HNF1B,TSPAN8 and NOTCH2 gene polymorphisms in women with gestational diabetes

Purpose: To investigate genes involved in pancreatic beta cell function, insulin production and glucose metabolism that may predispose to gestational diabetes mellitus (GDM).

Methods: The study group consisted of 204 women with GDM and 207 women with normal glucose tolerance (NGT). The following polymorphisms were genotyped for each patient: HNF1B rs4430796, TSPAN8 rs7961581 and NOTCH2 rs10923931. A p value of <.05 was considered to indicate a statistically significant result.

Results: There was a statistically significant increase in the frequency of HNF1B rs4430796 G allele among pregnant women with GDM (GG+AG versus AA, OR: 1.55, 95% CI: 1.01–2.36, p?=?.042; G versus A, OR: 1.39, 95% CI: 1.06–1.83, p?=?.018), whereas there were no statistically significant differences in the distributions of TSPAN8 rs7961581 and NOTCH2 rs10923931 genotypes and alleles between women with GDM and healthy pregnant women. In the multivariate logistic regression analysis, older age, higher BMI before pregnancy and a higher number of HNF1B rs4430796?G alleles were independent significant predictors of a higher risk of GDM.

Conclusions: The results of this study suggest that the HNF1B gene rs4430796?G allele may be associated with increased risk of GDM.     

Genetic variants and clinical relevance associated with gestational diabetes mellitus in Chinese women: a case-control study

Purpose: Gestational diabetes mellitus (GDM) may share similar mechanisms with type 2 diabetes and obesity. In the current study, we aimed to verify twenty genes reported to be associated with type 2 diabetes and obesity in the Chinese GDM population.

Methods: Pregnant women aged 20–49?years at 24–28 gestational weeks were recruited and 556 cases and 445 controls were enrolled in the study. The genotyping of single nucleotide polymorphisms (SNPs) was performed on peripheral blood samples.

Results: We discovered that GDM was associated with rs945508 (OR?=?1.368, 95% CI?=?1.080–1.732, p?=?.009), rs10804591 (OR?=?1.446, 95% CI?=?1.192–1.754, p?p?=?.043) and rs1552224 (OR?=?1.451, 95% CI?=?1.071–1.964, p?=?.016).

Conclusions: We found that four SNPs associated with type 2 diabetes and obesity may also increase the risk of developing GDM in the Chinese population. Among these SNPs, we report for the first time that rs945508 in ARHGEF11, rs10804591 in PLXND1 and rs10245353 in NFE2L3 were associated with GDM.     

Comparison of myo-inositol and metformin on glycemic control,lipid profiles,and gene expression related to insulin and lipid metabolism in women with polycystic ovary syndrome: a randomized controlled clinical trial

Abstract

This investigation was conducted to evaluate comparison of myo-inositol and metformin on glycemic control, lipid profiles, and gene expression related to insulin and lipid metabolism in women with polycystic ovary syndrome (PCOS). This randomized controlled trial was conducted on 53 women with PCOS, aged 18–40 years old. Subjects were randomly allocated into two groups to take either myo-inositol (n?=?26) or metformin (n?=?27) for 12 weeks. Myo-inositol supplementation, compared with metformin, significantly reduced fasting plasma glucose (FPG) (β ?5.12?mg/dL; 95% CI, ?8.09, ?2.16; p=.001), serum insulin levels (β ?1.49 µIU/mL; 95% CI, ?2.28, ?0.70; p<.001), homeostasis model of assessment-insulin resistance (β ?0.36; 95% CI, ?0.55, ?0.17; p<.001), serum triglycerides (β 12.42?mg/dL; 95% CI, ?20.47, ?4.37; p=.003) and VLDL-cholesterol levels (β ?2.48?mg/dL; 95% CI, ?4.09, ?0.87; p=.003), and significantly increased the quantitative insulin sensitivity check index (β 0.006; 95% CI, 0.002, 0.01; p=.006) compared with metformin. Moreover, myo-inositol supplementation upregulated gene expression of peroxisome proliferator-activated receptor gamma (PPAR-γ) (p=.002) compared with metformin. Overall, taking myo-inositol, compared with metformin, for 12 weeks by women with PCOS had beneficial effects on glycemic control, triglycerides and VLDL-cholesterol levels, and gene expression of PPAR-γ.     

