1
|
Vaught AJ, Boyer T, Ziogos E, Amat-Codina N, Minhas A, Darwin K, Debrosse A, Fedarko N, Burd I, Baschat A, Sharma G, Hays AG, Zakaria S, Leucker TM. The role of proprotein convertase subtillisin/kexin type 9 in placental salvage and lipid metabolism in women with preeclampsia. Placenta 2023; 132:1-6. [PMID: 36603351 DOI: 10.1016/j.placenta.2022.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 12/20/2022] [Accepted: 12/23/2022] [Indexed: 12/25/2022]
Abstract
INTRODUCTION Preeclampsia is associated with decreased maternal low-density lipoprotein cholesterol (LDL-c), which is essential for fetal growth. The underlying mechanisms for decreased LDL-c in preeclampsia remain unknown. Proprotein convertase subtillisin/kexin type 9 (PCSK9) regulates serum LDL-c via LDL receptor (LDL-R) degradation. We describe the possible role of PCSK9 in lipid metabolism in all compartments of the parturient (maternal blood, placental tissue, and fetal blood) in pregnancies with and without preeclampsia. METHODS This is an observational study examining PCSK9 levels in maternal sera, umbilical cord blood, and PCSK9 protein content in placental tissue in three different locations (maternal placental interface, fetal placental interface, and umbilical cord) in women with and without preeclampsia at >23 weeks gestation. RESULTS 68 parturients with preeclampsia and 55 without preeclampsia were enrolled. Maternal serum LDL-c (116.6 ± 48.9 mg/dL vs 146.1 ± 47.1 mg/dL, p = 0.0045) and PCSK9 (83 [61.8127.6] ng/mL vs 105.3 [83.5142.9] ng/mL, p = 0.011) were also reduced in the preeclamptics versus controls. There were no differences in PCSK9 protein content between preeclamptics and controls at comparative placental interfaces. However, PCSK9 protein content increased between the preeclampsia maternal placental interface (1.87 ± 0.62) and the preeclampsia umbilical cord (2.67 ± 1.08, p = 0.0243). DISCUSSION PCSK9 levels are lower in maternal sera in preeclampsia when compared to controls. Placental PCSK9 protein content in preeclampsia increases from the maternal interface to the umbilical cord; however, this is not seen in controls. This suggests a potential compensatory mechanism for PCSK9 which allows for higher circulating fetal LDL-c levels in preeclampsia.
Collapse
Affiliation(s)
- Arthur Jason Vaught
- Department of Gynecology and Obstetrics, Division of Maternal Fetal Medicine, USA.
| | - Theresa Boyer
- Department of Gynecology and Obstetrics, Division of Maternal Fetal Medicine, USA
| | | | | | - Anum Minhas
- Department of Medicine, Division of Cardiology, USA
| | - Kristin Darwin
- Department of Gynecology and Obstetrics, Division of Maternal Fetal Medicine, USA
| | - Alexia Debrosse
- Department of Gynecology and Obstetrics, Division of Maternal Fetal Medicine, USA
| | - Neal Fedarko
- Department of Medicine, Division of Geriatric Medicine. the Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Irina Burd
- Department of Gynecology and Obstetrics, Division of Maternal Fetal Medicine, USA
| | - Ahmet Baschat
- Department of Gynecology and Obstetrics, Division of Maternal Fetal Medicine, USA
| | | | | | | | | |
Collapse
|
2
|
Xu J, Fang H, Chong Y, Lin L, Xie T, Ji J, Shen C, Shi C, Shan J. Cyclophosphamide Induces Lipid and Metabolite Perturbation in Amniotic Fluid during Rat Embryonic Development. Metabolites 2022; 12:1105. [PMID: 36422245 PMCID: PMC9693482 DOI: 10.3390/metabo12111105] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 11/09/2022] [Indexed: 08/13/2023] Open
Abstract
Cyclophosphamide (CP) has been proven to be an embryo-fetal toxic. However, the mechanism responsible for the toxicity of the teratogenic agent has not been fully explored. This study aimed to examine the teratogenicity of CP when administered in the sensitive period of pregnant rats. The effect of CP on the lipid and metabolic profiles of amniotic fluid was evaluated using a UHPLC-Q-Exactive Orbitrap MS-based method. Metabolome analysis was performed using the MS-DIAL software with LipidBlast and NIST. Initially, we identified 636 and 154 lipid compounds in the positive and negative ion modes and 118 metabolites for differential analysis. Mainly 4 types of oxidized lipids in the amniotic fluid were found to accumulate most significantly after CP treatment, including very-long-chain unsaturated fatty acids (VLCUFAs), polyunsaturated fatty acid (PUFA)-containing triglycerides (TGs), oxidized phosphatidylcholine (PC), and sphingomyelin (SM). Tryptophan and some long-chain saturated fatty acids were lowered pronouncedly after CP treatment. These findings suggest that CP may exert teratogenic toxicity on pregnant rats through maternal and fetal oxidative stress. The UHPLC-Q-Exactive Orbitrap MS-based lipidomics approach is worthy of wider application for evaluating the potential toxicity of other agents (toxicants) during embryonic development.
Collapse
Affiliation(s)
- Jianya Xu
- Jiangsu Key Laboratory of Pediatric Respiratory Disease, Nanjing University of Chinese Medicine, Nanjing 210023, China
- School of Medicine & Holistic Integrative Medicine, Nanjing University of Chinese Medicine, Nanjing 210023, China
| | - Huafeng Fang
- Jiangsu Key Laboratory of Pediatric Respiratory Disease, Nanjing University of Chinese Medicine, Nanjing 210023, China
- School of Medicine & Holistic Integrative Medicine, Nanjing University of Chinese Medicine, Nanjing 210023, China
| | - Ying Chong
- Jiangsu Key Laboratory of Pediatric Respiratory Disease, Nanjing University of Chinese Medicine, Nanjing 210023, China
- Medical Metabolomics Center, Nanjing University of Chinese Medicine, Nanjing 210023, China
| | - Lili Lin
- Jiangsu Key Laboratory of Pediatric Respiratory Disease, Nanjing University of Chinese Medicine, Nanjing 210023, China
- Medical Metabolomics Center, Nanjing University of Chinese Medicine, Nanjing 210023, China
| | - Tong Xie
- Jiangsu Key Laboratory of Pediatric Respiratory Disease, Nanjing University of Chinese Medicine, Nanjing 210023, China
- Medical Metabolomics Center, Nanjing University of Chinese Medicine, Nanjing 210023, China
| | - Jianjian Ji
- Jiangsu Key Laboratory of Pediatric Respiratory Disease, Nanjing University of Chinese Medicine, Nanjing 210023, China
- Medical Metabolomics Center, Nanjing University of Chinese Medicine, Nanjing 210023, China
| | - Cunsi Shen
- Jiangsu Key Laboratory of Pediatric Respiratory Disease, Nanjing University of Chinese Medicine, Nanjing 210023, China
- Medical Metabolomics Center, Nanjing University of Chinese Medicine, Nanjing 210023, China
| | - Chen Shi
- Jiangsu Key Laboratory of Pediatric Respiratory Disease, Nanjing University of Chinese Medicine, Nanjing 210023, China
- School of Medicine & Holistic Integrative Medicine, Nanjing University of Chinese Medicine, Nanjing 210023, China
| | - Jinjun Shan
- Jiangsu Key Laboratory of Pediatric Respiratory Disease, Nanjing University of Chinese Medicine, Nanjing 210023, China
- Medical Metabolomics Center, Nanjing University of Chinese Medicine, Nanjing 210023, China
| |
Collapse
|
3
|
Cai X, Liang N, Cai X, Zhou Q, Dang Q, Hu Z, Yu H. Lipid Metabolic Genes and Maternal Supraphysiological Hypercholesterolemia: An Analysis of Maternal-fetal Interaction. J Clin Endocrinol Metab 2022; 107:e3134-e3144. [PMID: 35575245 DOI: 10.1210/clinem/dgac317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Indexed: 11/19/2022]
Abstract
CONTEXT The joint associations of maternal and fetal single nucleotide polymorphisms (SNPs) of lipid metabolic genes with the risk of maternal supraphysiological hypercholesterolemia (MSPH) are unclear. OBJECTIVE This study aims to investigate the associations of maternal/fetal SNPs of APOE, LPL, LDLR, PCSK9, and SCARB1 with the risk of MSPH and explore whether the maternal-fetal pairing pattern of the risk alleles can affect MSPH risk. METHODS A nested case-control study was conducted that included 182 pregnant women with MSPH and 182 with maternal physiological hypercholesterolemia. Maternal venous and umbilical venous blood were collected to detect the SNPs of genes. The primary outcome was MSPH. Logistic regression model was used to determine the associations of SNPs with risk of MSPH. RESULTS The C-allele in maternal APOE rs429358 T > C (adjusted odds ratio [OR] = 1.72, P = 0.033), G-allele in fetal APOE rs440446 C > G (adjusted OR = 1.62, P = 0.012) and T-allele in fetal LPL rs263 C > T (adjusted OR = 1.53, P = 0.011) increased the risk of MSPH. The A-allele in maternal LDLR rs7258950 G > A decreased the risk of MSPH (adjusted OR = 0.67, P = 0.028). For maternal-fetal pairing analysis, the variant concordance of PCSK9 rs2149041, rs7523141, rs7523242, rs7525649, and LDLR rs7258950 were associated with the decreased risk of MSPH under the dominant model. The variant concordance of other SNPs of PCSK9, APOE, LDLR, LPL, and SCARB1 were associated with the increased risk of MSPH. CONCLUSION This study supports the hypothesis that maternal and fetal genetic polymorphisms of lipid metabolic genes are associated with the risk of MSPH. The maternal-fetal variant concordance is also associated with this risk.
Collapse
Affiliation(s)
- Xiaxia Cai
- School of Public Health, Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing 100069, P. R. China
| | - Ning Liang
- School of Public Health, Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing 100069, P. R. China
- Department of Clinical Nutrition, Haidian Maternal and Child Health Hospital, Beijing 100080, P. R. China
| | - Xueping Cai
- School of Public Health, Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing 100069, P. R. China
- Department of Clinical Nutrition, Zhongshan Hospital Affiliated to Xiamen University, Xiamen 361004, P. R. China
| | - Qi Zhou
- Department of Gynaecology and Obstetrics, Xuanwu Hospital of Capital Medical University, Beijing 100053, P. R. China
| | - Qinyu Dang
- School of Public Health, Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing 100069, P. R. China
| | - Zhuo Hu
- School of Public Health, Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing 100069, P. R. China
| | - Huanling Yu
- School of Public Health, Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing 100069, P. R. China
| |
Collapse
|
4
|
Abdel-Hamid TA, AbdelLatif D, Ahmed E, Abdel-Rasheed M, A-Mageed A. Relation between Maternal and Neonatal Serum Lipid Profile and Their Impact on Birth Weight. Am J Perinatol 2022; 39:1112-1116. [PMID: 33321526 DOI: 10.1055/s-0040-1721690] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Maternal malnutrition with disturbed lipid metabolism during pregnancy may affect the fetal lipid profile. We aimed to detect the relation between maternal and neonatal serum lipid profile, as well as to detect the serum lipid profile difference between small for gestational age (SGA) infants and appropriate for gestational age (AGA) infants to disclose the impact of maternal malnutrition on birth weight. STUDY DESIGN A cross-sectional study was conducted on 150 pregnant women coming to the labor room. Before delivery, maternal serum levels of high-density lipoprotein (HDL), low density lipoprotein (LDL), triglycerides (TGs), and total cholesterol were assessed, then after delivery, cord blood samples were taken for assessment of the neonatal lipid profile. Birth weights were measured, then the neonates were divided into SGA and AGA groups. RESULTS Serum levels of LDL, TGs, and total cholesterol in the SGA infants were lower than that in the AGA infants. A positive correlation between maternal and neonatal serum TGs levels was found. Besides, there was a positive correlation between birth weight and maternal serum levels of LDL, TGs, and total cholesterol. CONCLUSION Maternal serum lipid profile could be an indicator of the neonatal serum lipid profile and birth weight. KEY POINTS · SGA neonates have lower levels of serum lipids compared to AGA neonates.. · There is a positive correlation between maternal and neonatal triglycerides.. · There is a positive correlation between birth weight and maternal serum lipids..
