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María de los Angeles MM, del Socorro CRE, Hugo MZ, José de Jesús GG. Glucose metabolism in gestational diabetes and their relationship with fat mass / muscle mass index. Eur J Obstet Gynecol Reprod Biol X 2024; 21:100274. [PMID: 38292823 PMCID: PMC10824678 DOI: 10.1016/j.eurox.2023.100274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 12/20/2023] [Accepted: 12/22/2023] [Indexed: 02/01/2024] Open
Abstract
Introduction During pregnancy, women experience metabolic changes that may induce insulin resistance, which can be traced to the blood glucose levels A number of factors may intervene in the metabolism of glucose in pregnant women; one of them is body composition. This factor is useful for studying metabolic diseases, for which the identification of the fat mass/muscle mass index (FMMMI) considered an especially relevant factor. Owing to their nature, techniques such as bioimpedance have been sparsely used for analysis during pregnancy. Aim This study aimed to identify the relationship between fat mass / muscle mass index and glucose metabolism in pregnant women. Methods This descriptive cross-sectional study included 231 women between the ages of 18 and 35 years and 24-28 weeks of gestation, who attended a state hospital for regular check-ups and exhibited risk factors for the development of gestational diabetes (GD) according to the Current Practice Guidelines in Primary Care. The participants underwent a physical examination, anthropometric measurements bio impedance were obtained, and oral glucose tolerance curves were constructed. FMMMI was calculated. Results The prevalence of gestational diabetes was observed to be 13.4%. Women with a GD diagnosis had a significantly higher FMMMI than in those with no GD (0.746 ± 0.168 vs 0.567 ± 0.167;p < 0.005). The assessment of the FMMMI tertiles revealed that GD prevalence was higher in tertile 3 than in tertiles 1 and 2 (tertile 1: 2.6%; tertile 2: 9.1%; tertile 3: 24%). Conclusion FMMMI is associated with glucose tolerance test response in pregnant women and a higher prevalence of GD.
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Affiliation(s)
| | | | - Mendieta Zerón Hugo
- School of Medicine, Universidad Autónoma del Estado de México (UAEMex), Toluca, Mexico
- Cipres Grupo Médico, S.C, Toluca, Mexico
- Mónica Pretelini Saénz5 Maternal Perinatal Hospital, Toluca, Mexico
| | - Garduño García José de Jesús
- School of Medicine, Universidad Autónoma del Estado de México (UAEMex), Toluca, Mexico
- Regional General Hospital 251, Instituto Mexicano del Seguro Social (IMSS), Metepec, Mexico
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Haroon S, Tan JN, Lau T, Chan SY, Davenport A. Segmental bioimpedance in pregnant end stage renal failure patient for dry weight titration and volume management (case report). BMC Nephrol 2023; 24:308. [PMID: 37875806 PMCID: PMC10598990 DOI: 10.1186/s12882-023-03360-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 10/04/2023] [Indexed: 10/26/2023] Open
Abstract
BACKGROUND Volume assessment, dry weight titration, and blood pressure control in pregnant kidney failure patients are often challenging, with physiological fluid accumulation in the trunk and lower limbs and an increased risk of preeclampsia. We used segmental bioimpedance in the volume management of our kidney failure patient on haemodialysis. CASE PRESENTATION We report a case of a female patient on maintenance haemodiafiltration with no residual kidney function for whom we used segmental bioimpedance to guide dry weight adjustment. At different gestational periods, we targeted a different extracellular to total body water ratio according to body segments. This allowed us to support her high-risk pregnancy, identify her as probably developing preeclampsia and trigger a plan for closer monitoring and delivery during the third trimester when she had rapid weight gain. CONCLUSION Segmental bioimpedance is a practical, simple, and non-invasive test that can be performed at the dialysis unit and is useful as an adjunct decision-making tool in the management of pregnant dialysis patients.
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Affiliation(s)
- Sabrina Haroon
- Division of Nephrology, University Medicine Cluster, National University Hospital Singapore, Level 10, NUHS Tower Block, 1E Kent Ridge Road, 119228, Singapore, Republic of Singapore.
