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Foussard N, Cougnard-Grégoire A, Rajaobelina K, Delcourt C, Helmer C, Lamireau T, Gonzalez C, Grouthier V, Haissaguerre M, Blanco L, Alexandre L, Mohammedi K, Rigalleau V. Skin Autofluorescence of Pregnant Women With Diabetes Predicts the Macrosomia of Their Children. Diabetes 2019; 68:1663-1669. [PMID: 31127055 DOI: 10.2337/db18-0906] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Accepted: 05/18/2019] [Indexed: 11/13/2022]
Abstract
Advanced glycation end products (AGEs) accumulated during long-term hyperglycemia are involved in diabetes complications and can be estimated by skin autofluorescence (sAF). During pregnancy, hyperglycemia exposes women to the risk of having a macrosomic newborn. The aim of this study was to determine whether sAF of women with diabetes during a singleton pregnancy could predict macrosomia in their newborns. Using an AGE Reader, we measured the sAF at the first visit of 343 women who were referred to our diabetology department during years 2011-2015. Thirty-nine women had pregestational diabetes, 95 early gestational diabetes mellitus (GDM), and 209 late GDM. Macrosomia was defined as birth weight ≥4,000 g and/or large for gestational age ≥90th percentile. Forty-six newborns were macrosomic. Their mothers had 11% higher sAF compared with other mothers: 2.03 ± 0.30 arbitrary units (AUs) vs. 1.80 ± 0.34 (P < 0.0001). Using multivariate logistic regression, the relation between sAF and macrosomia was significant (odds ratio 4.13 for 1-AU increase of sAF [95% CI 1.46-11.71]) after adjusting for several potential confounders. This relation remained significant after further adjustment for HbA1c (among 263 women with available HbA1c) and for women with GDM only. sAF of pregnant women with diabetes, a marker of long-term hyperglycemic exposure, predicts macrosomia in their newborns.
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Affiliation(s)
- Ninon Foussard
- Nutrition-Diabetology, CHU de Bordeaux, Hôpital Haut-Lévêque, Pessac, France
| | - Audrey Cougnard-Grégoire
- University of Bordeaux, INSERM, Bordeaux Population Health Research Center, Team Lifelong Exposures Health and Aging, UMR 1219, Bordeaux, France
| | - Kalina Rajaobelina
- University of Bordeaux, INSERM, Bordeaux Population Health Research Center, Team Lifelong Exposures Health and Aging, UMR 1219, Bordeaux, France
| | - Cécile Delcourt
- University of Bordeaux, INSERM, Bordeaux Population Health Research Center, Team Lifelong Exposures Health and Aging, UMR 1219, Bordeaux, France
| | - Catherine Helmer
- University of Bordeaux, INSERM, Bordeaux Population Health Research Center, Team Lifelong Exposures Health and Aging, UMR 1219, Bordeaux, France
| | - Thierry Lamireau
- University of Bordeaux, INSERM, Bordeaux Population Health Research Center, Team Lifelong Exposures Health and Aging, UMR 1219, Bordeaux, France
| | - Concepcion Gonzalez
- Nutrition-Diabetology, CHU de Bordeaux, Hôpital Haut-Lévêque, Pessac, France
| | - Virginie Grouthier
- Nutrition-Diabetology, CHU de Bordeaux, Hôpital Haut-Lévêque, Pessac, France
| | | | - Laurence Blanco
- Nutrition-Diabetology, CHU de Bordeaux, Hôpital Haut-Lévêque, Pessac, France
| | - Laure Alexandre
- Nutrition-Diabetology, CHU de Bordeaux, Hôpital Haut-Lévêque, Pessac, France
| | - Kamel Mohammedi
- Nutrition-Diabetology, CHU de Bordeaux, Hôpital Haut-Lévêque, Pessac, France
| | - Vincent Rigalleau
- Nutrition-Diabetology, CHU de Bordeaux, Hôpital Haut-Lévêque, Pessac, France
- University of Bordeaux, INSERM, Bordeaux Population Health Research Center, Team Lifelong Exposures Health and Aging, UMR 1219, Bordeaux, France
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Cosson E, Gary F, Nguyen MT, Bianchi L, Sandre-Banon D, Biri L, Jaber Y, Cussac-Pillegand C, Banu I, Chiheb S, Carbillon L, Valensi P. Gradual increase in advanced glycation end-products from no diabetes to early and regular gestational diabetes: A case-control study. DIABETES & METABOLISM 2018; 45:586-589. [PMID: 29402596 DOI: 10.1016/j.diabet.2018.01.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Revised: 01/05/2018] [Accepted: 01/06/2018] [Indexed: 10/18/2022]
Affiliation(s)
- E Cosson
- Department of endocrinology-diabetology-nutrition, CRNH-IdF, CINFO, Jean-Verdier hospital, Paris 13 university, AP-HP, 93143 Bondy cedex, France; Unité de recherche épidémiologique nutritionnelle, UMR U1153 Inserm, U11125 Inra, CNAM, université Paris13, 93000 Bobigny, France.