Effect of vitamin D deficiency on the 75 g oral glucose tolerance test screening and insulin resistance

Abstract

Gestational diabetes mellitus (GDM), is the most common medical complications of pregnancy. This study aimed to clarify the effect of second-trimester vitamin D deficiency on the 75?g oral glucose tolerance test (OGTT) screening and insulin resistance. A total of 120 pregnant women with a singleton pregnancy at a gestational age of 26–28?weeks were analyzed. Participants were divided into two groups according to 25-hydroxyvitamin D levels; vitamin D deficiency, and control groups. For GDM scan, 75?g OGTT was preferred. GDM prevalence was 17.5% in vitamin D deficiency group and 13.75% in control group, there is no significant difference in GDM prevalence (p?=?0.149). Fasting plasma glucose and 1-h plasma glucose levels were significantly higher in the vitamin D deficiency group than in the control group (p?<?.001 and p?<?.001, respectively). No significant differences were observed between 2-hour plasma glucose levels (p?=?.266). The HOMA-IR level was significantly higher in the vitamin D deficiency group than in the control group (p?<?.001). The findings of the present study suggested that vitamin D deficiency in the second trimester was inversely correlated with fasting and 1-h plasma glucose after 75?g glucose challenge test; also, low 25 OHD₃ levels were associated with insulin resistance.     

Colostrum and mature breast milk analysis of serum irisin and sterol regulatory element-binding proteins-1c in gestational diabetes mellitus

Background: We aimed to evaluate irisin and SREBP-1c levels in serum, colostrum and mature breast milk in women with and without gestational diabetes (GDM); and to relate them with maternal glucose, lipid profile and weight status of babies.

Methods: GDM positive women (n?=?33) and normal glucose tolerant women (NGT) (n?=?33) were recruited. Maternal blood samples were collected at 28th week of gestation and later at 6-week post-partum while breast milk samples of the lactating mothers were collected within 72?hours of birth (colostrum) and at 6 weeks post-partum (mature milk). Irisin and SREBP-1c levels were analyzed by commercially available ELISA kits for all maternal samples.

Results: Lower levels of irisin were seen in serum, colostrum and mature breast milk of GDM females (p?r?=?0.439; p?r?=?0.403; p?=?.01), HbA1c (r?=??0.312; p?=?.011), Fasting blood glucose (r?=?0.992; p?=?.008), and baby weight at birth (r?=?0.486; p?r?=?0.325; p?=?.017; r?=?0.296; p?=?.022, respectively). Serum SREBP-1c at 6 weeks correlated with random blood glucose (r?=?0.318; p?=?.009), and HbA1c (r=??0.292; p?=?.011). All correlations were lost once we adjusted for maternal BMI.

Conclusions: Low irisin and SREBP1-c levels may favor development of GDM in pregnant subjects. Further, low mature breast milk levels may act as a continued stressor from fetal to infant life as long as breast-feeding is continued. Further studies are required to identify the mechanistic relationship between these biomarkers and GDM.     

The effects of vitamin E supplementation on endometrial thickness,and gene expression of vascular endothelial growth factor and inflammatory cytokines among women with implantation failure

Objective: Data on the effects of vitamin E supplementation on endometrial thickness, and gene expression of vascular endothelial growth factor (VEGF) and inflammatory cytokines among women with implantation failure are limited. This research was performed to determine the effects of vitamin E supplementation on endometrial thickness, and gene expression of VEGF and inflammatory cytokines among women with implantation failure.

Methods: A randomized clinical trial was done among 40 women with implantation failure aged 18–37 years old. Participants were randomly divided into two groups: group A (n?=?20) received 400-IU vitamin E supplements and group B (n?=?20) received placebo for 12 weeks. Fasting blood samples were taken at baseline and after the 12-week treatment to determine biomarkers of oxidative stress, and gene expression of VEGF and inflammatory cytokines.

Results: After the 12-week intervention, compared with the placebo, women with implantation failure who consumed vitamin E supplements had significantly increased serum vitamin E levels (+18.6?±?15.0 versus ?1.5?±?1.0?nmol/mL, p?p?=?.01), and significantly decreased plasma malondialdehyde (MDA) concentrations (?0.4?±?0.3 versus +0.4?±?0.3 µmol/L, p?p?=?.008), interleukin-1 (IL-1) (p?=?.02), and tumor necrosis factor alpha (TNF-α) (p?=?.007) in peripheral blood mononuclear cells of women with implantation failure.