| | - Jia Neng Tan
- Division of Nephrology, University Medicine Cluster, National University Hospital Singapore, Level 10, NUHS Tower Block, 1E Kent Ridge Road, 119228, Singapore, Republic of Singapore
| | - Titus Lau
- Division of Nephrology, University Medicine Cluster, National University Hospital Singapore, Level 10, NUHS Tower Block, 1E Kent Ridge Road, 119228, Singapore, Republic of Singapore
| | - Shiao-Yng Chan
- Department of Obstetrics and Gynecology, School of Medicine, National University Hospital and Yong Loo Lin, National University of Singapore, Singapore, Republic of Singapore
| | - Andrew Davenport
- Department of Renal Medicine, University College London, Royal Free Hospital, London, UK
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Nguyen G, Hayes L, Ngongalah L, Bigirumurame T, Gaudet L, Odeniyi A, Flynn A, Crowe L, Skidmore B, Simon A, Smith V, Heslehurst N. Association between maternal adiposity measures and infant health outcomes: A systematic review and meta-analysis. Obes Rev 2022; 23:e13491. [PMID: 35801513 PMCID: PMC9539955 DOI: 10.1111/obr.13491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 06/13/2022] [Accepted: 06/13/2022] [Indexed: 11/04/2022]
Abstract
Maternal obesity increases risks of adverse fetal and infant outcomes. Guidelines use body mass index to diagnose maternal obesity. Evidence suggests body fat distribution might better predict individual risk, but there is a lack of robust evidence during pregnancy. We explored associations between maternal adiposity and infant health. Searches included six databases, references, citations, and contacting authors. Screening and quality assessment were carried out by two authors independently. Random effects meta-analysis and narrative synthesis were conducted. We included 34 studies (n = 40,143 pregnancies). Meta-analysis showed a significant association between maternal fat-free mass and birthweight (average effect [AE] 18.07 g, 95%CI 12.75, 23.38) but not fat mass (AE 8.76 g, 95%CI -4.84, 22.36). Women with macrosomic infants had higher waist circumference than controls (mean difference 4.93 cm, 95% confidence interval [CI] 1.05, 8.82). There was no significant association between subcutaneous fat and large for gestational age (odds ratio 1.06 95% CI 0.91, 1.25). Waist-to-hip ratio, neck circumference, skinfolds, and visceral fat were significantly associated with several infant outcomes including small for gestational age, preterm delivery, neonatal morbidity, and mortality, although meta-analysis was not possible for these variables. Our findings suggest that some measures of maternal adiposity may be useful for risk prediction of infant outcomes. Individual participant data meta-analysis could overcome some limitations in our ability to pool published data.
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Affiliation(s)
- Giang Nguyen
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Louise Hayes
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Lem Ngongalah
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | | | - Laura Gaudet
- Department of Obstetrics and Gynaecology, Queen's University, Kingston, Ontario, Canada
| | - Adefisayo Odeniyi
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Angela Flynn
- Department of Nutritional Sciences, King's College London, London, UK
| | - Lisa Crowe
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Becky Skidmore
- Independent Information Specialist, Ottawa, Ontario, Canada
| | - Alexandre Simon
- Department of Obstetrics and Gynaecology, University of Ottawa, Ottawa, Ontario, Canada
| | - Vikki Smith
- Nursing, Midwifery & Health, Northumbria University, Newcastle upon Tyne, UK
| | - Nicola Heslehurst
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
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Heslehurst N, Ngongalah L, Bigirumurame T, Nguyen G, Odeniyi A, Flynn A, Smith V, Crowe L, Skidmore B, Gaudet L, Simon A, Hayes L. Association between maternal adiposity measures and adverse maternal outcomes of pregnancy: Systematic review and meta-analysis. Obes Rev 2022; 23:e13449. [PMID: 35467075 PMCID: PMC9285432 DOI: 10.1111/obr.13449] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 03/15/2022] [Accepted: 03/15/2022] [Indexed: 12/23/2022]
Abstract
Maternal obesity increases pregnancy-related risks. Women with a body mass index (BMI) ≥ 30 kg/m2 are considered to be at risk and should receive additional care, although approximately half will have uncomplicated pregnancies. This systematic review aimed to identify early pregnancy measures of adiposity associated with adverse maternal health outcomes. Searches included six databases, reference lists, citations, and contacting authors. Screening and quality assessment were carried out by two authors independently. Random effects meta-analysis and narrative synthesis were conducted. Seventy studies were included with a pooled sample of 89,588 women. Meta-analysis showed significantly increased odds of gestational diabetes mellitus (GDM) with higher waist circumference (WC) categories (1.40, 95% confidence interval [CI] 1.04, 1.88) and per unit increase in WC (1.31, 95% CI 1.03, 1.67). Women with GDM had higher WC than controls (mean difference [MD] 6.18 cm, 95% CI 3.92, 8.44). WC was significantly associated with hypertensive disorders, delivery-related outcomes, metabolic syndrome, and composite pregnancy outcomes. Waist to hip ratio was significantly associated with GDM, hypertensive disorders, and delivery-related outcomes. Fat mass, neck circumference, skinfolds, and visceral fat were significantly associated with adverse outcomes, although limited data were available. Our findings identify the need to explore how useful adiposity measures are at predicting risk in pregnancy, compared with BMI, to direct care to women with the greatest need.
