nach oben

Current Diabetes Reports

Erschienen in:

01.06.2018 | Diabetes and Pregnancy (M-F Hivert and CE Powe, Section Editors)

Maternal Non-glycemic Contributors to Fetal Growth in Obesity and Gestational Diabetes: Spotlight on Lipids

verfasst von: Linda A. Barbour, Teri L. Hernandez

Erschienen in: Current Diabetes Reports | Ausgabe 6/2018

Einloggen, um Zugang zu erhalten

Abstract

Purpose of Review

Excess fetal growth is increasingly recognized as a risk factor for childhood obesity, and mounting evidence supports that maternal glucose is not the only driver. This review focuses on the role of clinically applicable maternal non-glycemic contributors to excess fetal growth, particularly lipids, in addition to amino acids (AA), insulin resistance, inflammation, maternal nutrition, and gestational weight gain (GWG) in obesity and gestational diabetes mellitus (GDM).

Recent Findings

Lipids, specifically triglycerides and free fatty acids, appear to be strong contributors to excess fetal fat accretion and adiposity at birth, particularly in obese pregnancies, which account for the largest number of large-for-gestational-age infants. Maternal pre-pregnancy body mass index (BMI), GWG, insulin resistance, inflammation, and glucose, lipid, and AA concentrations have both independent and interacting effects on fetal growth, operating both early and late in pregnancy. All are sensitive to maternal nutrition.

Summary

Early vs. later gestational exposure to excess maternal fuels in fasting and postprandial conditions may differentially impact fetoplacental outcomes. Compelling evidence suggests that targeting interventions early in pregnancy beyond glucose may be critical to improve fetal growth patterns.

Pedersen J. Diabetes and pregnancy; blood sugar of newborn infants during fasting and glucose administration. Nord Med. 1952;47(30):1049.PubMed

Freinkel N. Banting lecture 1980. Of pregnancy and progeny. Diabetes. 1980;29(12):1023–35.CrossRefPubMed

Hernandez TL. Glycemic targets in pregnancies affected by diabetes: historical perspective and future directions. Curr Diab Rep. 2015;15(1):565.CrossRefPubMed

Ryan EA. Diagnosing gestational diabetes. Diabetologia. 2011;54(3):480–6.CrossRefPubMedPubMedCentral

Barbour LA. Changing perspectives in pre-existing diabetes and obesity in pregnancy: maternal and infant short- and long-term outcomes. Curr Opin Endocrinol Diabetes Obes. 2014;21(4):257–63.CrossRefPubMed

Deputy NP, Dub B, Sharma AJ. Prevalence and trends in prepregnancy normal weight—48 states, New York City, and District of Columbia, 2011–2015. MMWR Morb Mortal Wkly Rep. 2018;66(5152):1402–7.CrossRefPubMedPubMedCentral

Flegal KM, Kruszon-Moran D, Carroll MD, Fryar CD, Ogden CL. Trends in obesity among adults in the United States, 2005 to 2014. JAMA. 2016;315(21):2284–91.CrossRefPubMed

Metzger BE, Lowe LP, Dyer AR, Trimble ER, Chaovarindr U, Coustan DR, et al. Hyperglycemia and adverse pregnancy outcomes. N Engl J Med. 2008;358(19):1991–2002.CrossRefPubMed

Ng M, Fleming T, Robinson M, Thomson B, Graetz N, Margono C, et al. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2014;384(9945):766–81.CrossRefPubMedPubMedCentral

10.

Cunningham SA, Kramer MR, Narayan KM. Incidence of childhood obesity in the United States. N Engl J Med. 2014;370(17):1660–1.PubMed

11.

• Friedman JE. Obesity and gestational diabetes mellitus pathways for programming in mouse, monkey, and man-where do we go next? The 2014 Norbert Freinkel Award Lecture. Diabetes Care. 2015;38(8):1402–11. An informative review of our understanding of developmental programming in animal models and humans. CrossRefPubMedPubMedCentral

12.

