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del Valle L, Melero V, Bodas A, Martín O’Connor R, Ramos-Levi A, Barabash A, Valerio J, de Miguel P, Díaz Pérez JÁ, Familiar Casado C, Moraga Guerrero I, Jiménez-Varas I, Marcuello Foncillas C, Pazos M, Rubio-Herrera MA, López-Plaza B, Runkle I, Matía-Martín P, Calle-Pascual AL. A Greater Adherence to the Mediterranean Diet Supplemented with Extra Virgin Olive Oil and Nuts During Pregnancy Is Associated with Improved Offspring Health at Six Years of Age. Nutrients 2025; 17:1719. [PMID: 40431459 PMCID: PMC12113803 DOI: 10.3390/nu17101719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2025] [Revised: 05/13/2025] [Accepted: 05/16/2025] [Indexed: 05/29/2025] Open
Abstract
Background/Objectives: Children's health may be influenced by maternal eating habits during pregnancy. A Mediterranean diet (MedDiet)-based pattern has been associated with benefits in infectious disease and allergies in children. Methods: From a total 2228 pregnant women evaluated between 2015 and 2017 in the St. Carlos cohort, 1292 women belonging to the intervention group (IG) undertook a MedDiet supplemented with extra virgin olive oil (EVOO) and nuts from early on in pregnancy. The control group (CG) consisted of 516 pregnant women who were advised to follow a fat-restricted MedDiet. The modified 12-point Mediterranean diet adherence screener (MEDAS) was applied. A total of 1808 (81.2%) children were analyzed at 6 years postpartum. All women from both groups received the same postpartum nutritional recommendations as the IG had during pregnancy. Results: Children from the IG showed lower rates of bronchiolitis and atopic eczema compared to the CG. Children whose mother's MEDAS score was ≥6 at 24-28 GW vs. MEDAS scores < 6 presented lower rates of bronchiolitis [222/695 (28.8%) vs. 441/1113 (39.6%); p = 0.022] and atopic eczema [311/695 (39.0%) vs. 564/1113 (50.7%); p = 0.039]. The offspring of mothers with MEDAS scores ≥ 8 (n = 176) vs. MEDAS scores ≤ 3 (n = 564) showed a lower relative risk (RR) (95% CI) for developing bronchiolitis [0.75 (0.58-0.97)] and atopic eczema [0.82 (0.69-0.98)], with both having a p < 0.001 trend. Conclusions: A higher adherence to a MedDiet supplemented with EVOO and nuts during pregnancy is associated with health benefits in offspring at 6 years of age.
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Affiliation(s)
- Laura del Valle
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC), 28040 Madrid, Spain; (L.d.V.); (V.M.); (R.M.O.); (A.R.-L.); (A.B.); (J.V.); (P.d.M.); (J.Á.D.P.); (C.F.C.); (I.M.G.); (I.J.-V.); (C.M.F.); (M.P.); (M.A.R.-H.); (I.R.)
| | - Verónica Melero
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC), 28040 Madrid, Spain; (L.d.V.); (V.M.); (R.M.O.); (A.R.-L.); (A.B.); (J.V.); (P.d.M.); (J.Á.D.P.); (C.F.C.); (I.M.G.); (I.J.-V.); (C.M.F.); (M.P.); (M.A.R.-H.); (I.R.)
| | - Andrés Bodas
- Paediatrics Department, Hospital Clínico Universitario San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC), 28040 Madrid, Spain;
| | - Rocío Martín O’Connor
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC), 28040 Madrid, Spain; (L.d.V.); (V.M.); (R.M.O.); (A.R.-L.); (A.B.); (J.V.); (P.d.M.); (J.Á.D.P.); (C.F.C.); (I.M.G.); (I.J.-V.); (C.M.F.); (M.P.); (M.A.R.-H.); (I.R.)
| | - Ana Ramos-Levi
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC), 28040 Madrid, Spain; (L.d.V.); (V.M.); (R.M.O.); (A.R.-L.); (A.B.); (J.V.); (P.d.M.); (J.Á.D.P.); (C.F.C.); (I.M.G.); (I.J.-V.); (C.M.F.); (M.P.); (M.A.R.-H.); (I.R.)
- Facultad de Medicina, Medicina II Department, Universidad Complutense de Madrid, 28040 Madrid, Spain;
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), 28029 Madrid, Spain
| | - Ana Barabash
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC), 28040 Madrid, Spain; (L.d.V.); (V.M.); (R.M.O.); (A.R.-L.); (A.B.); (J.V.); (P.d.M.); (J.Á.D.P.); (C.F.C.); (I.M.G.); (I.J.-V.); (C.M.F.); (M.P.); (M.A.R.-H.); (I.R.)
