Mediterranean Diet for the Prevention of Gestational Diabetes in the Covid-19 Era: Implications of Il-6 In Diabesity

The aim of this review is to highlight the influence of the Mediterranean Diet (MedDiet) on Gestational Diabetes Mellitus (GDM) and Gestational Weight Gain (GWG) during the COVID-19 pandemic era and the specific role of interleukin (IL)-6 in diabesity. It is known that diabetes, high body mass index, high glycated hemoglobin and raised serum IL-6 levels are predictive of poor outcomes in coronavirus disease 2019 (COVID-19). The immunopathological mechanisms of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection include rising levels of several cytokines and in particular IL-6. The latter is associated with hyperglycemia and insulin resistance and could be useful for predicting the development of GDM. Rich in omega-3 polyunsaturated fatty acids, vitamins, and minerals, MedDiet improves the immune system and could modulate IL-6, C reactive protein and Nuclear Factor (NF)-κB. Moreover, polyphenols could modulate microbiota composition, inhibit the NF-κB pathway, lower IL-6, and upregulate antioxidant enzymes. Finally, adhering to the MedDiet prior to and during pregnancy could have a protective effect, reducing GWG and the risk of GDM, as well as improving the immune response to viral infections such as COVID-19.

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C-Reactive Protein and Gestational Diabetes: The Central Role of Maternal Obesity

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2003-030186 ◽

2003 ◽

Vol 88 (8) ◽

pp. 3507-3512 ◽

Cited By ~ 148

Author(s):

Ravi Retnakaran ◽

Anthony J. G. Hanley ◽

Nuryt Raif ◽

Philip W. Connelly ◽

Mathew Sermer ◽

...

Keyword(s):

Gestational Diabetes ◽

Maternal Obesity ◽

C Reactive Protein ◽

Reactive Protein

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Dietary fiber and blueberry intervention lowers gestational weight gain and C-reactive protein in women at high risk for gestational diabetes

Metabolism ◽

10.1016/j.metabol.2019.12.063 ◽

2020 ◽

Vol 104 ◽

pp. 154117 ◽

Cited By ~ 1

Author(s):

Arpita Basu ◽

James Alexander ◽

Jeffrey Ebersole ◽

Petar Planinic

Keyword(s):

Weight Gain ◽

High Risk ◽

Gestational Diabetes ◽

Dietary Fiber ◽

Gestational Weight Gain ◽

C Reactive Protein ◽

Reactive Protein ◽

Gestational Weight

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Role of C-reactive Protein(CRP) or high-sensitivity CRP in predicting gestational diabetes Mellitus:Systematic review

Diabetes & Metabolic Syndrome Clinical Research & Reviews ◽

10.1016/j.dsx.2020.02.004 ◽

2020 ◽

Vol 14 (3) ◽

pp. 229-236 ◽

Cited By ~ 2

Author(s):

Azam Amirian ◽

Fatemeh Alsadat Rahnemaei ◽

Fatemeh Abdi

Keyword(s):

Gestational Diabetes ◽

High Sensitivity ◽

C Reactive Protein ◽

Reactive Protein

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Implications of inflammation and insulin resistance in obese pregnant women with gestational diabetes: A case study

SAGE Open Medical Case Reports ◽

10.1177/2050313x19843737 ◽

2019 ◽

Vol 7 ◽

pp. 2050313X1984373

Author(s):

Ebtisam Aziz Al-ofi

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Insulin Resistance ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Polycystic Ovary ◽