McCurdy CE, Bishop JM, Williams SM, Grayson BE, Smith MS, Friedman JE, et al. Maternal high-fat diet triggers lipotoxicity in the fetal livers of nonhuman primates. J Clin Invest. 2009;119(2):323–35.PubMedPubMedCentral

13.

• Boyle KE, Patinkin ZW, Shapiro AL, Baker PR 2nd, Dabelea D, Friedman JE. Mesenchymal stem cells from infants born to obese mothers exhibit greater potential for adipogenesis: the healthy start BabyBUMP project. Diabetes. 2016;65(3):647–59. A compelling study that suggests that umbilical cord stem cells may be influcenced by maternal obesity to differentiate into adipocytes rather than skeletal muscle cells. CrossRefPubMed

14.

• Dutton H, Borengasser SJ, Gaudet LM, Barbour LA, Keely EJ. Obesity in pregnancy: Optimizing Outcomes for Mom and Baby. Med Clin North Am. 2018;102(1):87–106. Recent review on the short-term and long-term risks of maternal obesity to mother and infant. CrossRefPubMed

15.

Kral JG, Biron S, Simard S, Hould FS, Lebel S, Marceau S, et al. Large maternal weight loss from obesity surgery prevents transmission of obesity to children who were followed for 2 to 18 years. Pediatrics. 2006;118(6):e1644–9.CrossRefPubMed

16.

Dabelea D, Knowler WC, Pettitt DJ. Effect of diabetes in pregnancy on offspring: follow-up research in the Pima Indians. J Matern Fetal Med. 2000;9(1):83–8.PubMed

17.

Woo Baidal JA, Locks LM, Cheng ER, Blake-Lamb TL, Perkins ME, Taveras EM. Risk factors for childhood obesity in the first 1,000 days: A Systematic Review. Am J Prev Med. 2016;50(6):761–79.CrossRefPubMed

18.

Boney CM, Verma A, Tucker R, Vohr BR. Metabolic syndrome in childhood: association with birth weight, maternal obesity, and gestational diabetes mellitus. Pediatrics. 2005;115(3):e290–e6.CrossRefPubMed

19.

Catalano PM, Farrell K, Thomas A, Huston-Presley L, Mencin P, de Mouzon SH, et al. Perinatal risk factors for childhood obesity and metabolic dysregulation. Am J Clin Nutr. 2009;90(5):1303–13.CrossRefPubMedPubMedCentral

20.

Sewell MF, Huston-Presley L, Super DM, Catalano P. Increased neonatal fat mass, not lean body mass, is associated with maternal obesity. Am J Obstet Gynecol. 2006;195(4):1100–3.CrossRefPubMed

21.

Brumbaugh DE, Tearse P, Cree-Green M, Fenton LZ, Brown M, Scherzinger A, et al. Intrahepatic fat is increased in the neonatal offspring of obese women with gestational diabetes. J Pediatr. 2012;

22.

Wesolowski SR, Kasmi KC, Jonscher KR, Friedman JE. Developmental origins of NAFLD: a womb with a clue. Nat Rev Gastroenterol Hepatol. 2017;14(2):81–96.CrossRefPubMed

23.

Hull HR, Thornton JC, Ji Y, Paley C, Rosenn B, Mathews P, et al. Higher infant body fat with excessive gestational weight gain in overweight women. Am J Obstet Gynecol. 2011;205(3):211 e1–7.CrossRef

24.

Andersen CS, Gamborg M, Sorensen TI, Nohr EA. Weight gain in different periods of pregnancy and offspring’s body mass index at 7 years of age. Int J Pediatr Obes. 2011;6(2–2):e179–86.CrossRefPubMed

25.

Catalano PM. Management of obesity in pregnancy. Obstet Gynecol. 2007;109(2 Pt 1):419–33.CrossRefPubMed

26.

Fuemmeler BF, Wang L, Iversen ES, Maguire R, Murphy SK, Hoyo C. Association between prepregnancy body mass index and gestational weight gain with size, tempo, and velocity of infant growth: analysis of the newborn epigenetic study cohort. Child Obes. 2016;12(3):210–8.CrossRefPubMedPubMedCentral

27.

