Intermediate- and long-term associations between air pollution and ambient temperature and glycated hemoglobin levels in women of child bearing age

Background: Air pollution has been linked to obesity while higher ambient temperatures typically reduce metabolic demand in a compensatory manner. Both relationships may impact glucose metabolism, thus we examined the association between intermediate- and long-term exposure to fine particulate matter (PM2.5) and ambient temperature and glycated hemoglobin (HbA1c), a longer-term marker of glucose control. Methods: We assessed 3-month, 6-month, and 12-month average air pollution and ambient temperature at 1-km2 spatial resolution via satellite remote sensing models (2013–2019), and assessed HbA1c at four, six, and eight years postpartum in women enrolled in the Programming Research in Obesity, Growth, Environment and Social Stressors (PROGRESS) cohort based in Mexico City. PM2.5 and ambient temperature were matched to participants’ addresses and confirmed by GPS tracker. Using linear mixed-effects models, we examined the association between 3-month, 6-month, and 12-month average PM2.5 and ambient temperature with repeated log-transformed HbA1c values. All models included a random intercept for each woman and were adjusted for calendar year, season, and individual-level confounders (age, marital status, smoking, alcohol consumption level, and education level). Results: We analyzed 1,265 HbA1c measurements of 484 women. Per 1 µg/m3 increase in 3-month and 6-month PM2.5, HbA1c levels increased by 0.28% (95% confidence interval (95 %CI): 0.14, 0.42%) and 0.28% (95 %CI: 0.04, 0.52%) respectively. No association was seen for 12-month average PM2.5. Per 1 °C increase in ambient temperature, HbA1c levels decreased by 0.63% (95 %CI: −1.06, −0.21%) and 0.61% (95 %CI: −1.08, −0.13%), while the 12-month average again is not associated with HbA1c. Conclusions: Intermediate-term exposure to PM2.5 and ambient temperature are associated with opposing changes in HbA1c levels, in this region of high PM2.5 and moderate temperature fluctuation. These effects, measurable in mid-adult life, may portend future risk of type 2 diabetes and possible heart disease

Intestinal Dysbiosis and Rheumatoid Arthritis: A Link between Gut Microbiota and the Pathogenesis of Rheumatoid Arthritis

Characterization and understanding of gut microbiota has recently increased representing a wide research eld, especially in autoimmune diseases. Gut microbiota is the major source of microbes which might exert benecial as well as pathogenic effects on human health. Intestinal microbiome’s role as mediator of inammation has only recently emerged. Microbiota has been observed to differ in subjects with early rheumatoid arthritis compared to controls, and this nding has commanded this study as a possible autoimmune process. Studies with intestinal microbiota have shown that rheumatoid arthritis is characterized by an expansion and/or decrease of bacterial groups as compared to controls. In this review, we present evidence linking intestinal dysbiosis with the autoimmune mechanisms involved in the development of rheumatoid arthritis

Asociación entre parámetros hematológicos y fenotipos metabólicamente poco saludables en niños y adolescentes: Association between hematological parameters and metabolically unhealthy phenotypes in children and adolescents.