Collapse
Affiliation(s)
| | - Dalia AbdelLatif
- Pediatrics Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Eman Ahmed
- Pediatrics Department, Alhayat Hospital, Alhayat, Egypt
| | | | - Ahmed A-Mageed
- Obstetrics and Gynecology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| |
Collapse
|
5
|
Gopalakrishnan K, Mishra JS, Ross JR, Abbott DH, Kumar S. Hyperandrogenism diminishes maternal-fetal fatty acid transport by increasing FABP 4-mediated placental lipid accumulation. Biol Reprod 2022; 107:514-528. [PMID: 35357467 DOI: 10.1093/biolre/ioac059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 02/22/2022] [Accepted: 03/17/2022] [Indexed: 11/12/2022] Open
Abstract
Long-chain polyunsaturated fatty acids (LCPUFAs) are critical for fetal brain development. Infants born to preeclamptic mothers or those born growth restricted due to placental insufficiency have reduced LCPUFA, and are at higher risk for developing neurodevelopmental disorders. Since plasma levels of testosterone (T) and fatty acid-binding protein 4 (FABP4) are elevated in preeclampsia, we hypothesized that elevated T induces the expression of FABP4 in the placenta leading to compromised transplacental transport of LCPUFAs. Increased maternal T in pregnant rats significantly decreased n-3 and n-6 LCPUFA levels in maternal and fetal circulation, but increased their placental accumulation. Dietary LCPUFAs supplementation in T dams increased LCPUFA levels in the maternal circulation and further augmented placental storage, while failing to increase fetal levels. The placenta in T dams exhibited increased FABP4 mRNA and protein levels. In vitro, T dose-dependently upregulated FABP4 transcription in trophoblasts. T stimulated androgen receptor (AR) recruitment to the androgen response element and trans-activated FABP4 promoter activity, both of which were abolished by AR antagonist. T in pregnant rats and cultured trophoblasts significantly reduced transplacental transport of C14-docosahexaenoic acid (DHA) and increased C14-DHA accumulation in the placenta. Importantly, FABP4-overexpression by itself in pregnant rats and trophoblasts increased transplacental transport of C14-DHA with no significant placental accumulation. T exposure, in contrast, inhibited this FABP4-mediated effect by promoting C14-DHA placental accumulation. In summary, our studies show that maternal hyperandrogenism increases placental FABP4 expression via transcriptional upregulation and preferentially routes LCPUFAs toward cellular storage in the placenta leading to offspring lipid deficiency.
Collapse
Affiliation(s)
- Kathirvel Gopalakrishnan
- Department of Comparative Biosciences, School of Veterinary Medicine, University of Wisconsin, Madison, WI 53706, USA
| | - Jay S Mishra
- Department of Comparative Biosciences, School of Veterinary Medicine, University of Wisconsin, Madison, WI 53706, USA
| | - Jordan R Ross
- Department of Comparative Biosciences, School of Veterinary Medicine, University of Wisconsin, Madison, WI 53706, USA
| | - David H Abbott
- Department of Obstetrics and Gynecology, School of Medicine and Public Health, University of Wisconsin, Madison, WI 53792, USA.,Endocrinology-Reproductive Physiology Program, University of Wisconsin, Madison, WI 53715, USA.,Wisconsin National Primate Research Center, University of Wisconsin, Madison, WI 53715, USA
| | - Sathish Kumar
- Department of Comparative Biosciences, School of Veterinary Medicine, University of Wisconsin, Madison, WI 53706, USA.,Department of Obstetrics and Gynecology, School of Medicine and Public Health, University of Wisconsin, Madison, WI 53792, USA.,Endocrinology-Reproductive Physiology Program, University of Wisconsin, Madison, WI 53715, USA
| |
Collapse
|
6
|
Ferreira BD, Barros T, Moleiro ML, Guedes-Martins L. Preeclampsia and Fetal Congenital Heart Defects. Curr Cardiol Rev 2022; 18:80-91. [PMID: 35430980 PMCID: PMC9896419 DOI: 10.2174/1573403x18666220415150943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 12/01/2021] [Accepted: 01/16/2022] [Indexed: 11/22/2022] Open
Abstract
Endothelial dysfunction, impaired implantation and placental insufficiency have been identified as mechanisms behind the development of pre-eclampsia, resulting in angiogenic factors' alteration. Angiogenic imbalance is also associated with congenital heart defects, and this common physiologic pathway may explain the association between them and pre-eclampsia. This review aims to understand the physiology shared by these two entities and whether women with pre-eclampsia have an increased risk of fetal congenital heart defects (or the opposite). The present research has highlighted multiple vasculogenic pathways associated with heart defects and preeclampsia, but also epigenetic and environmental factors, contributing both. It is also known that fetuses with a prenatal diagnosis of congenital heart disease have an increased risk of several comorbidities, including intrauterine growth restriction. Moreover, the impact of pre-eclampsia goes beyond pregnancy as it increases the risk for following pregnancies and for diseases later in life in both offspring and mothers. Given the morbidity and mortality associated with these conditions, it is of foremost importance to understand how they are related and its causative mechanisms. This knowledge may allow earlier diagnosis, an adequate surveillance or even the implementation of preventive strategies.
Collapse
Affiliation(s)
| | - Tânia Barros
- Address correspondence to this author at the Instituto de Ciências Biomédicas Abel Salazar, University of Porto, P.O. Box: 4050-313, Porto, Portugal; Tel/Fax: +351917518938; E-mail:
| | | | | |
Collapse
|
7
|
Alabduljabbar S, Zaidan SA, Lakshmanan AP, Terranegra A. Personalized Nutrition Approach in Pregnancy and Early Life to Tackle Childhood and Adult Non-Communicable Diseases. Life (Basel) 2021; 11:life11060467. [PMID: 34073649 PMCID: PMC8224671 DOI: 10.3390/life11060467] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 05/05/2021] [Accepted: 05/11/2021] [Indexed: 02/07/2023] Open
Abstract
The development of childhood and adult non-communicable diseases (NCD) is associated with environmental factors, starting from intrauterine life. A new theory finds the roots of epigenetic programming in parental gametogenesis, continuing during embryo development, fetal life, and finally in post-natal life. Maternal health status and poor nutrition are widely recognized as implications in the onset of childhood and adult diseases. Early nutrition, particularly breastfeeding, also plays a primary role in affecting the health status of an individual later in life. A poor maternal diet during pregnancy and lack of breastfeeding can cause a nutrient deficiency that affects the gut microbiota, and acts as a cofactor for many pathways, impacting the epigenetic controls and transcription of genes involved in the metabolism, angiogenesis, and other pathways, leading to NCDs in adult life. Both maternal and fetal genetic backgrounds also affect nutrient adsorption and functioning at the cellular level. This review discusses the most recent evidence on maternal nutrition and breastfeeding in the development of NCD, the potentiality of the omics technologies in uncovering the molecular mechanisms underlying it, with the future prospective of applying a personalized nutrition approach to prevent and treat NCD from the beginning of fetal life.
Collapse
|
8
|
Gupta P, Agarwal R, Bhaskaran S, Garg S, Mehndiratta M, Radhakrishnan G, Singh A, Agarwal R, Narang D. Evaluation of maternal plasma platelet activating factor acetylhydrolase activity and mRNA expression in pre-eclampsia: a case control study. J OBSTET GYNAECOL 2020; 41:726-732. [PMID: 33073639 DOI: 10.1080/01443615.2020.1789956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Preeclampsia (PE) remains a leading cause of maternal morbidity and mortality all over the world. However, its aetiology and pathophysiology remain elusive. Platelet activating factor (PAF) is produced in response to oxidative stress and is a potent hypotensive agent. PAF acetylhydrolase (PAF-AH) inactivates PAF and is seen to decrease in normotensive women. The role of PAF-AH in preeclampsia has been in investigational literature, so far. The few studies done have shown a positive association of elevated levels of PAF-AH with preeclampsia. However, this marker has not been studied in the Indian population to-date and such studies are needed to elucidate the pathogenesis of this condition. Our study aimed to determine the PAF-AH activity by spectrophotometric assay in maternal plasma of 73 PE patients versus 73 normotensive controls and plasma PAF-AH mRNA expression to know the aberration of PAF-AH activity at the genetic level. Relative mRNA expression was calculated by Δ DCT method and a fold change was calculated by 2-ΔDCT. We found that the mean plasma PAF-AH activity levels among cases was significantly higher than the normotensive controls. However, the mRNA expression of the PAF-AH gene was similar between the cases and controls, as well as between severe and non-severe preeclampsia (true fold change =1). To conclude, PAF-AH appears to be increased in women with preeclampsia and hence may contribute to pathophysiology and severity. However, a larger sample size will be required to reiterate this association. Recently, PAF-AH inhibitors such as Darapladib has been tested as a therapeutic option in atherosclerosis. After studying the role of PAF-AH in the pathogenesis of PE, PAF-AH inhibitors may be used as a therapeutic tool in the future in PE.IMPACT STATEMENTWhat is already known on this subject? Platelet activating factor (PAF) is produced in response to oxidative stress and is a potent hypotensive agent. PAF acetylhydrolase (PAF-AH) hydrolyses and inactivates PAF and is seen to decrease in normotensive women. The role of platelet activating factor-acetylhydrolase (PAF-AH) in preeclampsia has been investigational so far. Few studies done have shown a positive association of elevated levels of PAF-AH in preeclamptic women.What do the results of this study add? Our study aimed to determine the activity of PAF-AH in maternal plasma of PE patients versus normal pregnancy and plasma PAF-AH mRNA expression to know the aberration of PAF-AH activity at the level of the gene. We found that plasma PAF-AH activity among preeclamptics was significantly higher than in the controls with a possible role in early-onset preeclampsia (<32 weeks), in the Indian population. This marker has never been studied in this population earlier. The results of our study re-emphasised its role in the pathogenesis of preeclampsia.What are the implications of these findings for clinical practice and/or further research? Such studies are important to not only give us a greater understanding of the various pathways involved in this multifactorial dreaded condition, but can also offer us a marker for early identification of women at risk. Recently, PAF-AH inhibitors like Darapladib has been tested as a therapeutic option in atherosclerosis. After studying the role of PAF-AH in the pathogenesis of PE, PAF-AH inhibitors may be used as a therapeutic tool in the future in PE.
Collapse
Affiliation(s)
- Preeti Gupta
- Department of Obstetrics and Gynaecology, UCMS and Guru Teg Bahadur Hospital, Delhi, India
| | - Rachna Agarwal
- Department of Obstetrics and Gynaecology, UCMS and Guru Teg Bahadur Hospital, Delhi, India
| | - Sruthi Bhaskaran
- Department of Obstetrics and Gynaecology, UCMS and Guru Teg Bahadur Hospital/UCMS, Delhi, India
| | - Seema Garg
- Department of Biochemistry, AIIMS, Nagpur, India
| | - Mohit Mehndiratta
- Department of Biochemistry, UCMS and Guru Teg Bahadur Hospital/UCMS, Delhi, India
| | - Gita Radhakrishnan
- Department of Obstetrics and Gynaecology, UCMS and Guru Teg Bahadur Hospital/UCMS, Delhi, India
| | - Alpana Singh
- Department of Obstetrics and Gynaecology, UCMS and Guru Teg Bahadur Hospital/UCMS, Delhi, India
| | - Richa Agarwal
- Department of Obstetrics and Gynaecology, UCMS and Guru Teg Bahadur Hospital/UCMS, Delhi, India
| | - Divya Narang
- Department of Biochemistry, UCMS and Guru Teg Bahadur Hospital, Delhi, India
| |
Collapse
|
9
|
Wang J, Shen S, Price MJ, Lu J, Sumilo D, Kuang Y, Manolopoulos K, Xia H, Qiu X, Cheng KK, Nirantharakumar K. Glucose, Insulin, and Lipids in Cord Blood of Neonates and Their Association with Birthweight: Differential Metabolic Risk of Large for Gestational Age and Small for Gestational Age Babies. J Pediatr 2020; 220:64-72.e2. [PMID: 32093929 DOI: 10.1016/j.jpeds.2020.01.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 12/02/2019] [Accepted: 01/06/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVES To investigate the association of birthweight percentile with cord blood glucose, lipids, and insulin levels. STUDY DESIGN Data obtained from 1522 newborns were included in the Born in Guangzhou Cohort study. The generalized additive model and multivariable linear regression model were used to explore the nonlinear and linear relationships between birthweight and cord blood metabolic measures, and to evaluate the differences of metabolic measures Z-scores among small for gestational age, appropriate for gestational age, and large for gestational age babies. RESULTS Birthweight Z-score was linearly associated with increased cord blood insulin Z-score (adjusted β = 0.30; 95% CI, 0.22-0.37). Compared with appropriate for gestational age babies, neonates born small for gestational age had significantly higher cord blood triglycerides Z-score (adjusted mean difference [MDadj], 0.60; 95% CI, 0.40-0.79) and lower cord blood insulin (MDadj, -0.37; 95% CI, -0.57 to -0.16), high-density lipoprotein cholesterol (MDadj, -0.34; 95% CI, -0.55 to -0.13), total cholesterol (MDadj, -0.26; 95% CI, -0.47 to -0.05), and low-density lipoprotein (MDadj, -0.23; 95% CI, -0.43 to -0.02) Z-scores, and neonates born large for gestational age had higher cord blood insulin Z-score (MDadj, 0.31; 95% CI, 0.09 to 0.52). CONCLUSIONS Our findings support the hypothesis that babies born small for gestational age and large for gestational age are exposed to different intrauterine environments, which may contribute to altered fat accumulation patterns with implications for the risk of metabolic dysfunction later in life. There is a need to consider the development of tailored intervention strategies to prevent metabolic dysfunction in adult life for these babies.