Harmon KA, Gerard L, Jensen DR, Kealey EH, Hernandez TL, Reece MS, et al. Continuous glucose profiles in obese and normal-weight pregnant women on a controlled diet: metabolic determinants of fetal growth. Diabetes Care. 2011;34(10):2198–204.CrossRefPubMedPubMedCentral

28.

Barbour LA, Hernandez TL, Hirsch N, Reece MS, Chartier-Logan C, Friedman JE, et al. Lipid predictors of infant adiposity in early and late pregnancy, fasting and fed. Diabetes. 2017;66(Suppl 1):A55.

29.

• Nicholas LM, Morrison JL, Rattanatray L, Zhang S, Ozanne SE, McMillen IC. The early origins of obesity and insulin resistance: timing, programming and mechanisms. Int J Obes (Lond). 2016;40(2):229–38. A recent review providing mechanistic clues as how intrauterine programming may promote adult obesity and insulin resistance. CrossRef

30.

Butte NF. Carbohydrate and lipid metabolism in pregnancy: normal compared with gestational diabetes mellitus. Am J Clin Nutr. 2000;71(5 Suppl):1256S–61S.CrossRefPubMed

31.

Barbour LA, Shao J, Qiao L, Pulawa LK, Jensen DR, Bartke A, et al. Human placental growth hormone causes severe insulin resistance in transgenic mice. Am J Obstet Gynecol. 2002;186(3):512–7.CrossRefPubMed

32.

Buchanan TA, Xiang AH. Gestational diabetes mellitus. J Clin Invest. 2005;115(3):485–91.CrossRefPubMedPubMedCentral

33.

Buschur EO, Stetson B., Barbour LA, Thung S, editor. Diabetes in pregnancy: EndoText.org; 2018.

34.

• Barrett HL, Dekker NM, McIntyre HD, Callaway LK. Normalizing metabolism in diabetic pregnancy: is it time to target lipids? Diabetes Care. 2014;37(5):1484–93. Review of literature supporting maternal lipids and an important fuel for fetal fat accretion. CrossRefPubMed

35.

Lain KY, Catalano PM. Metabolic changes in pregnancy. Clin Obstet Gynecol. 2007;50(4):938–48.CrossRefPubMed

36.

• Catalano PM, Shankar K. Obesity and pregnancy: mechanisms of short term and long term adverse consequences for mother and child. BMJ. 2017;356:j1. Clinically based discussion of the developmental implications of obesity on maternal and offspring health. CrossRefPubMed

37.

Schaefer-Graf UM, Graf K, Kulbacka I, Kjos SL, Dudenhausen J, Vetter K, et al. Maternal lipids as strong determinants of fetal environment and growth in pregnancies with gestational diabetes mellitus. Diabetes Care. 2008;31(9):1858–63.CrossRefPubMedPubMedCentral

38.

Vrijkotte TG, Algera SJ, Brouwer IA, van Eijsden M, Twickler MB. Maternal triglyceride levels during early pregnancy are associated with birth weight and postnatal growth. J Pediatr. 2011;159(5):736–42. e1 CrossRefPubMed

39.

Di Cianni G, Miccoli R, Volpe L, Lencioni C, Ghio A, Giovannitti MG, et al. Maternal triglyceride levels and newborn weight in pregnant women with normal glucose tolerance. Diabet Med. 2005;22(1):21–5.CrossRefPubMed

40.

Whyte K, Kelly H, O'Dwyer V, Gibbs M, O'Higgins A, Turner MJ. Offspring birth weight and maternal fasting lipids in women screened for gestational diabetes mellitus (GDM). Eur J Obstet Gynecol Reprod Biol. 2013;170(1):67–70.CrossRefPubMed

41.

Haggarty P. Fatty acid supply to the human fetus. Annu Rev Nutr. 2010;30:237–55.CrossRefPubMed

42.

Herrera E. Lipid metabolism in pregnancy and its consequences in the fetus and newborn. Endocrine. 2002;19(1):43–55.CrossRefPubMed

43.