Objective. Metabolic syndrome has been associated with changes in the composition of circulating blood cells. Hematologic indices can be used to identify the subjects at risk of metabolically unhealthy phenotype (MUP). This study investigated whether hematological indices can serve as biomarkers to distinguish metabolically healthy phenotype (MHP) from MUP in children and adolescents. Methods. Two hundred ninety-two children and adolescents were enrolled in a cross-sectional study. The MUP was diagnosed using consensus-based criteria proposed by Damanhoury et al. Group comparisons were performed using one-way ANOVA. To examine if sex, age group, nutritional status, puberty, hematological parameters, and insulin resistance were associated with MUP, we used multiadjusted logistic regression analysis with metabolic status as the dependent variable.    Results. The subject's age mean was 11 years (SD: 2.61). RDW values were significantly lower in children with metabolically unhealthy normal weight (MUNW) compared to children with metabolically unhealthy obesity (MUO) (12.33 ± 0.90 vs. 13.67 ± 0.52; p = 0.01), and in metabolically healthy obesity (MHO) compared to MUO (13.15 ± 0.53 vs. 13.67 ± 0.52; p = 0.04). In adolescents, the PLR was higher for the MHNW group, with a mean value of 152.60 (SD 62.97) compared to 111.16 (SD 44.12) for the MHO group. After adjusting for age, nutritional status, and puberty, hematological indices were not associated with MUP.   Conclusions. The study demonstrates that hematological indices are not independently associated with the metabolically unhealthy phenotype. Hematologic indices are unlikely to represent reliable biomarkers of MU phenotype in the pediatric population.    Objetivo. El síndrome metabólico se ha asociado con cambios en la composición de las células sanguíneas circulantes. Los índices hematológicos  pueden ser utilizados para identificar a los sujetos con un fenotipo metabólicamente no saludable (MUP). Este estudio investigó  si los índices hematológicos pueden servir como biomarcadores para distinguir el fenotipo metabólicamente saludable (MHP) del fenotipo no saludable (MUP) en niños y adolescentes. Métodos. Doscientos noventa y dos niños y adolescentes participaron en un estudio transversal. La MUP se diagnosticó utilizando los criterios consensuados propuestos por Damanhoury et al. Las comparaciones de grupos se realizaron mediante ANOVA de una vía. Para examinar si el sexo, el grupo de edad, el estado nutricional, la pubertad, los parámetros hematológicos y la resistencia a la insulina estaban asociados con la MUP, utilizamos un análisis de regresión logística multiajustado con el estado metabólico como variable dependiente. Resultados. La media de edad de los participantes fue de 11 años (±2.61). Los valores de RDW fueron significativamente más bajos en niños con peso normal metabólicamente no saludables (MUNW) en comparación con niños con obesidad metabólicamente no saludable (MUO) (12,33 ± 0,90 vs. 13,67 ± 0,52; p = 0,01), y en niños con obesidad y metabólicamente saludable (MHO) en comparación con MUO (13,15 ± 0,53 frente a 13,67 ± 0,52; p = 0,04). En adolescentes, el PLR fue mayor para el grupo MHNW, con un valor medio de 152,60 (±62,97) en comparación con 111.16 (±44,12) para el grupo MHO. Después de ajustar por edad, estado nutricional y pubertad, los índices hematológicos no se asociaron con MUP.   Conclusiones. El estudio demuestra que los índices hematológicos no están asociados de forma independiente con el fenotipo metabólicamente poco saludable. Es poco probable que los índices hematológicos representen biomarcadores fiables del fenotipo MU en la población pediátrica. &nbsp

Patterns of Weight Change One Year after Delivery Are Associated with Cardiometabolic Risk Factors at Six Years Postpartum in Mexican Women

Pregnancy is a contributor to the obesity epidemic in women, probably through postpartum weight retention (PPWR), weight gain (PPWG), or a combination of both (PPWR + WG). The contribution of these patterns of postpartum weight change to long-term maternal health remains understudied. In a secondary analysis of 361 women from the prospective cohort PROGRESS, we evaluated the associations between patterns of weight change one year after delivery and cardiometabolic risk factors at six years postpartum. Using principal component analysis, we grouped cardiometabolic risk factors into: (1) body mass index (BMI), waist circumference (WC), homeostatic model assessment of insulin resistance (HOMA-IR), high-density lipoprotein cholesterol (HDL-c), triglycerides (TG), and glucose; (2) systolic (SBP) and diastolic blood pressure (DBP); and (3) low-density lipoprotein cholesterol and total cholesterol. Using path analysis, we studied direct (patterns of weight change-outcomes) and indirect associations through BMI at six years postpartum. Around 60% of women returned to their pregestational weight (reference) by one year postpartum, 6.6% experienced PPWR, 13.9% PPWG, and 19.9% PPWR + WG. Women with PPWR + WG, vs. the reference, had higher BMI and WC at six years (2.30 kg/m2, 95% CI [1.67, 2.93]; 3.38 cm [1.14, 5.62]). This was also observed in women with PPWR (1.80 kg/m2 [0.80, 2.79]; 3.15 cm [−0.35, 6.65]) and PPWG (1.22 kg/m2 [0.53, 1.92]; 3.32 cm [0.85, 5.78]). PPWR + WG had a direct association with HOMA-IR (0.21 units [0.04, 0.39]). The three patterns of weight change, vs. the reference, had significant indirect associations with HOMA-IR, glucose, TG, HDL-c, SBP, and DBP through BMI at six years. In conclusion, women with PPWR + WG are at high-risk for obesity and insulin resistance. Interventions targeting women during pregnancy and the first year postpartum may have implications for their long-term risk of obesity and cardiovascular disease

Gut Microbiota and Endothelial Dysfunction Markers in Obese Mexican Children and Adolescents