- Facultad de Medicina, Medicina II Department, Universidad Complutense de Madrid, 28040 Madrid, Spain;
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), 28029 Madrid, Spain
| | - Johanna Valerio
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC), 28040 Madrid, Spain; (L.d.V.); (V.M.); (R.M.O.); (A.R.-L.); (A.B.); (J.V.); (P.d.M.); (J.Á.D.P.); (C.F.C.); (I.M.G.); (I.J.-V.); (C.M.F.); (M.P.); (M.A.R.-H.); (I.R.)
| | - Paz de Miguel
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC), 28040 Madrid, Spain; (L.d.V.); (V.M.); (R.M.O.); (A.R.-L.); (A.B.); (J.V.); (P.d.M.); (J.Á.D.P.); (C.F.C.); (I.M.G.); (I.J.-V.); (C.M.F.); (M.P.); (M.A.R.-H.); (I.R.)
- Facultad de Medicina, Medicina II Department, Universidad Complutense de Madrid, 28040 Madrid, Spain;
| | - José Ángel Díaz Pérez
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC), 28040 Madrid, Spain; (L.d.V.); (V.M.); (R.M.O.); (A.R.-L.); (A.B.); (J.V.); (P.d.M.); (J.Á.D.P.); (C.F.C.); (I.M.G.); (I.J.-V.); (C.M.F.); (M.P.); (M.A.R.-H.); (I.R.)
- Facultad de Medicina, Medicina II Department, Universidad Complutense de Madrid, 28040 Madrid, Spain;
| | - Cristina Familiar Casado
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC), 28040 Madrid, Spain; (L.d.V.); (V.M.); (R.M.O.); (A.R.-L.); (A.B.); (J.V.); (P.d.M.); (J.Á.D.P.); (C.F.C.); (I.M.G.); (I.J.-V.); (C.M.F.); (M.P.); (M.A.R.-H.); (I.R.)
| | - Inmaculada Moraga Guerrero
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC), 28040 Madrid, Spain; (L.d.V.); (V.M.); (R.M.O.); (A.R.-L.); (A.B.); (J.V.); (P.d.M.); (J.Á.D.P.); (C.F.C.); (I.M.G.); (I.J.-V.); (C.M.F.); (M.P.); (M.A.R.-H.); (I.R.)
| | - Inés Jiménez-Varas
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC), 28040 Madrid, Spain; (L.d.V.); (V.M.); (R.M.O.); (A.R.-L.); (A.B.); (J.V.); (P.d.M.); (J.Á.D.P.); (C.F.C.); (I.M.G.); (I.J.-V.); (C.M.F.); (M.P.); (M.A.R.-H.); (I.R.)
| | - Clara Marcuello Foncillas
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC), 28040 Madrid, Spain; (L.d.V.); (V.M.); (R.M.O.); (A.R.-L.); (A.B.); (J.V.); (P.d.M.); (J.Á.D.P.); (C.F.C.); (I.M.G.); (I.J.-V.); (C.M.F.); (M.P.); (M.A.R.-H.); (I.R.)
| | - Mario Pazos
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC), 28040 Madrid, Spain; (L.d.V.); (V.M.); (R.M.O.); (A.R.-L.); (A.B.); (J.V.); (P.d.M.); (J.Á.D.P.); (C.F.C.); (I.M.G.); (I.J.-V.); (C.M.F.); (M.P.); (M.A.R.-H.); (I.R.)
| | - Miguel A. Rubio-Herrera
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC), 28040 Madrid, Spain; (L.d.V.); (V.M.); (R.M.O.); (A.R.-L.); (A.B.); (J.V.); (P.d.M.); (J.Á.D.P.); (C.F.C.); (I.M.G.); (I.J.-V.); (C.M.F.); (M.P.); (M.A.R.-H.); (I.R.)
- Facultad de Medicina, Medicina II Department, Universidad Complutense de Madrid, 28040 Madrid, Spain;
| | - Bricia López-Plaza
- Facultad de Medicina, Medicina II Department, Universidad Complutense de Madrid, 28040 Madrid, Spain;
| | - Isabelle Runkle
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC), 28040 Madrid, Spain; (L.d.V.); (V.M.); (R.M.O.); (A.R.-L.); (A.B.); (J.V.); (P.d.M.); (J.Á.D.P.); (C.F.C.); (I.M.G.); (I.J.-V.); (C.M.F.); (M.P.); (M.A.R.-H.); (I.R.)
| | - Pilar Matía-Martín
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC), 28040 Madrid, Spain; (L.d.V.); (V.M.); (R.M.O.); (A.R.-L.); (A.B.); (J.V.); (P.d.M.); (J.Á.D.P.); (C.F.C.); (I.M.G.); (I.J.-V.); (C.M.F.); (M.P.); (M.A.R.-H.); (I.R.)