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Affiliation(s)
- Nicola Heslehurst
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Lem Ngongalah
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | | | - Giang Nguyen
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Adefisayo Odeniyi
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Angela Flynn
- Department of Nutritional Sciences, King's College London, London, UK
| | - Vikki Smith
- Department of Nursing, Midwifery and Health, Northumbria University, Newcastle upon Tyne, UK
| | - Lisa Crowe
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Becky Skidmore
- Independent Information Specialist, Ottawa, Ontario, Canada
| | - Laura Gaudet
- Department of Obstetrics and Gynaecology, Queen's University, Kingston, Ontario, Canada
| | | | - Louise Hayes
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
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Soldavini CM, Piuri G, Rossi G, Corsetto PA, Benzoni L, Maggi V, Privitera G, Spadafranca A, Rizzo AM, Ferrazzi E. Maternal AA/EPA Ratio and Triglycerides as Potential Biomarkers of Patients at Major Risk for Pharmacological Therapy in Gestational Diabetes. Nutrients 2022; 14:2502. [PMID: 35745231 DOI: 10.3390/nu14122502] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 06/08/2022] [Accepted: 06/13/2022] [Indexed: 02/04/2023] Open
Abstract
Gestational diabetes mellitus (GD) is characterized by glycemic and lipid metabolism alterations in an environment of low-grade inflammation. Our trial aimed to assess the effect of nutraceutical supplements (omega-3 fatty acids, anthocyanins, and alpha-cyclodextrins) in GD patients and evaluate the role of anthropometric, metabolic, and inflammatory parameters as biomarkers to identify subjects who require pharmacological hypoglycemic treatment during gestation. Pregnant women with GD at 24-28 weeks of gestation were enrolled in a double-blind trial and randomized to receive either nutraceutical supplements or a placebo for 12 weeks. No statistically significant differences were observed between the two groups in blood and urine measurements of metabolic, inflammatory, and antioxidant parameters. In the whole cohort, pre-pregnancy BMI and anthropometric measurements were significantly different in patients who required pharmacological intervention. These patients showed higher triglycerides, CRP, and insulin levels and gave birth to newborns with significantly higher weights. Subjects with a greater AA/EPA ratio had higher PAF levels and gave birth four days earlier. In conclusion, one-to-one nutritional coaching and poor compliance with nutraceutical supplementation might have outweighed the impact of this intervention. However, triglyceride concentration and the AA/EPA ratio seems to be a biomarker for higher inflammatory levels and GD candidates for pharmacological treatment. An adequate assumption of omega-3 in women with GD, either by a controlled diet or by nutraceutical supplementation, reduces the need for pharmacological therapy.
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Moroni A, Vardè C, Giustetto A, Stagi S, Marini E, Micheletti Cremasco M. Bioelectrical Impedance Vector Analysis (BIVA) for the monitoring of body composition in pregnancy. Eur J Clin Nutr 2022; 76:604-609. [PMID: 34363054 DOI: 10.1038/s41430-021-00990-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 07/07/2021] [Accepted: 07/09/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND/OBJECTIVES During pregnancy, body composition alterations can be considered as markers of complications and in this context, a non-invasive and low-cost method such as Bioelectrical Impedance Vector Analysis (BIVA), can be employed to monitor such changes. This study aimed at identifying body compartments trend during physiological pregnancy. SUBJECTS/METHODS Classic and specific BIVA variables have been measured in a sample of 37 pregnant women approximately every 4 weeks of gestation and once postpartum. Researchers used both longitudinal and cross-sectional approach. The first case included data of women from the 11th to the 15th week along with data from the 28th to the 32nd week of gestation. The cross-sectional approach regarded two more specific moments (11th-12th weeks and 30th-31st weeks) and data within two months postpartum RESULTS: The longitudinal approach showed a significant decrease in classic BIVA variables (R/H, Xc/H, Z/H p < 0.001) and a shortening of the vector, pointing out that TBW and hydration increased significantly. Specific vector length increased significantly, indicating a physiological gain of FM% (p < 0.01). The cross-sectional approach showed lower values of R/H, Xc/H, Z/H between 12th-13th and 30th-31st weeks (p < 0.01), while in the postpartum period values tended to those registered at the beginning of pregnancy. No changes have been found for the phase angle in both approaches, indicating that ECW/ICW ratio remained constant CONCLUSIONS: Among physiological pregnancies, bioelectric values showed a coherent trend and these results represent a first contribution to support routine exams, leading to an early detection of anomalous values potentially correlated to pathologies.
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Affiliation(s)
- A Moroni
- Department of Life Sciences and Systems Biology, University of Torino, Torino, Italy
| | - C Vardè
- Edoardo Agnelli Hospital, Gynaecology and Obstetrics Division, Pinerolo, Italy
| | - A Giustetto
- Department of Life Sciences and Systems Biology, University of Torino, Torino, Italy
| | - S Stagi
- Department of Life and Environmental Sciences, University of Cagliari, Cittadella di Monserrato, Cagliari, Italy
| | - E Marini
- Department of Life and Environmental Sciences, University of Cagliari, Cittadella di Monserrato, Cagliari, Italy
| | - M Micheletti Cremasco
- Department of Life Sciences and Systems Biology, University of Torino, Torino, Italy.