Collapse
Affiliation(s)
- Jingya Wang
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China; Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
| | - Songying Shen
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Malcolm James Price
- Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
| | - Jinhua Lu
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Dana Sumilo
- Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
| | - Yashu Kuang
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | | | - Huimin Xia
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Xiu Qiu
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.
| | - Kar Keung Cheng
- Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
| | | |
Collapse
|
10
|
Mocarzel CC, Velarde GC, Antunes RDA, Moreira de Sá RA, Kurjak A. Maternal obesity influences the endocrine cord blood profile of their offspring. J Perinat Med 2020; 48:242-248. [PMID: 32083452 DOI: 10.1515/jpm-2019-0387] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2019] [Accepted: 01/28/2020] [Indexed: 12/27/2022]
Abstract
UNLABELLED Objective To compare the endocrine cord blood characteristics of offspring from obese mothers with those of offspring from healthy controls. Methods Cross-sectional case control study. SETTING University medical centers. PATIENT(S) Offspring from obese mothers (n = 41) and healthy controls (n = 31). INTERVENTION(S) Cord blood withdrawal from neonates. MAIN OUTCOME MEASURE(S) Cord blood total cholesterol (TC), triglycerides (TGs), high-density lipoprotein-cholesterol (HDL-C), low-density lipoprotein-cholesterol (LDL-C), blood glucose (GL) and insulin (Ins). Result(s) Fetal GL and TGs were reduced in the offspring of obese women when compared to those in the offspring of the controls. The mean cord blood GL level was 47.8 mg/dL standard deviation (SD 33.1) in the offspring of the obese group vs. 57.9 mg/dL (SD 12.5) in the offspring of the control group, and the mean cord blood TG level was 26.5 (SD 33.6) in the offspring of the obese group vs. 34.6 (SD 12.3) in the offspring of the control group. Maternal obesity was also associated with reduced levels of TC and HDL-C in the pregnant women. Conclusion The observed results suggest that GL and TGs in the cord blood of the offspring of obese mothers were significantly lower than those in the offspring of the control group.
Collapse
Affiliation(s)
| | | | | | | | - Asim Kurjak
- Medical School Universities of Zagreb and Sarajevo, Zagreb, Croatia
| |
Collapse
|
11
|
Lee IL, Barr ELM, Longmore D, Barzi F, Brown ADH, Connors C, Boyle JA, Kirkwood M, Hampton V, Lynch M, Lu ZX, O'Dea K, Oats J, McIntyre HD, Zimmet P, Shaw JE, Maple-Brown LJ. Cord blood metabolic markers are strong mediators of the effect of maternal adiposity on fetal growth in pregnancies across the glucose tolerance spectrum: the PANDORA study. Diabetologia 2020; 63:497-507. [PMID: 31915893 DOI: 10.1007/s00125-019-05079-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Accepted: 10/23/2019] [Indexed: 01/30/2023]
Abstract
AIMS/HYPOTHESIS We aimed to assess associations between cord blood metabolic markers and fetal overgrowth, and whether cord markers mediated the impact of maternal adiposity on neonatal anthropometric outcomes among children born to Indigenous and Non-Indigenous Australian women with normal glucose tolerance (NGT), gestational diabetes mellitus (GDM) and pregestational type 2 diabetes mellitus. METHODS From the Pregnancy and Neonatal Outcomes in Remote Australia (PANDORA) study, an observational cohort of 1135 mother-baby pairs, venous cord blood was available for 645 singleton babies (49% Indigenous Australian) of women with NGT (n = 129), GDM (n = 419) and type 2 diabetes (n = 97). Cord glucose, triacylglycerol, HDL-cholesterol, C-reactive protein (CRP) and C-peptide were measured. Multivariable logistic and linear regression were used to assess the associations between cord blood metabolic markers and the outcomes of birthweight z score, sum of skinfold thickness (SSF), being large for gestational age (LGA) and percentage of body fat. Pathway analysis assessed whether cord markers mediated the associations between maternal and neonatal adiposity. RESULTS Elevated cord C-peptide was significantly associated with increasing birthweight z score (β 0.57 [95% CI 0.42, 0.71]), SSF (β 0.83 [95% CI 0.41, 1.25]), percentage of body fat (β 1.20 [95% CI 0.69, 1.71]) and risk for LGA [OR 3.14 [95% CI 2.11, 4.68]), after adjusting for age, ethnicity and diabetes type. Cord triacylglycerol was negatively associated with birthweight z score for Indigenous Australian women only. No associations between cord glucose, HDL-cholesterol and CRP >0.3 mg/l (2.9 nmol/l) with neonatal outcomes were observed. C-peptide mediated 18% (95% CI 13, 36) of the association of maternal BMI with LGA and 11% (95% CI 8, 17) of the association with per cent neonatal fat. CONCLUSIONS/INTERPRETATION Cord blood C-peptide is an important mediator of the association between maternal and infant adiposity, across the spectrum of maternal glucose tolerance.
Collapse
Affiliation(s)
- I-Lynn Lee
- Wellbeing and Preventable Chronic Disease Division, Menzies School of Health Research, Charles Darwin University, PO Box 41096, Casuarina, NT, 0811, Australia
| | - Elizabeth L M Barr
- Wellbeing and Preventable Chronic Disease Division, Menzies School of Health Research, Charles Darwin University, PO Box 41096, Casuarina, NT, 0811, Australia
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Danielle Longmore
- Wellbeing and Preventable Chronic Disease Division, Menzies School of Health Research, Charles Darwin University, PO Box 41096, Casuarina, NT, 0811, Australia
| | - Federica Barzi
- Wellbeing and Preventable Chronic Disease Division, Menzies School of Health Research, Charles Darwin University, PO Box 41096, Casuarina, NT, 0811, Australia
| | - Alex D H Brown
- South Australian Health and Medical Research Institute, Adelaide, SA, Australia
- Faculty of Health and Medical Sciences, the University of Adelaide, Adelaide, SA, Australia
| | | | - Jacqueline A Boyle
- Monash Centre for Health Research and Implementation, School of Public Health and Preventative Medicine, Monash University, Clayton, VIC, Australia
| | - Marie Kirkwood
- Wellbeing and Preventable Chronic Disease Division, Menzies School of Health Research, Charles Darwin University, PO Box 41096, Casuarina, NT, 0811, Australia
| | - Vanya Hampton
- Wellbeing and Preventable Chronic Disease Division, Menzies School of Health Research, Charles Darwin University, PO Box 41096, Casuarina, NT, 0811, Australia
| | - Michael Lynch
- Pathology Network, Top End Health and Hospital Services, Darwin, NT, Australia
| | - Zhong X Lu
- Monash Pathology, Monash Health, Melbourne, VIC, Australia
- Department of Medicine, Monash University, Melbourne, VIC, Australia
| | - Kerin O'Dea
- School of Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Jeremy Oats
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - H David McIntyre
- Mater Medical Research Institute, University of Queensland, Brisbane, QLD, Australia
| | - Paul Zimmet
- Department of Diabetes, Central Clinical School, Monash University, Melbourne, VIC, Australia
| | - Jonathan E Shaw
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Louise J Maple-Brown
- Wellbeing and Preventable Chronic Disease Division, Menzies School of Health Research, Charles Darwin University, PO Box 41096, Casuarina, NT, 0811, Australia.
- Division of Medicine, Royal Darwin Hospital, Darwin, NT, Australia.
| | | |
Collapse
|
12
|
Hessami K, Kasraeian M, Asadi N, Vafaei H, Foroughinia L. Association of Maternal and Umbilical Cord Blood Lipid Parameters with Uterine and Fetal-Placental Blood Flow in Hypertensive and Normotensive Pregnancies. Int J Womens Health 2020; 12:115-125. [PMID: 32184675 PMCID: PMC7054007 DOI: 10.2147/ijwh.s233029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 02/20/2020] [Indexed: 01/15/2023] Open
Abstract
Purpose There is a growing evidence suggesting that hypertensive disorders of pregnancy (HDP), especially preeclampsia, are associated with an increased risk of cardiometabolic disease for both mother and child later in life. The objective of this study was to determine the association of maternal and umbilical cord blood (UCB) lipid profiles with uterine and fetal-placental blood flow at the third trimester of pregnancy. Patients and Methods A total of 1,135 women were prospectively followed through pregnancy and data for 812 mother-newborn pairs, including 170 HDP developed subjects and 642 normotensive subjects were analyzed at the end of the study. Maternal serum and UCB triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and non-HDL-C levels were compared between HDP and normotensive groups; moreover, the association between lipid parameters and abnormal pulsatility indices (PIs) of uterine (UtA), umbilical (UA), and middle cerebral (MCA) arteries was evaluated with multivariate regression analysis models. The same analyses were carried out on subgroups of HDP (preeclampsia vs gestational hypertension). Results The mean TG, TC, LDL-C, and non-HDL-C levels were significantly higher in mother-newborn pairs of the HDP group compared to the normotensive group. In the HDP group, maternal TG and non-HDL-C levels were shown to have a significant association with abnormal UtA-PI (p<0.001 and p=0.039, respectively). We also found a positive significant association of fetal hypertriglyceridemia with abnormal UA-PI and MCA-PI in the HDP group (p=0.042 and p=0.021, respectively). However, no such associations were observed in normotensive mother-newborn pairs. Similar trends were observed in preeclamptic subjects after subgroup analysis. Conclusion Maternal TG and non-HDL-C levels as well as fetal TG level are significantly associated with disturbed uterine and fetal-placental blood flow in HDP.
Collapse
Affiliation(s)
- Kamran Hessami
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.,Maternal-Fetal Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Kasraeian
- Maternal-Fetal Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nasrin Asadi
- Maternal-Fetal Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Homeira Vafaei
- Maternal-Fetal Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Leila Foroughinia
- Eastern Health, Box Hill Hospital, FRANZCOG, Box Hill, Victoria, Australia
| |
Collapse
|
13
|
Cai X, Liang N, Wang H, Gao A, Xiao R, Yu H. Lipidomic profiles of maternal blood at the earlier stage of gestation and umbilical venous blood in response to supraphysiological hypercholesterolemia versus physiological hypercholesterolemia: An evidence of potential biomarkers and early intervention. Biochim Biophys Acta Mol Cell Biol Lipids 2019; 1865:158587. [PMID: 31843384 DOI: 10.1016/j.bbalip.2019.158587] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 11/08/2019] [Accepted: 12/04/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND To our knowledge, we lack a complete understanding of the lipidomes alterations caused by maternal supraphysiological hypercholesterolemia (MSPH) at the third trimester. OBJECTIVES The aim of this study was to investigate lipidomes alterations in maternal and umbilical venous (UV) serum and explore the association between these alterations and MSPH. METHODS We conducted a nest case-control study between maternal physiological hypercholesterolemia (MPH) and MSPH subjects during pregnancy. Lipidomic profiling of maternal serum at the first trimester of gestation and UV serum was performed by ultra-high-performance liquid chromatography system connected to a quadrupole time-of-light/mass spectrometer. RESULTS Several glycerophospholipids and sphingolipids (C18 sphingoid base) species were distinctly altered in maternal serum and/or UV serum with MSPH versus MPH. Glycerophospholipid metabolism, sphingolipid metabolism and propanoate metabolism were the main pathways that involved the most of discriminate metabolites. Higher HDL-c and phosphatidylcholine (16:0/0:0) (PC (16:0/0:0)) during pregnancy, higher PC (16:0/0:0) and lower cholesterol ester 20:4(8Z,11Z,14Z,17Z) (CE (20:4(8Z,11Z,14Z,17Z))) in the UV serum may be the risk factors for the increased placental circulation resistance. The total cholesterol levels of maternal serum both at the first trimester and at the third trimester were significantly correlated with some lipid species of UV serum. CONCLUSION This study clarifies the differential lipid profiles to distinguish MSPH from MPH and the pathway which is influenced under the condition of MSPH. Also, it provides a resource to look for potential therapeutic targets for MSPH.