Dube E, Gravel A, Martin C, Desparois G, Moussa I, Ethier-Chiasson M, et al. Modulation of fatty acid transport and metabolism by maternal obesity in the human full-term placenta. Biol Reprod. 2012;87(1):14. 1-,11CrossRefPubMed

44.

Herrera E, Amusquivar E, Lopez-Soldado I, Ortega H. Maternal lipid metabolism and placental lipid transfer. Horm Res. 2006;65(Suppl 3):59–64.PubMed

45.

Hao ZM, Ye YF, Zhang YK, Yang SF, Ye XL. Lipoprotein lipase and lipid profiles in plasma and placenta from normal pregnancies compared with patients with intrahepatic cholestasis of pregnancy. Eur J Obstet Gynecol Reprod Biol. 2016;203:279–85.CrossRefPubMed

46.

Houde AA, St-Pierre J, Hivert MF, Baillargeon JP, Perron P, Gaudet D, et al. Placental lipoprotein lipase DNA methylation levels are associated with gestational diabetes mellitus and maternal and cord blood lipid profiles. J Dev Orig Health Dis. 2014;5(2):132–41.CrossRefPubMed

47.

Barrett HL, Kubala MH, Scholz Romero K, Denny KJ, Woodruff TM, McIntyre HD, et al. Placental lipases in pregnancies complicated by gestational diabetes mellitus (GDM). PLoS One. 2014;9(8):e104826.CrossRefPubMedPubMedCentral

48.

Magnusson AL, Waterman IJ, Wennergren M, Jansson T, Powell TL. Triglyceride hydrolase activities and expression of fatty acid binding proteins in the human placenta in pregnancies complicated by intrauterine growth restriction and diabetes. J Clin Endocrinol Metab. 2004;89(9):4607–14.CrossRefPubMed

49.

Qiao L, Guo Z, Bosco C, Guidotti S, Wang Y, Wang M, et al. Maternal high-fat feeding increases placental lipoprotein lipase activity by reducing SIRT1 expression in mice. Diabetes. 2015;64(9):3111–20.CrossRefPubMedPubMedCentral

50.

Heerwagen MJ, Stewart MS, de la Houssaye BA, Janssen RC, Friedman JE. Transgenic increase in N-3/n-6 fatty acid ratio reduces maternal obesity-associated inflammation and limits adverse developmental programming in mice. PLoS One. 2013;8(6):e67791.CrossRefPubMedPubMedCentral

51.

Heerwagen MJR, Gumina DL, Hernandez TL, Van Pelt RE, Kramer AW, Janssen RC, et al. Placental lipoprotein lipase activity is positively associated with newborn adiposity. Placenta. 2018;64:53-60.

52.

Olmos PR, Rigotti A, Busso D, Berkowitz L, Santos JL, Borzone GR, et al. Maternal hypertriglyceridemia: A link between maternal overweight-obesity and macrosomia in gestational diabetes. Obesity (Silver Spring). 2014;22:2156–63.

53.

Liu B, Geng H, Yang J, Zhang Y, Deng L, Chen W, et al. Early pregnancy fasting plasma glucose and lipid concentrations in pregnancy and association to offspring size: a retrospective cohort study. BMC Pregnancy Childbirth. 2016;16:56.CrossRefPubMedPubMedCentral

54.

Mudd LM, Holzman CB, Evans RW. Maternal mid-pregnancy lipids and birthweight. Acta Obstet Gynecol Scand. 2015;94(8):852–60.CrossRefPubMedPubMedCentral

55.

Jin WY, Lin SL, Hou RL, Chen XY, Han T, Jin Y, et al. Associations between maternal lipid profile and pregnancy complications and perinatal outcomes: a population-based study from China. BMC Pregnancy Childbirth. 2016;16:60.CrossRefPubMedPubMedCentral

56.

Eslamian L, Akbari S, Marsoosi V, Jamal A. Effect of different maternal metabolic characteristics on fetal growth in women with gestational diabetes mellitus. Iran J Reprod Med. 2013;11(4):325–34.PubMedPubMedCentral

57.