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Trindade CR, Torloni MR, Mattar R, Sun SY. Good performance of bioimpedance in early pregnancy to predict preeclampsia. Pregnancy Hypertens 2021; 26:24-30. [PMID: 34469830 DOI: 10.1016/j.preghy.2021.08.115] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 07/04/2021] [Accepted: 08/12/2021] [Indexed: 12/25/2022]
Abstract
INTRODUCTION Preeclampsia (PE) affects 2-8% of pregnancies and is one of the main causes of maternal morbidity and mortality worldwide. Early identification of pregnant women at higher risk for PE would allow the use of interventions to reduce adverse maternal and perinatal outcomes. OBJECTIVE To assess the ability of bioelectrical impedance analysis (BIA) in pregnancy to predict the development of PE. METHODS This prospective cohort involved healthy nulliparas who underwent BIA at 17-20 weekś gestation and were followed until delivery. We used univariate and multivariate logistic regression to assess the ability of BIA measures to predict the occurrence of PE. We used an adjusted regression model to estimate the probability of developing PE, the Hosmer-Lemeshow test to assess the adequacy of the final model, and ROC curves to assess the sensitivity and specificity of different BIA measures in the prediction of PE. RESULTS Twelve (6.1%) of the 196 participants developed PE. In the final multivariate model, the following BIA measures were associated with the occurrence of PE: extracellular water/intracellular water ≤ 0.618, skeletal muscle mass ≥ 25 Kg, and body fat percentage ≥ 44%. The combination of these three measures had a predictive accuracy of 83.7%, a sensitivity of 83.3%, a specificity of 83.7%, and a negative predictive value of 98.7% for PE. CONCLUSION BIA done on nulliparous women at 17-20 weekś gestation has a good accuracy and high negative predictive value for the risk of developing PE.
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Affiliation(s)
- Célia R Trindade
- Escola Superior de Ciências da Santa Casa de Misericórdia de Vitória, EMESCAM, Avenida Nossa Senhora da Penha 2190, Vitória, ES, Brazil, CEP: 29027-502 ES, Brazil; Universidade Federal do Espírito Santo - UFES Centro de Ciências da Saúde, Departamento de Ginecologia e Obstetrícia, Avenida Marechal Campos 1468, Vitória, ES, Brazil, CEP: 29047-105, ES, Brazil
| | - Maria Regina Torloni
- Universidade Federal de São Paulo-UNIFESP, Departamento de Obstetrícia, Rua Napoleão de Barros 875, São Paulo, SP, Brazil, CEP: 04024-002, SP, Brazil
| | - Rosiane Mattar
- Universidade Federal de São Paulo-UNIFESP, Departamento de Obstetrícia, Rua Napoleão de Barros 875, São Paulo, SP, Brazil, CEP: 04024-002, SP, Brazil
| | - Sue Y Sun
- Universidade Federal de São Paulo-UNIFESP, Departamento de Obstetrícia, Rua Napoleão de Barros 875, São Paulo, SP, Brazil, CEP: 04024-002, SP, Brazil
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Obuchowska A, Standyło A, Kimber-Trojnar Ż, Leszczyńska-Gorzelak B. The Possibility of Using Bioelectrical Impedance Analysis in Pregnant and Postpartum Women. Diagnostics (Basel) 2021; 11:1370. [PMID: 34441305 DOI: 10.3390/diagnostics11081370] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 07/22/2021] [Accepted: 07/29/2021] [Indexed: 12/14/2022] Open
Abstract
Pregnancy is a time of significant changes occurring in the composition of a woman’s body in order to provide support for the growth and development of the foetus. Bioelectrical impedance analysis (BIA) is used to assess the body composition and hydration status. This technique represents a non-invasive, reliable, and fast clinical approach, which is well tolerated by patients. A segmental impedance measurement might be advantageous in pregnant women, particularly in late pregnancy. The purpose of this paper is to provide a review of different applications of BIA in pregnant and postpartum women. It seems that BIA has a better prognostic potential for gestational and post-partum outcomes than body mass index. The BIA method can be successfully used to study the effect of excessive gestational weight gain in pregnancy on the development of obstetric complications. Studying the mother’s body composition and correlating it with her energy balance could facilitate the development of dietary recommendations for women. Evaluation of the body composition can provide important clues for diagnosis of gestational diabetes mellitus in pregnant women with a low risk of this disease. BIA is also used as one of the additional tests in assessing the risk of developing gestational hypertension and preeclampsia.