Collapse
Affiliation(s)
- Xiaxia Cai
- School of Public Health, Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing 100069, PR China
| | - Ning Liang
- School of Public Health, Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing 100069, PR China
| | - Hongliang Wang
- School of Public Health, Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing 100069, PR China
| | - Ai Gao
- School of Public Health, Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing 100069, PR China.
| | - Rong Xiao
- School of Public Health, Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing 100069, PR China.
| | - Huanling Yu
- School of Public Health, Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing 100069, PR China.
| |
Collapse
|
14
|
Bhowmik B, Siddique T, Majumder A, Mdala I, Hossain IA, Hassan Z, Jahan I, Moreira NCDV, Alim A, Basit A, Hitman GA, Khan AKA, Hussain A. Maternal BMI and nutritional status in early pregnancy and its impact on neonatal outcomes at birth in Bangladesh. BMC Pregnancy Childbirth 2019; 19:413. [PMID: 31711436 PMCID: PMC6849244 DOI: 10.1186/s12884-019-2571-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 10/25/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND To assess the maternal characteristics and nutritional status according to body mass index (BMI) at 6-14 weeks of gestation and to examine the relationship between maternal nutritional status in early pregnancy and its impact on neonatal birth weight. METHODS The investigation was conducted from April 2011 to June 2012 in Dhaka, Bangladesh. A total of 498 primigravida pregnant women participated in the study; women with known diabetes or previous gestational diabetes (GDM) were excluded. Maternal demographic details, pregnancy history and anthropometric measurements were obtained from the mother at the recruitment (6-14 weeks), 2nd visit between 24 and 28 week of gestation and 3rd visit at delivery. Cord venous blood samples of newborns (n = 138) were collected immediately after delivery for blood glucose, insulin, lipid profile, leptin and micronutrients including serum folate, ferritin, homocysteine, vitamin D, and vitamin B12. RESULTS The prevalence at 6-14 weeks of pregnancy of anemia (Hb, < 11 g/dl), vitamin D deficiency (< 30 nmol/l), vitamin B12 deficiency (< 200 pg/ml), high homocysteine level (> 15 μmol/l), folate deficiency (< 3 ng/ml) and iron deficiency (ferritin < 13 ng/ml) were 19.5, 46.4, 15.1, 1.2, 0.4, and 12.7% respectively. GDM was found in 18.4% women. The prevalence of GDM was higher in overweight women (28.1%) than underweight (16.7%) and normal weight women (16.0%: p < 0.05). The incidence of low birth weight (LBW) and preterm delivery were 11.6 and 5.8% respectively and was not related to maternal BMI at 6-14 weeks of pregnancy. Maternal height was positively (p = 0.02), and homocysteine was negatively associated with neonatal birth weight (p = 0.02). In addition, the newborn's cord serum folate was positively (p = 0.03) and cord triglyceride was negatively (p = 0.03) associated with neonatal birth weight. CONCLUSION Multiple maternal micronutrient deficiencies were present in early pregnancy. Maternal BMI in early pregnancy was not related to preterm deliveries or LBW. LBW was associated with lower folate, elevated cord triglyceride concentrations of the neonates and mother's height and increase in maternal homocysteine levels. The data has important implications for pregnancy care in Bangladesh and other similar communities.
Collapse
Affiliation(s)
- Bishwajit Bhowmik
- Centre of Global Health Research, Diabetic Association of Bangladesh, Dhaka, 1200 Bangladesh
- Institute of Health and Society, Faculty of Medicine, University of Oslo, 0318 Oslo, Norway
- Centre for Global Health Research, Diabetic Association of Bangladesh, Dhaka, 1000 Bangladesh
| | - Tasnima Siddique
- Centre of Global Health Research, Diabetic Association of Bangladesh, Dhaka, 1200 Bangladesh
| | - Anindita Majumder
- Department of Pathology, Ibrahim Medical College, Diabetic Association of Bangladesh, Dhaka, 1200 Bangladesh
| | - Ibrahimu Mdala
- Institute of Health and Society, Faculty of Medicine, University of Oslo, 0318 Oslo, Norway
| | - Israt A. Hossain
- Department of Biochemistry & Cell Biology, Bangladesh University of Health Sciences, Dhaka, 1216 Bangladesh
| | - Zahid Hassan
- Dept of Physiology and Molecular Biology, Bangladesh University of Health Sciences, Dhaka, 1216 Bangladesh
| | - Ishrat Jahan
- Maternal and Child Health Training Institute, Dhaka, Azimpur 1205 Bangladesh
| | - Nayla Cristina do V. Moreira
- Institute of Health and Society, Faculty of Medicine, University of Oslo, 0318 Oslo, Norway
- Faculty of Medicine, Federal University of Ceara (FAMED-UFC), Fortaleza, Ceara 60020-181 Brazil
| | - Abdul Alim
- Centre of Global Health Research, Diabetic Association of Bangladesh, Dhaka, 1200 Bangladesh
- Non Communicable Disease Control, DGHS, Mohakhali Dhaka, Bangladesh
| | - Abdul Basit
- Baquai Institute of Diabetology and Endocrinology, Baquai Medical University, Karachi, Pakistan
| | - Graham A. Hitman
- Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, 4 Newark Street: London E1 2AT, London, United Kingdom
| | - Abul Kalam A. Khan
- Centre of Global Health Research, Diabetic Association of Bangladesh, Dhaka, 1200 Bangladesh
| | - Akhtar Hussain
- Centre of Global Health Research, Diabetic Association of Bangladesh, Dhaka, 1200 Bangladesh
- Faculty of Health Sciences, Nord University, 8049 Bodø, Norway
| |
Collapse
|
15
|
Andraweera PH, Lassi ZS. Cardiovascular Risk Factors in Offspring of Preeclamptic Pregnancies-Systematic Review and Meta-Analysis. J Pediatr 2019; 208:104-113.e6. [PMID: 30876753 DOI: 10.1016/j.jpeds.2018.12.008] [Citation(s) in RCA: 65] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 11/01/2018] [Accepted: 12/05/2018] [Indexed: 01/13/2023]
Abstract
OBJECTIVE To evaluate evidence for increased cardiovascular disease (CVD) risk factors in children exposed to preeclampsia in utero. STUDY DESIGN PubMed, the Cumulative Index to Nursing and Allied Health Literature, the Cochrane Library, and EMBASE electronic databases were searched with an end of search date of June 4, 2018. Prospective and retrospective studies that compared CVD risk factors in those exposed to preeclampsia in utero with controls were eligible. Information was extracted on established CVD risk factors, including blood pressure, lipid profile, blood glucose, fasting insulin, body mass index, and endothelial/microvascular function. RESULTS Thirty-six studies provided cumulated data on 53 029 individuals. In utero exposure to preeclampsia was associated with 5.17 mm Hg (95% CI 1.60-8.73) greater mean systolic, 4.06 mm Hg (95% CI 0.67-7.44) greater mean diastolic blood pressure, and 0.36 kg/m2 (95% CI 0.04-0.68) greater mean body mass index during childhood or young adulthood. No significant association was seen between exposure to preeclampsia in utero and other CVD risk factors. CONCLUSIONS Offspring of preeclamptic pregnancies demonstrate risk factors for CVD during childhood and young adult life. Early blood pressure screening of children born after preeclamptic pregnancies may identify those that require interventions or preventive strategies to reduce later life CVD risk.
Collapse
Affiliation(s)
- Prabha H Andraweera
- Adelaide Medical School and The Robinson Research Institute, The University of Adelaide, Adelaide, Australia.
| | - Zohra S Lassi
- Adelaide Medical School and The Robinson Research Institute, The University of Adelaide, Adelaide, Australia
| |
Collapse
|
16
|
Goffin SM, Derraik JGB, Groom KM, Cutfield WS. Maternal pre-eclampsia and long-term offspring health: Is there a shadow cast? Pregnancy Hypertens 2018; 12:11-15. [PMID: 29674189 DOI: 10.1016/j.preghy.2018.02.003] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Accepted: 02/06/2018] [Indexed: 12/18/2022]
Abstract
Pre-eclampsia is a common pregnancy disorder with important short-term complications for mother and baby. Evidence suggests pre-eclampsia also has implications for the mother beyond pregnancy, as well as long-term effects on offspring health. Limited research has linked pre-eclampsia with changes in offspring blood pressure, BMI, and stroke risk. Underpinning mechanisms are poorly understood, but developmental programming may be involved. Research in this area has been hindered by difficulties in defining pre-eclampsia and problems with study design. Further targeted evaluation through to adulthood is required to determine the long-term impact of pre-eclampsia on offspring disease risk and how this develops.
Collapse
Affiliation(s)
- Sarah M Goffin
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - José G B Derraik
- Liggins Institute, University of Auckland, Auckland, New Zealand; A Better Start - National Science Challenge, University of Auckland, Auckland, New Zealand; Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Katie M Groom
- Department of Obstetrics & Gynaecology, University of Auckland, Auckland, New Zealand; National Women's Health, Auckland City Hospital, Auckland, New Zealand
| | - Wayne S Cutfield
- Liggins Institute, University of Auckland, Auckland, New Zealand; A Better Start - National Science Challenge, University of Auckland, Auckland, New Zealand.
| |
Collapse
|
17
|
Pecks U, Rath W, Bauerschlag DO, Maass N, Orlikowsky T, Mohaupt MG, Escher G. Serum cholesterol acceptor capacity in intrauterine growth restricted fetuses. J Perinat Med 2017; 45:829-835. [PMID: 28195552 DOI: 10.1515/jpm-2016-0270] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Accepted: 01/10/2017] [Indexed: 01/30/2023]
Abstract
AIM Intrauterine growth restriction (IUGR) is an independent risk factor for the development of cardiovascular diseases later in life. The mechanisms whereby slowed intrauterine growth confers vascular risk are not clearly established. In general, a disturbed cholesterol efflux has been linked to atherosclerosis. The capacity of serum to accept cholesterol has been repeatedly evaluated in clinical studies by the use of macrophage-based cholesterol efflux assays and, if disturbed, precedes atherosclerotic diseases years before the clinical diagnosis. We now hypothesized that circulating cholesterol acceptors in IUGR sera specifically interfere with cholesterol transport mechanisms leading to diminished cholesterol efflux. METHODS RAW264.7 cells were used to determine efflux of [3H]-cholesterol in response to [umbilical cord serum (IUGR), n=20; controls (CTRL), n=20]. RESULTS Cholesterol efflux was lower in IUGR as compared to controls [controls: mean 7.7% fractional [3H]-cholesterol efflux, standard deviation (SD)=0.98; IUGR: mean 6.3%, SD=0.79; P<0.0001]. Values strongly correlated to HDL (ρ=0.655, P<0.0001) and apoE (ρ=0.510, P=0.0008), and mildly to apoA1 (ρ=0.3926, P=0.0122) concentrations. CONCLUSIONS Reduced cholesterol efflux in IUGR could account for the enhanced risk of developing cardiovascular diseases later in life.
Collapse
|
18
|
Ravlić S, Škrobot Vidaček N, Nanić L, Laganović M, Slade N, Jelaković B, Rubelj I. Mechanisms of fetal epigenetics that determine telomere dynamics and health span in adulthood. Mech Ageing Dev 2017; 174:55-62. [PMID: 28847485 DOI: 10.1016/j.mad.2017.08.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Revised: 08/18/2017] [Accepted: 08/21/2017] [Indexed: 01/11/2023]
Abstract
Advances in epigenetics now enable us to better understand environmental influences on the genetic background of human diseases. This refers especially to fetal development where an adverse intrauterine environment impacts oxygen and nutrient supply to the fetus. Recently, differences in telomere length and telomere loss dynamics among individuals born with intrauterine growth restriction compared to normal controls have been described. In this paper we propose possible molecular mechanisms that (pre)program telomere epigenetics during pregnancy. This programming sets differences in telomere lengths and dynamics of telomere shortening in adulthood and therefore dictates the dynamics of aging and morbidity in later life.
Collapse
Affiliation(s)
- Sanda Ravlić
- Laboratory for Molecular and Cellular Biology, Division of Molecular Biology, RBI, Zagreb, Croatia.
| | - Nikolina Škrobot Vidaček
- Laboratory for Molecular and Cellular Biology, Division of Molecular Biology, RBI, Zagreb, Croatia.
| | - Lucia Nanić
- Laboratory for Molecular and Cellular Biology, Division of Molecular Biology, RBI, Zagreb, Croatia.
| | - Mario Laganović
- Department for Nephrology, Hypertension, Dialysis and Transplantation, University Hospital Centre Zagreb, Zagreb, Croatia.
| | - Neda Slade
- Laboratory for Protein Dynamics, Division of Molecular Medicine, RBI, Zagreb, Croatia.
| | - Bojan Jelaković
- Department for Nephrology, Hypertension, Dialysis and Transplantation, University Hospital Centre Zagreb, Zagreb, Croatia.
| | - Ivica Rubelj
- Laboratory for Molecular and Cellular Biology, Division of Molecular Biology, RBI, Zagreb, Croatia.
| |
Collapse
|
19
|
Milenković S, Jankovic B, Mirković L, Jovandaric MZ, Milenković D, Otašević B. Lipids and Adipokines in Cord Blood and at 72 h in Discordant Dichorionic Twins. Fetal Pediatr Pathol 2017; 36:106-122. [PMID: 27841711 DOI: 10.1080/15513815.2016.1242675] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND Intrauterine growth restriction (IUGR) is a risk factor for developing metabolic syndrome later in life. We explored whether adipokine concentrations in cord blood (CB) and on day 3 (D3) were related to impaired fetal growth and lipids in IUGR twins. PATIENTS AND METHODS Thirty-six discordant (birth weight [BW] discordance ≥20% calculated in relation to the heavier co-twins) and 42 concordant (BW discordance ≤ 10%) twin pairs were included. RESULTS In IUGR twins, both adiponectin/BW and triglyceride (TG) levels were significantly higher, while total cholesterol, high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol were lower in CB. On D3, both leptin and HDL-C levels were significantly lower and TG levels were significantly higher in IUGR twins. In the discordant group, the alterations in lipids were not related to any adipokine. CONCLUSIONS IUGR is related to lower leptin level and proatherogenic lipid profile (higher TG and lower HDL-C), which are not influenced by adipokine at birth.
