Imbalance of gut microbiota in gestational diabetes.

AIM: To investigate the differences in gut microbiota composition among nonpregnant women of reproductive age, healthy pregnant women, and gestational diabetes (GD) patients. METHODS: A total of 45 outpatients were enrolled and divided into three groups: nonpregnant women of reproductive age (control group, n = 23), healthy pregnant women (normal group, n = 10), and GD patients (GD group, n = 12). Faecal samples were collected and sequenced using 16S rRNA gene sequencing to analyse the microbial composition. RESULTS: (1) Pregnant patients exhibited an increase in the abundance of Streptococcus (Pnormal = 0.01286, PGD = 0.002965) and Blautia (Pnormal = 0.0003924, PGD = 0.000246) but a decrease in the abundance of Roseburia (Pnormal = 0.0361, PGD = 0.007075), Phascolarctobacterium (Pnormal = 0.0003906, PGD = 0.02499) and Lachnoclostridium (Pnormal = 0.0003906, PGD = 0.03866). (2) Compared with healthy pregnant women, GD patients had an excessive increase in Streptococcus abundance and decrease in Roseburia abundance. The increase in Blautia abundance and the decrease in Phascolarctobacterium and Lachnoclostridium abundance in GD patients were less than those in healthy pregnant women. (3) The abundance of Faecalibacterium prausnitzii decreased significantly in GD patients (PGD = 0.02985) but not in healthy pregnant patients (Pnormal = 0.1643). CONCLUSIONS: Abnormal increases and decreases in the abundances of gut microbiota components, especially Faecalibacterium prausnitzii, were observed in GD patients. TRIAL REGISTRATION: The cross-sectional research was conducted in accordance with the Declaration of Helsinki, and approved by Sir Run Run Shaw Hospital Clinical Trials and Biomedical Ethics Committee. The study has been registered in the Chinese Clinical Trial Registry (ChiCTR1900026164, 24/09/2019, http://www.chictr.org.cn/showproj.aspx?proj=43,455 ).

Knowledge domain and research trends for Gestational Diabetes Mellitus and nutrition from 2011 to 2021: a bibliometric analysis.

Objective: Nutrient management and lifestyle changes are the frontlines of treatment for all pregnant women diagnosed with Gestational Diabetes Mellitus (GDM). This study aimed to identify the global research architecture, trends, and hotpots of GDM and nutrition. Methods: We obtained publications from the sub-databases of Science Citation Index Expanded and Social Science Citation Index sourced from the Web of Science Core Collection database on January 4, 2022, using publication years between 2011 and 2021. CiteSpace software, VOSviewer, and Microsoft Excel 2019 were used to conduct the bibliometric analyses. Results: A growing publication trend was observed for GDM and nutrition, and this field has great potential. More GDM and nutrition research has been conducted in developed countries than developing countries. The top three authors with a high publication frequency, co-citations, and a good h-index were from the United States. There were the four studies of randomized controlled trials (RCTs) or meta-analyses of RCTs, as well as one review in the top five items of cited literature. Keywords were categorized into four clusters based on the keywords visualization. Conclusion: It is important to strengthen the collaboration between nations of different economies to produce more high-quality research on GDM and nutrition. It may be beneficial to further study the etiology, diagnosis, and treatment of GDM based on current results to provide a new perspective on GDM and nutrition.

Low fermentable oligosaccharides, disaccharides, monosaccharides, and polyols diet compared with traditional dietary advice for diarrhea-predominant irritable bowel syndrome: a parallel-group, randomized controlled trial with analysis of clinical and microbiological factors associated with patient outcomes.

BACKGROUND: The efficacy and factors associated with patient outcomes for a diet low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (LFD) compared with traditional dietary advice (TDA) based on modified National Institute for Clinical Excellence guidelines for irritable bowel syndrome with diarrhea (IBS-D) in regions consuming a non-Western diet are unclear. OBJECTIVES: We aimed to determine the efficacy of an LFD compared with TDA for the treatment of IBS-D in Chinese patients and to investigate the factors associated with favorable outcomes. METHODS: One hundred and eight Chinese IBS-D patients (Rome III criteria) were randomly assigned to an LFD or TDA. The primary endpoint was a ≥50-point reduction in the IBS Severity Scoring System at 3 wk. Fecal samples collected before and after the dietary intervention were assessed for changes in SCFAs and microbiota profiles. A logistic regression model was used to identify predictors of outcomes. RESULTS: Among the 100 patients who completed the study, the primary endpoint was met in a similar number of LFD (30 of 51, 59%) and TDA (26 of 49, 53%) patients (∆6%; 95% CI: -13%, 24%). Patients in the LFD group achieved earlier symptomatic improvement in stool frequency and excessive wind than those following TDA. LFD reduced carbohydrate-fermenting bacteria such as Bifidobacterium and Bacteroides, and decreased saccharolytic fermentation activity. This was associated with symptomatic improvement in the responders. High saccharolytic fermentation activity at baseline was associated with a higher symptom burden (P = 0.01) and a favorable therapeutic response to the LFD (log OR: 4.9; 95% CI: -0.1, 9.9; P = 0.05). CONCLUSIONS: An LFD and TDA each reduced symptoms in Chinese IBS-D patients; however, the LFD achieved earlier symptomatic improvements in stool frequency and excessive wind. The therapeutic effect of the LFD was associated with changes in the fecal microbiota and the fecal fermentation index. At baseline, the presence of severe symptoms and microbial metabolic dysbiosis characterized by high saccharolytic capability predicted favorable outcomes to LFD intervention.This trial was registered at clinicaltrials.gov as NCT03304041.