Conclusions: Overall, vitamin E supplementation for 12 weeks among women with implantation failure had beneficial effects on endometrial thickness, MDA values, and gene expression of LDLR, IL-1, and TNF-α.     

Comparison of placental three-dimensional power Doppler indices and volume in the first and the second trimesters of pregnancy complicated by gestational diabetes mellitus

Objective: To compare the changes of placental three-dimensional power Doppler indices and volume in the first and the second trimesters of pregnancy with gestational diabetes mellitus (GDM).

Methods: This was a prospective case-control study of singleton pregnancies with risk factors for GDM. Data on placental vascular indices including vascularization index (VI), flow index (FI), and vascularization flow index (VFI), as well as placental volume were obtained and analyzed during the first and the second trimesters between pregnant women with and without GDM.

Results: Of the 155 pregnant women enrolled, 31 developed GDM and 124 did not. VI and VFI were significantly lower in the GDM group during the first and second trimesters (VI: p?=?.023, and VFI: p?=?.014 in the first trimester; VI: p?=?.049, and VFI: p?=?.031 in the second trimester). However, the placental volume was similar in both the groups during the first trimester, while it was significantly increased in the GDM group during the second trimester (p?=?.022). There were no significant differences in FI and uterine artery pulsatility index between the two groups. After adjustments in multivariate logistic regression analysis, significant differences were observed in the first trimester VFI (adjusted odds ratio (OR) 0.76, 95% confidence interval (CI) 0.61–0.93), second trimester VFI (adjusted or 0.83, 95%CI 0.71–0.96), and second trimester placental volume (adjusted or 1.03, 95%CI 1.01–1.05).

Conclusions: Placental vascular indices can provide an insight into placental vascularization in GDM during early pregnancy. VFI rather than placental volume may be a sensitive sonographic marker in the first trimester of GDM placentas.     

Relationship between advanced glycation end products and gestational diabetes mellitus

Objective: To investigate the levels of and dynamic changes of advanced glycation end products (AGEs) in maternal plasma during pregnancy and explore the association between these levels and gestational diabetes mellitus (GDM).

Methods: This study recruited 90 GDM women and 90 healthy pregnant controls. The women received prenatal care and were hospitalized for delivery in Peking University First Hospital in China between October 2015 and April 2016. The patients were recruited and provided blood samples during gestational weeks 24–29. The levels of AGEs, TNF-α, hs-CRP, plasma glucose, and FINS and lipid profiles were measured, and HOMA-IR was calculated. New blood samples were collected and AGE was measured again in the two groups at 33–41 weeks of gestation to identify its dynamic changes.

Results: The levels of AGEs were significantly higher in the GDM group than in the NGT group at both 24–29 weeks (473.65?±?105.32 versus 324.36?±?57.86?ng/L; p?p?p?p?=?.003), TNF-α (p?=?.005), and hs-CRP (p?p?=?.001). In the NGT group, there was no significant change in the concentration of AGEs between the two gestational periods (p?=?.388).

Conclusions: Plasma levels of AGEs are associated with GDM. During pregnancy, the changes observed in the levels of AGEs were different between GDM and normal pregnancies.     

The effect of vitamin D supplementation on insulin resistance,visceral fat and adiponectin in vitamin D deficient women with polycystic ovary syndrome: a randomized placebo-controlled trial

Introduction: Low plasma 25-hydroxy-vitamin D (25OHD) is associated with polycystic ovary syndrome (PCOS). Vitamin D deficiency may contribute to the development of insulin resistance, visceral fat and low level of adiponectin which are common feature in PCOS women. This study aimed to evaluate the effect of vitamin D supplementation on insulin resistance, visceral fat, and adiponectin in hypovitaminosis D women with polycystic ovary syndrome.

Methods: In this randomized, placebo-controlled clinical trial, 44 PCOS women aged 20–38?years with plasma 25OHD?<20?ng/mL were randomized in the intervention or placebo groups and followed for 8?weeks. Participants received 50,000?IU of oral vitamin D3 once weekly in the intervention group or placebo. The visceral adipose tissue, Insulin resistance (HOMA-IR), HOMA-B, QUICKI, and circulating adiponectin were compared before and after the intervention within groups using paired tests and the mean changes were analyzed between two groups by independent t-test.

