scholarly journals Capillary Triglycerides in Late Pregnancy—Challenging to Measure, Hard to Interpret: A Cohort Study of Practicality

Nutrients ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 1266
Author(s):  
Helen L. Barrett ◽  
Marloes Dekker Nitert ◽  
Michael D’Emden ◽  
Barbara Lingwood ◽  
Susan de Jersey ◽  
...  
Keyword(s):  
Cohort Study ◽  
Gestational Diabetes ◽  
Home Monitoring ◽  
Area Under The Curve ◽  
Late Pregnancy ◽  
High Fat ◽  
Before And After ◽  
Capillary Glucose ◽  
Carbohydrate Meal ◽  
At Home

Background: Maternal triglycerides are increasingly recognised as important predictors of infant growth and fat mass. The variability of triglyceride patterns during the day and their relationship to dietary intake in women in late pregnancy have not been explored. This prospective cohort study aimed to examine the utility of monitoring capillary triglycerides in women in late pregnancy. Methods: Twenty-nine women (22 with gestational diabetes (GDM) and 7 without) measured capillary glucose and triglycerides using standard meters at home for four days. On two of those days, they consumed one of two standard isocaloric breakfast meals: a high-fat/low-carbohydrate meal (66% fat) or low fat/high carbohydrate meal (10% fat). Following the standard meals, glucose and triglyceride levels were monitored. Results: Median capillary triglycerides were highly variable between women but did not differ between GDM and normoglycaemic women. There was variability in capillary triglycerides over four days of home monitoring and a difference in incremental area under the curve for capillary triglycerides and glucose between the two standard meals. The high-fat standard meal lowered the incremental area under the curve for capillary glucose (p < 0.0001). Fasting (rho 0.66, p = 0.0002) and postpradial capillary triglycerides measured at home correlated with venous triglyceride levels. Conclusions: The lack of differences in response to dietary fat intake and the correlation between capillary and venous triglycerides suggest that monitoring of capillary triglycerides before and after meals in pregnancy is unlikely to be useful in the routine clinical practice management of women with gestational diabetes mellitus.

scholarly journals Combined accelerometer and genetic analysis to differentiate essential tremor from Parkinson’s disease

PeerJ ◽  
2018 ◽  
Vol 6 ◽  
pp. e5308 ◽  
Author(s):  
Bhuvan Molparia ◽  
Brian N. Schrader ◽  
Eli Cohen ◽  
Jennifer L. Wagner ◽  
Sandeep R. Gupta ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Essential Tremor ◽  
Simple Procedure ◽  
Home Monitoring ◽  
Area Under The Curve ◽  
Community Setting ◽  
Diagnostic Procedures ◽  
Polygenic Risk Score ◽  
At Home

Essential tremor (ET) and Parkinson’s disease (PD) are among the most common adult-onset tremor disorders. Clinical and pathological studies suggest that misdiagnosis of PD for ET, and vice versa, occur in anywhere from 15% to 35% of cases. Complex diagnostic procedures, such as dopamine transporter imaging, can be powerful diagnostic aids but are lengthy and expensive procedures that are not widely available. Preliminary studies suggest that monitoring of tremor characteristics with consumer grade accelerometer devices could be a more accessible approach to the discrimination of PD from ET, but these studies have been performed in well-controlled clinical settings requiring multiple maneuvers and oversight from clinical or research staff, and thus may not be representative of at-home monitoring in the community setting. Therefore, we set out to determine whether discrimination of PD vs. ET diagnosis could be achieved by monitoring research subject movements at home using consumer grade devices, and whether discrimination could be improved with the addition of genetic profiling of the type that is readily available through direct-to-consumer genetic testing services. Forty subjects with PD and 27 patients with ET were genetically profiled and had their movements characterized three-times a day for two weeks through a simple procedure meant to induce rest tremors. We found that tremor characteristics could be used to predict diagnosis status (sensitivity = 76%, specificity = 65%, area under the curve (AUC) = 0.75), but that the addition of genetic risk information, via a PD polygenic risk score, did not improve discriminatory power (sensitivity = 80%, specificity = 65%, AUC = 0.73).

scholarly journals Metabolic flexibility during late pregnancy is associated with neonatal adiposity

2021 ◽  
Vol 46 (4) ◽  
pp. 404-407
Author(s):  
Rachel A. Tinius ◽  
Maire M. Blankenship ◽  
Karen E. Furgal ◽  
W. Todd Cade ◽  
Cathryn Duchette ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Late Pregnancy ◽  
Metabolic Flexibility ◽  
Maternal Body Mass Index ◽  
High Fat ◽  
Before And After ◽  
Registration Number ◽  
Clinical Trail ◽  
Neonatal Adiposity

