Moderate alcohol consumption increases insulin sensitivity and ADIPOQ expression in postmenopausal women: a randomised, crossover trial

Aims/hypothesis To determine whether 6 weeks of daily, moderate alcohol consumption increases expression of the gene encoding adiponectin (ADIPOQ) and plasma levels of the protein, and improves insulin sensitivity in postmenopausal women. Methods In a randomised, open-label, crossover trial conducted in the Netherlands, 36 apparently healthy postmenopausal women who were habitual alcohol consumers, received 250 ml white wine (~25 g alcohol/day) or 250 ml of white grape juice (control) daily during dinner for 6 weeks. Randomisation to treatment allocation occurred according to BMI. Insulin sensitivity and ADIPOQ mRNA and plasma adiponectin levels were measured at the end of both periods. Insulin sensitivity was estimated using the homeostasis model assessment of insulin resistance (HOMA-IR). Levels of ADIPOQ mRNA in subcutaneous adipose tissue were determined by RT-PCR. Results All subjects completed the study. Six weeks of white wine consumption reduced fasting insulin (mean¿±¿SEM 40.0¿±¿3.4 vs 46.5¿±¿3.4 pmol/l; p

Continuous glucose monitoring metrics and birthweight: informing management of type 1 diabetes throughout pregnancy

Objective: To determine gestational weekly changes in continuous glucose monitoring (CGM) metrics and 24hr glucose profiles, and their relationship to birthweight in pregnant women with type 1 diabetes. Research Design and Methods: An analysis of >10.5 million CGM glucose measures from 386 pregnant women with type 1 diabetes, from two international, multicentre studies. CGM glucose metrics and 24hr glucose profiles were calculated for each gestational week and the relationship to normal (10-90th percentile) and large (>90th percentile) for gestational age (LGA) birthweight infants determined. Results: Mean CGM glucose concentration fell and percentage of time spent in the pregnancy target range 3.5-7.8 mmol/L [63-140mg/dL] increased in the first 10 weeks of pregnancy, plateaued until 28 weeks gestation, before further improvements in mean glucose and percentage time-in-range until delivery. The maternal CGM glucose metrics diverged at 10 weeks gestation, with significantly lower mean CGM glucose concentration (7.1mmol/L 95% CI 7.05-7.15 [127.8mg/dL 95% CI 126.9-128.7] vs.7.5mmol/L 95% CI 7.45-7.55 [135mg/dL 95% CI 134.1-135.9]) and higher percentage time-in-range (55% [95% CI 54-56] vs.50% [95% CI 49-51]) in women who had normal versus LGA. The 24hr glucose profiles were significantly higher across the day from 10 weeks gestation in LGA. Conclusion: Normal birthweight is associated with achieving a significantly lower mean CGM glucose concentration across the 24-hour day and higher CGM time-in-range from before the end of the first trimester, emphasizing the need for a shift in clinical management, with increased focus on using weekly CGM glucose targets for optimising maternal glycemia from early pregnancy

Relationship between artificially sweetened and sugar-sweetened cola beverage consumption during pregnancy and preterm delivery in a multi-ethnic cohort: analysis of the Born in Bradford cohort study.

noThe aim of this study was to investigate the relationship between the intake of sugar-sweetened (SS) and artificially sweetened (AS) cola beverages during pregnancy and the risk of preterm delivery (PTD). At baseline (2007–2010), 8914 pregnant women were recruited to the Born in Bradford birth cohort study at 24–28 weeks of pregnancy. Women completed a questionnaire describing their health and lifestyle behaviours, including their consumption of AS and SS cola beverages reported as cups per day, which were then linked to maternity records. The relationship between SS and AS cola beverage consumption was examined using logistic regression analyses. No relationship was observed between daily AS cola beverage consumption and PTD. Women who drank four cups per day of SS cola beverages had higher odds of a PTD when compared with women who did not consume these beverages daily. We conclude that high daily consumption of SS cola beverages during pregnancy is associated with increases in the rate of PTD

Low-level maternal exposure to cadmium, lead, and mercury and birth outcomes in a Swedish prospective birth-cohort

Observational studies have indicated that low-to-moderate exposure to cadmium (Cd), lead (Pb), and mercury (Hg) adversely affects birth anthropometry, but results are inconclusive. The aim of this study was to elucidate potential impact on birth anthropometry of exposure to Cd, Pb, and Hg in pregnant women, and to identify the main dietary sources. In the NICE (Nutritional impact on Immunological maturation during Childhood in relation to the Environment) birth-cohort in northern Sweden, blood and urine were collected from pregnant women in early third trimester. Cd, Pb and Hg were measured in erythrocytes (n = 584), and Cd also in urine (n = 581), by inductively coupled plasma mass spectrometry. Dietary data were collected through a semi-quantitative food frequency questionnaire administered in mid-third trimester. Birth anthropometry data were extracted from hospital records. In multivariable-adjusted spline regression models, a doubling of maternal erythrocyte Cd (median: 0.29 mu g/kg) above the spline knot of 0.50 mu g/kg was associated with reduced birth weight (B: -191 g; 95% CI: -315, -68) and length (-0.67 cm; -1.2, -0.14). The association with birth weight remained when the analysis was restricted to never-smokers. Likewise, a doubling of erythrocyte Hg (median 1.5 mu g/kg, mainly MeHg) above 1.0 mu g/kg, was associated with decreased birth weight (-59 g; -115, -3.0), and length (-0.29 cm; -0.54, -0.047). Maternal Pb (median 11 mu g/kg) was unrelated to birth weight and length. Erythrocyte Cd was primarily associated with intake of plant derived foods, Pb with game meat, tea and coffee, and Hg with fish. The results indicated that low-level maternal Cd and Hg exposure were associated with poorer birth anthropometry. Further prospective studies in low-level exposed populations are warranted