Collapse
Affiliation(s)
- Svetlana Milenković
- a Clinic for Gynecology and Obstetrics , Neonatology, Clinical Center of Serbia , Belgrade , Serbia
| | - Borisav Jankovic
- b Institute for Mother and Child Health "Dr Vukan Čupić ," Belgrade , Serbia.,c School of Medicine , University of Belgrade , Belgrade , Serbia
| | - Ljiljana Mirković
- c School of Medicine , University of Belgrade , Belgrade , Serbia.,d Clinic for Gynecology and Obstetrics , Perinatology, School of Medicine, Clinical Center of Serbia , Belgrade , University of Belgrade
| | - Miljana Z Jovandaric
- a Clinic for Gynecology and Obstetrics , Neonatology, Clinical Center of Serbia , Belgrade , Serbia
| | - Dušan Milenković
- e Center for Anesthesia and Resuscitation , Clinical Center of Serbia , Belgrade , Serbia
| | - Biljana Otašević
- a Clinic for Gynecology and Obstetrics , Neonatology, Clinical Center of Serbia , Belgrade , Serbia
| |
Collapse
|
20
|
Reyna-Villasmil E, Navarro-Briceño Y, Mejía-Montilla J, Reyna-Villasmil N, Torres-Cepeda D, Santos-Bolívar J, Fernández-Ramírez A. Lípidos y lipoproteínas en restricción intrauterina del crecimiento con velocimetría Doppler anormal de la arteria umbilical. PERINATOLOGÍA Y REPRODUCCIÓN HUMANA 2016. [DOI: 10.1016/j.rprh.2016.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
|
21
|
Tank S, Jain SK. Altered cord blood lipid profile, insulin resistance & growth restriction during the perinatal period & its potential role in the risk of developing cardiovascular disease later in life. Indian J Med Res 2016; 144:151-153. [PMID: 27934793 PMCID: PMC5206865 DOI: 10.4103/0971-5916.195021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Indexed: 11/21/2022] Open
Affiliation(s)
- Surinder Tank
- Department of Pediatrics, Louisiana State University Health Sciences Center, Shreveport, LA 71130, USA
| | - Sushil K. Jain
- Department of Pediatrics, Louisiana State University Health Sciences Center, Shreveport, LA 71130, USA
| |
Collapse
|
22
|
Stojanovska V, Scherjon SA, Plösch T. Preeclampsia As Modulator of Offspring Health. Biol Reprod 2016; 94:53. [PMID: 26792940 DOI: 10.1095/biolreprod.115.135780] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2015] [Accepted: 01/15/2016] [Indexed: 02/01/2023] Open
Abstract
A balanced intrauterine homeostasis during pregnancy is crucial for optimal growth and development of the fetus. The intrauterine environment is extremely vulnerable to multisystem pregnancy disorders such as preeclampsia, which can be triggered by various pathophysiological factors, such as angiogenic imbalance, immune responses, and inflammation. The fetus adapts to these conditions by a mechanism known as developmental programming that can lead to increased risk of chronic noncommunicable diseases in later life. This is shown in a substantial number of epidemiological studies that associate preeclampsia with increased onset of cardiovascular and metabolic diseases in the later life of the offspring. Furthermore, animal models based predominantly on one of the pathophysiological mechanism of preeclampsia, for example, angiogenic imbalance, immune response, or inflammation, do address the susceptibility of the preeclamptic offspring to increased maternal blood pressure and disrupted metabolic homeostasis. Accordingly, we extensively reviewed the latest research on the role of preeclampsia on the offspring's metabolism and cardiovascular phenotype. We conclude that future research on the pathophysiological changes during preeclampsia and methods to intervene in the harsh intrauterine environment will be essential for effective therapies.
Collapse
Affiliation(s)
- Violeta Stojanovska
- Department of Obstetrics and Gynecology, University of Groningen, University Medical Center Groningen, The Netherlands
| | - Sicco A Scherjon
- Department of Obstetrics and Gynecology, University of Groningen, University Medical Center Groningen, The Netherlands
| | - Torsten Plösch
- Department of Obstetrics and Gynecology, University of Groningen, University Medical Center Groningen, The Netherlands
| |
Collapse
|
23
|
Hou RL, Jin WY, Chen XY, Jin Y, Wang XM, Shao J, Zhao ZY. Cord blood C-peptide, insulin, HbA1c, and lipids levels in small- and large-for-gestational-age newborns. Med Sci Monit 2014; 20:2097-105. [PMID: 25357084 PMCID: PMC4226317 DOI: 10.12659/msm.890929] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Background Small- and large-for-gestational-age (SGA, LGA) newborns are associated with metabolic syndrome in their later life. Cord blood C-peptide, insulin, glycosylated hemoglobin (HbA1c), and lipids levels may be altered in SGA and LGA newborns; however, the results are conflicting. Therefore, this study aimed to determine the effect of cord blood markers on SGA and LGA newborns. Material/Methods This was a prospective cohort study and included 2873 term newborns of non-diabetic women. Among these newborns, 83 (2.9%) were SGA, 2236 (77.8%) were appropriate-for-gestational-age (AGA), and 554 (19.3%) were LGA newborns. Cord blood C-peptide, insulin, HbA1c, triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) levels were measured. The chi-square, Kruskal-Wallis, and Mann-Whitney tests were used to analyze categorical variables and continuous variables, respectively. Multinomial logistic regression analysis was used to determine the independent effect of these variables on SGA and LGA newborns. Results Cord serum TG level was significantly higher in the SGA group than in AGA and LGA groups (p<0.05). The LGA group had significantly higher cord serum insulin level than AGA and SGA groups (p<0.05). After adjustment for confounding variables, including maternal age, parity, pre-pregnancy body mass index (BMI), education, annual household income, pregnancy-induced hypertension (PIH), mode of delivery, and newborn sex, high TG and insulin levels remained significantly associated with SGA and LGA newborns, respectively (p<0.05). Conclusions High cord serum TG and insulin levels are independently associated with SGA and LGA newborns, respectively.
Collapse
Affiliation(s)
- Ruo-Lin Hou
- Department of Children's Health Care, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China (mainland)
| | - Wen-Yuan Jin
- Department of Children's Health Care, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China (mainland)
| | - Xiao-Yang Chen
- Department of Children's Health Care, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China (mainland)
| | - Yan Jin
- Department of Children's Health Care, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China (mainland)
| | - Xiu-Min Wang
- Department of Endocrinology, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China (mainland)
| | - Jie Shao
- Department of Children's Health Care, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China (mainland)
| | - Zheng-Yan Zhao
- Department of Children's Health Care, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China (mainland)
| |
Collapse
|
24
|
Spracklen CN, Smith CJ, Saftlas AF, Robinson JG, Ryckman KK. Maternal hyperlipidemia and the risk of preeclampsia: a meta-analysis. Am J Epidemiol 2014; 180:346-58. [PMID: 24989239 DOI: 10.1093/aje/kwu145] [Citation(s) in RCA: 122] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Published reports examining lipid levels during pregnancy and preeclampsia have been inconsistent. The objective of this meta-analysis was to test the association between preeclampsia and maternal total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), non-HDL-C, and triglyceride levels measured during pregnancy. We conducted a systematic search for studies published between the index date until July 2013 reporting maternal lipid levels in women with preeclampsia and normotensive pregnant women. Seventy-four studies met all eligibility criteria and were included in the meta-analysis. Weighted mean differences in lipid levels were calculated using a random-effects model. Statistical heterogeneity was investigated using the I(2) statistic. Meta-regression was used to identify sources of heterogeneity. Preeclampsia was associated with elevated total cholesterol, non-HDL-C, and triglyceride levels, regardless of gestational age at the time of blood sampling, and with lower levels of HDL-C in the third trimester. A marginal association was found with LDL-C levels. Statistical heterogeneity was detected in all analyses. Meta-regression analyses suggested that differences in body mass index (weight (kg)/height (m)(2)) across studies may be partially responsible for the heterogeneity in the triglyceride and LDL-C analyses. This systematic review and meta-analysis demonstrates that women who develop preeclampsia have elevated levels of total cholesterol, non-HDL-C, and triglycerides during all trimesters of pregnancy, as well as lower levels of HDL-C during the third trimester.
Collapse
|
25
|
Pecks U, Kirschner I, Wölter M, Schlembach D, Koy C, Rath W, Glocker MO. Mass spectrometric profiling of cord blood serum proteomes to distinguish infants with intrauterine growth restriction from those who are small for gestational age and from control individuals. Transl Res 2014; 164:57-69. [PMID: 24373862 DOI: 10.1016/j.trsl.2013.12.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Revised: 11/06/2013] [Accepted: 12/03/2013] [Indexed: 12/26/2022]
Abstract
Intrauterine growth restriction (IUGR) is a multifactorial condition in that the fetus does not reach its genetically given growth potential. Besides its contribution to perinatal mortality, it is a risk factor for cardiovascular and metabolic diseases later in life. The diagnosis is based on antenatal sonography, which allows differentiating between IUGR and fetuses that are small by constitution (small for gestational age [SGA]). Yet, neither a clinical nor a biochemical tool is available to confirm reliably the diagnosis of IUGR postnatally. Recently, we identified umbilical cord blood proteins of the apolipoprotein family by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry with differential signal intensities between the IUGR group and a control group. We hypothesized that identified molecules have the potential to generate a proteome profile specific for IUGR. A total of 114 serum samples (42 from the IUGR group, 12 from the SGA group, and 60 from the control group) of the umbilical vein (99 samples) and umbilical artery (15 samples) were analyzed. Sample quality was estimated by determining the abundance of hemoglobin (hemolysis) and CXC-motif chemokines CXCL4 and CXCL7 (platelet activation). Samples passing the quality criteria were forwarded to multiplex apolipoprotein profiling. Assay performance was tested with the sample sets, resulting in a sensitivity of 0.91 and a specificity of 0.85 in the test set with venous blood samples. Arterial cord blood samples followed the trend (sensitivity, 0.67; specificity, 0.85). SGA samples grouped together with the control samples. We conclude that the proteome profiling signature is confirmatory to clinical surveillance with the potential to identify neonates with IUGR postnatally in low-birth weight babies born at uncertain gestational age when antenatal sonography data have not been recorded.
Collapse
Affiliation(s)
- Ulrich Pecks
- Department of Obstetrics and Gynecology, Medical Faculty, RWTH Aachen, Aachen, Germany
| | - Isabelle Kirschner
- Department of Obstetrics and Gynecology, Medical Faculty, RWTH Aachen, Aachen, Germany; Proteome Center Rostock, Medical Faculty and Natural Science Faculty, University of Rostock, Rostock, Germany
| | - Manja Wölter
- Proteome Center Rostock, Medical Faculty and Natural Science Faculty, University of Rostock, Rostock, Germany
| | | | - Cornelia Koy
- Proteome Center Rostock, Medical Faculty and Natural Science Faculty, University of Rostock, Rostock, Germany
| | - Werner Rath
- Department of Obstetrics and Gynecology, Medical Faculty, RWTH Aachen, Aachen, Germany
| | - Michael O Glocker
- Proteome Center Rostock, Medical Faculty and Natural Science Faculty, University of Rostock, Rostock, Germany.
| |
Collapse
|
26
|
Dabelea D, Harrod CS. Role of developmental overnutrition in pediatric obesity and type 2 diabetes. Nutr Rev 2014; 71 Suppl 1:S62-7. [PMID: 24147926 DOI: 10.1111/nure.12061] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Childhood obesity continues to be a significant public health burden. Empirical evidence has begun to identify intrauterine and postnatal pathways that increase the likelihood of excess adiposity and increased risk of type 2 diabetes among offspring. Reviewed here is the evidence supporting a transgenerational vicious cycle that increases obesity and diabetes in offspring and contributes substantially to the increases in obesity and type 2 diabetes observed over the past several decades. The public health impact of these findings is discussed and future research opportunities are outlined.