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Bijlholt M, Maslin K, Ameye L, Shawe J, Bogaerts A, Devlieger R. Phase Angle and Bio-Impedance Values during the First Year after Delivery in Women with Previous Excessive Gestational Weight Gain: Innovative Data from the Belgian INTER-ACT Study. Int J Environ Res Public Health 2021; 18:7482. [PMID: 34299927 DOI: 10.3390/ijerph18147482] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 07/06/2021] [Accepted: 07/09/2021] [Indexed: 01/26/2023]
Abstract
Phase angle (PhA) is a body composition parameter that measures changes in the amount and quality of soft tissue. Few studies have explored PhA in pregnancy or postpartum. The aim of this study was to explore the PhA during the first year postpartum in a Belgian cohort using data from the control group of the INTER-ACT study, an intervention trial targeting those with excess gestational weight gain. A secondary aim was to examine associations between PhA and potential explanatory variables. Women aged ≥18 with excessive weight gain in a singleton pregnancy and without a chronic disease were eligible. Data collection included anthropometry as well as demographic and lifestyle questionnaires at 6 weeks, 6 months and 12 months postpartum. Body composition, including PhA, was measured with the Tanita MC780SMA device. Data was analysed using correlation and mixed model analyses. A total of 509 participants (median age 31.2) were included. The median PhA at 6 weeks postpartum was 5.8°. Higher PhA values were seen in multiparous women (p = 0.02) but there was no association with any other lifestyle or demographic factors. PhA values were positively associated with muscle mass and BMI (r = 0.13, p = 0.004 and r = 0.18, p < 0.001) at 6 weeks postpartum. PhA increased slightly in the 12 months postpartum, which was related to a decrease in fat percentage (p = 0.004). Further research in the pregnant/postpartum population is needed to elucidate any links with perinatal or future health outcomes.
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Prado-Nóvoa O, Rodríguez J, Martín García A, Mateos A. Body composition helps: Differences in energy expenditure between pregnant and nonpregnant females. Am J Hum Biol 2020; 33:e23518. [PMID: 33155733 DOI: 10.1002/ajhb.23518] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 09/28/2020] [Accepted: 09/29/2020] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVES Human pregnancy is associated with important physiological changes that usually increase energetic requirements. However, great variability exists in the costs and mechanisms required to bear pregnancy. Since body mass (BM) and composition are modified during gestation, it is of great interest to compare the influence of BM on energy expenditure (EE) in pregnant and nonpregnant females. METHODS BM, body composition, and EE of 77 volunteers (35 pregnant and 42 nonpregnant females) were measured. The pregnant volunteers completed two measurement rounds at 28 and 32 gestation weeks. Differences on the measured parameters were sought, and comparison of regression lines was computed to test how BM affected the EE of the volunteers. RESULTS BM and body composition parameters are significantly higher in pregnant females, but EE is not statistically different. Pregnant females have a larger percentage of fat mass, but lower percentage of fat-free mass (FFM). The EE per kg of FFM is similar in both groups. Comparison of regression lines shows that pregnancy does not change the relationship between BM and EE, but for similar BM pregnant females expend less energy than nonpregnant females. CONCLUSIONS We propose that their larger percentage of passive body tissues is the reason why pregnant females expend less energy than nonpregnant females of similar BM, without changing the scaling of EE on BM. Thus, pregnancy could not be as energetically constraining as usually assumed, with important consequences for human reproductive ecology.
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Affiliation(s)
- Olalla Prado-Nóvoa
- Postgraduate School of Human Evolution, University of Burgos, Burgos, Spain
| | - Jesús Rodríguez
- Paleobiology Program, National Research Center on Human Evolution (CENIEH), Burgos, Spain
| | - Adrián Martín García
- Gynecology and Obstetrics Department, Complejo Asistencial Universitario de Burgos, Burgos, Spain
| | - Ana Mateos
- Paleobiology Program, National Research Center on Human Evolution (CENIEH), Burgos, Spain
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Liu Y, Liu J, Gao Y, Zheng D, Pan W, Nie M, Ma L. The Body Composition in Early Pregnancy is Associated with the Risk of Development of Gestational Diabetes Mellitus Late During the Second Trimester. Diabetes Metab Syndr Obes 2020; 13:2367-2374. [PMID: 32753921 PMCID: PMC7352009 DOI: 10.2147/dmso.s245155] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 06/22/2020] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVE Gestational diabetes mellitus (GDM) causes both short- and long-term harm to mothers and fetuses. It is important to predict the occurrence of GDM as early as possible and take adequate measures to prevent it. The purpose of this study was to investigate the association between body composition of pregnant women in early pregnancy and the risk of GDM. SUBJECTS AND METHODS A total of 1318 pregnant women in the early stage of pregnancy were recruited from the Guiyang Maternal and Child Health Care Hospital. Detailed clinical data were recorded. Body composition was determined using the bioimpedance method at 13 weeks of gestation. The association between BMI before pregnancy (pre-BMI), fat mass percentage (FMP) and skeletal muscle mass percentage (SMMP) and the results of glucose tolerance screening in the second trimester of pregnancy were analyzed. Fat mass index (FMI) was calculated using fat mass in kilograms as measured using BIA at 13 weeks of pregnancy divided by the square of the woman's height in meters (kg/m2) and was analyzed to determine the predictive effect of body fat on GDM. RESULTS Of the 1318 participants, 249 were diagnosed with GDM and 1069 with normal blood glucose. The FMI and FMP in GDM were higher than in NGT (P<0.001), while the SMMP in GDM was lower than in NGT (P<0.001). Overweight women (pre-BMI≥24kg/m2) had a higher risk of developing GDM than women with normal pre-BMI (adjusted OR 2.604, 95% CI 1.846-3.673). Women with FMP greater than 28% had a higher risk of developing to GDM than women with normal-range FMP (adjusted OR 1.572, 95% CI 1.104-2.240). When FMI is used to predict the incidence of GDM, the area under the curve (AUC) is 65.8%, which is comparable to BMI (AUC=67.2%). CONCLUSION Body composition early during gestation is associated with the risk of GDM. The fat mass index in early pregnancy is a predictor of GDM, and it could be an indicator of the efficacy of any intervention to reduce the risk of GDM.