Sommer C, Sletner L, Morkrid K, Jenum AK, Birkeland KI. Effects of early pregnancy BMI, mid-gestational weight gain, glucose and lipid levels in pregnancy on offspring's birth weight and subcutaneous fat: a population-based cohort study. BMC Pregnancy Childbirth. 2015;15:84.CrossRefPubMedPubMedCentral

58.

Jaskolowski J, Ritz C, Sjodin A, Astrup A, Szecsi PB, Stender S, et al. Weekday variation in triglyceride concentrations in 1.8 million blood samples. J Lipid Res. 2017;58(6):1204–13.CrossRefPubMedPubMedCentral

59.

Ryckman KK, Spracklen CN, Smith CJ, Robinson JG, Saftlas AF. Maternal lipid levels during pregnancy and gestational diabetes: a systematic review and meta-analysis. BJOG. 2015;122(5):643–51.CrossRefPubMed

60.

• Hernandez TL, van Pelt RE, Anderson MA, Daniels LJ, West NA, Donahoo WT, et al. A higher-complex carbohydrate diet in gestational diabetes mellitus achieves glucose targets and lowers postprandial lipids: a randomized crossover study. Diabetes Care. 2014;37(5):1254–62. Data that support the role of a lower carbohydrate/higher fat diet worsening maternal insulin resistance and fetal growth. CrossRefPubMedPubMedCentral

61.

Simeonova-Krstevska S, Krstevska B, Velkoska-Nakova V, Hadji Lega M, Samardjiski I, Serafimoski V, et al. Effect of lipid parameters on foetal growth in gestational diabetes mellitus pregnancies. Pril (Makedon Akad Nauk Umet Odd Med Nauki). 2014;35(2):131–6.

62.

Geraghty AA, Alberdi G, O'Sullivan EJ, O'Brien EC, Crosbie B, Twomey PJ, et al. Maternal blood lipid profile during pregnancy and associations with child adiposity: findings from the ROLO study. PLoS One. 2016;11(8):e0161206.CrossRefPubMedPubMedCentral

63.

Metzger BE, Phelps RL, Freinkel N, Navickas IA. Effects of gestational diabetes on diurnal profiles of plasma glucose, lipids, and individual amino acids. Diabetes Care. 1980;3(3):402–9.CrossRefPubMed

64.

Phelps RL, Metzger BE, Freinkel N. Carbohydrate metabolism in pregnancy. XVII. Diurnal profiles of plasma glucose, insulin, free fatty acids, triglycerides, cholesterol, and individual amino acids in late normal pregnancy. Am J Obstet Gynecol. 1981;140(7):730–6.CrossRefPubMed

65.

Ryckman KK, Donovan BM, Fleener DK, Bedell B, Borowski KS. Pregnancy-related changes of amino acid and acylcarnitine concentrations: the impact of obesity. AJP Rep. 2016;6(3):e329–36.CrossRefPubMedPubMedCentral

66.

Newgard CB. Interplay between lipids and branched-chain amino acids in development of insulin resistance. Cell Metab. 2012;15(5):606–14.CrossRefPubMedPubMedCentral

67.

• Castillo-Castrejon M, Powell TL. Placental nutrient transport in gestational diabetic pregnancies. Front Endocrinol (Lausanne). 2017;8:306. Recent review on placental transport in gestational diabetes. CrossRef

68.

Catalano PM, Huston L, Amini SB, Kalhan SC. Longitudinal changes in glucose metabolism during pregnancy in obese women with normal glucose tolerance and gestational diabetes mellitus. Am J Obstet Gynecol. 1999;180(4):903–16.CrossRefPubMed

69.

O'Keeffe M, St-Onge MP. Sleep duration and disorders in pregnancy: implications for glucose metabolism and pregnancy outcomes. Int J Obes. 2013;37(6):765–70.CrossRef

70.

Sivan E, Homko CJ, Whittaker PG, Reece EA, Chen X, Boden G. Free fatty acids and insulin resistance during pregnancy. J Clin Endocrinol Metab. 1998;83(7):2338–42.PubMed

71.