Obesity is a metabolic disease characterized by low-grade inflammation and accompanied by dyslipidemia and up-regulation of other bioactive molecules, creating a predisposition to endothelial dysfunction and metabolic syndrome. We studied the association between gut microbiota diversity and endothelial dysfunction (EDF) markers in obese Mexican children and adolescents. We examined clinical data including metabolic factors and EDF markers in blood samples. Gut bacterial diversity was characterized by high-throughput sequencing of V3-16S rDNA libraries. Triglycerides, insulin, homeostasis model assessment-insulin resistant (HOMA-IR), leptin, C-reactive protein (CRP), and EDF marker intercellular adhesion molecule 1 (ICAM-1) were significantly higher in obese children and adolescents. Multivariate analysis showed statistically significant positive associations between vascular cell adhesion molecule 1 (VCAM-1) and Veillonellaceae, and between ICAM-1 and Ruminococcus in obese children. In obese adolescents, there was a statistically significant positive association between total cholesterol and Ruminococcus, and between ICAM-1 and Bacteroides. LEfSe analysis showed that the genus Lactobacillus and family Coriobacteriaceae were enriched in children, and genera Collinsella and Prevotella were enriched in obese adolescents. Obese children and adolescents had higher levels of insulin resistance and metabolic syndrome. These results suggest that obese Mexican children and adolescents had increased levels of CRP and a reduction of adiponectin, which causes higher expression of EDF markers, affecting endothelial function and associating with changes in the gut microbiota

The associations of phthalate biomarkers during pregnancy with later glycemia and lipid profiles

Background: Pregnancy induces numerous cardiovascular and metabolic changes. Alterations in these sensitive processes may precipitate long-term post-delivery health consequences. Studies have reported associations between phthalates and metabolic complications of pregnancy, but no study has investigated metabolic outcomes beyond pregnancy. Objectives: To examine associations of exposure to phthalates during pregnancy with post-delivery metabolic health. Design: We quantified 15 urinary phthalate biomarker concentrations during the second and third trimesters among 618 pregnant women from Mexico City. Maternal metabolic health biomarkers included fasting blood measures of glycemia [glucose, insulin, Homeostatic Model Assessment of Insulin Resistance [HOMA-IR], % hemoglobin A1c (HbA1c%)] and lipids (total, high-density lipoprotein (HDL), low-density lipoprotein (LDL) cholesterol, triglycerides), at 4–5 and 6–8 years post-delivery. To estimate the influence of the phthalates mixture, we used Bayesian weighted quantile sum regression and Bayesian kernel machine regression; for individual biomarkers, we used linear mixed models. Results: As a mixture, higher urinary phthalate biomarker concentrations during pregnancy were associated with post-delivery concentrations of plasma glucose (interquartile range [IQR] difference: 0.13 SD, 95%CrI: 0.05, 0.20), plasma insulin (IQR difference: 0.06 SD, 95%CrI: −0.02, 0.14), HOMA-IR (IQR difference: 0.08 SD, 95% CrI: 0.01, 0.16), and HbA1c% (IQR difference: 0.15 SD, 95%CrI: 0.05, 0.24). Associations were primarily driven by mono-2-ethyl-5-carboxypentyl terephthalate (MECPTP) and the sum of dibutyl phthalate biomarkers (∑DBP). The phthalates mixture was associated with lower HDL (IQR difference: −0.08 SD, 95%CrI: −0.16, −0.01), driven by ∑DBP and monoethyl phthalate (MEP), and higher triglyceride levels (IQR difference: 0.15 SD, 95%CrI: 0.08, 0.22), driven by MECPTP and MEP. The overall mixture was not associated with total cholesterol and LDL. However, ∑DBP and MEP were associated with lower and higher total cholesterol, respectively, and MECPTP and ∑DBP were associated with lower LDL. Conclusions: Phthalate exposure during pregnancy is associated with adverse long-term changes in maternal metabolic health. A better understanding of timing of the exact biological changes and their implications on metabolic disease risk is needed

Length of gestation and birth weight are associated with indices of combined kidney biomarkers in early childhood.

Infants born prematurely or with low birth weights are more susceptible to kidney dysfunction throughout their lives. Multiple proteins measured in urine are noninvasive biomarkers of subclinical kidney damage, but few studies have examined the joint effects of multiple biomarkers. We conducted an exploratory study of 103 children in the Programing Research in Obesity, Growth, Environment, and Social Stressors (PROGRESS) longitudinal birth cohort, and measured nine proteins selected a priori in banked spot urine samples collected at ages 4-6. The goal of our study was to explore the combined effects of kidney damage biomarkers previously associated with birth outcomes. To do this, we generated kidney biomarker indices using weighted quantile sum regression and assessed associations with length of gestation or birth weight. A decile increase in each kidney biomarker index was associated with 2-day shorter gestations (β = -2.0, 95% CI: -3.2, -0.9) and 59-gram lower birth weights (β = -58.5, 95% CI: -98.3, -18.7), respectively. Weights highlighting the contributions showed neutrophil gelatinase-associated lipocalin (NGAL) (60%) and osteopontin (19%) contributed most to the index derived for gestational age. NGAL (66%) and beta-2-microglobulin (10%) contributed most to the index derived for birth weight. Joint analyses of multiple kidney biomarkers can provide integrated measures of kidney dysfunction and improved statistical assessments compared to biomarkers assessed individually. Additionally, shorter gestations and lower birth weights may contribute to subclinical kidney damage measurable in childhood