scholarly journals FGF21 Serum Levels in the Early Second Trimester Are Positively Correlated With the Risk of Subsequent Gestational Diabetes Mellitus: A Propensity-Matched Nested Case-Control Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Zhiheng Wang ◽  
Min Yuan ◽  
Chengjie Xu ◽  
Yang Zhang ◽  
Chunmei Ying ◽  
...  

BackgroundAs an important endocrine hormone regulating glucose metabolism, fibroblast growth factor 21 (FGF21) is increased in individuals with gestational diabetes mellitus (GDM) after 24 gestational weeks. However, it is unknown whether the increase in FGF21 precedes the diagnosis of GDM.MethodsIn this nested case-control study, 133 pregnant women with GDM and 133 pregnant women with normal glucose tolerance (NGT) were identified through propensity score matching, and serum FGF21 levels were measured at 14 to 21 gestational weeks, before GDM is routinely identified. The differences in FGF21 levels were compared. The association between FGF21 and the occurrence of GDM was evaluated using logistic regression models with adjustment for confounders.ResultsThe serum FGF21 levels of the GDM group at 14 to 21 gestational weeks were significantly higher than those of the NGT group overall (P < 0.001), with similar results observed between the corresponding BMI subgroups (P < 0.05). The 2nd (OR 1.224, 95% CI 0.603–2.485), 3rd (OR 2.478, 1.229–5.000), and 4th (OR 3.419, 95% CI 1.626–7.188) FGF21 quartiles were associated with greater odds of GDM occurrence than the 1st quartile after multivariable adjustments.ConclusionsThe serum FGF21 levels in GDM groups increased in the early second trimester, regardless of whether participants were stratified according to BMI. After adjusting for confounding factors, the FGF21 levels in the highest quartile were associated with more than three times higher probability of the diagnosis of GDM in the pregnancy as compared to levels in the first quartile.

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e025908 ◽  
Author(s):  
Maëlle Dandjinou ◽  
Odile Sheehy ◽  
Anick Bérard

ObjectivesThe aim of this study was to determine the association between antidepressant (AD) classes, types and duration of use during pregnancy and the risk of gestational diabetes mellitus (GDM).Design and settingA nested case–control study was conducted within the Quebec Pregnancy Cohort (QPC), a Canadian provincial database which includes data on all pregnancies and children in Quebec from January 1998 to December 2015.Primary outcome measuresGestational diabetes mellitus.ParticipantsCases of GDM were identified after week 20 of pregnancy and randomly matched 1:10 to controls on gestational age at index date (ie, calendar date of GDM) and year of pregnancy. AD exposure was assessed by filled prescriptions between the beginning of pregnancy (first day of last menstrual period) and index date. Conditional logistic regression models were used to estimate crude and adjusted odds ratios (aOR).ResultsAmong 20 905 cases and 209 050 matched controls, 9741 (4.2%) women were exposed to ADs. When adjusting for potential confounders, AD use was associated with an increased risk of GDM (aOR 1.19, 95% CI 1.08 to 1.30); venlafaxine (aOR 1.27, 95% CI 1.09 to 1.49) and amitriptyline (aOR 1.52, 95% CI 1.25 to 1.84) were also associated with an increased risk of GDM. Moreover, the risk of GDM was increased with longer duration of AD use, specifically for serotonin norepinephrine reuptake inhibitors, tricyclic ADs and combined use of two AD classes. No statistically significant association was observed for selective serotonin reuptake inhibitors.ConclusionThe findings suggest that ADs—and specifically venlafaxine and amitriptyline—were associated with an increased risk of GDM.


2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Elnaz Daneshzad ◽  
Hatav Tehrani ◽  
Nick Bellissimo ◽  
Leila Azadbakht

Background. Elevated oxidative stress status has been reported among pregnant women with gestational diabetes mellitus (GDM). In diabetic condition, glucose and lipid peroxidation, and alteration in antioxidant defense lead to increased free radicals. The objective of this study was to investigate the association between dietary total antioxidant capacity (DTAC) and GDM. Methods. This hospital-based case-control study was conducted in 463 pregnant women (healthy, n=263; GDM, n=200). Anthropometric indices, blood pressure, and biochemical analyses were measured. Dietary intake was assessed by the average of three 24-hour dietary intake records. DTAC was calculated by three indices: ferric reducing ability of plasma (FRAP), total radical-trapping antioxidant parameter (TRAP), and Trolox equivalent antioxidant capacity (TEAC). Multivariable logistic regression was performed to examine the relationship between DTAC and GDM risk in crude and adjusted models. Results. The mean age and BMI were 28.33±6.23 years and 29.67±4.73 kg/m2, respectively. Total energy, protein, and selenium intakes were significantly higher in cases than controls (P<0.05). Moreover, intakes of carbohydrate, vitamins C, B6, and A, manganese, fruits, fruit juices, vegetables, legumes, and FRAP were significantly lower in cases than controls (P<0.05). The risk of gestational diabetes mellitus was 85% lower among those in the highest tertile of FRAP (OR: 0.15; 95% CI: 0.08-0.29). There was no significant association between the risk of GDM and TRAP (OR: 1.62; 95% CI: 0.94-2.79) as well as TEAC (OR: 1.56; 95% CI: 0.89-2.72). Conclusion. Pregnant women who were in the highest tertile of FRAP were at lower risk of GDM. However, larger prospective studies are needed to confirm our findings.


