Leptin and Nutrition in Gestational Diabetes

Leptin is highly expressed in the placenta, mainly by trophoblastic cells, where it has an important autocrine trophic effect. Moreover, increased leptin levels are found in the most frequent pathology of pregnancy: gestational diabetes, where leptin may mediate the increased size of the placenta and the fetus, which becomes macrosomic. In fact, leptin mediates the increased protein synthesis, as observed in trophoblasts from gestational diabetic subjects. In addition, leptin seems to facilitate nutrients transport to the fetus in gestational diabetes by increasing the expression of the glycerol transporter aquaporin-9. The high plasma leptin levels found in gestational diabetes may be potentiated by leptin resistance at a central level, and obesity-associated inflammation plays a role in this leptin resistance. Therefore, the importance of anti-inflammatory nutrients to modify the pathology of pregnancy is clear. In fact, nutritional intervention is the first-line approach for the treatment of gestational diabetes mellitus. However, more nutritional intervention studies with nutraceuticals, such as polyphenols or polyunsaturated fatty acids, or nutritional supplementation with micronutrients or probiotics in pregnant women, are needed in order to achieve a high level of evidence. In this context, the Mediterranean diet has been recently found to reduce the risk of gestational diabetes in a multicenter randomized trial. This review will focus on the impact of maternal obesity on placental inflammation and nutrients transport, considering the mechanisms by which leptin may influence maternal and fetal health in this setting, as well as its role in pregnancy pathologies.

Nutrient budgets for large Chinese estuaries and embayment

Nutrient concentrations among the Chinese rivers and bays vary 10–75 fold depending on nutrient elements. The silicic acid levels in South China rivers are higher than those from North China rivers and the yields of dissolved silicate increased from the north to the south of China, indicating the effect of climate on weathering. The nutrient levels in Chinese rivers are higher than those from the large and less-disturbed world rivers such as Amazon and Zaire, but comparable to the values for European and North American polluted and eutrophic rivers like the Loire and Po. This may be ascribed to both of extensive leaching and influences from agricultural and domestic activities over the drainage basins of Chinese rivers. DIN:PO3−4 ratios in most of Chinese rivers and bays are higher (up to 2800) than the other rivers in the world. The atomic ratios of DIN to PO43− in the major Chinese rivers and embayment decrease in exponential trend with increase in the atomic ratios of PO43− to Si(OH)4, indicating that primary production in coastal environments changes with the nutrients transport when the urbanization develops to a certain extent, and the potential limited nutrient elements can be changed from phosphorus to nitrogen limitation, which can modify aquatic food webs and then the ocean ecosystem. A simple steady-state mass-balance box model was employed. The output shows that the estuaries and embayment behave as a sink or source of nutrients. For the major Chinese estuaries, both residual and mixing flow transport nutrients off the estuaries, and nutrient transport fluxes in summer is 3–4 fold that in winter except comparable for NH4+. These fluxes are 1.0–1.7 fold that estimated by timing riverine nutrient concentrations and freshwater discharge. For the major Chinese embayment, nutrient elements are transported to China Seas except PO43− and Si(OH)4 in Sanggou Bay and Jiaozhou Bay. Seasonally, nutrients transport fluxes off the bays in the summer are 2.2–7.0 fold that in the winter. In the embayment, the exchange flow dominated the water budgets, resulting in average system salinity approaching the China seas salinity where river discharge is limited. The major Chinese estuaries and embayment transport 1.0–3.1% of nitrogen, 0.2–0.5% of phosphorus and 3% of silicon necessary for phytoplankton growth for the China Seas. This demonstrates regenerated nutrients in water column and sediments and nutrients transport fluxes between the China Seas and open ocean play an important role for phytoplankton growth. Atmospheric deposition may be another important source of nutrients for the China Seas.