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Affiliation(s)
- Yanping Liu
- Department of Clinical Nutrition, Peking Union Medical College Hospital, CAMS and PUMC, Beijing100730, People’s Republic of China
| | - Jing Liu
- Guiyang Maternal and Child Health Care Hospital, Guiyang Children’s Hospital, Beijing100730, People’s Republic of China
| | - Yinjie Gao
- NHC Key Laboratory of Endocrinology, Department of Endocrinology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing100730, People’s Republic of China
| | - Dan Zheng
- Guiyang Maternal and Child Health Care Hospital, Guiyang Children’s Hospital, Beijing100730, People’s Republic of China
| | - Wei Pan
- Guiyang Maternal and Child Health Care Hospital, Guiyang Children’s Hospital, Beijing100730, People’s Republic of China
| | - Min Nie
- NHC Key Laboratory of Endocrinology, Department of Endocrinology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing100730, People’s Republic of China
- Correspondence: Min Nie; Liangkun Ma Email ;
| | - Liangkun Ma
- Department of Obstetrics & Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing100730, People’s Republic of China
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Naranjo-Hernández D, Reina-Tosina J, Roa LM, Barbarov-Rostán G, Aresté-Fosalba N, Lara-Ruiz A, Cejudo-Ramos P, Ortega-Ruiz F. Smart Bioimpedance Spectroscopy Device for Body Composition Estimation. Sensors (Basel) 2019; 20:E70. [PMID: 31877699 PMCID: PMC6983241 DOI: 10.3390/s20010070] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 12/14/2019] [Accepted: 12/17/2019] [Indexed: 12/15/2022]
Abstract
The purpose of this work is to describe a first approach to a smart bioimpedance spectroscopy device for its application to the estimation of body composition. The proposed device is capable of carrying out bioimpedance measurements in multiple configurable frequencies, processing the data to obtain the modulus and the bioimpedance phase in each of the frequencies, and transmitting the processed information wirelessly. Another novelty of this work is a new algorithm for the identification of Cole model parameters, which is the basis of body composition estimation through bioimpedance spectroscopy analysis. Against other proposals, the main advantages of the proposed method are its robustness against parasitic effects by employing an extended version of Cole model with phase delay and three dispersions, its simplicity and low computational load. The results obtained in a validation study with respiratory patients show the accuracy and feasibility of the proposed technology for bioimpedance measurements. The precision and validity of the algorithm was also proven in a validation study with peritoneal dialysis patients. The proposed method was the most accurate compared with other existing algorithms. Moreover, in those cases affected by parasitic effects the proposed algorithm provided better approximations to the bioimpedance values than a reference device.
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Affiliation(s)
- David Naranjo-Hernández
- Biomedical Engineering Group, University of Seville, 41092 Seville, Spain; (J.R.-T.); (L.M.R.)
| | - Javier Reina-Tosina
- Biomedical Engineering Group, University of Seville, 41092 Seville, Spain; (J.R.-T.); (L.M.R.)
| | - Laura M. Roa
- Biomedical Engineering Group, University of Seville, 41092 Seville, Spain; (J.R.-T.); (L.M.R.)
| | - Gerardo Barbarov-Rostán
- Biomedical Engineering Group, University of Seville, 41092 Seville, Spain; (J.R.-T.); (L.M.R.)
| | - Nuria Aresté-Fosalba
- Nephrology Service of the Virgen Macarena University Hospital in Seville, 41009 Seville, Spain; (N.A.-F.); (A.L.-R.)
| | - Alfonso Lara-Ruiz
- Nephrology Service of the Virgen Macarena University Hospital in Seville, 41009 Seville, Spain; (N.A.-F.); (A.L.-R.)
| | - Pilar Cejudo-Ramos
- Medical-Surgical Unit of Respiratory Diseases, University Hospital Virgen del Rocío, 41013 Seville, Spain; (P.C.-R.); (F.O.-R.)