Association between dietary pattern and the risk of type 2 diabetes mellitus in Zhejiang Province, China: A case-control study.

BACKGROUND AND OBJECTIVES: Diet is a modifiable risk factor of T2DM with the potential to improve the patients' quality of life. The diet-diabetes relationship has received considerable attention in past decades. This study describes dietary intake of nutrients in a matched case-control study of adults with and without T2DM. METHODS AND STUDY DESIGN: Dietary nutrient intake was evaluated by semi-quantitative FFQ and biochemical indexes were studied in enrolled 207 participants with T2DM (diabetes group) and 215 healthy participants (control group). The t-test of two independent-sample and chi-square test were used to compare data by age and other characters. Exploratory factor analysis was used for dietary pattern analysis. Logistic regression analysis were used to test the effect of different dietary patterns and dietary intakes on the risk of T2DM. RESULTS: The blood glucose, triglyceride and low-density lipoprotein cholesterol levels were significantly higher in the diabetes group (p<0.05). Three major dietary patterns were identified, "High-salt and high-fat", "Traditional Chinese" and "Western" dietary patterns. With or without adjustment, highest quintile of high-salt and high-fat dietary pattern showed a significantly higher risk of T2DM than the lowest quintile. (OR=2.08, 95%CI: 1.24, 3.49, OR=1.70, 95%CI: 0.98, 2.54, OR=1.67, 95%CI: 0.97, 2.51). CONCLUSIONS: Individuals with a high-fat and high-salt dietary pattern had an increased risk of T2DM. These findings offered further insights into the dietary structure of T2DM patients. These findings put nutrition education at the center for T2DM patient management. Further follow-up study is needed to assess the dynamic changes of nutrient-metabolism association.

Lactation and progression to type 2 diabetes in patients with gestational diabetes mellitus: A systematic review and meta-analysis of cohort studies.

AIMS/INTRODUCTION: To explore the association between lactation and type 2 diabetes incidence in women with prior gestational diabetes. MATERIALS AND METHODS: We searched PubMed, Embase and the Cochrane Library for cohort studies published through 12 June 2017 that evaluated the effect of lactation on the development of type 2 diabetes in women with prior gestational diabetes. A random effects model was used to estimate relative risks (RRs) with 95% confidence intervals (CIs). RESULTS: A total of 13 cohort studies were included in the meta-analysis. The pooled result suggested that compared with no lactation, lactation was significantly associated with a lower risk of type 2 diabetes (RR 0.66, 95% CI 0.48-0.90, I2  = 72.8%, P < 0.001). This relationship was prominent in a study carried out in the USA (RR 0.66, 95% CI 0.43-0.99), regardless of study design (prospective design RR 0.56, 95% CI 0.41-0.76; retrospective design RR 0.63, 95% CI 0.40-0.99), smaller sample size (RR 0.52, 95% CI 0.30-0.92, P = 0.024) and follow-up duration >1 years (RR 0.75, 95% CI 0.56-1.00), and the study used adjusted data (RR 0.69, 95% CI 0.50-0.94). Finally, by pooling data from three studies, we failed to show that compared with no lactation, long-term lactation (>1 to 3 months postpartum) was associated with the type 2 diabetes risk (RR 0.69, 95% CI 0.41-1.17). CONCLUSIONS: The present meta-analysis showed that lactation was associated with a lower risk of type 2 diabetes in women with prior gestational diabetes. Furthermore, no significant relationship between long-term lactation and type 2 diabetes risk was detected. The impact of long-term lactation and the risk of type 2 diabetes should be verified in further large-scale studies.

Decreased Serum 25OHD Concentration in Chinese Women with Type 2 Diabetes. [corrected].