- Facultad de Medicina, Medicina II Department, Universidad Complutense de Madrid, 28040 Madrid, Spain;
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), 28029 Madrid, Spain
| | - Alfonso L. Calle-Pascual
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC), 28040 Madrid, Spain; (L.d.V.); (V.M.); (R.M.O.); (A.R.-L.); (A.B.); (J.V.); (P.d.M.); (J.Á.D.P.); (C.F.C.); (I.M.G.); (I.J.-V.); (C.M.F.); (M.P.); (M.A.R.-H.); (I.R.)
- Facultad de Medicina, Medicina II Department, Universidad Complutense de Madrid, 28040 Madrid, Spain;
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), 28029 Madrid, Spain
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Ong YY, Pang WW, Huang JY, Aris IM, Sadananthan SA, Tint MT, Yuan WL, Chen LW, Chan YH, Karnani N, Velan SS, Fortier MV, Choo J, Ling LH, Shek L, Tan KH, Gluckman PD, Yap F, Chong YS, Godfrey KM, Chong MFF, Chan SY, Eriksson JG, Wlodek ME, Lee YS, Michael N. Breastfeeding may benefit cardiometabolic health of children exposed to increased gestational glycemia in utero. Eur J Nutr 2022; 61:2383-2395. [PMID: 35124728 PMCID: PMC7613060 DOI: 10.1007/s00394-022-02800-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 01/06/2022] [Indexed: 02/03/2023]
Abstract
PURPOSE There is altered breastmilk composition among mothers with gestational diabetes and conflicting evidence on whether breastfeeding is beneficial or detrimental to their offspring's cardiometabolic health. We aimed to investigate associations between breastfeeding and offspring's cardiometabolic health across the range of gestational glycemia. METHODS We included 827 naturally conceived, term singletons from a prospective mother-child cohort. We measured gestational (26-28 weeks) fasting plasma glucose (FPG) and 2-h plasma glucose (2 hPG) after an oral glucose tolerance test as continuous variables. Participants were classified into 2 breastfeeding categories (high/intermediate vs. low) according to their breastfeeding duration and exclusivity. Main outcome measures included magnetic resonance imaging (MRI)-measured abdominal fat, intramyocellular lipids (IMCL), and liver fat, quantitative magnetic resonance (QMR)-measured body fat mass, blood pressure, blood lipids, and insulin resistance at 6 years old (all continuous variables). We evaluated if gestational glycemia (FPG and 2 hPG) modified the association of breastfeeding with offspring outcomes after adjusting for confounders using a multiple linear regression model that included a 'gestational glycemia × breastfeeding' interaction term. RESULTS With increasing gestational FPG, high/intermediate (vs. low) breastfeeding was associated with lower levels of IMCL (p-interaction = 0.047), liver fat (p-interaction = 0.033), and triglycerides (p-interaction = 0.007), after adjusting for confounders. Specifically, at 2 standard deviations above the mean gestational FPG level, high/intermediate (vs. low) breastfeeding was linked to lower adjusted mean IMCL [0.39% of water signal (0.29, 0.50) vs. 0.54% of water signal (0.46, 0.62)], liver fat [0.39% by weight (0.20, 0.58) vs. 0.72% by weight (0.59, 0.85)], and triglycerides [0.62 mmol/L (0.51, 0.72) vs. 0.86 mmol/L (0.75, 0.97)]. 2 hPG did not significantly modify the association between breastfeeding and childhood cardiometabolic risk. CONCLUSION Our findings suggest breastfeeding may confer protection against adverse fat partitioning and higher triglyceride concentration among children exposed to increased glycemia in utero.
