Fetal erythrocyte phospholipid polyunsaturated fatty acids are altered in pregnancy complicated with gestational diabetes mellitus.

Insulin resistance and altered maternal metabolism in gestational diabetes mellitus (GDM) may impair fetal arachidonic acid (AA) and docosahexaenoic acid (DHA) status. The objectives were to test the hypothesis that fetal polyunsaturated fatty acids would be altered with GDM and identify factors related to fetal phospholipid (PL) AA and DHA. Maternal and cord vein erythrocyte PL fatty acids were determined in GDM (n = 13) and healthy pregnant women (controls, n = 12). Cord vein erythrocyte PL AA and DHA concentrations were significantly lower in GDM vs. controls. Maternal blood hemoglobin A1C was inversely correlated to fetal erythrocyte PL DHA and AA in controls and GDM (n = 25). Pregravid body mass index was negatively associated with fetal PL DHA. The data support the hypothesis that there is impairment in fetal accretion of DHA and AA in GDM.

Maternal plasma phospholipid polyunsaturated fatty acids in pregnancy with and without gestational diabetes mellitus: relations with maternal factors.

BACKGROUND: The fatty acids arachidonic acid (AA; 20:4n-6) and docosahexaenoic acid (DHA; 22:6n-3) are essential for fetal growth and development, but their metabolism may be altered in insulin resistance. OBJECTIVES: The objectives were to determine maternal plasma phospholipid polyunsaturated fatty acid concentrations in pregnant women receiving dietary therapy for gestational diabetes mellitus (GDM) and to identify maternal factors associated with plasma phospholipid AA and DHA concentrations in the third trimester. DESIGN: Fasting plasma phospholipid fatty acids were determined in women with GDM (n = 15) receiving dietary therapy only and in healthy, pregnant women without GDM (control group, n = 15) at 27-30, 33-35, and 36-39 wk gestation. RESULTS: Maternal plasma phospholipid (as % by wt of total fatty acids and mg/L) linoleic acid (18:2n-6), AA, and 22:5n-6 concentrations did not differ significantly between women with GDM and control subjects. The other n-6 long-chain polyunsaturated fatty acids (% by wt) were lower in GDM subjects than in control subjects. Plasma phospholipid (expressed as % by wt and mg/L) linolenic acid (18:3n-3) and summed precursors of DHA were lower and DHA (% by wt and mg/L), adjusted for dietary DHA intake, was 13% higher in GDM subjects than in control subjects. Maternal blood hemoglobin A1C was inversely related to plasma phospholipid AA (% by wt) (r = -0.56, P = 0.03) in control subjects and positively associated with plasma phospholipid AA (% by wt) in women with GDM (r = 0.76, P = 0.001). Pregravid body mass index was negatively associated with plasma phospholipid DHA (% by wt) in control subjects (r = -0.55, P = 0.04) and in women with GDM with a body mass index (in kg/m2) <30 (r = -0.76, P = 0.007). CONCLUSIONS: This is the first report documenting alterations in maternal plasma phospholipid PUFAs in pregnant women receiving dietary therapy for GDM. In pregnant woman, both with and without GDM, maternal glycemic control and pregravid BMI appear to be significant predictors of plasma phospholipid AA and DHA, respectively, during the third trimester. Additionally, dietary DHA significantly affects phospholipid DHA concentrations.

Maternal and cord plasma lipid and lipoprotein concentrations in women with and without gestational diabetes mellitus. Predictors of birth weight?

OBJECTIVE: To describe lipid and lipoprotein perturbations in gestational diabetes mellitus (GDM) and to examine the potential consequences--e.g, increased birth weight and increased placental lipid transfer. STUDY DESIGN: Maternal and cord free fatty acids (FFAs) and total, very low density lipoprotein (VLDL), low density lipoprotein (LDL), high density lipoprotein (HDL) (and maternal HDL2 and HDL3), triglyceride (TG), and cholesterol and dietary intake were determined for women with diet-treated GDM and for healthy pregnant women with normal glucose tolerance. RESULTS: Women with GDM had higher hemoglobin A1c than controls, while body weight gain was significantly lower for women with GDM as compared to controls. Plasma and lipoprotein TG concentrations were greater for women with GDM, and although plasma FFAs were higher in women with GDM versus controls, the difference was not significant. No differences were observed between groups with respect to maternal plasma or lipoprotein cholesterol. Cord plasma and lipoprotein lipids were similar between groups; with the exception of VLDL + LDL TG, which was lower in women with GDM. In controls, there were significant correlations between maternal plasma TG and cord FFAs; maternal HDL2 cholesterol and cord plasma cholesterol; and maternal plasma TG, maternal HDL2 cholesterol, cord FFAs, and infant birth weight. In GDM, maternal plasma cholesterol and cord VLDL + LDL cholesterol correlated. There were no significant correlations between maternal or cord lipids and infant birth weight in women with GDM. CONCLUSION: Hypertriglyceridemia, rather than hypercholesterolemia, is a feature of GDM. However, elevations in maternal plasma and lipoprotein TGs in women with GDM were not related to fetal lipid concentrations or infant birth weight.