Author(s):  
Parichehr Pooransari ◽  
Atefeh Ebrahimi ◽  
Nataliya Nazemi ◽  
Fariba Yaminifar ◽  
Zhila Abediasl

Background: The relation of placental gross morphology and the outcome of pregnancies complicated with diabetes mellitus in comparison with healthy pregnancies is not known. Identifying significant differences in pregnancy outcomes in Gestational Diabetes Mellitus (GDM) and healthy pregnancies by the means of morphologic measurements can induce the use of antenatal ultrasonography of placental parameters to predict pregnancy outcomes. Objective: This study aimed to evaluate the relationship between placental morphological parameters of the placenta and cord and the outcomes of pregnancies complicated with diabetes mellitus. Materials and Methods: In this case-control study, which was conducted at two referral perinatology center in Tehran between March 2017 and November 2018, 60 pregnant women with GDM who were controlled with either diet or insulin as the case group and 60 pregnant women without GDM as the control group were enrolled. The study population were selected from patients who had their prenatal care and delivery in Mahdieh and Shohadaye Tajrish Hospital. The data was collected by taking sickness history, using data from patients files, and measuring of placental and newborn parameters after delivery. GDM was diagnosed either by 75 gr or 100 gr oral glucose tolerance tests. Placenta parameters, umbilical cord features, and newborn outcomes were compared between the two groups. Results: Placental weight, diameter, number of lobes, thickness, placental weight tonewborn weight ratio, place of umbilical cord insertion, length, coiling, and diameter of the umbilical cord are similar in two groups. Newborn weight, NICU admission, ABG, and Apgar score are also the same in well-controlled GDM pregnancy and pregnancy without GDM. Conclusion: Good controlled GDM causes no difference in placental gross morphology and pregnancy outcome compared to a healthy pregnancy. Key words: Placenta, Umbilical cord, Gestational diabetes mellitus.


2019 ◽  
Author(s):  
Lei Liu ◽  
Jiajin Hu ◽  
Ningning Wang ◽  
Yang Liu ◽  
Xiaotong Wei ◽  
...  

Abstract Background: Gestational diabetes mellitus (GDM) is a growing global epidemic. Our study aims to confirm the association between circulatory coiled-coil domain-containing 80 (CCDC80) in pregnant women with GDM, to investigate the discriminatory power of CCDC80 on GDM, and to explore the relationships between this molecular level and clinical cardiometabolic parameters. Methods: A 1:2 matched case-control study with 61 GDM patients and 122 controls was conducted using a propensity score matching protocol. All participants were screened from a multicenter prospective pre-birth cohort: Born in Shenyang Cohort Study (BISCS). During 24 and 28 weeks of gestation, follow-up individuals underwent an oral glucose tolerance test (OGTT) and blood sampling for cardiometabolic characterization. Results: Following propensity score matching adjustment for clinical variables, including maternal age, gestational age, body mass index, SBP and DBP, plasma CCDC80 levels were significantly decreased in patients with GDM when compared with controls (0.25±0.10 vs. 0.31±0.12 ng/ml, P =0.003). Conditional multi-logistic regression analyses after adjustments for potential confounding factors revealed that CCDC80 was a strong and independent protective factor for GDM (ORs <1). In addition, the results of the ROC analysis indicated the CCDC80 exhibited the capability to identify pregnant women with GDM (AUC=0.633). Finally, multivariate regression analyses showed that CCDC80 levels were positively associated with AST, monoamine oxidase, complement C1q, LDL-C, apolipoprotein A1and B, and negatively associated with blood glucose levels at 1 h post- OGTT. Conclusions: Biomarker CCDC80 could be of great value for the development of prediction, diagnosis and therapeutic strategies against GDM in pregnant women.


2021 ◽  
Author(s):  
Peng Tang ◽  
Jun Liang ◽  
Qian Liao ◽  
Huishen Huang ◽  
Xiaojing Guo ◽  
...  

Abstract A growing number of epidemiologic studies have estimated the associations between endocrine-disrupting chemicals and gestational diabetes mellitus (GDM). However, reports on the association between bisphenol A (BPA) substitutes and GDM are limited. This investigation aimed to explore the associations of maternal serum BPA, bisphenol B (BPB), bisphenol F (BPF), bisphenol S (BPS), and tetrabromobisphenol A (TBBPA) with the risk of GDM. A nested case-control study was performed among 500 pregnant women. Associations between the serum bisphenol levels and the risk of GDM were assessed by conditional logistic regression analysis and two-mixture modeling approaches (Bayesian kernel machine regression [BKMR] and quantile g-computation). BPA and TBBPA were negatively associated with the risk of GDM in the adjusted models, respectively. Intermediate BPS levels were associated with increased odds (OR: 1.84; 95% CI: 1.04, 3.27) of GDM compared with the low concentration groups only based on the single-bisphenol models. Associations between BPA, BPS, and TBBPA with the risk of GDM were also found in the BKMR analysis. The quantile g-computation (OR: 0.55; 95% CI: 0.43, 0.69) and BKMR models revealed a statistically significant and negative joint effect of the five bisphenols on the risk of GDM. This study demonstrates the association between exposure to BPS with the increased risk of GDM. In addition, exposure to BPA and TBBPA were associated with the reduced risk of GDM. Moreover, exposure to the mixture of the five bisphenols was negatively associated with the risk of GDM.


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