Collapse
Affiliation(s)
- Dana Dabelea
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Denver, Aurora, Colorado, USA
| | | |
Collapse
|
27
|
Florido J, de Paco-Matallana C, Quezada MS, Garrido-Sánchez MC, Padilla C, Ocón O, Luna JDD, Ochoa-Herrera JJ. Umbilical cord serum lipids between early and late clamping in full-term newborns. A systematic assignment treatment group. J Matern Fetal Neonatal Med 2014; 28:186-9. [DOI: 10.3109/14767058.2014.909802] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
|
28
|
Pecks U, Rath W, Caspers R, Sosnowsky K, Ziems B, Thiesen HJ, Maass N, Huppertz B. Oxidatively modified LDL particles in the human placenta in early and late onset intrauterine growth restriction. Placenta 2013; 34:1142-9. [DOI: 10.1016/j.placenta.2013.10.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
|
29
|
La Torre D, Seppänen-Laakso T, Larsson HE, Hyötyläinen T, Ivarsson SA, Lernmark Å, Orešič M. Decreased cord-blood phospholipids in young age-at-onset type 1 diabetes. Diabetes 2013; 62:3951-6. [PMID: 23929934 PMCID: PMC3806611 DOI: 10.2337/db13-0215] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Children developing type 1 diabetes may have risk markers already in their umbilical cord blood. It is hypothesized that the risk for type 1 diabetes at an early age may be increased by a pathogenic pregnancy and be reflected in altered cord-blood composition. This study used metabolomics to test if the cord-blood lipidome was affected in children diagnosed with type 1 diabetes before 8 years of age. The present case-control study of 76 index children diagnosed with type 1 diabetes before 8 years of age and 76 healthy control subjects matched for HLA risk, sex, and date of birth, as well as the mother's age and gestational age, revealed that cord-blood phosphatidylcholines and phosphatidylethanolamines were significantly decreased in children diagnosed with type 1 diabetes before 4 years of age. Reduced levels of triglycerides correlated to gestational age in index and control children and to age at diagnosis only in the index children. Finally, gestational infection during the first trimester was associated with lower cord-blood total lysophosphatidylcholines in index and control children. In conclusion, metabolomics of umbilical cord blood may identify children at increased risk for type 1 diabetes. Low phospholipid levels at birth may represent key mediators of the immune system and contribute to early induction of islet autoimmunity.
Collapse
Affiliation(s)
- Daria La Torre
- Department of Clinical Sciences, Lund University Clinical Research Centre, Skåne University Hospital, Malmö, Sweden
- Corresponding author: Daria La Torre, or
| | | | - Helena E. Larsson
- Department of Clinical Sciences, Lund University Clinical Research Centre, Skåne University Hospital, Malmö, Sweden
| | | | - Sten A. Ivarsson
- Department of Clinical Sciences, Lund University Clinical Research Centre, Skåne University Hospital, Malmö, Sweden
| | - Åke Lernmark
- Department of Clinical Sciences, Lund University Clinical Research Centre, Skåne University Hospital, Malmö, Sweden
| | - Matej Orešič
- VTT Technical Research Centre of Finland, Espoo, Finland
| | | |
Collapse
|
30
|
Human Serum PCSK9 Is Elevated at Parturition in Comparison to Nonpregnant Subjects While Serum PCSK9 from Umbilical Cord Blood is Lower Compared to Maternal Blood. ISRN ENDOCRINOLOGY 2013; 2013:341632. [PMID: 23862071 PMCID: PMC3687493 DOI: 10.1155/2013/341632] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/09/2013] [Accepted: 05/15/2013] [Indexed: 01/03/2023]
Abstract
Background. Serum lipids including total cholesterol (TC), triglycerides (TG), and low density lipoprotein cholesterol (LDL-C) are increased in pregnancy. Serum proprotein convertase subtilisin kexin 9 (PCSK9) is a significant player in lipoprotein metabolism. Circulating PCSK9 downregulates the LDL receptor on the surface of the liver, inhibiting clearance of LDL-C. Therefore, our study assessed serum PCSK9 concentrations at parturition (Maternal) compared to a nonpregnant (Control) cohort, as well as between mother and newborn (Maternal and Newborn). Methods. Blood was collected from women at parturition and from umbilical cords. Serum lipids and PCSK9 were measured and data were analysed for significance by Mann-Whitney U test at P < 0.05 and presented as median levels. Spearman's correlations were made at a 95% confidence interval. Results. Serum PCSK9 was significantly higher in Maternal versus Control cohorts (493.1 versus 289.7 ng/mL; P < 0.001, resp.), while the Newborn cohort was significantly lower than Maternal (278.2 versus 493.1 ng/mL; P < 0.0001, resp.). PCSK9 was significantly correlated with TC and HDL-C in Maternal and with TC, LDL-C, and HDL-C in Newborn cohorts. Conclusions. Our study provides the first quantitative report on PCSK9 in pregnancy (at parturition) and in umbilical cord blood. Further research will determine how these changes may affect lipoprotein levels during this physiological state.
Collapse
|
31
|
Hashemi S, Ramezani Tehrani F, Mehrabi Y, Azizi F. Hypertensive pregnancy disorders as a risk factor for future cardiovascular and metabolic disorders (Tehran Lipid and Glucose Study). J Obstet Gynaecol Res 2013; 39:891-7. [PMID: 23438323 DOI: 10.1111/j.1447-0756.2012.02069.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2012] [Accepted: 09/18/2012] [Indexed: 12/01/2022]
Abstract
BACKGROUND Although hypertensive pregnancy disorders (HPD) are common worldwide, there is no consensus regarding their long-term cardiovascular and metabolic consequences. We aimed to ascertain the association between HPD and the development of cardiovascular and metabolic disturbances later in life. MATERIAL AND METHODS A cohort of 226 women with a history of HPD was selected as the case group, and a group of 226 age- and body-mass-index-matched women, with no history of HPD, was selected as controls. Both groups were selected from among participants of the Tehran Lipid and Glucose Study and were compared for concentrations of metabolic parameters and incidence of hypertension, type 2 diabetes mellitus (T2DM) and dyslipidemia over a follow up of 10 years. RESULTS Women with a history of HPD, compared with age- and body-mass-index-matched women without such a history, had an increased risk of cardiovascular and metabolic disorders, including a twofold increased risk for hypertension (95% confidence interval [CI]: 1.4-3.2), a threefold increased risk for T2DM (95% CI: 1.8-5.2) and a 1.3-fold increased risk for dyslipidemia (95% CI: 1.2-1.5). CONCLUSIONS Women with a history of hypertension in pregnancy are at increased risk for subsequent diagnosis of hypertension, dyslipidemia and T2DM later in life. These women may benefit from close monitoring and timely implementation of primary prevention measures of cardiovascular and metabolic risk factors and lifestyle modifications.
Collapse
Affiliation(s)
- Somayeh Hashemi
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, I.R. Iran
| | | | | | | |
Collapse
|
32
|
Morrison KM, Anand SS, Yusuf S, Atkinson SA, Schulze KM, Rao-Melacini P, McQueen MJ, McDonald S, Persadie R, Hunter B, Bourgeois J, Jansen JW, Teo KK. Maternal and pregnancy related predictors of cardiometabolic traits in newborns. PLoS One 2013; 8:e55815. [PMID: 23418462 PMCID: PMC3572188 DOI: 10.1371/journal.pone.0055815] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2012] [Accepted: 01/02/2013] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND The influence of multiple maternal and pregnancy characteristics on offspring cardiometabolic traits at birth is not well understood and was evaluated in this study. METHODS AND FINDINGS The Family Atherosclerosis Monitoring In earLY life (FAMILY) Study prospectively evaluated 11 cardiometabolic traits in 901 babies born to 857 mothers. The influence of maternal age, health (pre-pregnancy weight, blood pressure, glycemic status, lipids), health behaviors (diet, activity, smoking) and pregnancy characteristics (gestational age at birth, gestational weight gain and placental-fetal ratio) were examined. Greater gestational age influenced multiple newborn cardiometabolic traits including cord blood lipids, glucose and insulin, body fat and blood pressure. In a subset of 442 singleton mother/infant pairs, principal component analysis grouped 11 newborn cardiometabolic traits into 5 components (anthropometry/insulin, 2 lipid components, blood pressure and glycemia), accounting for 74% of the variance of the 11 outcome variables. Determinants of these components, corrected for sex and gestational age, were examined. Baby anthropometry/insulin was independently predicted by higher maternal pre-pregnancy weight (standardized estimate 0.30) and gestational weight gain (0.30; both p<0.0001) and was inversely related to smoking during pregnancy (-0.144; p = 0.01) and maternal polyunsaturated to saturated fat intake (-0.135;p = 0.01). Component 2 (HDL-C/Apo Apolipoprotein1) was inversely associated with maternal age. Component 3 (blood pressure) was not clustered with any other newborn cardiometabolic trait and no associations with maternal pregnancy characteristics were identified. Component 4 (triglycerides) was positively associated with maternal hypertension and triglycerides, and inversely associated with maternal HDL and age. Component 5 (glycemia) was inversely associated with placental/fetal ratio (-0.141; p = 0.005). LDL-C was a bridging variable between the lipid factors and glycemia. CONCLUSIONS Maternal health, health behaviours and placenta to fetal weight ratio are associated with newborn cardiometabolic traits over and above gestational age. Future investigations are needed to determine if these factors remain important determinants of cardiometabolic health throughout childhood.
Collapse
Affiliation(s)
- Katherine M Morrison
- Department of Pediatrics, Hamilton Health Sciences and McMaster University, Hamilton, Ontario, Canada.
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
33
|
Sreckovic I, Birner-Gruenberger R, Obrist B, Stojakovic T, Scharnagl H, Holzer M, Scholler M, Philipose S, Marsche G, Lang U, Desoye G, Wadsack C. Distinct composition of human fetal HDL attenuates its anti-oxidative capacity. Biochim Biophys Acta Mol Cell Biol Lipids 2013; 1831:737-46. [PMID: 23321267 DOI: 10.1016/j.bbalip.2012.12.015] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2012] [Revised: 12/17/2012] [Accepted: 12/28/2012] [Indexed: 12/12/2022]
Abstract
In human high-density lipoprotein (HDL) represents the major cholesterol carrying lipoprotein class in cord blood, while cholesterol is mainly carried by low-density lipoprotein in maternal serum. Additionally, to carrying cholesterol, HDL also associates with a range of proteins as cargo. We tested the hypothesis that fetal HDL carries proteins qualitatively and quantitatively different from maternal HDL. These differences then contribute to distinct HDL functionality in both circulations. Shotgun proteomics and biochemical analyses were used to assess composition/function of fetal and maternal HDL isolated from uncomplicated human pregnancies at term of gestation. The pattern of analyzed proteins that were statistically elevated in fetal HDL (apoE, proteins involved in coagulation, transport processes) suggests a particle characteristic for the light HDL2 sub-fraction. In contrast, proteins that were enriched in maternal HDL (apoL, apoF, PON1, apoD, apoCs) have been described almost exclusively in the dense HDL3 fraction and relevant to its anti-oxidative function and role in innate immunity. Strikingly, PON1 mass and activity were 5-fold lower (p<0.01) in the fetus, which was accompanied by attenuation of anti-oxidant capacity of fetal HDL. Despite almost equal quantity of CETP in maternal and fetal HDL, its enzymatic activity was 55% lower (p<0.001) in the fetal circulation, whereas LCAT activity was not altered. These findings indicate that maternally derived HDL differs from fetal HDL with respect to its proteome, size and function. Absence of apoA-1, apoL and PON1 on fetal HDL is associated with decreased anti-oxidative properties together with deficiency in innate immunity collectively indicating distinct HDLs in fetuses.