Barbour LA, McCurdy CE, Hernandez TL, Kirwan JP, Catalano PM, Friedman JE. Cellular mechanisms for insulin resistance in normal pregnancy and gestational diabetes. Diabetes Care. 2007;30(Suppl 2):S112–9.CrossRefPubMed

72.

Shapiro AL, Schmiege SJ, Brinton JT, Glueck D, Crume TL, Friedman JE, et al. Testing the fuel-mediated hypothesis: maternal insulin resistance and glucose mediate the association between maternal and neonatal adiposity, the healthy start study. Diabetologia. 2015;58(5):937–41.CrossRefPubMedPubMedCentral

73.

Crume TL, Shapiro AL, Brinton JT, Glueck DH, Martinez M, Kohn M, et al. Maternal fuels and metabolic measures during pregnancy and neonatal body composition: the healthy start study. J Clin Endocrinol Metab. 2015;100(4):1672–80.CrossRefPubMedPubMedCentral

74.

Hamilton JK, Odrobina E, Yin J, Hanley AJ, Zinman B, Retnakaran R. Maternal insulin sensitivity during pregnancy predicts infant weight gain and adiposity at 1 year of age. Obesity (Silver Spring). 2010;18(2):340–6.CrossRef

75.

Basu S, Haghiac M, Surace P, Challier JC, Guerre-Millo M, Singh K, et al. Pregravid obesity associates with increased maternal endotoxemia and metabolic inflammation. Obesity (Silver Spring). 2011;19(3):476–82.CrossRef

76.

Kirwan JP, Hauguel-De Mouzon S, Lepercq J, Challier JC, Huston-Presley L, Friedman JE, et al. TNF-alpha is a predictor of insulin resistance in human pregnancy. Diabetes. 2002;51(7):2207–13.CrossRefPubMed

77.

Radaelli T, Varastehpour A, Catalano P, Hauguel-de Mouzon S. Gestational diabetes induces placental genes for chronic stress and inflammatory pathways. Diabetes. 2003;52(12):2951–8.CrossRefPubMed

78.

Desoye G, Hauguel-de Mouzon S. The human placenta in gestational diabetes mellitus. The insulin and cytokine network. Diabetes Care. 2007;30(Suppl 2):S120–S6.CrossRefPubMed

79.

Catalano PM, Hoegh M, Minium J, Huston-Presley L, Bernard S, Kalhan S, et al. Adiponectin in human pregnancy: implications for regulation of glucose and lipid metabolism. Diabetologia. 2006;49(7):1677–85.CrossRefPubMed

80.

Aye IL, Powell TL, Jansson T. Review: adiponectin—the missing link between maternal adiposity, placental transport and fetal growth? Placenta. 2013;34(Suppl):S40–5.CrossRefPubMed

81.

Combs TP, Marliss EB. Adiponectin signaling in the liver. Rev Endocr Metab Disord. 2014;15(2):137–47.CrossRefPubMedPubMedCentral

82.

Christou GA, Kiortsis DN. Adiponectin and lipoprotein metabolism. Obes Rev. 2013;14(12):939–49.CrossRefPubMed

83.

Lekva T, Roland MCP, Michelsen AE, Friis CM, Aukrust P, Bollerslev J, et al. Large reduction in adiponectin during pregnancy is associated with large-for-gestational-age newborns. J Clin Endocrinol Metab. 2017;102(7):2552–9.CrossRefPubMed

84.

Ong GK, Hamilton JK, Sermer M, Connelly PW, Maguire G, Zinman B, et al. Maternal serum adiponectin and infant birthweight: the role of adiponectin isoform distribution. Clin Endocrinol. 2007;67(1):108–14.CrossRef

85.

Powe CE, Allard C, Battista MC, Doyon M, Bouchard L, Ecker JL, et al. Heterogeneous contribution of insulin sensitivity and secretion defects to gestational diabetes mellitus. Diabetes Care. 2016;39(6):1052–5.CrossRefPubMedPubMedCentral

86.