The aim of this study was to determine the relationships between maternal metabolic flexibility during pregnancy and neonatal health outcomes. Percent change in lipid oxidation (before and after a high-fat meal) was calculated as the measure of “metabolic flexibility”. Neonatal adiposity was assessed within 48 h of delivery by skinfold anthropometry. Metabolic flexibility (r = −0.271, p = 0.034), maternal HOMA-IR (r = 0.280, p = 0.030), and maternal body mass index (r = 0.299, p = 0.018) were correlated with neonatal subscapular skinfold (i.e., measure of neonatal adiposity). Clinical Trail Registration Number: NCT03504319. Novelty: This is the first study to link maternal metabolic flexibility, body mass index, and insulin resistance during pregnancy to neonatal adiposity at parturition.

scholarly journals Simple and non-invasive screening method for diabetes based on myoinositol levels in urine samples collected at home

2020 ◽  
Vol 8 (1) ◽  
pp. e000984
Author(s):  
Misaki Takakado ◽  
Yasunori Takata ◽  
Fumio Yamagata ◽  
Michiko Yaguchi ◽  
Go Hiasa ◽  
...  
Keyword(s):  
Test Meal ◽  
Screening Method ◽  
Area Under The Curve ◽  
Tolerance Test ◽  
Urine Samples ◽  
Oral Glucose ◽  
Operating Characteristics ◽  
Non Invasive ◽  
Before And After ◽  
At Home

ObjectiveTo establish a simple screening method for diabetes based on myoinositol (MI) in urine samples collected at home.Research design and methodsInitially, we evaluated the stability of urinary MI (UMI) at room temperature (RT; 25°C) and 37°C in 10 outpatients with type 2 diabetes. We then enrolled 115 volunteers without a current or history of diabetes. In all subjects, glucose intolerance was diagnosed by 75 g oral glucose tolerance test (75gOGTT). To assess the association between UMI or urine glucose (UG) and plasma glucose (PG), urine samples were also collected at 0 and 2 hours during 75gOGTT. All the subjects collected urine samples at home before and 2 hours after consuming the commercially available test meal. UMI levels at wake-up time (UMIwake-up), before (UMIpremeal) and 2 hours after the test meal (UMI2h-postprandial) were measured using an enzymatic method. ΔUMI was defined as UMI2h-postprandial minus UMIpremeal.ResultsDiffering from UG, UMI was stable at RT and 37°C. UMI was increased linearly along with an increase in PG, and no threshold for UMI was observed. UMI was closely associated with blood glucose parameters obtained from a 75gOGTT and hemoglobin A1c (HbA1c) at hospital after adjustment for age, sex, body mass index and serum creatinine. UMIwake-up, UMIpremeal, UMI2h-postprandial and ΔUMI at home were higher in diabetic subjects than non-diabetic subjects even after the above adjustment. Receiver operating characteristics curve (ROC) analyses revealed that for the screening of diabetes, the area under the curve for ROC for UMI2h-postprandial and ΔUMI (0.83 and 0.82, respectively) were not inferior to that for HbA1c ≥48 mmol/mol, which is the American Diabetes Association (ADA) criteria for diabetes.ConclusionsMI measurement in urine samples collected at home before and after the meal would be a simple, non-invasive and valuable screening method for diabetes.

306. PREDICTING GESTATIONAL DIABETES FROM MATERNAL ANGIOTENSIN II AND ANGIOTENSIN 1–7 LEVELS AT 15 WEEKS GESTATION

2010 ◽  
Vol 22 (9) ◽  
pp. 106
Author(s):  
S. D. Sykes ◽  
E. R. Lumbers ◽  
K. G. Pringle ◽  
T. Zakar ◽  
G. A. Dekker ◽  
...  
Keyword(s):  
Angiotensin Ii ◽  
Gestational Diabetes ◽  
Area Under The Curve ◽  
Renin Angiotensin System ◽  
Late Pregnancy ◽  
Early Gestation ◽  
Disease Marker ◽  
Increased Risk ◽  
Unit Increase ◽  
Plasma Angiotensin

