期刊
INTERNATIONAL JOURNAL OF OBESITY
卷 45, 期 1, 页码 247-257出版社
SPRINGERNATURE
DOI: 10.1038/s41366-020-0596-5
关键词
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资金
- Singapore National Research Foundation under its Translational and Clinical Research (TCR) Flagship Programme
- Singapore National Medical Research Council [NMRC/CSAINV/0010/2016]
- UK Medical Research Council [MC_UU_12011/4]
- National Institute for Health Research (NIHR) [NF-SI-0515-10042]
- National Institute for Health Research (NIHR Southampton Biomedical Research Centre)
- European Union (Erasmus+ Programme Early Nutrition eAcademy Southeast Asia) [573651-EPP-1-2016-1-DE-EPPKA2-CBHE-JP]
- Singapore Institute for Clinical Sciences (SICS)
- Agency for Science Technology and Research (A*STAR)
- Metabolomics Australia at the University of Melbourne through the National Collaborative Research Infrastructure Strategy (NCRIS)
- Singapore Ministry of Health's National Medical Research Council (NMRC), Singapore [NMRC/TCR/004-NUS/2008, NMRC/TCR/012-NUHS/2014]
This study found that placental inositol levels vary under maternal hyperglycemia and are associated with offspring birthweight and adiposity at birth. High placental inositol may protect the fetus from the adverse effects of maternal hyperglycemia. Further investigations are needed to explore whether prenatal inositol supplementation can increase placental inositol levels and reduce fetal adiposity.
Background/Objectives Maternal glycaemia promotes fetal adiposity. Inositol, an insulin sensitizer, has been trialled for gestational diabetes prevention. The placenta has been implicated in how maternal hyperglycaemia generates fetal pathophysiology, but no studies have examined whether placental inositol biology is altered with maternal hyperglycaemia, nor whether such alterations impact fetal physiology. We aimed to investigate whether the effects of maternal glycaemia on offspring birthweight and adiposity at birth differed across placental inositol levels. Methods Using longitudinal data from the Growing Up in Singapore Towards healthy Outcomes cohort, maternal fasting glucose (FPG) and 2-hour plasma glucose (2hPG) were obtained in pregnant women by a 75-g oral glucose tolerance test around 26 weeks' gestation. Relative placental inositol was quantified by liquid chromatography-mass spectrometry. Primary outcomes were birthweight (n = 884) and abdominal adipose tissue (AAT) volumes measured by neonatal MRI scanning in a subset (n = 262) of term singleton pregnancies. Multiple linear regression analyses were performed. Results Placental inositol was lower in those with higher 2hPG, no exposure to tobacco smoke antenatally, with vaginal delivery and shorter gestation. Positive associations of FPG with birthweight (adjusted beta [95% CI] 164.8 g [109.1, 220.5]) and AAT (17.3 ml [11.9, 22.6] per mmol glucose) were observed, with significant interactions between inositol tertiles and FPG in relation to these outcomes (p < 0.05). Stratification by inositol tertiles showed that each mmol/L increase in FPG was associated with increased birthweight and AAT volume among cases within the lowest (birthweight = 174.2 g [81.2, 267.2], AAT = 21.0 ml [13.1, 28.8]) and middle inositol tertiles (birthweight = 202.0 g [103.8, 300.1], AAT = 19.7 ml [9.7, 29.7]). However, no significant association was found among cases within the highest tertile (birthweight = 81.0 g [-21.2, 183.2], AAT = 0.8 ml [-8.4, 10.0]). Conclusions High placental inositol may protect the fetus from the pro-adipogenic effects of maternal glycaemia. Studies are warranted to investigate whether prenatal inositol supplementation can increase placental inositol and reduce fetal adiposity.
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