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Affiliation(s)
- Yi Ying Ong
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Wei Wei Pang
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Jonathan Y Huang
- Brenner Centre for Molecular Medicine, Singapore Institute for Clinical Science, Agency for Science, Technology, and Research, 30 Medical Drive, Singapore, 117609, Singapore
| | - Izzuddin M Aris
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Suresh Anand Sadananthan
- Brenner Centre for Molecular Medicine, Singapore Institute for Clinical Science, Agency for Science, Technology, and Research, 30 Medical Drive, Singapore, 117609, Singapore
| | - Mya-Thway Tint
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Brenner Centre for Molecular Medicine, Singapore Institute for Clinical Science, Agency for Science, Technology, and Research, 30 Medical Drive, Singapore, 117609, Singapore
| | - Wen Lun Yuan
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Ling-Wei Chen
- Brenner Centre for Molecular Medicine, Singapore Institute for Clinical Science, Agency for Science, Technology, and Research, 30 Medical Drive, Singapore, 117609, Singapore
| | - Yiong Huak Chan
- Biostatistics Unit, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Neerja Karnani
- Brenner Centre for Molecular Medicine, Singapore Institute for Clinical Science, Agency for Science, Technology, and Research, 30 Medical Drive, Singapore, 117609, Singapore
| | - S Sendhil Velan
- Brenner Centre for Molecular Medicine, Singapore Institute for Clinical Science, Agency for Science, Technology, and Research, 30 Medical Drive, Singapore, 117609, Singapore
- Singapore Bioimaging Consortium, Agency for Science Technology and Research, Singapore, Singapore
| | - Marielle V Fortier
- Brenner Centre for Molecular Medicine, Singapore Institute for Clinical Science, Agency for Science, Technology, and Research, 30 Medical Drive, Singapore, 117609, Singapore
- Department of Diagnostic and Interventional Imaging, KK Women's and Children's Hospital, Singapore, Singapore
| | - Jonathan Choo
- Department of Paediatrics, KK Women's and Children's Hospital, Singapore, Singapore
| | - Lieng Hsi Ling
- Department of Cardiology, National University Heart Centre, Singapore, Singapore
| | - Lynette Shek
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Brenner Centre for Molecular Medicine, Singapore Institute for Clinical Science, Agency for Science, Technology, and Research, 30 Medical Drive, Singapore, 117609, Singapore
- Division of Paediatric Endocrinology, Department of Paediatrics, Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, National University Health System, Singapore, Singapore
| | - Kok Hian Tan
- Duke-NUS Medical School, Singapore, Singapore
- Department of Maternal Fetal Medicine, KK Women's and Children's Hospital, Singapore, Singapore
| | - Peter D Gluckman
- Brenner Centre for Molecular Medicine, Singapore Institute for Clinical Science, Agency for Science, Technology, and Research, 30 Medical Drive, Singapore, 117609, Singapore
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Fabian Yap
- Department of Paediatrics, KK Women's and Children's Hospital, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Yap-Seng Chong
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Brenner Centre for Molecular Medicine, Singapore Institute for Clinical Science, Agency for Science, Technology, and Research, 30 Medical Drive, Singapore, 117609, Singapore
| | - Keith M Godfrey
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Mary F-F Chong
- Brenner Centre for Molecular Medicine, Singapore Institute for Clinical Science, Agency for Science, Technology, and Research, 30 Medical Drive, Singapore, 117609, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Shiao-Yng Chan
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Brenner Centre for Molecular Medicine, Singapore Institute for Clinical Science, Agency for Science, Technology, and Research, 30 Medical Drive, Singapore, 117609, Singapore
| | - Johan G Eriksson
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Brenner Centre for Molecular Medicine, Singapore Institute for Clinical Science, Agency for Science, Technology, and Research, 30 Medical Drive, Singapore, 117609, Singapore
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
- Folkhälsan Research Center, Helsinki, Finland
| | - Mary E Wlodek
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Brenner Centre for Molecular Medicine, Singapore Institute for Clinical Science, Agency for Science, Technology, and Research, 30 Medical Drive, Singapore, 117609, Singapore
- Department of Physiology, University of Melbourne, Melbourne, Australia
| | - Yung Seng Lee
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
- Brenner Centre for Molecular Medicine, Singapore Institute for Clinical Science, Agency for Science, Technology, and Research, 30 Medical Drive, Singapore, 117609, Singapore.
- Division of Paediatric Endocrinology, Department of Paediatrics, Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, National University Health System, Singapore, Singapore.
| | - Navin Michael
- Brenner Centre for Molecular Medicine, Singapore Institute for Clinical Science, Agency for Science, Technology, and Research, 30 Medical Drive, Singapore, 117609, Singapore.
- , 1E Kent Ridge Road, NUHS Tower Block Level 12, Singapore, 119228, Singapore.
