Ethnic differences in maternal total cholesterol and triglyceride levels during pregnancy: the contribution of demographics, behavioural factors and clinical characteristics

Schreuder, Y J; Hutten, Barbara A.; Eijsden, Manon van; Jansen, Eugène; Vissers, Maud N.; Twickler, Marcel Th B; Vrijkotte, Tanja G. M.

doi:10.1038/ejcn.2010.282

Cited by 35 publications

(42 citation statements)

References 44 publications

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“…Ethnic differences in lipids have been described both in the nonpregnant (31) and the pregnant state (32), and the relationship between maternal lipids and pregnancy outcomes has been shown to vary between ethnicities (33). It is therefore difficult to compare directly between studies, even in women with the same underlying medical condition, and a more reliable comparison can only be made between groups within the same study under similar sampling conditions (Supplementary Table 1).…”

Section: Maternal Obesitymentioning

confidence: 99%

Normalizing Metabolism in Diabetic Pregnancy: Is It Time to Target Lipids?

et al. 2014

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Outcomes in pregnancies complicated by preexisting diabetes (type 1 and type 2) and gestational diabetes mellitus have improved, but there is still excess morbidity compared with normal pregnancy. Management strategies appropriately focus on maternal glycemia, which demonstrably improves pregnancy outcomes for mother and infant. However, we may be reaching the boundaries of obtainable glycemic control for many women. It has been acknowledged that maternal lipids are important in pregnancies complicated by diabetes. Elevated maternal lipids are associated with preeclampsia, preterm delivery, and large-forgestational-age infants. Despite this understanding, assessment of management strategies targeting maternal lipids has been neglected to date. Consideration needs to be given to whether normalizing maternal lipids would further improve pregnancy outcomes. This review examines the dyslipidemia associated with pregnancy complicated by diabetes, reviews possible therapies, and considers whether it is time to start actively managing this aspect of maternal metabolism.Although rates of adverse outcomes in pregnancies complicated by preexisting diabetes (type 1 and type 2) and gestational diabetes mellitus (GDM) have improved, there is still excess maternal and fetal morbidity compared with normal pregnancy. Current management strategies focus on maternal glycemic control, which demonstrably improves pregnancy outcomes for mother and infant. Truly "normal" glucose levels in pregnancy appear lower than previously thought (1) and achieving currently recommended glucose targets in pregnancy carries a risk of hypoglycemia (2). The challenges in reaching glycemic targets before and after conception raise the question of whether other aspects of maternal metabolism could potentially be addressed to provide benefit to mother and infant.Multiple maternal metabolic, hormonal, and inflammatory factors other than maternal glucose are associated with maternal and fetal outcomes and are altered in pregnancies complicated by prepregnancy diabetes and GDM. These include maternal amino acids, glycerol, ketones, and lipids (3). Lipid management in diabetes is acknowledged as a key therapeutic target in the nonpregnant setting. However, it has not been accorded the same attention in pregnancy. Abnormal maternal lipids in pregnancy have been associated with preeclampsia (4,5), preterm delivery (6), and large-forgestational-age (LGA) infants (7). This review examines the dyslipidemia associated with pregnancy complicated by diabetes, reviews possible therapies, and considers whether there is sufficient evidence to start actively managing lipids in pregnancy. LIPID METABOLISM IN PREGNANCYMaternal metabolism is designed to provide adequate nutrition for fetal growth, in the form of glucose, ketones, lipids, and other fuels. In early pregnancy, maternal

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Section: Maternal Obesitymentioning

confidence: 99%

Normalizing Metabolism in Diabetic Pregnancy: Is It Time to Target Lipids?

et al. 2014

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“…In this regard, other potential targets such as lifestyle behaviors [sedentary time (ST) and physical activity (PA)] might help pregnant women to control and regulate immunometabolic responses during early pregnancy. 4,[11][12][13][14] To date, two studies 12,15 have suggested that ST is not associated with any immunometabolic marker during early pregnancy. Furthermore, maintaining appropriate PA levels during early pregnancy seems to be associated with lower risk of developing gestational diabetes mellitus (GDM), better insulin sensitivity, and lower plasma triglycerides and total cholesterol concentrations.…”

Section: Introductionmentioning

confidence: 99%

“…Furthermore, maintaining appropriate PA levels during early pregnancy seems to be associated with lower risk of developing gestational diabetes mellitus (GDM), better insulin sensitivity, and lower plasma triglycerides and total cholesterol concentrations. 4,13,14 However, the role of PA on inflammatory cytokines during early pregnancy is not clear. 12 Thereby, previous literature 4,16 has highlighted that more evidence is imperative regarding the impact of ST and PA (intensity, frequency, and duration) on immunometabolic health.…”