Results: Of 44 eligible participates, 36 patients (81.8%) completed the study. After 8?week intervention, vitamin D supplementation compared to the placebo group significantly decreased fasting plasma glucose (FPG) (7.67?±?7.66 versus 1.71?±?7.50?mg/dL, p?=?.001) and significantly increased homeostasis model of assessment-estimated B cell function (HOMA-B) (129.76?±?121.02 versus 48.32?±?128.35, p?=?.014), Adiponectin (5.17?±?8.09 versus ?5.29?±?8.64?mg/dL, p?=?.001), and serum vitamin D level (28.24?±?6.47 versus 3.55?±?4.25?ng/mL, p?=?.001).

Conclusion: Vitamin D supplementation in vitamin D deficient women with PCOS, improved the FPG, HOMA-B, Adiponectin, and serum vitamin D level.     

The influence of zinc sulfate on neonatal jaundice: a systematic review and meta-analysis

Introduction: Zinc sulfate may be a promising approach to treat neonatal jaundice. However, the results remain controversial. We conducted a systematic review and meta-analysis to evaluate the efficacy and safety of zinc sulfate on hyperbilirubinemia among neonates.

Methods: PubMed, EMbase, Web of science, EBSCO, Cochrane library databases, Ovid, BMJ database, and CINAHL were systematically searched. Randomized controlled trials (RCTs) assessing the effect of zinc sulfate versus placebo on the prevention of jaundice in neonates were included. Two investigators independently searched articles, extracted data, and assessed the quality of included studies. The primary outcomes were total serum bilirubin (TSB) on three days and seven days, the incidence of hyperbilirubinemia. Meta-analysis was performed using random- or fixed-effect models.

Results: Five RCTs involving 645 patients were included in the meta-analysis. Overall, compared with placebo, zinc sulfate supplementation failed to significantly reduce TSB on three days (mean difference (MD)?=?0.09?mg/dL; 95% confidence interval (CI)?=??0.49 to 0.67; p?=?.77), TSB on seven days (MD?=??0.37?mg/dL; 95% CI?=??98 to 0.25; p?=?.25) as well as the incidence of hyperbilirubinemia (OR?=?1.14; 95% CI?=?0.74 to 1.76; p?=?.56). Zinc sulfate showed no influence on phototherapy requirement (OR?=?0.90; 95% CI?=?0.41 to 1.98; p?=?.79), but resulted in significantly decreased duration of phototherapy (MD?=??16.69?h; 95% CI?=??25.09 to ?8.3?h; p?Conclusions: Zinc sulfate could not reduce the TSB on three days and seven days, the incidence of hyperbilirubinemia and phototherapy requirement, but lead to significantly decreased duration of phototherapy.     

Serum collectrin levels in patients with early- and late-onset preeclampsia

Aim: The aim of this study is to investigate the maternal levels of collectrin in early-onset preeclampsia (EOPE) and late-onset preeclampsia (LOPE). To assess the correlation between serum collectrin levels and blood pressure in humans.

Material and methods: This cross-sectional study was conducted including 79 pregnant women, 27 with normal pregnancy, 30 with EOPE and 22 with LOPE. Maternal serum levels of collectrin were measured by using enzyme-linked immunosorbent assay kits.

Results: The mean serum collectrin level was significantly lower in women with PE compared with the control group (8.49?±?3.12?ng/ml (EOPE), 9.69?±?3.01?ng/ml (LOPE) versus 11.51?±?4.33?ng/ml) and was found to be the lowest in the EOPE group (8.49?±?3.12?ng/ml). The mean serum urea and uric acid levels were significantly higher in the PE group than the control group. Serum collectrin concentrations did not correlate with maternal age, BMI and serum creatinine levels. However, collectrin concentrations were negatively correlated with systolic blood pressure (r?=??0.284, p?=?.011) and diastolic blood pressure (r?=??0.275, p?=?.014) as well as with maternal serum urea (r?=??0.269, p?=?.017) and uric acid (r?=??0.219, p?=?.049) concentrations.

Conclusion: Maternal serum collectrin levels are significantly lower in patients with preeclampsia than in the control group. There is an inverse correlation between serum collectrin levels and blood pressure.     

Efficacy of probiotic supplement for gestational diabetes mellitus: a systematic review and meta-analysis

Background: Probiotic supplement might be beneficial for gestational diabetes mellitus. However, the results remained controversial. We conducted a systematic review and meta-analysis to explore the efficacy of probiotic supplement in gestational diabetes mellitus.