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Use of oral glucose tolerance testing and HbA1c at 6-14 gestational weeks to predict gestational diabetes mellitus in high-risk women. Arch Gynecol Obstet 2022; 307:1451-1457. [PMID: 35670847 DOI: 10.1007/s00404-022-06637-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Accepted: 05/17/2022] [Indexed: 11/02/2022]
Abstract
PURPOSE To study the prediction of gestational diabetes mellitus (GDM) in high-risk pregnant women by testing fasting blood glucose, 1-h(1hPG) and 2-h plasma glucose (2hPG) after an oral glucose tolerance test, and glycated hemoglobin (HbA1c) in early pregnancy (6-14 weeks). METHODS We recruited 1311 pregnant women at high risk for diabetes from the Obstetrics Clinic of Daxing District People's Hospital between June 2017 and December 2019. The tests performed during the first trimester included fasting blood glucose (FPG), HbA1c, and 75-g oral glucose tolerance test (OGTT) with 1hPG and 2hPG. Seventy-three pregnant women diagnosed with pregestational diabetes mellitus (PGDM) early in pregnancy and 36 who were missed in the second trimester were excluded. A total of 1202 women were followed up until 24-28 weeks for GDM. The receiver operating characteristic (ROC) and area under the ROC curve (AUC) were calculated to determine the predictive values of FPG, 1hPG, 2hPG, and HbA1c for GDM in early pregnancy in high-risk pregnant women. RESULTS The AUC for 1hPG for the prediction of GDM in high-risk pregnant women was greater than those for FPG, 2hPG, and HbA1c. All differences were significant. The AUCs for the predictive values of FPG, 1hPG, 2hPG, and HbA1c in high-risk pregnant women were 0.63, 0.76, 0.71, and 0.67, respectively. The prevalence of PGDM among pregnant women at high risk of diabetes was 5.6%. CONCLUSION First-trimester levels of FPG, 1hPG, 2hPG, and HbA1c in high-risk women are significant predictors of GDM, with 1hPG having the most significant predictive value.
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Tang J, Fan L, Lv C, Wan R, Liu J, Liu X. Efficacy of Shenqi Jiangtang Granules-Assisted Western Medicine in the Treatment of Gestational Diabetes Mellitus (GDM). IRANIAN JOURNAL OF PUBLIC HEALTH 2021; 50:2191-2201. [PMID: 35223593 PMCID: PMC8826322 DOI: 10.18502/ijph.v50i11.7573] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Accepted: 03/19/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND We aimed to investigate the efficacy of Shenqi Jiangtang granules-assisted Western medicine in the treatment of gestational diabetes mellitus (GDM). METHODS A total of 147 patients with GDM treated in Qilu Hospital of Shandong University from Jan 2018 to Apr 2019 were enrolled. They were randomly divided into traditional Chinese medicine (TCM) combined with Western medicine group, Western medicine group and control group. The control group was treated with exercise combined with diet therapy, and the Western medicine group was additionally treated with metformin tablets. The TCM combined with Western medicine group was additionally treated with Shenqi Jiangtang granules. RESULTS After treatment, the levels of 10 indicators in the three groups were lower than those before treatment (P < 0.05). These indicators were the lowest in the TCM combined with Western medicine group. However, high-density lipoprotein cholesterol (HDL-C), glutathione peroxidase (GSH-PX) and superoxide dismutase (SOD) after treatment increased in the three groups compared with those before treatment (P < 0.05), which was the most obvious in the TCM combined with Western medicine group. After treatment, the number of patients with natural delivery in the TCM combined with Western medicine group was the largest. The incidences of complications in pregnant women, fetuses and newborns were the lowest in the TCM combined with Western medicine group. CONCLUSION Application of Shenqi Jiangtang granules-assisted Western medicine in patients with GDM can effectively control blood glucose and lipid levels, enhance antioxidant capacity, reduce the levels of inflammatory cytokines and decrease the incidence of adverse pregnancy outcomes.