Barbour LA, McCurdy CE, Hernandez TL, Friedman JE. Chronically increased S6K1 is associated with impaired IRS1 signaling in skeletal muscle of GDM women with impaired glucose tolerance postpartum. J Clin Endocrinol Metab. 2011;96(5):1431–41.CrossRefPubMedPubMedCentral

87.

Hernandez TL, Anderson MA, Chartier-Logan C, Friedman JE, Barbour LA. Strategies in the nutritional management of gestational diabetes. Clin Obstet Gynecol. 2013;56(4):803–15.CrossRefPubMedPubMedCentral

88.

Hernandez TL. Higher-complex carbohydrate diets in gestational diabetes. In: Patel VB, Preedy VR, Rajendram R (eds). Nutrition and diet in maternal diabetes: An Evidence-Based Approach. Springer: New York, 2018.

89.

Lichtenstein AH, Schwab US. Relationship of dietary fat to glucose metabolism. Atherosclerosis. 2000;150(2):227–43.CrossRefPubMed

90.

McGowan CA, Walsh JM, Byrne J, Curran S, McAuliffe FM. The influence of a low glycemic index dietary intervention on maternal dietary intake, glycemic index and gestational weight gain during pregnancy: a randomized controlled trial. Nutr J. 2013;12(1):140.CrossRefPubMedPubMedCentral

91.

• Hernandez TL. Carbohydrate Content in the GDM Diet: Two Views: View 1: Nutrition Therapy in Gestational Diabetes: The Case for Complex Carbohydrates. Diabetes Spectr. 2016;29:82–8. Recent review of our current undertanding of how macronutrient composition influences fetal outcomes in diet therapy for management of gestational diabetes.

92.

Hernandez TL, van Pelt RE, Anderson MA, Reece MS, Reynolds RM, de la Houssaye BA, et al. Women with gestational diabetes mellitus randomized to a higher-complex carbohydrate/low-fat diet manifest lower adipose tissue insulin resistance, inflammation, glucose, and free fatty acids: a pilot study. Diabetes Care. 2016;39(1):39–42.CrossRefPubMed

93.

Margerison Zilko CE, Rehkopf D, Abrams B. Association of maternal gestational weight gain with short- and long-term maternal and child health outcomes. Am J Obstet Gynecol. 2010;202(6):574 e1–8.CrossRef

94.

Jedrychowski W, Maugeri U, Kaim I, Budzyn-Mrozek D, Flak E, Mroz E, et al. Impact of excessive gestational weight gain in non-smoking mothers on body fatness in infancy and early childhood. Prospective prebirth cohort study in Cracow. J Physiol Pharmacol. 2011;62(1):55–64.PubMed

95.

Crozier SR, Inskip HM, Godfrey KM, Cooper C, Harvey NC, Cole ZA, et al. Weight gain in pregnancy and childhood body composition: findings from the Southampton Women’s Survey. Am J Clin Nutr. 2010;91(6):1745–51.CrossRefPubMedPubMedCentral

96.

Catalano PM, Roman NM, Tyzbir ED, Merritt AO, Driscoll P, Amini SB. Weight gain in women with gestational diabetes. Obstet Gynecol. 1993;81(4):523–8.PubMed

97.

Starling AP, Brinton JT, Glueck DH, Shapiro AL, Harrod CS, Lynch AM, et al. Associations of maternal BMI and gestational weight gain with neonatal adiposity in the healthy start study. Am J Clin Nutr. 2015;101(2):302–9.CrossRefPubMed

98.

Haghiac M, Yang XH, Presley L, Smith S, Dettelback S, Minium J, et al. Dietary omega-3 fatty acid supplementation reduces inflammation in obese pregnant women: a randomized double-blind controlled clinical trial. PLoS One. 2015;10(9):e0137309.CrossRefPubMedPubMedCentral

99.

Facco FL, Parker CB, Reddy UM, Silver RM, Koch MA, Louis JM, et al. Association between sleep-disordered breathing and hypertensive disorders of pregnancy and gestational diabetes mellitus. Obstet Gynecol. 2017;129(1):31–41.CrossRefPubMedPubMedCentral

100.