- Biomedical Research Center in Network (CIBER) of Respiratory Diseases (CIBERES), 28029 Madrid, Spain
| | - Francisco Ortega-Ruiz
- Medical-Surgical Unit of Respiratory Diseases, University Hospital Virgen del Rocío, 41013 Seville, Spain; (P.C.-R.); (F.O.-R.)
- Biomedical Research Center in Network (CIBER) of Respiratory Diseases (CIBERES), 28029 Madrid, Spain
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Abstract
Studies have found that the measurement of body composition can be used to identify the gestational diabetes mellitus (GDM) risk in pregnant women. However, few studies focused on the relationship between body composition and GDM development in low GDM risk population. Thus, the objective of this study was to examine the association between body composition and the development of GDM in pregnant women with low risk of gestational diabetes.A retrospective case-control study was conducted. We reviewed the medical records of 3965 pregnant women who had body composition measurement from March, 2016 to May, 2018 in our hospital. Their sociodemographic, clinical data, and body composition information were collected from medical record. Multiple logistic regression analyses were used.A total of 2698 subjects were eligible for the study. The mean age of the gravidas was 30.95 ± 4.01 years old. Of all gravidas, 462 had gestational diabetes. Percentage body fat was the strongest risk factor for gestational diabetes after adjusting pre-pregnancy body mass index (BMI) (odds ratio = 1.786, 95% confidence interval = 1.112-2.866, P = .02). The age and extracellular water/intracellular water ratio were independently associated with gestational diabetes.Percentage body fat was the strongest risk factor for gestational diabetes after adjusting pre-pregnancy BMI. Assessment of body composition may provide important guidance to identify gestational diabetes in pregnant women with low gestational diabetes risk.
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Affiliation(s)
- Yan Wang
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education
| | - Bi-Ru Luo
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education
- Department of Nursing, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
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Lee YQ, Lumbers ER, Oldmeadow C, Collins CE, Johnson V, Keogh L, Sutherland K, Gordon A, Smith R, Rae KM, Pringle KG. The relationship between maternal adiposity during pregnancy and fetal kidney development and kidney function in infants: the Gomeroi gaaynggal study. Physiol Rep 2019; 7:e14227. [PMID: 31515958 PMCID: PMC6742895 DOI: 10.14814/phy2.14227] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Revised: 07/22/2019] [Accepted: 08/06/2019] [Indexed: 12/15/2022] Open
Abstract
Maternal obesity during pregnancy has a detrimental impact on offspring renal development and function. This is pertinent to Indigenous Australians as they are twice as likely as non-Indigenous Australians to develop chronic kidney disease (CKD). The aim of this study was to examine whether there was an association between maternal adiposity and fetal kidney growth in late gestation (>28 weeks) and kidney function in infants, <2.5 years of age, from the Gomeroi gaaynggal cohort. Pre-pregnancy body mass index (BMI) was recorded at the first prenatal visit and maternal adiposity indicators (percent body fat and visceral fat area) measured at >28 weeks gestation by bioelectrical impedance analysis. Fetal kidney structure was assessed by ultrasound. Renal function indicators (urinary albumin:creatinine and protein:creatinine) were measured in infants from a spot urine collection from nappies. Multiple linear regression and multi-level mixed effects linear regression models with clustering were used to account for repeated measures of urine. 147 mother-child pairs were examined. Estimated fetal weight (EFW), but not fetal kidney size, was positively associated with maternal adiposity and pre-pregnancy BMI. When adjusted for smoking, combined kidney volume relative to EFW was negatively associated with maternal percentage body fat. Infant kidney function was not influenced by maternal adiposity and pre-pregnancy BMI (n = 84 observations). Current findings show that Indigenous babies born to obese mothers have reduced kidney size relative to EFW. We suggest that these babies are experiencing a degree of glomerular hyperfiltration in utero, and therefore are at risk of developing CKD in later life, especially if their propensity for obesity is maintained. Although no impact on renal function was observed at <2.5 years of age, long-term follow-up of offspring is required to evaluate potential later life impacts.