Physiologic-chemoattractant-induced migration of polymorphonuclear leukocytes in milk.

The somatic cell count (SCC; leukocytes and epithelial cells) in milk is used as an indicator of udder health status. A SCC above the regulatory standard is generally considered as an indication of mastitis. Therefore, milk with a SCC equal to or greater than the regulatory limit cannot be sold to the public because it is unsuitable for human consumption. This study was performed to determine whether SCC levels above the regulatory limit observed in goats during late lactation are a physiologic or a pathological response of the goat mammary gland. Differential counts of cells in nonmastitic goat milk samples during late lactation revealed that approximately 80% of the cells were polymorphonuclear leukocytes (PMNs). In addition, microchemotaxis assay results indicated that normal nonmastitic late-lactation-stage goat milk is significantly higher (P < 0.001) in PMN chemotactic activity than early-lactation-stage goat milk, with a mean chemotactic activity of 14.9 and 42.7/mg of protein for early and late lactation stages, respectively. Physicochemical analyses also suggest that the PMN infiltration observed in normal late-lactation-stage goat milk is due to a PMN chemotactic factor(s) that is different from the PMN chemotactic factor(s) present in mastitic milk. Interestingly, the PMN chemotactic factor in late-lactation-stage goat milk is highly acid resistant (pH 2), suggesting that the factor is able to survive the highly acidic gastric environment and may therefore be important in the augmentation of the immune systems of sucklings. These results indicate that the chemotactic factor(s) present in the milk of normal late-lactation-stage goats is nonpathological and may play a physiologic regulatory role in mammary gland involution. Hence, the regulatory standard for goat milk needs to be redefined in order to reflect this.

Elevated lipoprotein lipids and gestational hormones in women with diet-treated gestational diabetes mellitus compared to healthy pregnant controls.

The objective of this study was to describe plasma and lipoprotein perturbations in gestational diabetes mellitus (GDM) compared to controls, and determine if alterations in lipids are related to gestational hormones and/or glucose control. Maternal HbA1c, free fatty acids (FFA), beta-estradiol, progesterone, prolactin, and plasma, very-low-density lipoprotein (VLDL), low-density lipoprotein (LDL), high-density lipoprotein (HDL), HDL2 and HDL3 triglyceride (TG), cholesterol, and dietary intake were determined for women with diet-treated GDM and controls in a longitudinal design. Subjects (N = 25/group) were matched for age, race, and body-mass index (BMI). Women with GDM had significantly higher HbA1c than controls, although both groups were within the normal range (4%-6%). However, body weight gain was less for women with GDM. There was a trend for higher plasma FFAs at 37-38 weeks in GDM versus controls. Plasma and lipoprotein TG among the groups increased over the third trimester, and mean concentrations were greater for women with GDM. In GDM versus controls, VLDL and HDL3 TGs were higher at all times, HDL and HDL2 TGs at 33-34 and 37-38 weeks, and LDL TGs at 37-38 weeks. In VLDL, core lipids (TG + cholesterol) increased over gestation and were greater in GDM. In HDL, the TG/cholesterol ratio was greater in GDM. In GDM versus controls, plasma progesterone and prolactin were higher at all times; beta-estradiol was elevated at 37-38 weeks. HbA1c, progesterone, and prolactin correlated with all lipoprotein TG fractions. Exaggerated hypertriglyceridemia, particularly in the VLDL and HDL fractions, is a feature of GDM. The increase in VLDL TG is likely due to an increase in VLDL synthesis, whereas particle enrichment in TG is a plausible explanation for changes in HDL TG. Slight perturbations in glucose control and gestational hormones in diet-treated GDM may contribute to the observed increase in plasma and lipoprotein TG.

Iron deficiency and anemia of chronic disease in elderly women: a discriminant-analysis approach for differentiation.

To differentiate iron-deficiency anemia and anemia associated with chronic inflammatory diseases in elderly women, subsets of laboratory, dietary, and functional assessment variables were obtained by using discriminant analysis. Fifty-one subjects (70-79 y of age) were classified into one of four groups on the basis of the presence of iron deficiency and chronic inflammatory disease. Iron deficiency was defined on the basis of a significant response in hemoglobin concentration after iron supplementation. The discriminating subset of laboratory tests consisted of measures for serum ferritin, plasma transferrin receptors, and erythrocyte sedimentation rate. The discriminant function classified subjects into iron-deficient, anemia of chronic disease, or a category in which the two coexist, with an error rate of 18.6%. The addition of other variables (dietary iron and functional assessment information) did not appreciably improve the classification. The results of these three key laboratory tests may help to identify functional iron deficiency in the presence of chronic inflammation.