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Affiliation(s)
- Juan Tang
- International Medical Services, Qilu Hospital of Shandong University, Jinan 250012, China
| | - Li Fan
- Jinan Lixiaqu Municipal Center For Disease Control and Precention, Jinan 250100, China
| | - Chunlei Lv
- Operation Room, The Affiliated Hospital of Shandong University of TCM, Jinan 250011, China
| | - Runjie Wan
- Department of Obstetrics and Gynecology, Qilu Hospital of Shandong University, Jinan 250012, China
| | - Jianjian Liu
- Department of Obstetrics and Gynecology, Qilu Hospital of Shandong University, Jinan 250012, China
| | - Xiaoyan Liu
- Department of Obstetrics and Gynecology, Qilu Hospital of Shandong University, Jinan 250012, China
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Melero V, Assaf-Balut C, García de la Torre N, Jiménez I, Bordiú E, del Valle L, Valerio J, Familiar C, Durán A, Runkle I, de Miguel MP, Montañez C, Barabash A, Cuesta M, Herraiz MA, Izquierdo N, Rubio MA, Calle-Pascual AL. Benefits of Adhering to a Mediterranean Diet Supplemented with Extra Virgin Olive Oil and Pistachios in Pregnancy on the Health of Offspring at 2 Years of Age. Results of the San Carlos Gestational Diabetes Mellitus Prevention Study. J Clin Med 2020; 9:jcm9051454. [PMID: 32414066 PMCID: PMC7290358 DOI: 10.3390/jcm9051454] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 05/09/2020] [Accepted: 05/11/2020] [Indexed: 12/14/2022] Open
Abstract
The intrauterine environment may be related to the future development of chronic diseases in the offspring. The St. Carlos gestational diabetes mellitus (GDM) prevention study, is a randomized controlled trial that evaluated the influence of the early (before 12th gestational week) Mediterranean diet (MedDiet) on the onset of GDM and adverse gestational outcomes. Out of 874 women assessed after delivery (440 control group (CG)/434 intervention group (IG)), 703 children were followed (365/338; CG/IG), with the aim to assess whether the adherence to a MedDiet during pregnancy induces health benefits for the offspring during the first two years of life. Logistic regression analysis showed that the IG in children of mothers with pre-gestational body mass index (BMI) < 25 kg/m2 and normal glucose tolerance (NGT), was associated with a lower risk (RR(95% CI)) of suffering from severe events requiring hospitalization due to bronchiolitis/asthma (0.75(0.58–0.98) and 0.77(0.59–0.99), respectively) or other diseases that required either antibiotic (0.80(0.65–0.98) and 0.80(0.65–0.99), respectively), corticosteroid treatment (0.73(0.59–0.90) and 0.79(0.62–1.00) respectively) or both (all p < 0.05). A nutritional intervention based on the MedDiet during pregnancy is associated with a reduction in offspring’s hospital admissions, especially in women with pre-gestational BMI < 25 kg/m2 and NGT.
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Affiliation(s)
- Verónica Melero
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (V.M.); (C.A.-B.); (N.G.d.l.T.); (I.J.); (E.B.); (L.d.V.); (J.V.); (C.F.); (A.D.); (I.R.); (M.P.d.M.); (C.M.); (A.B.); (M.C.); (M.A.R.)
- Facultad de Medicina. Medicina II Department, Universidad Complutense de Madrid, 28040 Madrid, Spain; (M.A.H.); (N.I.)
| | - Carla Assaf-Balut
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (V.M.); (C.A.-B.); (N.G.d.l.T.); (I.J.); (E.B.); (L.d.V.); (J.V.); (C.F.); (A.D.); (I.R.); (M.P.d.M.); (C.M.); (A.B.); (M.C.); (M.A.R.)
- Facultad de Medicina. Medicina II Department, Universidad Complutense de Madrid, 28040 Madrid, Spain; (M.A.H.); (N.I.)
| | - Nuria García de la Torre
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (V.M.); (C.A.-B.); (N.G.d.l.T.); (I.J.); (E.B.); (L.d.V.); (J.V.); (C.F.); (A.D.); (I.R.); (M.P.d.M.); (C.M.); (A.B.); (M.C.); (M.A.R.)
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), 28029 Madrid, Spain
| | - Inés Jiménez
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (V.M.); (C.A.-B.); (N.G.d.l.T.); (I.J.); (E.B.); (L.d.V.); (J.V.); (C.F.); (A.D.); (I.R.); (M.P.d.M.); (C.M.); (A.B.); (M.C.); (M.A.R.)
| | - Elena Bordiú
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (V.M.); (C.A.-B.); (N.G.d.l.T.); (I.J.); (E.B.); (L.d.V.); (J.V.); (C.F.); (A.D.); (I.R.); (M.P.d.M.); (C.M.); (A.B.); (M.C.); (M.A.R.)