Collapse
Affiliation(s)
- Ivana Sreckovic
- Department of Obstetrics and Gynecology, Medical University of Graz, Austria
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
34
|
Sifianou P, Zisis D. Cord blood triglycerides are associated with IGF-I levels and contribute to the identification of growth-restricted neonates. Growth Horm IGF Res 2012; 22:219-223. [PMID: 22951368 DOI: 10.1016/j.ghir.2012.08.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2012] [Revised: 08/02/2012] [Accepted: 08/14/2012] [Indexed: 10/27/2022]
Abstract
OBJECTIVE The aim of this study was to investigate whether readily available laboratory tests may aid in the identification of growth-restricted neonates. DESIGN Cord serum levels of 15 chemical analytes, including insulin-like growth factor I (IGF-I) and insulin-like growth factor binding protein 3 (IGFBP-3) were measured in newborns ≥36 weeks gestational age (GA). Based on the number of anthropometric indices (out of four) with values ≤25th centile for GA, the babies were allocated into three groups, i.e., Group(25)0, Group(25)1 and Group(25)2 corresponding to neonates with 0, 1 and 2 or more indices, respectively, that were ≤25th centile for GA. Furthermore, two composite variables were developed: A25 (Group(25)0 and Group(25)1) and B25 (Group(25)0 and Group(25)2). The data were evaluated by the Mann-Whitney test and multiple regression analyses. RESULTS Cord serum triglycerides and total cholesterol levels were significantly higher in Group(25)2 compared to Group(25)0 (p values 0.004 and 0.0009, respectively). The triglycerides almost doubled the power of the variable B25 for predicting IGF-I levels and were found to have a highly significant, negative association with the IGF-I levels (p<0.0001). The IGF-I along with the IGFBP-3 levels explained almost one third of the variation of triglycerides. CONCLUSION Cord serum triglycerides can assist in the identification of growth-restricted neonates. The novel finding of the association of triglycerides with IGF-I calls for further research as this can illuminate unknown aspects of the fetal lipid metabolism.
Collapse
Affiliation(s)
- Popi Sifianou
- Dept. of Neonatology, General and Maternity Hospital, Elena Venizelou, Athens, Greece.
| | | |
Collapse
|
35
|
Vaziri Esfarjani S, Iravani E, Razzaghi Azar M. Determination of the Lipid Profile of Cord Blood in Neonates and its Correlation with Maternal Age in Iran. ACTA ACUST UNITED AC 2012. [DOI: 10.17795/compreped-6347] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
36
|
Hallows SE, Regnault TRH, Betts DH. The long and short of it: the role of telomeres in fetal origins of adult disease. J Pregnancy 2012; 2012:638476. [PMID: 23094159 PMCID: PMC3471439 DOI: 10.1155/2012/638476] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2012] [Accepted: 08/24/2012] [Indexed: 12/30/2022] Open
Abstract
Placental insufficiency, maternal malnutrition, and other causes of intrauterine growth restriction (IUGR) can significantly affect short-term growth and long-term health. Following IUGR, there is an increased risk for cardiovascular disease and Type 2 Diabetes. The etiology of these diseases is beginning to be elucidated, and premature aging or cellular senescence through increased oxidative stress and DNA damage to telomeric ends may be initiators of these disease processes. This paper will explore the areas where telomere and telomerase biology can have significant effects on various tissues in the body in IUGR outcomes.
Collapse
Affiliation(s)
- Stephanie E. Hallows
- Department of Physiology and Pharmacology, University of Western Ontario, Ontario, London, ON, Canada N6A 5C1
| | - Timothy R. H. Regnault
- Department of Physiology and Pharmacology, University of Western Ontario, Ontario, London, ON, Canada N6A 5C1
- Department of Obstetrics and Gynaecology, University of Western Ontario, Ontario, London, ON, Canada N6H 5W9
- Children's Health Research Institute, Lawson Health Research Institute, London, ON, Canada N6C 2V5
| | - Dean H. Betts
- Department of Physiology and Pharmacology, University of Western Ontario, Ontario, London, ON, Canada N6A 5C1
- Children's Health Research Institute, Lawson Health Research Institute, London, ON, Canada N6C 2V5
| |
Collapse
|
37
|
Fan P, Liu XH, He GL, Zhang S, Zhang JX, Bai H. Maternal and fetal plasma platelet-activating factor acetylhydrolase activity and distribution in pre-eclampsia. Pediatr Res 2012; 72:426-31. [PMID: 22797139 DOI: 10.1038/pr.2012.87] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND Distribution of platelet-activating factor acetylhydrolase (PAF-AH) in lipoproteins plays important roles in the onset of inflammation and atherosclerosis. We hypothesized that women with pre-eclampsia (PE), showing signs of inflammation and oxidative stress, and their fetuses have aberrations of PAF-AH activity and distribution. METHODS Maternal and fetal plasma PAF-AH activity, high-density lipoprotein (HDL)-associated PAF-AH (H-PAF-AH) and low-density lipoprotein (LDL)-associated PAF-AH (L-PAF-AH) were examined in women with PE (n = 127) and in women with uncomplicated pregnancies (n = 88). RESULTS The neonates of women with severe PE (n = 42) had significantly higher plasma PAF-AH, L-PAF-AH activities, and ratio of L-PAF-AH to H-PAF-AH activities than the neonates of women with normal pregnancies (n = 83). The mothers with severe PE (n = 106) and their neonates presented a significantly higher atherogenic index (AI) and triglyceride (TG)/HDL cholesterol (C) ratio than the control mothers and their neonates. The ratio of L-PAF-AH to H-PAF-AH activities correlated positively with TG levels, TG/HDL(C) ratio, and AI and negatively with HDL(C) levels in the neonates of women with PE. CONCLUSION The neonates of women with severe PE presented with a chronic inflammation status, increased oxidative stress, and unfavorable lipid changes, which may potentially link to related complications responsible for oxidative stress and inflammation in later life.
Collapse
Affiliation(s)
- Ping Fan
- Laboratory of Genetic Disease and Perinatal Medicine, West China Second University Hospital, Sichuan University, Sichuan, People's Republic of China
| | | | | | | | | | | |
Collapse
|
38
|
Relationship between cord blood atherogenic index and birth weight in preeclampsia. MEDITERRANEAN JOURNAL OF NUTRITION AND METABOLISM 2012. [DOI: 10.1007/s12349-012-0106-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
39
|
Lin G, Liu C, Feng C, Fan Z, Dai Z, Lai C, Li Z, Wu G, Wang J. Metabolomic analysis reveals differences in umbilical vein plasma metabolites between normal and growth-restricted fetal pigs during late gestation. J Nutr 2012; 142:990-8. [PMID: 22513987 DOI: 10.3945/jn.111.153411] [Citation(s) in RCA: 82] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Intrauterine growth restriction (IUGR) remains a major problem for both human health and animal production due to its association with high rates of neonatal morbidity and mortality, low efficiency of food utilization, permanent adverse effects on postnatal growth and development, and long-term health and productivity of the offspring. However, the underlying mechanisms for IUGR are largely unknown. In this study, one IUGR fetus and one normal body weight (NBW) fetus were obtained from each of 9 gilts at each of 2 gestational ages (d 90 and 110). Metabolomes of umbilical vein plasma in IUGR and NBW fetuses were determined by MS, while hormones, amino acids, and related metabolites in maternal and fetal plasma were measured using assay kits and chromatographic methods. Metabolites (including glucose, urea, ammonia, amino acids, and lipids) in umbilical vein plasma exhibited a cluster of differences between IUGR and NBW fetuses on d 90 and 110 of gestation. These changes in the IUGR group are associated with disorders of nutrient and energy metabolism as well as endocrine imbalances, which may contribute to the retardation of fetal growth and development. The findings help provide information regarding potential mechanisms responsible for IUGR in swine and also have important implications for the design of effective strategies to prevent, diagnose, and treat IUGR in other mammalian species, including humans.
Collapse
Affiliation(s)
- Gang Lin
- China AgriculturalUniversity, Beijing, China
| | | | | | | | | | | | | | | | | |
Collapse
|
40
|
Davis EF, Lazdam M, Lewandowski AJ, Worton SA, Kelly B, Kenworthy Y, Adwani S, Wilkinson AR, McCormick K, Sargent I, Redman C, Leeson P. Cardiovascular risk factors in children and young adults born to preeclamptic pregnancies: a systematic review. Pediatrics 2012; 129:e1552-61. [PMID: 22614768 DOI: 10.1542/peds.2011-3093] [Citation(s) in RCA: 350] [Impact Index Per Article: 29.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Preeclampsia is an independent cardiovascular risk factor for the mother, and recent studies reveal that offspring of affected pregnancies also may have an increased cardiovascular risk. Our objective was to examine evidence for increased cardiovascular risk factors in children exposed to preeclampsia in utero. METHODS We performed a systematic review and meta-analysis on studies reporting traditional cardiovascular risk factors in those exposed to preeclampsia compared to controls. Information was extracted on the classic cardiovascular risk factors, including blood pressure, lipid profile, glucose metabolism, and BMI from articles published between 1948 and August 2011 in Medline and Embase. RESULTS Eighteen studies provided cumulated data on 45,249 individuals. In utero exposure to preeclampsia was associated with a 2.39 mm Hg (95% confidence interval: 1.74-3.05; P < .0001) higher systolic and a 1.35 mm Hg (95% confidence interval: 0.90-1.80; P < .00001) higher diastolic blood pressure during childhood and young adulthood. BMI was increased by 0.62 kg/m2 (P < .00001). Associations were similar in children and adolescents, for different genders, and with variation in birth weight. There was insufficient evidence to identify consistent variation in lipid profile or glucose metabolism. CONCLUSIONS Young offspring of pregnancies complicated by preeclampsia already have increased blood pressure and BMI, a finding that may need to be considered in future primary prevention strategies for cardiovascular disease.
Collapse
Affiliation(s)
- Esther Frances Davis
- Department of Cardiovascular Medicine, University of Oxford, Oxford, United Kingdom
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
41
|
Pre-eclampsia and offspring cardiovascular health: mechanistic insights from experimental studies. Clin Sci (Lond) 2012; 123:53-72. [PMID: 22455350 PMCID: PMC3315178 DOI: 10.1042/cs20110627] [Citation(s) in RCA: 138] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Pre-eclampsia is increasingly recognized as more than an isolated disease of pregnancy. Women who have had a pregnancy complicated by pre-eclampsia have a 4-fold increased risk of later cardiovascular disease. Intriguingly, the offspring of affected pregnancies also have an increased risk of higher blood pressure and almost double the risk of stroke in later life. Experimental approaches to identify the key features of pre-eclampsia responsible for this programming of offspring cardiovascular health, or the key biological pathways modified in the offspring, have the potential to highlight novel targets for early primary prevention strategies. As pre-eclampsia occurs in 2–5% of all pregnancies, the findings are relevant to the current healthcare of up to 3 million people in the U.K. and 15 million people in the U.S.A. In the present paper, we review the current literature that concerns potential mechanisms for adverse cardiovascular programming in offspring exposed to pre-eclampsia, considering two major areas of investigation: first, experimental models that mimic features of the in utero environment characteristic of pre-eclampsia, and secondly, how, in humans, offspring cardiovascular phenotype is altered after exposure to pre-eclampsia. We compare and contrast the findings from these two bodies of work to develop insights into the likely key pathways of relevance. The present review and analysis highlights the pivotal role of long-term changes in vascular function and identifies areas of growing interest, specifically, response to hypoxia, immune modification, epigenetics and the anti-angiogenic in utero milieu.
Collapse
|
42
|
Ziaei S, Jahanian S, Kazemnejad A. Lipid concentration in small for gestational age (SGA)pregnancies and hypertensive disorders. Pregnancy Hypertens 2012; 2:164-7. [DOI: 10.1016/j.preghy.2012.01.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2011] [Revised: 12/17/2011] [Accepted: 01/30/2012] [Indexed: 11/30/2022]
|
43
|
Tea I, Le Gall G, Küster A, Guignard N, Alexandre-Gouabau MC, Darmaun D, Robins RJ. 1H-NMR-based metabolic profiling of maternal and umbilical cord blood indicates altered materno-foetal nutrient exchange in preterm infants. PLoS One 2012; 7:e29947. [PMID: 22291897 PMCID: PMC3264558 DOI: 10.1371/journal.pone.0029947] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2011] [Accepted: 12/08/2011] [Indexed: 11/18/2022] Open
Abstract
Background Adequate foetal growth is primarily determined by nutrient availability, which is dependent on placental nutrient transport and foetal metabolism. We have used 1H nuclear magnetic resonance (NMR) spectroscopy to probe the metabolic adaptations associated with premature birth. Methodology The metabolic profile in 1H NMR spectra of plasma taken immediately after birth from umbilical vein, umbilical artery and maternal blood were recorded for mothers delivering very-low-birth-weight (VLBW) or normo-ponderal full-term (FT) neonates. Principal Findings Clear distinctions between maternal and cord plasma of all samples were observed by principal component analysis (PCA). Levels of amino acids, glucose, and albumin-lysyl in cord plasma exceeded those in maternal plasma, whereas lipoproteins (notably low-density lipoprotein (LDL) and very low-density lipoprotein (VLDL) and lipid levels were lower in cord plasma from both VLBW and FT neonates. The metabolic signature of mothers delivering VLBW infants included decreased levels of acetate and increased levels of lipids, pyruvate, glutamine, valine and threonine. Decreased levels of lipoproteins glucose, pyruvate and albumin-lysyl and increased levels of glutamine were characteristic of cord blood (both arterial and venous) from VLBW infants, along with a decrease in levels of several amino acids in arterial cord blood. Conclusion These results show that, because of its characteristics and simple non-invasive mode of collection, cord plasma is particularly suited for metabolomic analysis even in VLBW infants and provides new insights into the materno-foetal nutrient exchange in preterm infants.