Methods: PubMed, Embase, Web of science, EBSCO, and Cochrane Library databases were systematically searched. Randomized controlled trials (RCTs) assessing the effect of probiotic supplement in gestational diabetes mellitus were included. Two investigators independently searched articles, extracted data, and assessed the quality of included studies. The primary outcome were fasting serum insulin and fasting plasma glucose. Meta-analysis was performed using the fixed-effect or random-effect model.

Results: Six RCTs involving 830 patients were included in the meta-analysis. Overall, compared with control intervention in gestational diabetes mellitus, probiotic supplementation intervention was found to significantly reduce fasting serum insulin (Std. mean difference?=??0.95; 95% CI?=??1.73 to ?0.17; p?p?=?.02), but showed no substantial impact on fasting plasma glucose (Std. mean difference =??0.49; 95% CI?=??1.05–0.08; p?=?.09), gestational age (Std. mean difference?=?0.07; 95% CI?=??0.20–0.34; p?=?.63), and gestational weight (Std. mean difference?=??0.11; 95% CI?=??0.38–0.16; p?=?.43).

Conclusions: Compared with control intervention in gestational diabetes mellitus, probiotic supplementation was found to significantly reduce insulin resistance (HOMA-IR) and fasting serum insulin, but had no substantial influence on fasting plasma glucose, gestational age and gestational weight.     

Characteristics of abnormal oral glucose tolerance test in GDM diagnosis and clinical correlation

Objectives: To describe the characteristics of abnormal oral glucose tolerance test (OGTT) values at gestational diabetes mellitus (GDM) diagnosis and their associations with clinical characteristics, and to evaluate the effect on GDM diagnosis if any OGTT value was omitted.

Materials and methods: A cross-sectional study was conducted in 415 women diagnosed with GDM. The OGTT results were recorded and analyzed.

Results: Of the 415 included women, mean gestational age at GDM diagnosis was 19.2 weeks and 57.6% were diagnosed before 20 weeks. The highest proportions of abnormal values were found at the 1st and 2nd hour (85.3% and 96.6%, respectively). If the 3rd hour OGTT value was omitted, 16.7% of GDM cases would be missed. Number of abnormal OGTT values and abnormal FPG were significantly associated with obesity. Only pre-pregnancy overweight and obesity independently associated with insulin requirement (adjusted OR: 2.28, 95%CI: 1.02–5.06; p?=?.044; and adjusted OR: 6.29, 95%CI: 2.67–14.85; p?Conclusions: Over half of the GDM women had three or four abnormal OGTT values. Omission of the 3rd hour OGTT value would result in 16.7% of patients not being diagnosed with GDM. Number of abnormal OGTT values and abnormal FPG were associated with obesity, and insulin requirement was associated with pre-pregnancy overweight and obesity.     

Efficacy of zinc supplementation for neonatal sepsis: a systematic review and meta-analysis

Background: Zinc supplementation has some potential in treating neonatal sepsis. We conduct a systematic review and meta-analysis to explore the efficacy of zinc supplementation for neonatal sepsis.

Methods: PubMed, Embase, Web of science, EBSCO, and Cochrane Library databases are systematically searched. Randomized controlled trials (RCTs) assessing the efficacy of zinc supplementation in neonatal sepsis are included. Two investigators independently search articles, extract the data, and assessed the quality of included studies. Meta-analysis is performed using the random-effect model.

Results: Four RCTs involving 986 patients are included in the meta-analysis. Overall, compared with control intervention in neonatal sepsis, zinc supplementation is able to significantly reduce mortality rate (risk ratio (RR)?=?0.48; 95% confidence intervals (CIs)?=?0.25–0.94; p?=?.03) and improve serum zinc (mean difference (MD)?=?81.97; 95% CI?=?34.57–129.37; p?=?.0007), but has no remarkable influence on hospital stay (MD?=??4.51; 95% CI?=??15.08 to 6.05; p?=?.40) and the number of expired patients (RR?=?0.63; 95% CI?=?0.24–1.65; p?=?.35).

Conclusions: Zinc supplementation may significantly reduce mortality rate and improve serum zinc in neonatal sepsis, but has no substantial influence on hospital stay and the number of expired patients.     

First-trimester irisin and fetuin-A concentration in predicting macrosomia

Objective: We investigated the diagnostic value of first-trimester adipokines and placental markers in predicting macrosomia.