Carcass composition of "bob" and "special-fed" veal and its prediction.

Percentage of lean, fat, and bone were determined in 18 bob veal (BV) and 28 special-fed veal (SFV) carcasses. Carcasses were subjected to a set of visual conformation scores and a variety of physical measurements. No significant differences were found regarding carcass percentage of lean, fat, and bone within the three BV weight groups (P > .05). On average, SFV were 12% fatter than BV and did not have a greater percentage of lean (P > .05), except for SFV carcasses weighing 88.2 to 97.7 kg. Bob veal had less fat (internal, external, and intermuscular) and a higher bone percentage than SFV (P < .05). The round and shoulder primals had the greatest proportion of lean in both the BV and SFV carcasses. Bob veal carcasses had an average conformation score of average Good and SFV carcasses had an average conformation score of average Choice. In addition, a parsimonious subset of variables was identified for predicting total percentage of lean (TPLEAN) for both BV and SFV separately, using "stepwise" regression model building procedures. For BV, all four identified predictor variables were subjective conformation scores (i.e., muscling, appearance, leg thickness, loin-back plumpness) (R = .73, P < .03). For SFV, four predictor variables were also identified: kidney and pelvic fat, fat thickness, carcass length, and lateral thickness (R = .61, P < .03). Although both regression equations were significant predictors of TPLEAN, confidence limits for predicting future TPLEAN value were wide relative to the variation in the actual TPLEAN values. Thus, the practical utility of the regression equations is limited.

Effect of relative risk and cluster configuration on the power of the one-dimensional scan statistic.

The scan test for clustering in time is based on the maximum number of events in an interval (window) of width w as the window moves across the entire time frame. Power estimates of the scan statistic are simulated for a variety of epidemiologically motivated situations. Two cluster configurations are used: a rectangular pulse, and a triangular pulse designed to emulate environmental contamination. For a rectangular pulse, the relative risk R of disease in the cluster region is R-fold as high as it is for the background region. The power is strongly influenced by the sample size, the relative risk, and the width or duration of the cluster region, whereas the effect of the cluster configuration is small. Using a 5 per cent significance level, a relative risk of 4, a standardized cluster duration of 0.10, a relative window width of 1.5, and a (non-random) sample size of 50, the simulated power is approximately 80 per cent, indicating that the minimum sample size in the cluster region for adequate power is in the 12-32 range for values of the parameters used in this study.

Perinatal lactation protocol and outcome in mothers with and without insulin-dependent diabetes mellitus.

This study compared the course of lactation from days 2 to 84 postpartum in 33 women with insulin-dependent diabetes mellitus (IDDM); 33 women without diabetes selected by using gestational age of the infant, method of delivery, sex of the infant, and prior lactation experience as a means of ensuring similar patterns in factors known to influence success (control subjects); and 11 healthy reference subjects who delivered vaginally. Nutritionists visited the mothers on days 2, 3, 7, 14, 42, and 84 postpartum; obtained prenatal and perinatal medical information; and questioned the mothers on their breast-feeding experience. Women with IDDM were able to establish lactation despite postpartum separation from their infants, delays in the start of breast-feeding, reduced frequency of feeding, increased use of supplemental feedings, and the high rate of cesarean section. Clinicians must recognize the need to provide appropriate counseling so that mothers with IDDM will not be discouraged by problems with breast-feeding.

Delayed lactogenesis in women with insulin-dependent diabetes mellitus.

Breast milk lactose, total nitrogen, conductivity, osmolality, and intake by infants of 33 women with insulin-dependent diabetes mellitus (IDDM), 33 control women without diabetes, and 11 reference women were determined in a 3-mo study of lactation. Milk of women with IDDM had significantly lower lactose and higher total nitrogen (2-3 d postpartum), and their infants had significantly less milk intake (7-14 d postpartum) than did control or reference women. Total nitrogen was negatively correlated with milk lactose for women with IDDM at all times and for control women through day 14 postpartum. The data indicate delayed lactogenesis for women with IDDM, which was more likely to occur with poor metabolic control. Differences in milk composition of women with IDDM do not preclude them from breast-feeding their infants.

Word identification performance in the presence of competing speech and noise in learning disabled adults.