- Facultad de Medicina. Medicina II Department, Universidad Complutense de Madrid, 28040 Madrid, Spain; (M.A.H.); (N.I.)
| | - Laura del Valle
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (V.M.); (C.A.-B.); (N.G.d.l.T.); (I.J.); (E.B.); (L.d.V.); (J.V.); (C.F.); (A.D.); (I.R.); (M.P.d.M.); (C.M.); (A.B.); (M.C.); (M.A.R.)
| | - Johanna Valerio
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (V.M.); (C.A.-B.); (N.G.d.l.T.); (I.J.); (E.B.); (L.d.V.); (J.V.); (C.F.); (A.D.); (I.R.); (M.P.d.M.); (C.M.); (A.B.); (M.C.); (M.A.R.)
| | - Cristina Familiar
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (V.M.); (C.A.-B.); (N.G.d.l.T.); (I.J.); (E.B.); (L.d.V.); (J.V.); (C.F.); (A.D.); (I.R.); (M.P.d.M.); (C.M.); (A.B.); (M.C.); (M.A.R.)
| | - Alejandra Durán
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (V.M.); (C.A.-B.); (N.G.d.l.T.); (I.J.); (E.B.); (L.d.V.); (J.V.); (C.F.); (A.D.); (I.R.); (M.P.d.M.); (C.M.); (A.B.); (M.C.); (M.A.R.)
- Facultad de Medicina. Medicina II Department, Universidad Complutense de Madrid, 28040 Madrid, Spain; (M.A.H.); (N.I.)
| | - Isabelle Runkle
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (V.M.); (C.A.-B.); (N.G.d.l.T.); (I.J.); (E.B.); (L.d.V.); (J.V.); (C.F.); (A.D.); (I.R.); (M.P.d.M.); (C.M.); (A.B.); (M.C.); (M.A.R.)
- Facultad de Medicina. Medicina II Department, Universidad Complutense de Madrid, 28040 Madrid, Spain; (M.A.H.); (N.I.)
| | - María Paz de Miguel
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (V.M.); (C.A.-B.); (N.G.d.l.T.); (I.J.); (E.B.); (L.d.V.); (J.V.); (C.F.); (A.D.); (I.R.); (M.P.d.M.); (C.M.); (A.B.); (M.C.); (M.A.R.)
- Facultad de Medicina. Medicina II Department, Universidad Complutense de Madrid, 28040 Madrid, Spain; (M.A.H.); (N.I.)
| | - Carmen Montañez
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (V.M.); (C.A.-B.); (N.G.d.l.T.); (I.J.); (E.B.); (L.d.V.); (J.V.); (C.F.); (A.D.); (I.R.); (M.P.d.M.); (C.M.); (A.B.); (M.C.); (M.A.R.)
| | - Ana Barabash
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (V.M.); (C.A.-B.); (N.G.d.l.T.); (I.J.); (E.B.); (L.d.V.); (J.V.); (C.F.); (A.D.); (I.R.); (M.P.d.M.); (C.M.); (A.B.); (M.C.); (M.A.R.)
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), 28029 Madrid, Spain
| | - Martín Cuesta
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (V.M.); (C.A.-B.); (N.G.d.l.T.); (I.J.); (E.B.); (L.d.V.); (J.V.); (C.F.); (A.D.); (I.R.); (M.P.d.M.); (C.M.); (A.B.); (M.C.); (M.A.R.)
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), 28029 Madrid, Spain
| | - Miguel A. Herraiz
- Facultad de Medicina. Medicina II Department, Universidad Complutense de Madrid, 28040 Madrid, Spain; (M.A.H.); (N.I.)
- Gynecology and Obstetrics Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain
| | - Nuria Izquierdo
- Facultad de Medicina. Medicina II Department, Universidad Complutense de Madrid, 28040 Madrid, Spain; (M.A.H.); (N.I.)
- Gynecology and Obstetrics Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain
| | - Miguel A. Rubio
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (V.M.); (C.A.-B.); (N.G.d.l.T.); (I.J.); (E.B.); (L.d.V.); (J.V.); (C.F.); (A.D.); (I.R.); (M.P.d.M.); (C.M.); (A.B.); (M.C.); (M.A.R.)
- Facultad de Medicina. Medicina II Department, Universidad Complutense de Madrid, 28040 Madrid, Spain; (M.A.H.); (N.I.)
| | - Alfonso L. Calle-Pascual
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (V.M.); (C.A.-B.); (N.G.d.l.T.); (I.J.); (E.B.); (L.d.V.); (J.V.); (C.F.); (A.D.); (I.R.); (M.P.d.M.); (C.M.); (A.B.); (M.C.); (M.A.R.)
- Facultad de Medicina. Medicina II Department, Universidad Complutense de Madrid, 28040 Madrid, Spain; (M.A.H.); (N.I.)