Section: Introductionmentioning

confidence: 99%

Association of sedentary time and physical activity levels with immunometabolic markers in early pregnancy: The GESTAFIT project

Acosta‐Manzano

Acosta

Femia

et al. 2019

Scandinavian Med Sci Sports

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Objectives:To analyze the association of sedentary time and physical activity (PA) intensity levels with immunometabolic markers during early pregnancy; and to examine if meeting the PA recommendations is associated with the immunometabolic profile of pregnant women. Methods: Fifty Caucasian pregnant women (age: 32.8 ± 4.7 years old, body mass index: 24.2 ± 4.1kg/m 2 , gestational age: 17 ± 1.5weeks) participated in this crosssectional study (from September 2015 through May 2016). Sedentary time and PA intensity levels were objectively measured with triaxial accelerometer (seven consecutive valid days). Fasting serum glucose, total cholesterol, phospholipids, and triglycerides were assessed with standard methods. Serum pro-inflammatory and anti-inflammatory cytokines (fractalkine, interleukin-1β, interleukin-6, interleukin-8, interleukin-10, interferon-γ, and tumor necrosis factor-α) were measured using Luminex xMAP technology. Results: Sedentary time and PA were not correlated with any glycemic or lipid marker (P > .05). After adjusting for the potential confounders, vigorous PA showed a positive non-significant association with interleukin-6 (P = .06), and bouts of moderatevigorous PA was inversely associated with interleukin-1β and interferon-γ (P = .02 and P = .04, respectively). Meeting the PA guidelines was inversely associated with interleukin-1β and positively associated with interleukin-8 (P = .01 and P = .04, respectively). These associations disappeared after controlling for multiplicity. | 149ACOSTA-MANZANO eT Al. | 157ACOSTA-MANZANO eT Al.Víctor Segura-Jiménez https://orcid.

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“…The examination of ethnicity in the current analyses is a post hoc subgroup analysis and thus needs to be treated with caution. However, ethnic differences in the relationship between insulin resistance, body adipose stores (26), lipids (27,28), and adipokines (29,30) have been reported before, and ethnic differences in lipid and lipoprotein metabolism have also been described in pregnancy (31,32). It is also possible that there are ethnic variations in the metabolism of or pharmacological response to metformin (33–35).…”

Section: Discussionmentioning

confidence: 98%

Determinants of Maternal Triglycerides in Women With Gestational Diabetes Mellitus in the Metformin in Gestational Diabetes (MiG) Study

Barrett¹,

Nitert²,

Jones³

et al. 2013

Diabetes Care

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OBJECTIVEFactors associated with increasing maternal triglyceride concentrations in late pregnancy include gestational age, obesity, preeclampsia, and altered glucose metabolism. In a subgroup of women in the Metformin in Gestational Diabetes (MiG) trial, maternal plasma triglycerides increased more between enrollment (30 weeks) and 36 weeks in those treated with metformin compared with insulin. The aim of this study was to explain this finding by examining factors potentially related to triglycerides in these women.RESEARCH DESIGN AND METHODSOf the 733 women randomized to metformin or insulin in the MiG trial, 432 (219 metformin and 213 insulin) had fasting plasma triglycerides measured at enrollment and at 36 weeks. Factors associated with maternal triglycerides were assessed using general linear modeling.RESULTSMean plasma triglyceride concentrations were 2.43 (95% CI 2.35–2.51) mmol/L at enrollment. Triglycerides were higher at 36 weeks in women randomized to metformin (2.94 [2.80–3.08] mmol/L; +23.13% [18.72–27.53%]) than insulin (2.65 [2.54–2.77] mmol/L, P = 0.002; +14.36% [10.91–17.82%], P = 0.002). At 36 weeks, triglycerides were associated with HbA1c (P = 0.03), ethnicity (P = 0.001), and treatment allocation (P = 0.005). In insulin-treated women, 36-week triglycerides were associated with 36-week HbA1c (P = 0.02), and in metformin-treated women, they were related to ethnicity.CONCLUSIONSAt 36 weeks, maternal triglycerides were related to glucose control in women treated with insulin and ethnicity in women treated with metformin. Whether there are ethnicity-related dietary changes or differences in metformin response that alter the relationship between glucose control and triglycerides requires further study.

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Ethnic differences in maternal total cholesterol and triglyceride levels during pregnancy: the contribution of demographics, behavioural factors and clinical characteristics

Cited by 35 publications

References 44 publications

Normalizing Metabolism in Diabetic Pregnancy: Is It Time to Target Lipids?

Normalizing Metabolism in Diabetic Pregnancy: Is It Time to Target Lipids?

Association of sedentary time and physical activity levels with immunometabolic markers in early pregnancy: The GESTAFIT project

Determinants of Maternal Triglycerides in Women With Gestational Diabetes Mellitus in the Metformin in Gestational Diabetes (MiG) Study

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