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Affiliation(s)
- Yu Qi Lee
- Priority Research Centre in Reproductive SciencesUniversity of NewcastleCallaghanNew South WalesAustralia
- School of Biomedical Sciences and PharmacyFaculty of Health and MedicineUniversity of NewcastleCallaghanNew South WalesAustralia
| | - Eugenie R. Lumbers
- Priority Research Centre in Reproductive SciencesUniversity of NewcastleCallaghanNew South WalesAustralia
- School of Biomedical Sciences and PharmacyFaculty of Health and MedicineUniversity of NewcastleCallaghanNew South WalesAustralia
| | - Christopher Oldmeadow
- Clinical Research Design and Statistical ServicesHunter Medical Research InstituteUniversity of NewcastleCallaghanNew South WalesAustralia
| | - Clare E. Collins
- Priority Research Centre in Physical Activity and NutritionUniversity of NewcastleCallaghanNew South WalesAustralia
- School of Health SciencesFaculty of Health and MedicineUniversity of NewcastleCallaghanNew South WalesAustralia
| | - Vanessa Johnson
- Gomeroi gaaynggal CentreFaculty of Health and MedicineUniversity of NewcastleTamworthNew South WalesAustralia
| | - Lyniece Keogh
- Gomeroi gaaynggal CentreFaculty of Health and MedicineUniversity of NewcastleTamworthNew South WalesAustralia
| | - Kathryn Sutherland
- Gomeroi gaaynggal CentreFaculty of Health and MedicineUniversity of NewcastleTamworthNew South WalesAustralia
| | | | - Roger Smith
- Priority Research Centre in Reproductive SciencesUniversity of NewcastleCallaghanNew South WalesAustralia
- School of Medicine and Public HealthFaculty of Health and MedicineUniversity of NewcastleCallaghanNew South WalesAustralia
| | - Kym M. Rae
- Priority Research Centre in Reproductive SciencesUniversity of NewcastleCallaghanNew South WalesAustralia
- Gomeroi gaaynggal CentreFaculty of Health and MedicineUniversity of NewcastleTamworthNew South WalesAustralia
- School of Medicine and Public HealthFaculty of Health and MedicineUniversity of NewcastleCallaghanNew South WalesAustralia
- Department of Rural HealthUniversity of NewcastleTamworthNew South WalesAustralia
- Priority Research Centre for Generational Health and AgeingUniversity of NewcastleCallaghanNew South WalesAustralia
| | - Kirsty G. Pringle
- Priority Research Centre in Reproductive SciencesUniversity of NewcastleCallaghanNew South WalesAustralia
- School of Biomedical Sciences and PharmacyFaculty of Health and MedicineUniversity of NewcastleCallaghanNew South WalesAustralia
- Gomeroi gaaynggal CentreFaculty of Health and MedicineUniversity of NewcastleTamworthNew South WalesAustralia
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Most J, Marlatt KL, Altazan AD, Redman LM. Advances in assessing body composition during pregnancy. Eur J Clin Nutr 2018; 72:645-656. [PMID: 29748651 DOI: 10.1038/s41430-018-0152-8] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 02/08/2018] [Indexed: 01/06/2023]
Abstract
The prevalence of excess gestational weight gain is increasing worldwide and is associated with pregnancy complications, including gestational diabetes mellitus, pre-eclampsia, preterm birth, macrosomia, and development of obesity in offspring. Whereas gestational weight gain positively correlates with the gain in fat mass (FM), fat-free mass (FFM) gain is relatively consistent across pregnancies. Commonly used methods to assess body composition include anthropometry, densitometry (air displacement plethysmography, underwater weighing), and hydrometry (isotope dilution, bioimpedance analysis). While these techniques can be applied to pregnancy, they require specific adjustments to assumptions inherent within each method, most importantly to accommodate for the hydration of FFM which is transient throughout gestation. Here we discuss the application of the abovementioned methods to pregnant women and the relevant adjustments needed to more accurately calculate FM based on body weight, body volume, or total body water. We also present a novel application of classical data to provide FFM density estimates for pregnant women at any stage of pregnancy. Use of these adjustments will help standardize assumptions on FFM hydration and minimize error in FM estimation. Techniques still fail, however, to fully distinguish tissue gains between mother and fetus. To fill this important gap, imaging techniques such as ultrasound and magnetic resonance imaging are being used more frequently and will provide more insight into fetal development, fetal adiposity, and depot specificity of maternal FM acquisition. Efforts to synchronize protocols are necessary to allow seamless comparison of data to advance the understanding of maternal body composition changes that contribute to pregnancy-related complications.
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Affiliation(s)
- Jasper Most
- Reproductive Endocrinology and Women's Health, Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, LA, 70808, USA
| | - Kara Lynn Marlatt
- Reproductive Endocrinology and Women's Health, Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, LA, 70808, USA
| | - Abby Duhé Altazan
- Reproductive Endocrinology and Women's Health, Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, LA, 70808, USA
| | - Leanne Maree Redman
- Reproductive Endocrinology and Women's Health, Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, LA, 70808, USA.
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