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), 28029 Madrid, Spain
- Correspondence:
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6
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Fadl H, Saeedi M, Montgomery S, Magnuson A, Schwarcz E, Berntorp K, Sengpiel V, Storck-Lindholm E, Strevens H, Wikström AK, Brismar-Wendel S, Persson M, Jansson S, Ahlsson F, Ursing C, Ryen L, Petersson K, Wennerholm UB, Hildén K, Simmons D. Changing diagnostic criteria for gestational diabetes in Sweden - a stepped wedge national cluster randomised controlled trial - the CDC4G study protocol. BMC Pregnancy Childbirth 2019; 19:398. [PMID: 31675922 PMCID: PMC6823965 DOI: 10.1186/s12884-019-2547-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 10/09/2019] [Indexed: 01/19/2023] Open
Abstract
Background The optimal criteria to diagnose gestational diabetes mellitus (GDM) remain contested. The Swedish National Board of Health introduced the 2013 WHO criteria in 2015 as a recommendation for initiation of treatment for hyperglycaemia during pregnancy. With variation in GDM screening and diagnostic practice across the country, it was agreed that the shift to new guidelines should be in a scientific and structured way. The aim of the Changing Diagnostic Criteria for Gestational Diabetes (CDC4G) in Sweden (www.cdc4g.se/en) is to evaluate the clinical and health economic impacts of changing diagnostic criteria for GDM in Sweden and to create a prospective cohort to compare the many long-term outcomes in mother and baby under the old and new diagnostic approaches. Methods This is a stepped wedge cluster randomised controlled trial, comparing pregnancy outcomes before and after the switch in GDM criteria across 11 centres in a randomised manner. The trial includes all pregnant women screened for GDM across the participating centres during January–December 2018, approximately two thirds of all pregnancies in Sweden in a year. Women with pre-existing diabetes will be excluded. Data will be collected through the national Swedish Pregnancy register and for follow up studies other health registers will be included. Discussion The stepped wedge RCT was chosen to be the best study design for evaluating the shift from old to new diagnostic criteria of GDM in Sweden. The national quality registers provide data on the whole pregnant population and gives a possibility for follow up studies of both mother and child. The health economic analysis from the study will give a solid evidence base for future changes in order to improve immediate pregnancy, as well as long term, outcomes for mother and child. Trial registration CDC4G is listed on the ISRCTN registry with study ID ISRCTN41918550 (15/12/2017)
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Affiliation(s)
- Helena Fadl
- Department of Obstetrics and Gynaecology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
| | - Maryam Saeedi
- Department of Obstetrics and Gynaecology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Scott Montgomery
- Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden.,Clinical Epidemiology Unit, Department of Medicine, Karolinska Institutet, Stockholm, Sweden.,Department of Epidemiology and Public Health, University College London, London, UK
| | - Anders Magnuson
- Clinical Epidemiology and Biostatistics, University Hospital Örebro, Örebro, Sweden
| | - Erik Schwarcz
- Department of Internal Medicine, School of medical health and sciences, Örebro University Hospital, Örebro, Sweden
| | - Kerstin Berntorp
- Department of Endocrinology, Skåne University Hospital, Clinical Research Center Malmö, Lund University, Lund, Sweden
| | - Verena Sengpiel
- Department of Obstetrics and Gynaecology, Sahlgrenska University Hospital, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | | | - Helena Strevens
- Department of Obstetrics and Gynaecology, Skåne University Hospital, Clinical Research Center Lund, Lund University, Lund, Sweden
| | | | - Sophia Brismar-Wendel
- Department of Clinical Sciences, Karolinska Institutet Danderyd Hospital, Stockholm, Sweden
| | - Martina Persson
- Department of Paediatrics, Sachsska Children's and Youth hospital and Department of Clinical Science and Education, Karolinska Institute, Stockholm, Sweden
| | - Stefan Jansson
- School of Medical Sciences, University Health Care Research Center, Örebro University, Örebro, Sweden
| | - Fredrik Ahlsson
- Department of Women's and Children's health, Uppsala University, Uppsala, Sweden
| | - Carina Ursing
- Department of Endocrinology, Södersjukhuset, Stockholm, Sweden
| | - Linda Ryen
- Center for Health Care Science, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Kerstin Petersson
- Department of Clinical Sciences, Obstetrics and Gynaecology, Umeå University, Umeå, Sweden
| | - Ulla-Britt Wennerholm
- Department of Obstetrics and Gynaecology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Karin Hildén
- Department of Obstetrics and Gynaecology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - David Simmons
- Macarthur Clinical School, Western Sydney University, Campbell town, Australia.,Faculty of Medicine and Health, Örebro University, Örebro, Sweden
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