Collapse
Affiliation(s)
- Illa Tea
- Elucidation of Biosynthesis by Isotopic Spectrometry Group, Unit for Interdisciplinary Chemistry, Synthesis-Analysis-Modelling (CEISAM), University of Nantes-CNRS UMR 6230, Nantes, France.
| | | | | | | | | | | | | |
Collapse
|
44
|
Kharb S, Batra A, Nanda S. Cord Blood Atherogenic Index in Preeclampsia: Tracing Fetal Origins of Adult Disease. ACTA ACUST UNITED AC 2012. [DOI: 10.3923/rjog.2012.4.7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
45
|
Abstract
During pregnancy, complex changes occur in lipid profiles. From the 12th week of gestation, phospholipids, cholesterol (total, LDL, HDL), and triglycerides (TG) increase in response to estrogen stimulation and insulin resistance. Transition to a catabolic state favors maternal tissue lipid use as energy sources, thus sparing glucose and amino acids for the fetus. In addition, maternal lipids, that is, cholesterol, are available for fetal use in building cell membranes and as precursor of bile acids and steroid hormones. It is also required for cell proliferation and development of the growing body. Free-fatty acids (FFA), oxidized in the maternal liver as ketone-bodies, represent an alternative fuel for the fetus. Maternal hypertriglyceridemia (vs. other lipids) has many positive effects such as contributing to fetal growth and development and serving as an energy depot for maternal dietary fatty acids. However, increased TG during pregnancy appears to increase risk of preeclampsia and preterm birth. Some have suggested that maternal hypertriglyceridemia has a role in increasing cardiovascular risk later in life. This chapter reviews lipid metabolism during pregnancy to elucidate its effect on fetal growth and its potential role in pregnancy-associated complications and future cardiovascular risk.
Collapse
Affiliation(s)
- Alessandra Ghio
- Department of Endocrinology and Metabolism, Section of Metabolic Diseases and Diabetes, AOUP, University of Pisa, Pisa, Italy.
| | | | | | | | | |
Collapse
|
46
|
Desoye G, Gauster M, Wadsack C. Placental transport in pregnancy pathologies. Am J Clin Nutr 2011; 94:1896S-1902S. [PMID: 21543540 DOI: 10.3945/ajcn.110.000851] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
The placenta is positioned between the maternal and fetal circulation and hence plays a key role in transporting maternal nutrients to the developing fetus. Fetal growth changes in the 2 most frequent pregnancy pathologies, gestational diabetes mellitus and fetal growth restriction, are predominantly characterized by an exaggerated and restricted fat accretion, respectively. Glucose, by its regulating effect on fetal insulin concentrations, and lipids have been strongly implicated in fetal fat deposition. Transplacental glucose flux is highly efficient and limited only by nutrient availability (flow-limited)--ie, driven by the maternal-fetal glucose concentration gradient and blood flow, with little, if any, effect of placental morphology, glucose consumption, and transporter expression. This explains why, despite changes in these determinants in both pathologies, transplacental glucose flux is unaltered.
Collapse
Affiliation(s)
- Gernot Desoye
- Department of Obstetrics and Gynaecology, Institute of Cell Biology, Histology and Embryology, Medical University of Graz, Graz, Austria.
| | | | | |
Collapse
|
47
|
Patterson TM, Parker CR. Intrapartum stress and lipid status of term infants: relation to fetal adrenal production of dehydroepiandrosterone sulphate. J Matern Fetal Neonatal Med 2008; 21:783-7. [PMID: 19031274 DOI: 10.1080/14767050802353564] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Evaluate the effect of acute intrapartum stress on umbilical cord plasma levels of cholesterol, triglyceride and dehydroepiandrosterone sulphate (DS) in term infants. METHODS Umbilical cord plasma levels of cholesterol, triglyceride and DS were measured in 176 infants that delivered >or=37 weeks' gestation. Eighty-eight infants experienced acute intrapartum stress while the remaining infants were non-stressed controls who were case-matched by gestational age and delivery method. RESULTS The umbilical cord plasma levels of cholesterol in the stressed infants (71.7 +/- 16.1 mg/dL, mean +/- SD) were similar to those of the control infants (70.9 +/- 16.0 mg/dL). Triglyceride levels in stressed infants were significantly higher (p = 0.003) than those of control infants. Both stressed and control infants with increased triglyceride levels had normal DS levels; however, those with increased cholesterol levels had reduced umbilical cord plasma levels of DS. Stressed infants with increased cholesterol levels had significantly lower DS levels than control infants (p = 0.008). CONCLUSIONS Intrapartum stress leads to increased fetal plasma levels of triglycerides; yet, cholesterol levels are usually unaffected. Infants with increased cholesterol levels also have reduced DS levels, suggesting that the rise in cholesterol was due to a reduction in fetal adrenal utilisation of plasma cholesterol as substrate for steroid formation.
Collapse
Affiliation(s)
- Tamula M Patterson
- Department of Obstetrics and Gynecology, Center for Women's Reproductive Health, University of Alabama at Birmingham, Birmingham, Alabama 35249-7333, USA.
| | | |
Collapse
|
48
|
Shibata E, Hubel C, Powers R, von Versen-Hoeynck F, Gammill H, Rajakumar A, Roberts J. Placental system A amino acid transport is reduced in pregnancies with small for gestational age (SGA) infants but not in preeclampsia with SGA infants. Placenta 2008; 29:879-82. [PMID: 18718657 PMCID: PMC2703008 DOI: 10.1016/j.placenta.2008.07.001] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2008] [Revised: 07/01/2008] [Accepted: 07/03/2008] [Indexed: 12/16/2022]
Abstract
Preeclampsia and intrauterine growth restriction (IUGR) are both associated with abnormal remodeling of maternal spiral arteries perfusing the placental site. This would be expected to be associated with reduced fetal growth, yet only one third of infants of mothers with preeclampsia are growth restricted. Infants with IUGR have decreased concentrations of amino acids in their blood and system A amino acid transporter activity is reduced in their placentas. Since infants of preeclamptic pregnancies have increased circulating amino acids, we tested system A amino acid transport activity of placental villous fragments from pregnancies with small for gestational age (SGA) infants with and without maternal preeclampsia and from uncomplicated and preeclamptic pregnancies with normal sized infants. We confirm the reduced uptake of amino acids in SGA pregnancies without preeclampsia but report that placental amino acid uptake of SGA infants with maternal preeclampsia is not reduced and is identical to uptake by normal and preeclamptic pregnancies with normal weight infants.
Collapse
Affiliation(s)
- E. Shibata
- Magee-Womens Research Institute, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Department of Obstetrics Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - C.A. Hubel
- Magee-Womens Research Institute, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Department of Obstetrics Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - R.W. Powers
- Magee-Womens Research Institute, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Department of Obstetrics Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - F. von Versen-Hoeynck
- Magee-Womens Research Institute, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Department of Obstetrics Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - H. Gammill
- Magee-Womens Research Institute, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Department of Obstetrics Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - A. Rajakumar
- Magee-Womens Research Institute, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Department of Obstetrics Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - J.M. Roberts
- Magee-Womens Research Institute, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Department of Obstetrics Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA
| |
Collapse
|
49
|
Schaefer-Graf UM, Graf K, Kulbacka I, Kjos SL, Dudenhausen J, Vetter K, Herrera E. Maternal lipids as strong determinants of fetal environment and growth in pregnancies with gestational diabetes mellitus. Diabetes Care 2008; 31:1858-63. [PMID: 18606978 PMCID: PMC2518359 DOI: 10.2337/dc08-0039] [Citation(s) in RCA: 298] [Impact Index Per Article: 18.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To determine the contribution of maternal glucose and lipids to intrauterine metabolic environment and fetal growth in pregnancies with gestational diabetes mellitus (GDM). RESEARCH DESIGN AND METHODS In 150 pregnancies, serum triglycerides (TGs), cholesterol, free fatty acids (FFAs), glycerol, insulin, and glucose were determined in maternal serum and cord blood during the 3rd trimester. Maternal glucose values came from oral glucose tolerance testing and glucose profiles. Measurements of fetal abdominal circumference (AC) were performed simultaneously with maternal blood sampling and birth weight, and BMI and neonatal fat mass were obtained following delivery. RESULTS Maternal TGs and FFAs correlated with fetal AC size (at 28 weeks: triglycerides, P = 0.001; FFAs, P = 0.02), and at delivery they correlated with all neonatal anthropometric measures (FFA: birth weight, P = 0.002; BMI, P = 0.001; fat mass, P = 0.01). After adjustment for confounding variables, maternal FFAs and TGs at delivery remained the only parameters independently related to newborns large for gestational age (LGA) (P = 0.008 and P = 0.04, respectively). Maternal FFA levels were higher in mothers with LGA newborns than in those with appropriate for gestational age (AGA) newborns (362.8 +/- 101.7 vs. 252.4 +/- 10.1, P = 0.002). Maternal levels of TGs, FFAs, and glycerol at delivery correlated with those in cord blood (P = 0.003, P = 0.004, and P = 0.005, respectively). Fetal triglyceride and cholesterol levels were negatively correlated with newborn birth weight (P = 0.001), BMI (P = 0.004), and fat mass (P = 0.001). TGs were significantly higher in small for gestational age (SGA) newborns compared with AGA or LGA newborns, while insulin-to-glucose ratio and FFAs were the highest in LGA newborns. CONCLUSIONS In well-controlled GDM pregnancies, maternal lipids are strong predictors for fetal lipids and fetal growth. Infants with abnormal growth seem to be exposed to a distinct intrauterine environment compared with those with appropriate growth.
Collapse
Affiliation(s)
- Ute M Schaefer-Graf
- Department of Obstetrics, Vivantes Medical Center Berlin-Neukoelln, Berlin, Germany.
| | | | | | | | | | | | | |
Collapse
|
50
|
Melvin AJ, Kang M, Hitti J, Livingston E, Cohn SE, Stocker V, Ross AC, Watts H, McComsey GA. Cord Blood Lipids in Infants Born to HIV-1-Infected Women Treated with Combination Antiretroviral Therapy. Antivir Ther 2008. [DOI: 10.1177/135965350801300310] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background To investigate the effect of exposure to protease inhibitor (PI) therapy in utero on cord blood lipids in infants born to mothers enrolled in AIDS Clinical Trials Group protocol 5084, a prospective, multi-centre, observational study of antiretroviral therapy (ART) during pregnancy. Methods Clinical outcome was determined in 80 infants born to women treated with PIs and 73 infants born to women treated with other antiretrovirals during pregnancy. Cord blood serum from 117 of these infants was assayed for total, low-density lipoprotein (LDL) and high-density lipoprotein (HDL) cholesterol, triglyceride, apolipoprotein A1 (apoA1), apolipoprotein B100 (apoB) and lipoprotein (a). Covariates considered in the analysis included race/ethnicity, gestational age, infant gender, infant birth weight, mode of delivery, maternal tobacco and alcohol use, post-partum body mass index, and ART duration. Results Cord blood total and HDL cholesterol, triglyceride, apoA1, apoB, lipoprotein (a) and apoB/apoA1 ratio were not different between the two groups. Cord blood lipid levels in these HIV-exposed infants were similar to those reported in other neonatal cohorts. Controlling for race/ethnicity, infants born to women treated with PIs had higher LDL cholesterol than those born to women not treated with PIs (29 mg/dl versus 27 mg/dl, P=0.006). Conclusion Only LDL cholesterol was significantly higher in the cord blood of PI-exposed infants versus those not exposed to PIs in utero. As the difference between the two groups was small, the clinical relevance of the effect of maternal PI treatment on infant LDL cholesterol levels at birth is not clear.
Collapse
Affiliation(s)
- Ann J Melvin
- Department of Pediatrics, University of Washington, Seattle, WA, USA
| | - Minhee Kang
- Center for Biostatistics in AIDS Research, Harvard School of Public Health, Boston, MA, USA
| | - Jane Hitti
- Department of Obstetrics and Gynecology, University of Washington, Seattle, WA, USA
| | - Elizabeth Livingston
- Department of Obstetrics and Gynecology, Duke University School of Medicine, Durham, NC, USA
| | - Susan E Cohn
- Department of Medicine, University of Rochester Medical Center, Rochester, NY, USA
| | - Vicki Stocker
- The AIDS Clinical Trials Group Operations Center, Rockville, MD, USA
| | - Allison C Ross
- Department of Pediatrics and Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - Heather Watts
- Adolescent and Maternal AIDS Branch, National Institute of Child Health and Human Development, Rockville, MD, USA
| | - Grace A McComsey
- Department of Pediatrics and Medicine, Case Western Reserve University, Cleveland, OH, USA
| |
Collapse
|