| | - F Gary
- Department of endocrinology-diabetology-nutrition, CRNH-IdF, CINFO, Jean-Verdier hospital, Paris 13 university, AP-HP, 93143 Bondy cedex, France
| | - M T Nguyen
- Department of endocrinology-diabetology-nutrition, CRNH-IdF, CINFO, Jean-Verdier hospital, Paris 13 university, AP-HP, 93143 Bondy cedex, France
| | - L Bianchi
- Department of endocrinology-diabetology-nutrition, CRNH-IdF, CINFO, Jean-Verdier hospital, Paris 13 university, AP-HP, 93143 Bondy cedex, France
| | - D Sandre-Banon
- Department of endocrinology-diabetology-nutrition, CRNH-IdF, CINFO, Jean-Verdier hospital, Paris 13 university, AP-HP, 93143 Bondy cedex, France
| | - L Biri
- Department of endocrinology-diabetology-nutrition, CRNH-IdF, CINFO, Jean-Verdier hospital, Paris 13 university, AP-HP, 93143 Bondy cedex, France
| | - Y Jaber
- Department of endocrinology-diabetology-nutrition, CRNH-IdF, CINFO, Jean-Verdier hospital, Paris 13 university, AP-HP, 93143 Bondy cedex, France
| | - C Cussac-Pillegand
- Department of endocrinology-diabetology-nutrition, CRNH-IdF, CINFO, Jean-Verdier hospital, Paris 13 university, AP-HP, 93143 Bondy cedex, France
| | - I Banu
- Department of endocrinology-diabetology-nutrition, CRNH-IdF, CINFO, Jean-Verdier hospital, Paris 13 university, AP-HP, 93143 Bondy cedex, France
| | - S Chiheb
- Department of endocrinology-diabetology-nutrition, CRNH-IdF, CINFO, Jean-Verdier hospital, Paris 13 university, AP-HP, 93143 Bondy cedex, France
| | - L Carbillon
- Department of gynecology-obstetrics, Jean-Verdier hospital, Paris 13 university, AP-HP, 93143 Bondy cedex, France
| | - P Valensi
- Department of endocrinology-diabetology-nutrition, CRNH-IdF, CINFO, Jean-Verdier hospital, Paris 13 university, AP-HP, 93143 Bondy cedex, France
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Cosson E, Carbillon L, Valensi P. High Fasting Plasma Glucose during Early Pregnancy: A Review about Early Gestational Diabetes Mellitus. J Diabetes Res 2017; 2017:8921712. [PMID: 29181414 PMCID: PMC5664285 DOI: 10.1155/2017/8921712] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Accepted: 09/19/2017] [Indexed: 01/20/2023] Open
Abstract
Fasting plasma glucose (FPG) is nowadays routinely measured during early pregnancy to detect preexisting diabetes (FPG ≥ 7 mmol/L). This screening has concomitantly led to identify early intermediate hyperglycemia, defined as FPG in the 5.1 to 6.9 mmol/L range, also early gestational diabetes mellitus (eGDM). Early FPG has been associated with poor pregnancy outcomes, but the recommendation by the IADPSG to refer women with eGDM for immediate management is more pragmatic than evidence based. Although eGDM is characterized by insulin resistance and associated with classical risk factors for type 2 diabetes and incident diabetes after delivery, it is not necessarily associated with preexisting prediabetes. FPG ≥ 5.1 mmol/L in early pregnancy is actually poorly predictive of gestational diabetes mellitus diagnosed after 24 weeks of gestation. An alternative threshold should be determined but may vary according to ethnicity, gestational age, and body mass index. Finally, observational data suggest that early management of intermediate hyperglycemia may improve prognosis, through reduced gestational weight gain and potential early introduction of hypoglycemic agents. Considering all these issues, we suggest an algorithm for the management of eGDM based on early FPG levels that would be measured in case of risk factors. Nevertheless, interventional randomized trials are still missing.
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Affiliation(s)
- E. Cosson
- Department of Endocrinology-Diabetology-Nutrition, AP-HP, Jean Verdier Hospital, Paris 13 University, Sorbonne Paris Cité, CRNH-IdF, CINFO, Bondy, France
- Sorbonne Paris Cité, UMR U1153 Inserm/U1125 Inra/Cnam/Université Paris 13, Bobigny, France
| | - L. Carbillon
- Department of Gynecology-Obstetrics, AP-HP, Jean Verdier Hospital, Paris 13 University, Sorbonne Paris Cité, Bondy, France
| | - P. Valensi
- Department of Endocrinology-Diabetology-Nutrition, AP-HP, Jean Verdier Hospital, Paris 13 University, Sorbonne Paris Cité, CRNH-IdF, CINFO, Bondy, France
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