Gestational diabetes (GD), a pregnancy complication defined by glucose intolerance with onset during pregnancy, is a condition affecting 5.5%–8.8% of Australian pregnancies1. Untreated GD increases perinatal mortality and babies from GD pregnancies have an increased risk of diabetes and obesity, whilst mothers have an increased risk of type II diabetes later in life1. Circulating levels of angiotensin 1–7 (Ang1–7), a peptide of the renin angiotensin system, have been reported to be reduced in third trimester pregnancies with GD2. The effects of Ang1–7 generally oppose those of angiotensin II (AngII) and it is possible that in early gestation pro-angiogenic functions of AngII are counterbalanced by Ang1–7, causing placental insufficiency and pregnancy complications. We wanted to determine the predictive capability of AngII and Ang1–7, in early gestation, for GD. Healthy nulliparous pregnant women from the Adelaide SCOPE cohort with GD (n = 36) or serving as controls (n = 131) had both peptides measured at 15 weeks using an RIA (D. Casley, Prosearch Pty. Ltd.) on EDTA treated plasma. A predictive model was constructed using logistic regression and area under the curve after ROC analysis (AROC, Table 1). AngII did not change the model and was omitted. This model shows that for every one unit increase of Log (Ang1–7 pg/mL) peptide levels the odds of acquiring GD increase five times, suggesting that Ang1–7 levels in early gestation may be a better disease marker than those seen at late pregnancy. (1) Hoffman L, Nolan C, Wilson JD, et al., 1998. Gestational diabetes mellitus – management guidelines. The Australasian Diabetes in Pregnancy Society. Med. J. Aust. 169, 93–97.(2) Nogueira AI, Santos RAS, Simoes e Silva AC, et al., 2007. The pregnancy-induced increase of plasma angiotensin-(1–7) is blunted in gestational diabetes. Regul. Pep., 141, 55–60.

scholarly journals Pregnancy outcomes of early detected gestational diabetes: a retrospective comparison cohort study, Qatar

BMJ Open ◽  
2019 ◽  
Vol 9 (2) ◽  
pp. e023612 ◽  
Author(s):  
Mohammed Bashir ◽  
Khaled Baagar ◽  
Emad Naem ◽  
Fadi Elkhatib ◽  
Noor Alshaybani ◽  
...  
Keyword(s):  
Cohort Study ◽  
Gestational Diabetes ◽  
Pregnancy Outcomes ◽  
Optimal Time ◽  
Early Screening ◽  
Glucose Levels ◽  
Retrospective Comparison ◽  
Increased Risk ◽  
Before And After ◽  
The Impact

ObjectiveTo compare pregnancy outcomes in patients with early versus usual gestational diabetes mellitus (GDM).DesignA retrospective cohort study.SettingsThe Women’s Hospital, Hamad Medical Corporation, Qatar.ParticipantsGDM women who attended and delivered in the Women’s Hospital, between January and December 2016. GDM was diagnosed based on the 2013-WHO criteria. The study included 801 patients; of which, 273 E-GDM and 528 U-GDM. Early GDM (E-GDM) and usual GDM (U-GDM) were defined as GDM detected before and after 24 weeks’ gestation, respectively.OutcomesMaternal and neonatal outcomes and the impact of timing of GDM-diagnosis on pregnancy outcomes.ResultsAt conception, E-GDM women were older (mean age 33.5±5.4 vs 32.0±5.4 years, p<0.001) and had higher body mass index (33.0±6.3 vs 31.7±6.1 kg/m2, p=0.0059) compared with U-GDM. The mean fasting, and 1-hour blood glucose levels were significantly higher in E-GDM vs U-GDM, respectively (5.3±0.7 vs 4.0±0.7 mmol/L, p<0.001 and 10.6±1.7 vs 10.3±1.6 mmol/L, p<0.001). More patients in the U-GDM were managed on diet alone compared with E-GDM (53.6% vs 27.5%, p<0.001). E-GDM subjects gained less weight per week compared with U-GDM (0.02±0.03 vs 0.12±0.03 kg/week, p=0.0274). Maternal outcomes were similar between the two groups apart from a higher incidence of preterm labour (25.5% vs 14.4%; p<0.001) and caesarean section (52.4% vs 42.8%; p=0.01) in E-GDM vs U-GDM, respectively. After correction for covariates; gestational age at which GDM was diagnosed was associated with increased risk of macrosomia (OR 1.06, 95% CI 1.00 to 1.11; p<0.05) and neonatal hypoglycaemia (OR 1.05, 95% CI 1.00 to 1.11; p<0.05).ConclusionOur data support the concept of early screening and treatment of GDM in high-risk patients. More data are needed to examine the optimal time for screening.

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