The effect of an antenatal lifestyle intervention in overweight and obese women on circulating cardiometabolic and inflammatory biomarkers: secondary analyses from the LIMIT randomised trial.
The effect of an antenatal lifestyle intervention in overweight and obese women on circulating cardiometabolic and inflammatory biomarkers: secondary analyses from the LIMIT randomised trial.
复制标题
DOI：
10.1186/s12916-017-0790-z
复制
发表时间：
2017-02-14
期刊：
影响因子：
9.3
通讯作者：
Dodd JM
中科院分区：
文献类型：
--
作者：
Moran LJ;Fraser LM;Sundernathan T;Deussen AR;Louise J;Yelland LN;Grivell RM;Macpherson A;Gillman MW;Robinson JS;Owens JA;Dodd JM
孕妇在怀孕期间超重和肥胖与胰岛素抵抗、高血糖、高脂血症和慢性炎症的低度状态有关。这种预先规定的次要结局指标分析的目的是评估提供产前饮食和生活方式建议对心脏代谢和炎症生物标志物的影响。我们进行了一项多中心试验，超重或肥胖的孕妇被随机分配接受生活方式建议或标准护理。我们报告了一系列预先指定的继发性母体和新生儿心脏代谢和炎症生物标志物结局。在试验入组时（平均妊娠14周;非空腹）、妊娠28周（空腹）和妊娠36周（非空腹）采集母体全血。在出生后和胎盘分娩前收集脐带血。分析了一系列心脏代谢和炎症标志物（总胆固醇、甘油三酯、非酯化脂肪酸、高密度脂蛋白胆固醇、胰岛素、葡萄糖、瘦素、脂联素、C反应蛋白、粒细胞巨噬细胞集落刺激因子、干扰素γ、TNF-α和白细胞介素1β、2、4、5、6、8和10）。参与者在他们被随机分配的组中进行分析，如果他们在任何时间点进行了测量，则将其纳入分析。从1951名妇女（989名生活方式咨询和962名标准护理）中获得了一个或多个生物标本，从1174名婴儿（596名生活方式咨询和578名标准护理）中获得了脐带血。各治疗组间妊娠期和婴儿脐带血中的平均心脏代谢和炎症标志物浓度无统计学显著差异。估计的治疗组差异接近于零，95%置信区间涵盖的差异范围不具有临床相关性。没有证据表明干预效果会受到母亲BMI类别的影响。尽管我们的研究结果，这将是值得考虑的心脏代谢和炎症标志物和临床结果之间的潜在关系，包括长期婴儿健康和肥胖。澳大利亚和新西兰临床试验注册中心（ACTRN 12607000161426;注册日期2007年9月3日）。本文的在线版本（doi：10.1186/s12916-017-0790-z）包含补充材料，可供授权用户使用。
Maternal overweight and obesity during pregnancy is associated with insulin resistance, hyperglycaemia, hyperlipidaemia and a low-grade state of chronic inflammation. The aim of this pre-specified analysis of secondary outcome measures was to evaluate the effect of providing antenatal dietary and lifestyle advice on cardiometabolic and inflammatory biomarkers. We conducted a multicentre trial in which pregnant women who were overweight or obese were randomised to receive either Lifestyle Advice or Standard Care. We report a range of pre-specified secondary maternal and newborn cardiometabolic and inflammatory biomarker outcomes. Maternal whole venous blood was collected at trial entry (mean 14 weeks gestation; non-fasting), at 28 weeks gestation (fasting), and at 36 weeks gestation (non-fasting). Cord blood was collected after birth and prior to the delivery of the placenta. A range of cardiometabolic and inflammatory markers were analysed (total cholesterol, triglycerides, non-esterified fatty acids, high-density lipoprotein cholesterol, insulin, glucose, leptin, adiponectin, C-reactive protein, granulocyte macrophage-colony stimulating factor, interferon gamma, TNF-α, and interleukins 1β, 2, 4, 5, 6, 8, and 10). Participants were analysed in the groups to which they were randomised, and were included in the analyses if they had a measure at any time point. One or more biological specimens were available from 1951 women (989 Lifestyle Advice and 962 Standard Care), with cord blood from 1174 infants (596 Lifestyle Advice and 578 Standard Care). There were no statistically significant differences in mean cardiometabolic and inflammatory marker concentrations across pregnancy and in infant cord blood between treatment groups. Estimated treatment group differences were close to zero, with 95% confidence intervals spanning a range of differences that were short of clinical relevance. There was no evidence to suggest that the intervention effect was modified by maternal BMI category. Despite our findings, it will be worth considering potential relationships between cardiometabolic and inflammatory markers and clinical outcomes, including longer-term infant health and adiposity. Australian and New Zealand Clinical Trials Registry (ACTRN12607000161426; Date Registered 09/03/2007). The online version of this article (doi:10.1186/s12916-017-0790-z) contains supplementary material, which is available to authorized users.