Eight learning disabled (LD) adults and eight control subjects identified monosyllabic words presented simultaneously in the presence of speech spectrum noise and three types of linguistic maskers. The performance of LD subjects was poorer than that of the control subjects under each masking condition. Word identification was poorest in the presence of speech noise for both groups. No difference in performance was seen as a function of the linguistic content of the competing speech maskers. These results suggest that LD subjects present greater susceptibility to acoustic masking relative to control subjects and may support the view that auditory-language deficits observed in LD individuals may be secondary to an underlying acoustic-phonetic disorder rather than a central phonologic disorder. LD college students may experience S/N ratios in the classroom that perpetuate or exacerbate their listening problems.

Comparison of skewness coefficient, coefficient of variation, and Gini coefficient as inequality measures within populations.

The moment skewness coefficient, coefficient of variation and Gini coefficient are contrasted as statistical measures of inequality among members of plant populations. Constructed examples, real data examples, and distributional considerations are used to illustrate pertinent properties of these statistics to assess inequality. All three statistics possess some undesirable properties but these properties are shown to be often unimportant with real data. If the underlying distribution of the variable follows the often assumed two-parameter lognormal model, it is shown that all three statistics are likely to be highly and positively correlated. In contrast, for distributions which are not two-parameter lognormally distributed, and when the distribution is not concentrated near zero, the coefficient of variation and Gini coefficient, which are sensitive to small shifts in the mean, are often of little practical use in ordering the equality of populations. The coefficent of variation is more sensitive to individuals in the right-hand tail of a distribution than is the Gini coefficient. Therefore, the coefficient of variation may often be recommended over the Gini coefficient if a measure of relative precision is selected to assess inequality. The skewness coeficient is suggested when the distribution is either three-parameter lognormally distributed (or close to such), or when a measure of relative precision is not indicated.

Interlist equivalence of the word intelligibility by picture identification test administered in broad-band noise.

The effect of broad-band noise on the interlist equivalence of the Word Intelligibility by Picture Identification Test (WIPI) was examined. Subjects were 24 normally hearing children aged 6:7-9:1 years (years:months) who were assigned in equal numbers to one of three signal-to-noise ratio (S/N) conditions (S/N = 0, +2, +4dBSPL). Each child was administered all four lists of the WIPI under one of these noise conditions. No significant order, gender or ear effects were observed. Performance increased linearly with increasing S/N. Statistically significant mean differences were seen between lists, and individual interlist pairwise comparisons revealed differences exceeding chance occurrence. Pooled correlations of interlist equivalence were of moderate strength. Caveats regarding clinical application of the WIPI administered in noise are discussed.

Equivalent forms and split-half reliability of the NU-CHIPS administered in noise.

The effects of white noise on the equivalent forms reliability and internal consistency reliability of the Northwestern University-Children's Perception of Speech Test (NU-CHIPS) were examined. Subjects were 36 normally hearing 10-year-old children who were assigned randomly in equal numbers to one of three experimental groups. Each group was administered all four forms of the NU-CHIPS at one of three signal-to-noise ratios (S/N = -4, S/N = 0, S/N = +2). The reliability of the NU-CHIPS when presented in noise is diminished relative to its reported reliability when administered in quiet as revealed by Pearson product-moment correlation coefficients.

Parent Attitude Research Instrument (PARI): clinical vs. statistical inferences in understanding abusive mothers.

Attitudes toward child rearing and early experiences in childhood traditionally have been regarded as psychodynamic factors that influence adult behavior. The present study assessed the capacity of the Parent Attitude Research Instrument (PARI) to differentiate between court-identified abusive mothers and a control sample of nonabusive, well-baby clinic mothers of comparable socioeconomic status. While univariate t-tests showed statistical significance for 3 of the 23 PARI scales, more sophisticated and appropriate multivariate tests (Discriminant Function Analysis) demonstrated that the PARI correctly classified the experimental and control Ss only 65% of the time. It appears that the PARI alone should not be used to identify potentially abusive mothers. Even more important, the results caution and alert non-statistically informed clinicians and researchers to the pitfall of over-interpreting clinical data that are based on the more simple univariate tests of statistical significance.

Quantitation of bovine immunoglobulins: comparison of single radial immunodiffusion, zinc sulfate turbidity, serum electrophoresis, and refractometer methods.

Laboratory methods designed to quantitate serum immunoglobulin were evaluated: single radial immunodiffusion, zinc sulfate turbidity, and serum electrophoresis. Estimation of immunoglobulin concentration in neonatle calves, using total protein measurements, was also evaluated. Single radial immunodiffusion proved useful for quantitation when either class or subclass information was needed. Zinc sulfate turbidity measurements gave accurate results for total immunoglobulin except when hemolysis was present in the sample. A correction factor for hemoglobin that will minimize errors resulting from hemolysis was presented. Serum electrophoresis was also found to be an accurate quantitation method. Large errors were encountered in attempting to estimate immunoglobulin on the basis of total protein.