Maternal lipids are associated with newborn adiposity, independent of GDM status, obesity and insulin resistance: a prospective observational cohort study.

OBJECTIVE: To determine the association between maternal lipaemia and neonatal anthropometrics in Malaysian mother-offspring pairs. DESIGN: Prospective observational cohort study. SETTING: Single tertiary multidisciplinary antenatal clinic in Malaysia. POPULATION: A total of 507 mothers: 145 with gestational diabetes mellitus (GDM); 94 who were obese with normal glucose tolerance (NGT) (pre-gravid body mass index, BMI ≥ 27.5 kg/m2 ), and 268 who were not obese with NGT. METHODS: Maternal demographic, anthropometric, and clinical data were collected during an interview/examination using a structured questionnaire. Blood was drawn for insulin, C-peptide, triglyceride (Tg), and non-esterified fatty acid (NEFA) during the 75-g 2-hour oral glucose tolerance test (OGTT) screening, and again at 36 weeks of gestation. At birth, neonatal anthropometrics were assessed and data such as gestational weight gain (GWG) were extracted from the records. MAIN OUTCOME MEASURES: Macrosomia, large-for-gestational-age (LGA) status, cohort-specific birthweight (BW), neonatal fat mass (NFM), and sum of skinfold thickness (SSFT) > 90th centile. RESULTS: Fasting Tg > 95th centile (3.6 mmol/L) at screening for OGTT was independently associated with LGA (adjusted odds ratio, aOR 10.82, 95% CI 1.26-93.37) after adjustment for maternal glucose, pre-gravid BMI, and insulin sensitivity. Fasting glucose was independently associated with a birthweight ratio (BWR) of >90th centile (aOR 2.06, 95% CI 1.17-3.64), but not with LGA status, in this well-treated GDM cohort with pre-delivery HbA1c of 5.27%. In all, 45% of mothers had a pre-gravid BMI of <23 kg/m2 and 61% had a pre-gravid BMI of ≤ 25 kg/m2 , yet a GWG of >10 kg was associated with a 4.25-fold risk (95% CI 1.71-10.53) of BWR > 90th centile. CONCLUSION: Maternal lipaemia and GWG at a low threshold (>10 kg) adversely impact neonatal adiposity in Asian offspring, independent of glucose, insulin resistance and pre-gravid BMI. These may therefore be important modifiable metabolic targets in pregnancy. TWEETABLE ABSTRACT: Maternal lipids are associated with adiposity in Asian babies independently of pre-gravid BMI, GDM status, and insulin resistance.

Incorporation of Si and SiO(x) into diamond-like carbon films: impact on surface properties and osteoblast adhesion.

The interaction of human osteoblast cells with diamond-like carbon films incorporating silicon and silicon oxide (SiO(x), 1 < or = x < or = 1.5) and synthesized using the direct-current plasma-activated chemical vapour deposition method was investigated. Cell culture studies were performed for films with Si contents ranging from approximately 4 at.% to 15 at.%. Substantial differences between Si-incorporated and SiO(x)-incorporated films were found for the bonding environments of Si atoms and the hybridization of underlying carbon structures. However, osteoblast-attachment studies did not show statistically significant trends in properties of cell growth (count, area and morphology) that can be attributed either to the Si content of the films or to the chemical structure of the films. The surface energy decreased by 40% as the Si content of the SiO(x) incorporated DLC films increased to 13 at.%. The cell adhesion properties however did not change in response to lowering of the surface energy. The incorporation of both Si and SiO(x) leads to a beneficial reduction in the residual stress of the films. The average roughness of the films increases and the hardness decreases when Si and SiO(x) are added to DLC films. The impact of these changes for load-bearing biomedical applications can be determined only by carefully controlled experiments using anatomic simulators.