Methods: Out of 328 women recruited during the prenatal diagnosis between 11th and 13th week of pregnancy and subjected to follow up until delivery, we selected 26 women who gave birth to macrosomic babies and 34 women who gave birth to normal weight neonates for the evaluation of first trimester serum levels of pregnancy associated plasma protein-A, free β-human chorionic gonadotropin, placental growth factor (PIGF), and selected adipokines.

Results: The mothers of macrosomic infants had higher PIGF (p?=?.049) and irisin concentrations (p?=?.00003), and lower fetuin-A levels (p?=?.0002) than had the mothers of normal weight babies. Newborn’s weight correlated positively with maternal irisin (R?=?0.454, p?=?.0003) and negatively with fetuin-A concentrations (R?=??0.497, p?=?.00005). Multiple regression analysis showed that only serum irisin concentration was a significant predictor of birth weight (β?=?0.329, p?=?.03), explaining 14% of its variability. The sensitivity and the specificity of irisin concentration in predicting macrosomia were 0.769 and 0.794, respectively (AUC?=?0.818 [95%CI: 0.708–0.928], p?=?.00001) with a proposed cut-off value of 1725.4?ng/ml.

Conclusions: Our results suggest that mother’s irisin may be an early biomarker of macrosomia.     

A comparison between the effects of ginger,pyridoxine (vitamin B6) and placebo for the treatment of the first trimester nausea and vomiting of pregnancy (NVP)

Introduction: Nausea and vomiting of pregnancy (NVP) are one of the most common complains of the early pregnancy period and are bothersome for pregnant women. Some prefer to use herbal medicine instead of chemical agents.

Objective: The purpose of the present study was to compare the effects of ginger, pyridoxine (vitamin B6), and placebo for the treatment of NVP.

Method: The study was performed as a triple blind clinical trial on pregnant women suffering mild to moderate NVP between 6 and 16 weeks of pregnancy. In these women ginger, 500?mg twice daily, vitamin B6 40?mg twice daily and placebo twice daily were administered for 4?d. Rhodes questionnaire was used for evaluation of the severity of symptoms. The severity of NVP was evaluated 24?h before entering the study and up to 4 d after using medications and results were compared among the three groups.

Results: Seventy-seven women finished the study (28 in the Ginger group, 26 in the B6 group, and 23 in the placebo group). The women of the three groups did not have significant differences according to age, gestational age, parity, and severity of each symptom before treatment and educational status. Total score of Rhodes questionnaire for nausea was decreased significantly in three groups after treatment. (p?p?=?.012, and p?=?.03 for ginger, vitamin B6, and placebo, respectively.) Also total score of Rhodes questionnaire for vomiting was decreased in three groups (p?=?.03 for ginger, p?=?.02 for B6, and p?=?.04 for placebo). Ginger and vitamin B6 could reduce the severity of all items of Rhodes questionnaire significantly; however, placebo was significantly effective only on the frequency of nausea, intensity of vomiting and frequency of retching. Ginger and vitamin B6 were more effective than placebo (p?=?.039 and p?=?.007, respectively); however, total score of Rhodes did not show significant difference between ginger and vitamin B6 (p?=?.128). Ginger was more effective for nausea (intensity and distress) and distress of vomit.

Conclusion: Ginger is more effective than placebo for the treatment of mild to moderate NVP and is comparable with vitamin B6.

Trial registration number and registry website: IRCT2015020320923N1     

Circulating levels of Elabela and Apelin in the second and third trimesters of pregnancies with gestational diabetes mellitus

Abstract

We design this study to detect levels of Elabela (ELA) and Apelin (APLN) in women with and without gestational diabetes mellitus (GDM) in the second and third trimesters, and to identify whether there is any association between ELA, APLN, and metabolic parameters. Seventy-nine GDM and 80 control subjects in the second trimester and 87 GDM and 88 healthy subjects in the third trimester were included. In the second trimester, lower ELA levels [(14.1 versus 16.9) ng/ml, p?=?.025] and higher APLN levels [(1021.8 versus 923.5) pg/ml, p?=?.046] were observed in GDM patients compared to controls. ELA levels were positively correlated with fasting plasma glucose (FPG) (r?=?0.423, p?<?.001) in the control group, and APLN levels were negatively correlated with triglycerides (TG) (r?=??0.251, p?=?.025) in the control group and total cholesterol (TC) (r?=??0.227, p?=?.044) in the GDM group. ELA appeared to be related to glucose metabolism and APLN is involved in lipid metabolism during pregnancy. The expression of ELA is significantly downregulated from the second trimester to the third trimester.     

