scholarly journals Diabetes in Pregnancy and MicroRNAs: Promises and Limitations in Their Clinical Application

2018 ◽  
Vol 4 (4) ◽  
pp. 32 ◽  
Author(s):  
Adriana Ibarra ◽  
Begoña Vega-Guedes ◽  
Yeray Brito-Casillas ◽  
Ana Wägner
Keyword(s):  
Gestational Diabetes ◽  
Maternal Diabetes ◽  
Long Term Outcomes ◽  
Pregnant Rats ◽  
Diagnostic Biomarkers ◽  
Obesity And Diabetes ◽  
Increased Risk ◽  
Short And Long Term

Maternal diabetes is associated with an increased risk of complications for the mother and her offspring. The latter have an increased risk of foetal macrosomia, hypoglycaemia, respiratory distress syndrome, preterm delivery, malformations and mortality but also of life-long development of obesity and diabetes. Epigenetics have been proposed as an explanation for this long-term risk, and microRNAs (miRNAs) may play a role, both in short- and long-term outcomes. Gestation is associated with increasing maternal insulin resistance, as well as β-cell expansion, to account for the increased insulin needs and studies performed in pregnant rats support a role of miRNAs in this expansion. Furthermore, several miRNAs are involved in pancreatic embryonic development. On the other hand, maternal diabetes is associated with changes in miRNA both in maternal and in foetal tissues. This review aims to summarise the existing knowledge on miRNAs in gestational and pre-gestational diabetes, both as diagnostic biomarkers and as mechanistic players, in the development of gestational diabetes itself and also of short- and long-term complications for the mother and her offspring.

scholarly journals Current Role of Surgery in Pancreatic Cancer With Synchronous Liver Metastasis

2020 ◽  
Vol 27 (1) ◽  
pp. 107327482097659
Author(s):  
Wentao Zhou ◽  
Dansong Wang ◽  
Wenhui Lou
Keyword(s):  
Pancreatic Cancer ◽  
Liver Metastasis ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Synchronous Liver Metastasis ◽  
Long Term Outcomes ◽  
Short And Long Term ◽  
Current Guidelines

Pancreatic cancer with synchronous liver metastasis has an extremely poor prognosis, and surgery is not recommended for such patients by the current guidelines. However, an increasing body of studies have shown that concurrent resection of pancreatic cancer and liver metastasis is not only technically feasible but also beneficial to the survival in the selected patients. In this review, we aim to summarize the short- and long-term outcomes following synchronous liver metastasectomy for pancreatic cancer patients, and discuss the potential criteria in selecting appropriate surgical candidates, which might be helpful in clinical decision-making.

scholarly journals The impact of gestational diabetes and maternal obesity on the mother and her offspring

2010 ◽  
Vol 1 (4) ◽  
pp. 208-215 ◽  
Author(s):  
P. M. Catalano
Keyword(s):  
Insulin Resistance ◽  
Gestational Diabetes ◽  
Glucose Intolerance ◽  
Maternal Obesity ◽  
Insulin Response ◽  
Obese Women ◽  
Increased Risk ◽  
Short And Long Term ◽  
The Impact

Thein uteromaternal metabolic environment is important relative to both short and long term development of the offspring. Although poor fetal growth remains a significant factor relative to long-term outcome, fetal overgrowth is assuming greater importance because of the increase in obesity in the world’s populations. Maternal obesity and gestational diabetes are the most common metabolic complications of pregnancy related to fetal overgrowth and more specifically adiposity.Women with gestational diabetes have increased insulin resistance and inadequate insulin response compared with weight-matched controls. Gestational diabetes increases the risk of maternal hypertensive disease (preeclampsia) as well as cesarean delivery. At birth the neonate has increased adiposity and is at risk for birth injury. Multiple studies have reported that children of women with gestational diabetes have a greater prevalence childhood obesity and glucose intolerance; even at glucose concentrations less than currently used to define gestational diabetes, compared with normoglycemic women.Obese women also have increased insulin resistance, insulin response and inflammatory cytokines compared with average weight women both before and during pregnancy. They too are at increased risk for the metabolic syndrome-like disorders during pregnancy that is hypertension, hyperlipidemia, glucose intolerance and coagulation disorders. Analogous to women with gestational diabetes, neonates of obese women are heavier at delivery because of increased fat and not lean body mass. Similarly, these children have an increased risk of childhood adiposity and metabolic dysregulation. Hence, the preconceptional and perinatal period offers a unique opportunity to modify both short and long term risks for both the woman and her offspring.

scholarly journals Adipose tissue function in healthy pregnancy, gestational diabetes mellitus and pre-eclampsia

2021 ◽  
Author(s):  
Cara Trivett ◽  
Zoe J. Lees ◽  
Dilys J. Freeman
Keyword(s):  
Diabetes Mellitus ◽  
Adipose Tissue ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Maternal Obesity ◽  
Sudden Onset ◽  
Healthy Pregnancy ◽  
Short And Long Term