High Body Mass Index ◽

C Reactive Protein ◽

Ovary Syndrome ◽

Reactive Protein

Background: Obesity is one of the leading pregnancy risks for both the mother and the neonate. The prevalence of gestational diabetes mellitus has been increasing, especially with the increase in obesity in reproductive-aged women. A high body mass index, a sedentary lifestyle, a previous macrosomic infant, polycystic ovary syndrome and hypothyroidism are the main risk factors for gestational diabetes mellitus. Early gestational diabetes mellitus detection in high-risk individuals is a useful method for preventing further complications and/or preventing this disease by improving the patient’s lifestyle. Case presentation: A morbidly obese woman with a high body mass index (>36) at 24 weeks gestational age presented with several gestational diabetes mellitus risk factors. Her glucose tolerance test verified gestational diabetes mellitus, and, incidentally, her C-reactive protein level was elevated without obvious reason. Her plasma levels of inflammatory cytokines had also been assessed and were exaggerated. After lifestyle intervention, including weight management, the patient’s inflammatory mediators, including her C-reactive protein level, dropped. Therefore, this study aimed to identify the relationship between the patient’s inflammation and obesity. Conclusion: Antenatal C-reactive protein screening could be used throughout pregnancy to predict inflammation from high-risk pregnant women. This case scenario describes the interrelationships between inflammation, insulin resistance and adipokines, as well as the contributions of hypothyroidism and polycystic ovary syndrome. Further research should emphasise the relationships between inflammation and obesity in pregnancy.

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Role of First Trimester Sex Hormone-Binding Globuline and High-Sensitivity C-Reactive Protein in Predicting Gestational Diabetes Mellitus

Journal of Academic Research in Medicine ◽

10.5152/jarem.2019.2309 ◽

2019 ◽

Vol 9 (3) ◽

pp. 130-134

Author(s):

Nurane Dikova ◽

◽

Suat Karatas ◽

Ayse Ender Yumru ◽

Burcu Dincgez Cakmak ◽

...

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

High Sensitivity ◽

First Trimester ◽

Sex Hormone ◽

Hormone Binding ◽

C Reactive Protein ◽

Reactive Protein

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Complementary Effects of Multivitamin and Omega-3 Fatty Acid Supplementation on Indices of Cardiovascular Health in Individuals with Elevated Homocysteine

International Journal for Vitamin and Nutrition Research ◽

10.1024/0300-9831/a000093 ◽

2012 ◽

Vol 82 (1) ◽

pp. 41-52 ◽

Cited By ~ 5

Author(s):

P. Earnest ◽

S. Kupper ◽

M. Thompson ◽

Guo ◽

S. Church

Keyword(s):

Risk Factors ◽

Cardiovascular Health ◽

Omega 3 Fatty Acids ◽

Omega 3 ◽

C Reactive Protein ◽

Fatty Acid Supplementation ◽

Omega 3 Fatty Acid ◽

Reactive Protein ◽

Daily Ingestion

Homocysteine (HCY), C-reactive protein (hsCRP), and triglycerides (TG) are risk factors for cardiovascular disease (CVD). While multivitamins (MVit) may reduce HCY and hsCRP, omega-3 fatty acids (N3) reduce TG; yet, they are seldom studied simultaneously. We randomly assigned 100 participants with baseline HCY (> 8.0 umol/L) to the daily ingestion of: (1) placebo, (2) MVit (VitC: 200 mg; VitE: 400 IU; VitB6: 25 mg; Folic Acid: 400 ug; VitB12: 400 ug) + placebo, (3) N3 (2 g N3, 760 mg EPA, 440 mg DHA)+placebo, or (4) MVit + N3 for 12 weeks. At follow-up, we observed significant reductions in HCY (umol/L) for the MVit (- 1.43, 95 %CI, - 2.39, - 0.47) and MVit + N3 groups (- 1.01, 95 %CI, - 1.98, - 0.04) groups, both being significant (p < 0.05) vs. placebo (- 0.57, 95 %CI, - 1.49, 0.35) and N3 (1.11, 95 % CI, 0.07, 2.17). hsCRP (nmol/L) was significantly reduced in the MVit (- 6.00, 95 %CI, - 1.04, - 0.15) and MVit + N3 (- 0.98, 95 %CI, - 1.51, - 0.46) groups, but not vs. placebo (- 0.15, 95 %CI, - 0.74, 0.43) or N3 (- 0.53, 95 %CI, - 1.18, 0.12). Lastly, we observed significant reductions in TG for the N3 (- 0.41, 95 %CI, - 0.69, - 0.13) and MVit + N3 (- 0.71, 95 %CI, - 0.93, - 0.46) groups, both significant vs. placebo (- 0.10, 95 %CI, - 0.36, 0.17) and MVit groups (0.15, 95 %CI, - 12, 0.42). The co-ingestion of MVit + N3 provides synergistic affects on HCY, hsCRP, and plasma TG.

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