Brumbaugh DE, Friedman JE. Developmental origins of nonalcoholic fatty liver disease. Pediatr Res. 2014;75(1–2):140–7.CrossRefPubMed

101.

• Simmons D. Prevention of gestational diabetes mellitus: where are we now? Diabetes Obes Metab. 2015;17(9):824–34. Discussion of why interventional trials targets in mid pregnancy are unlikely to be successful. CrossRefPubMed

102.

• Desoye G, Nolan CJ. The fetal glucose steal: an underappreciated phenomenon in diabetic pregnancy. Diabetologia. 2016;59(6):1089–94. Discussion of how very early maternal hyperglycemia may result in excess fetal growth that can not be reversed. CrossRefPubMedPubMedCentral

Titel: Maternal Non-glycemic Contributors to Fetal Growth in Obesity and Gestational Diabetes: Spotlight on Lipids
verfasst von: Linda A. Barbour
Teri L. Hernandez
Publikationsdatum: 01.06.2018
Verlag: Springer US
Erschienen in: Current Diabetes Reports / Ausgabe 6/2018
Print ISSN: 1534-4827
Elektronische ISSN: 1539-0829
DOI: https://doi.org/10.1007/s11892-018-1008-2

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

^{Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag}

Kostenlos registrieren

Neu im Fachgebiet Innere Medizin

Echinokokkose medikamentös behandeln oder operieren?

06.05.2024 DCK 2024 Kongressbericht

Die Therapie von Echinokokkosen sollte immer in spezialisierten Zentren erfolgen. Eine symptomlose Echinokokkose kann – egal ob von Hunde- oder Fuchsbandwurm ausgelöst – konservativ erfolgen. Wenn eine Op. nötig ist, kann es sinnvoll sein, vorher Zysten zu leeren und zu desinfizieren.

Aquatherapie bei Fibromyalgie wirksamer als Trockenübungen

03.05.2024 Fibromyalgiesyndrom Nachrichten

Bewegungs-, Dehnungs- und Entspannungsübungen im Wasser lindern die Beschwerden von Patientinnen mit Fibromyalgie besser als das Üben auf trockenem Land. Das geht aus einer spanisch-brasilianischen Vergleichsstudie hervor.

Wo hapert es noch bei der Umsetzung der POMGAT-Leitlinie?

03.05.2024 DCK 2024 Kongressbericht

Seit November 2023 gibt es evidenzbasierte Empfehlungen zum perioperativen Management bei gastrointestinalen Tumoren (POMGAT) auf S3-Niveau. Vieles wird schon entsprechend der Empfehlungen durchgeführt. Wo es im Alltag noch hapert, zeigt eine Umfrage in einem Klinikverbund.

VHF-Ablation nützt wohl nur bei reduzierter Auswurfleistung

02.05.2024 Ablationstherapie Nachrichten

Ob die Katheterablation von Vorhofflimmern bei Patienten mit Herzinsuffizienz die Komplikationsraten senkt, scheint davon abzuhängen, ob die Auswurfleistung erhalten ist oder nicht. Das legen die Ergebnisse einer Metaanalyse nahe.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Live-Webinar "Chronische Unterbauch- und Viszeralschmerzen in der Praxis managen"

Springer Medizin

Abstract

Purpose of Review

Recent Findings

Summary

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 6/2018

Type 2 Diabetes Mellitus, the Metabolic Syndrome, and Its Components in Adult Survivors of Acute Lymphoblastic Leukemia and Hematopoietic Stem Cell Transplantations

Pediatric Type 2 Diabetes in Japan: Similarities and Differences from Type 2 Diabetes in Other Pediatric Populations

Type 2 Diabetes in Youth: New Lessons from the SEARCH Study

Sex Differences in the Burden and Complications of Diabetes

Sugar-Sweetened Beverage, Obesity, and Type 2 Diabetes in Children and Adolescents: Policies, Taxation, and Programs