AbstractGestational diabetes mellitus (GDM) is a common disorder of pregnancy with short- and long-term consequences for mother and baby. Pre-eclampsia is of major concern to obstetricians due to its sudden onset and increased morbidity and mortality for mother and baby. The incidence of these conditions continues to increase due to widespread maternal obesity. Maternal obesity is a risk factor for GDM and pre-eclampsia, yet our understanding of the role of adipose tissue and adipocyte biology in their aetiology is very limited. In this article, available data on adipose tissue and adipocyte function in healthy and obese pregnancy and how these are altered in GDM and pre-eclampsia are reviewed. Using our understanding of adipose tissue and adipocyte biology in non-pregnant populations, a role for underlying adipocyte dysfunction in the pathological pathways of these conditions is discussed.

scholarly journals The role of public health in addressing child maltreatment in Canada

2010 ◽  
Vol 31 (1) ◽  
pp. 39-44 ◽  
Author(s):  
SM Jack
Keyword(s):  
Public Health ◽  
Child Maltreatment ◽  
Surveillance Systems ◽  
Long Term Outcomes ◽  
Community Based Interventions ◽  
Community Based ◽  
Complex Issue ◽  
Short And Long Term

Child maltreatment is a significant health and social issue given its prevalence across the general population and the significant short- and long-term outcomes associated with maltreatment in childhood. There is a need for a comprehensive, collaborative and multisectoral approach for identification, prevention and intervention of this complex issue. Within this multisectoral collaboration, it is essential for public health in Canada to define its role in addressing and preventing child maltreatment. This commentary summarizes how public health can address the issue of child maltreatment in Canada by specifically: 1) measuring the magnitude of maltreatment through public health surveillance systems such as the Canadian Incidence Study of Reported Child Abuse and Neglect; 2) identifying modifiable risk factors; 3) identifying and evaluating community-based interventions to prevent violence; and 4) implementing evidence-based primary prevention strategies.

scholarly journals Leptin partially mediates the association between early-life nutritional supplementation and long-term glycemic status among women in a Guatemalan longitudinal cohort

2020 ◽  
Vol 111 (4) ◽  
pp. 804-813 ◽  
Author(s):  
Siran He ◽  
Ngoc-Anh Le ◽  
Manuel Ramirez-Zea ◽  
Reynaldo Martorell ◽  
K M Venkat Narayan ◽  
...  
Keyword(s):  
Early Life ◽  
Cell Function ◽  
Fasting Glucose ◽  
Mediation Effect ◽  
Glycemic Status ◽  
Glucose Lowering ◽  
Obesity And Diabetes ◽  
Increased Risk

ABSTRACT Background Early-life exposure to improved nutrition is associated with decreased risk of diabetes but increased risk of obesity. Leptin positively correlates with adiposity and has glucose-lowering effects, thus it may mediate the association of early-life nutrition and long-term glycemic status. Objectives We aimed to investigate the role of leptin in the differential association between early-life nutrition and the risks of obesity and diabetes. Methods We analyzed data from a Guatemalan cohort who were randomly assigned at the village level to receive nutritional supplements as children. We conducted mediation analysis to examine the role of leptin in the associations of early-life nutrition and adult cardiometabolic outcomes. Results Among 1112 study participants aged (mean ± SD) 44.1 ± 4.2 y, 60.6% were women. Cardiometabolic conditions were common: 40.2% of women and 19.4% of men were obese, and 53.1% of women and 41.0% of men were hyperglycemic or diabetic. Median (IQR) leptin concentration was 15.2 ng/mL (10.2–17.3 ng/mL) in women and 2.7 ng/mL (1.3–5.3 ng/mL) in men. Leptin was positively correlated with BMI (Spearman's ρ was 0.6 in women, 0.7 in men). Women exposed to improved nutrition in early life had 2.8-ng/mL (95% CI: 0.3, 5.3 ng/mL) higher leptin and tended to have lower fasting glucose (–0.8 mmol/L; –1.8, 0.2 mmol/L, nonsignificant) than unexposed women. There were no significant differences in leptin (–0.7 ng/mL; –2.1, 0.8 ng/mL) or fasting glucose (0.2 mmol/L; –0.5, 0.9 mmol/L) in men exposed to improved nutrition in early life compared with unexposed men. Leptin mediated 34.9% of the pathway between early-life nutrition and fasting glucose in women. The mediation in women was driven by improved pancreatic β-cell function. We did not observe the mediation effect in men. Conclusions Leptin mediated the glucose-lowering effect of early-life nutrition in women but not in men.

Association of lipoprotein(a) level with short- and long-term outcomes after CABG: The role of lipoprotein apheresis

2017 ◽  
Vol 30 ◽  
pp. 187-192 ◽  
Author(s):  
Marat V. Ezhov ◽  
Olga I. Afanasieva ◽  
Larisa N. Il'ina ◽  
Maya S. Safarova ◽  
Irina Yu. Adamova ◽  
...  
Keyword(s):  
Long Term Outcomes ◽  
Lipoprotein A ◽  
Lipoprotein Apheresis ◽  
Short And Long Term

Maternal diabetes, gestational diabetes and the role of epigenetics in their long term effects on offspring

2015 ◽  
Vol 118 (1-2) ◽  
pp. 55-68 ◽  
Author(s):  
Ronald C.W. Ma ◽  
Greg E. Tutino ◽  
Karen A. Lillycrop ◽  
Mark A. Hanson ◽  
Wing Hung Tam
Keyword(s):  
Gestational Diabetes ◽  
Maternal Diabetes ◽  
Long Term Effects ◽  
Diabetes Gestational
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