T2DM management and prevention. Prior research attests to the health benefits of consuming nuts, which have a substantial amount of mono- and polyunsaturated fatty acids, for individuals at risk for or with T2DM, and walnuts appear to be particularly promising. Walnuts are rich in nutrients, minerals, antioxidants, and vitamins that can contribute to improved cardio-metabolic risk factors in individuals at risk for or with T2DM. This review assesses the cardio-metabolic benefits of walnuts in T2DM. The authors’ review indicates that the reported effects of walnuts on glycaemic control have been inconclusive, with several studies showing association with improved glycaemic control while others show no effect. Despite their high energy density and potential to contribute to weight gain, the authors’ review suggests that walnuts can contribute to satiety without association with weight gain. This review also suggests that walnut consumption has been associated with improved low-density lipoprotein cholesterol levels and endothelial function but has not been associated with blood pressure improvement. Meta-analyses are warranted to quantitatively assess impact of walnut consumption on these cardio-metabolic risk factors in T2DM.

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Cardio-metabolic risk factors among healthcare staff: a cross-sectional study at the hospitals in six cities of Ukraine dedicated to World Heart Day 2020

European Journal of Preventive Cardiology ◽

10.1093/eurjpc/zwab061.213 ◽

2021 ◽

Vol 28 (Supplement_1) ◽

Author(s):

I Sulska ◽

L Mishchenko ◽

A Sorokolietova ◽

M Hordina ◽

S Zhulinska

Keyword(s):

Risk Factors ◽

Family History ◽

High Risk ◽

Smoking Status ◽

Cross Sectional Study ◽

Metabolic Risk Factors ◽

Modifiable Risk Factors ◽

Metabolic Risk ◽

Sectional Study ◽

Cross Sectional

Abstract Funding Acknowledgements Type of funding sources: None. Background. There is a little information on the prevalence of cardio-metabolic risk factors in the Ukrainian medical staff. The aim of investigation was to determine the abundance of certain risk factors for cardiovascular (CV) diseases among the medical personnel in the six cities of Ukraine, a study dedicated to World Heart Day 2020. Purpose. To establish the presence of cardio-metabolic risk factors among medical workers in Ukraine. Materials and methods. A hospital-based cross-sectional study including 471 participants (415 female and 56 male) between the age of 19 and 79 years surveyed. The cardio-metabolic risk markers assessed were non-modifiable risk factors (family history) and modifiable risk factors (obesity, hypertension, dyslipidemia, diabetes, prediabetes, smoking status). The prevalence of hypertension (HTN) estimated by ESC 2018 recommendations, diabetes and prediabetes by ADA 2019, ESC 2019 and body mass index WHO criteria for obesity classifications. Using standard methods were assessed: fasting glucose concentration, glycosylated hemoglobin (HbA1c) and blood lipids (total cholesterol, LDL-C, triglycerides, HDL-C). Results The median age of participants was 53,3 ± 11,77 years. Positive smoking status reported by 66 persons (14,0%). Analysis of family history showed that 51,4% of the participants had of HTN, 14,9% of myocardial infarction and 25,1% of stroke. The prevalence of modifiable risk factors: HTN registered in 51,4% cases. Around 34,8% of participants were overweight, and 34,6% were obese, 70,7% had waist circumference more than 94 cm (men) and > 80 cm (woman). Prediabetes glycemic levels and diabetes incidence were 42,8% and 12,6%, accordingly. Atherogenic dyslipidemia estimated by increased level of LDL-C more than 4,9 mmol/l, which determinate high risk of CV disorders, estimated in 13,6% participants. Also high triglycerides levels were defined as those of at least 2,3 mmol/l were in 14,9%. Low level of aerobic activity (less than 150 min in week) had 33,4% participants. 30,7% of participants older than 40 years presented high CV risk and 23,9% were in very high risk. Conclusion. Cardio-metabolic risk factors prevail among medical workers in Ukraine. The results point to the relevance of public health recommendations to contribute lifestyle changes and early identification of risk factors for prevention of CV outcomes.

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Yoga’s effect on inflammatory biomarkers and metabolic risk factors in a high risk population – a controlled trial in primary care

BMC Cardiovascular Disorders ◽

10.1186/s12872-015-0086-1 ◽

2015 ◽

Vol 15 (1) ◽

Cited By ~ 5

Author(s):

Moa Wolff ◽

Ashfaque A. Memon ◽

John P. Chalmers ◽

Kristina Sundquist ◽

Patrik Midlöv

Keyword(s):

Risk Factors ◽

Primary Care ◽

High Risk ◽

Controlled Trial ◽

Metabolic Risk Factors ◽

Inflammatory Biomarkers ◽

High Risk Population ◽

Metabolic Risk ◽

Risk Population

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A Good Way to Reduce Screening for Retinopathy of Prematurity: Development of the ROP Model in a China Preterm Population

Frontiers in Pediatrics ◽

10.3389/fped.2021.697690 ◽

2021 ◽

Vol 9 ◽

Author(s):

Wenqian Ding ◽

Chenghan Luo ◽

Xinru Cheng ◽

Zanyang Shi ◽

Mengyuan Lei ◽

...

Keyword(s):

Risk Factors ◽

Mechanical Ventilation ◽

Weight Gain ◽

High Risk ◽

Invasive Mechanical Ventilation ◽

Gain Rate ◽

Independent Risk Factors ◽

High Risk Infants ◽

Weight Gain Rate ◽

Rop Screening

Importance: Retinopathy of prematurity (ROP) is a preventable cause of blindness in children. Without treatment, more than 45% of eyes may suffer permanent vision loss. Current ROP screening guidelines, which include a range of birth weights (BWs) and gestational ages (GAs), may require screening many low-risk preemies who might develop severe ROP.Method: All high-risk infants in the neonatal intensive care unit (NICU) of the First Affiliated Hospital of Zhengzhou University from 2017 to 2021 were included in this retrospective cohort study. Each of the 27 candidate risk factors was evaluated in univariate analysis and adjusted for known risk factors (i.e., GA and BW). The significant results were analyzed in a backward selection multivariate logistic regression model. Receiver operating characteristic (ROC) curves and a nomogram were drawn.Results: The study included 2,040 infants who underwent ROP screening. The weight gain rate [OR, 2.65; 95% confidence interval (CI), 1.49–1.21 ≤ 12 g/d vs. > 18 g/d; P = 0.001], blood transfusion (OR, 2.03; 95% CI, 1.14–3.64; P = 0.017), invasive mechanical ventilation (OR, 1.74; 95% CI, 1.15–2.66; P = 0.009) and N-terminal segment of pro-B-type natriuretic peptide (NT-proBNP) ≥ 25,000 ng/L (OR, 1.51; 95% CI, 1.00–2.28; P = 0.048) were four new statistically independent risk factors in addition to GA and BW. The area under the curve (AUC) of the final multivariate model was 0.90 (95% CI, 0.88–0.92; P < 0.001).Conclusions and Relevance: These findings add to our understanding of ROP screening because they include all eligible infants rather than only high-risk infants, as in previous studies. Under the control of BW and GA, low weight gain rate, increased number of blood transfusion, invasive mechanical ventilation and NT-proBNP ≥ 25,000 ng/L were “new” statistically independent risk factors for ROP. The ROP risk can be calculated manually or represented by a nomogram for clinical use.

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