The Chinese dietary structure is different from Western and Mediterranean diets. This study aimed to assess the association of dietary calcium, serum 25-hydroxyvitamin D (25OHD), and other macronutrients with type 2 diabetes (T2D) in Chinese patients. This case-control study enrolled 605 patients (males, 337; females, 268) with T2D and 724 healthy subjects (males, 405; females, 319) at Sir Run Run Shaw Hospital from February to April 2014. Dietary calcium, total energy, fat to energy ratio, glucose administration, 2-h postprandial blood glucose, serum total cholesterol and high density lipoprotein (HDL)-cholesterol, and serum 25OHD level were assessed. Logistic regression was used to assess the associations of various parameters with T2D. Total energy, fat, and the fat-to-energy ratio were significantly higher in healthy male and female controls than in T2D patients (p<0.05). In addition, significant differences were obtained between the T2D and control groups in glucose management, 2-h postprandial blood glucose, serum total cholesterol, and HDL-cholesterol (all p<0.05). Interestingly, statistically significant inverse associations of dietary calcium and total energy intake with the risk of T2D were obtained in women; binary logistic regression analysis showed diet calcium and serum 25OHD were protecting factors against T2D (OR=0.40, p=0.034; OR=0.50, p=0.019). Dietary calcium and serum 25OHD may independently protect Chinese women from T2D. These findings highlight the importance of vitamin D and calcium in daily diet or supplement in the early period of T2D, meanwhile indicators associated with bone metabolism should be assessed in clinical nutrition. It is possible that dietary education and guidance should be implemented based clinical bone metabolism data.

[A comparison of applicative effect with different diagnostic criteria of metabolic syndrome among the urban adult population].

OBJECTIVE: To compare the applicative effect of four diagnostic criteria of metabolic syndrome (MS) among the urban adult population of Zhejiang Province. METHODS: According to multi-stage stratified and proportional to size, cluster, random sampling principle, 3 417 adults population at urban areas were extracted by random number method from 320 families of Shangcheng and Jianggan community in Hangzhou,Jiangdong community in Ningbo and Wucheng community in Jinhua in 2009 and 2010 respectively, which excluded pregnant, wet nurse, children, and those who were at least 18 years of age. Height, weight, waist, blood pressure, fasting plasma glucose (FBG) , 2-hour postprandial blood glucose (2h-PBG), TG and HDL-C of all the subjects were measured by standard method. MS was diagnosed and compared according to four diagnostic criteria:Chinese Medical Association Diabetic Society (CDS), Joint Committee for Developing Chinese Guidelines (JCDCG), American National Cholesterol Education Program Adult Treatment PaneI II in 2005 (ATPIII) and International Diabetes Federation (IDF), respectively. RESULTS: The high prevalence of MS diagnosed by the criteria of ATPIII was 21.6% (737/3 417) , while the lowest prevalence diagnosed by CDS was 9.8% (335/3 417), the result of consistency check demonstrated the MS diagnostic criteria of ATPIII and IDF, ATPIII and JCDCG were in strong and the same accordance with the concordance rate, Kappa value was 0.75, while the consistency of the criteria of ATP III and CDS were in relatively weak agreement, Kappa value was 0.53; the detection result of MS abnormal components showed the highest proportion of having ≥ 3 risk factors was presented by ATPIII among subjects diagnosed as MS (100.0%) , meanwhile, the lowest proportion of having ≥ 3 risk factors was also found by ATPIII among those MS-free (0.8%) . CONCLUSIONS: The criteria of ATPIII may have more sensitivity when screening MS and its abnormal components.However, it's limited to extrapolate the results from the cross-sectional survey to the total population.

[Study on the relationship between dietary patterns and metabolic syndrome among urban residents in Zhejiang province].

OBJECTIVE: To analyze the relationship between dietary patterns and metabolic syndrome in urban residents in Zhejiang Province. METHODS: We undertook a cross-sectional survey based on the data from "China National Nutrition and Health Status Monitoring". Factor analysis was used to identify food patterns based on the frequency of food and unconditional logistic regression model was used to estimate adjusted odd ratios (OR) and 95% confidence intervals (95% CI) between MS including its components and dietary patterns. RESULTS: Three evident dietary patterns were derived by factor analysis in these 2116 participants including "animal food pattern" (35.68%), "plant food pattern" (31.00%) and "sea food pattern" (33.32%). Increased risks of abdominal obesity, hypertriglyceridemia, hypertension, hyperglycemia and MS were associated with animal food pattern, while plant food pattern play an important role to prevent against lowing HDL cholesterol. An inversed association with the risks of abdominal obesity, low HDL cholesterol and hypertension were seen in the pattern of sea food. CONCLUSION: The relationship between three kinds of dietary pattern and MS was complicated and characteristic, so it's not appropriate to emphasize some kind of food pattern or certain food, varieties of food will help to reduce the risk of MS and its components.