The influence of massage on neonatal hyperbilirubinemia: a meta-analysis of randomized controlled trials

Introduction: The efficacy of massage to treat neonatal hyperbilirubinemia remains controversial. We conducted a systematic review and meta-analysis to explore the influence of massage on the neonatal hyperbilirubinemia.

Methods: We search PubMed, Embase, Web of science, EBSCO, and Cochrane Library databases through November 2017 for randomized controlled trials (RCTs) assessing the effect of massage on neonatal hyperbilirubinemia. This meta-analysis is performed using the random-effect model.

Results: Six RCTs involving 357 patients are included in the meta-analysis. Overall, compared with the control group in neonatal hyperbilirubinemia, massage therapy is associated with substantially reduced serum bilirubin level within 4?d (mean difference (MD)?=??2.31; 95% CI?=??2.92 to ?1.70; p?p?p?=?.23), transcutaneous bilirubin level on 2?d (MD?=??0.17; 95% CI?=??1.34 to 1.00; p?=?.77), frequency of defecation daily on 2?d (MD?=?0.57; 95% CI?=??0.03 to 1.16; p?=?.06), and frequency of defecation daily within 4?d (MD?=?0.83; 95% CI?=??0.11 to 1.76; p?=?.08).

Conclusions: Massage therapy can significantly reduce serum bilirubin level and transcutaneous bilirubin level within 4?d, but demonstrates no influence on serum bilirubin level and transcutaneous bilirubin level on 2?d, frequency of defecation daily on 2 and 4?d for neonatal hyperbilirubinemia.     

Serum irisin concentration in women with gestational diabetes

Irisin is a novel myokine and adipokine which induces an increase in total body energy expenditure, improving insulin sensitivity and glucose tolerance in experimental animals. In the present study, serum irisin concentration was measured by an enzyme immunoassay in 130 women with gestational diabetes mellitus (GDM) and 140 BMI-matched patients with normal glucose tolerance (NGT). Median irisin level was significantly lower in the patients with GDM than in the NGT subjects (1703.3 [1354.8–2097.9?ng/ml] versus 1873.8 [1519.8–2294.8?ng/ml], p?=?0.01); however, 3 months after childbirth its concentrations did not differ markedly between the two groups (1165.9 [872.1–1497.5] ng/ml versus 1139.0 [984.0–1376.7] ng/ml). In the whole group, irisin concentration correlated negatively with 2?h glucose level (R?=??0.14, p?=?0.03). In the women with NGT, irisin concentration correlated positively with IS_OGTT (R?=?0.22, p?=?0.04) and the disposition index (DI₁₂₀) (R?=?0.24, p?=?0.03), as well as negatively with 2?h insulin level (R?=??0.23, p?=?0.03) and HOMA-IR (R?=??0.24, p?=?0.02). Multiple regression analysis revealed that 2?h glucose and DI₁₂₀ were the only variables significantly influencing serum irisin (β?=?0.158, p?=?0.03 and β?=?0.159, p?=?0.02, respectively). Our results suggest that serum irisin concentration increases markedly in pregnant women, but this increase seems to be significantly lower in patients with GDM.     

Second-trimester urinary neutrophil gelatinase-associated lipocalin levels in gestational diabetes: preliminary results

Objective: The objective of this study is to investigate the urinary neutrophil gelatinase-associated lipocalin (uNGAL) levels in the second trimester of pregnant patients at the time of gestational diabetes mellitus (GDM) screening.

Materials and methods: Urinary samples from 88 pregnant women who underwent gestational diabetes screening test were collected in late second trimester (24–28 weeks) prospectively. After an overnight fasting, 75?g GTT was performed. The blood samples were drawn for measurement of glucose, insulin, and HbA1c. The urinary and blood parameters were compared for pregnant women with or without gestational diabetes.

Results: uNGAL levels were significantly elevated in pregnant women with gesting compared with the control groups (p?p?=?.001).

Conclusions: In the second trimester, at the time of GDM screening, high levels of uNGAL indicate tubular injury in GDM cases which seems to be a result of hyperglycemia. uNGAL may correlate with an inflammatory renal involvement in GDM.