Time filter

Source Type

Liu J.,Brock University | Leng J.,Tianjin Women and Childrens Health Center | Tang C.,Tianjin Women and Childrens Health Center | Liu G.,Tianjin Women and Childrens Health Center | And 5 more authors.
BMJ Open | Year: 2014

Objective: To examine the impact of maternal blood glucose (BG) level and body mass index (BMI) measured at gestational diabetes mellitus (GDM) screening on the risk of macrosomia. Design: A perinatal cohort of women were followed up from receiving perinatal healthcare to giving birth. Setting: Beichen District, Tianjin, China between June 2011 and October 2012. Participants: 1951 women aged 19-42 years with valid values of BMI and BG level at GDM screening (24-28 weeks gestation), singleton birth and birth weight (BW)>2500 g. Main outcomes and measures: Primary outcome was macrosomia (BW>4000 g). BG level and BMI were measured at GDM screening. Results: 191 (9.7%) newborns were macrosomia. The ORs (95% CIs) of macrosomia from multiple logistic regression were 1.14 (1.10 to 1.19, p<0.0001) for BMI and 1.11 (1.01 to 1.23, p=0.03) for BG. When BMI and BG levels (continuous) were modelled simultaneously, the OR for BMI was similar, but significantly attenuated for BG. Areas of receiver operating characteristics (ROC) were 0.6530 (0.6258 to 0.6803) for BMI and 0.5548 (0.5248 to 0.5848) for BG (χ2=26.17, p<0.0001). BG (mmol/L, <6.7, 6.7- 7.8 or ≥7.8) and BMI in quintiles (Q1-Q5) were evaluated with BG <6.7 and Q2 BMI as the reference group. The ORs of macrosomia were not statistically different for mothers in Q1 or Q2 of BMI regardless of the BG levels; the ORs for ≥Q3 of BMI were elevated significantly with the highest OR observed in Q5 of BMI and BG levels ≥7.8 (6.93 (2.61 to 18.43), p<0.0001). Conclusions: High BMI measured at GDM screening was the most important determinant for risk of macrosomia. These findings suggest that GDM screening may be a critical gestational time point to initiate maternal weight control oriented intervention strategy to lower the risk.


PubMed | Tianjin Women and Childrens Health Center, National University of Singapore, Tulane University, Pennington Biomedical Research Center and Harvard University
Type: Journal Article | Journal: Diabetes | Year: 2016

Zinc transporter 8 genetic variant SLC30A8 has been associated with postpartum risk of type 2 diabetes among women with gestational diabetes mellitus (GDM). Gestational weight gain is one of the strongest risk factors for postpartum hyperglycemia. We assessed the interaction between type 2 diabetes-associated SLC30A8 rs13266634 and gestational weight gain on 1-5 years of postpartum glycemic changes in 1,071 women with prior GDM in a longitudinal study. Compared with gestation of 26-30 weeks, postpartum levels of fasting glucose, oral glucose tolerance test 2-h glucose, and hemoglobin A


PubMed | Beichen Women and Childrens Health Center, Tianjin Women and Childrens Health Center, Brock University and Tianjin Medical University
Type: Journal Article | Journal: BMJ open | Year: 2016

To examine whether maternal low blood glucose (BG), low body mass index (BMI) and small stature have a joint effect on the risk of delivery of a small-for-gestational age (SGA) infant.Women from a perinatal cohort were followed up from receiving perinatal healthcare to giving birth.Beichen District, Tianjin, China between June 2011 and October 2012.1572 women aged 19-39years with valid values of stature, BMI and BG level at gestational diabetes mellitus screening (gestational weeks 24-28), glucose challenge test <7.8mmol/L and singleton birth (37weeks gestation).SGA was defined as birth weight <10th centile for gender separated gestational age of Tianjin singletons.164 neonates (10.4%) were identified as SGA. From multiple logistic regression models, the ORs (95% CI) of delivery of SGA were 0.84 (0.72 to 0.98), 0.61 (0.49 to 0.74) and 0.64 (0.54 to 0.76) for every 1 SD increase in maternal BG, BMI and stature, respectively. When dichotomises, maternal BG (<6.0 vs 6.0mmol/L), BMI (<24 vs 24kg/m(2)) and stature (<160.0 vs 160.0cm), those with BG, BMI and stature all in the lower categories had 8 times higher odds of delivering an SGA neonate (OR (95% CI) 8.01 (3.78 to 16.96)) relative to the reference that had BG, BMI and stature all in the high categories. The odds for an SGA delivery among women who had any 2 variables in the lower categories were 2-4 times higher.Low maternal BG is associated with an increased risk of having an SGA infant. The risk of SGA is significantly increased when the mother is also short and has a low BMI. This may be a useful clinical tool to identify women at higher risk for having an SGA infant at delivery.


PubMed | Chinese University of Hong Kong, Tianjin Women and Childrens Health Center, Tianjin Medical University, Pennington Biomedical Research Center and Dalhousie University
Type: | Journal: Scientific reports | Year: 2016

Alanine aminotransferase (ALT) predicts type 2 diabetes but it is uncertain whether it also predicts gestational diabetes mellitus (GDM). We recruited 17359 Chinese women with ALT measured in their first trimester. At 24-28weeks of gestation, all women underwent a 50-gram 1-hour glucose challenge test (GCT) followed by a 75-gram 2-hour oral glucose tolerance test if GCT result was 7.8mmol/L. Restricted cubic spline analysis was used to examine full-range risk associations of ALT levels with GDM. Relative excess risk due to interaction, attributable proportion due to interaction and synergy index were used to estimate additive interaction between high ALT and overweight/obesity for GDM. Finally, 1332 (7.7%) women had GDM. ALT levels were positively associated with GDM risk without a clear threshold. Using ALT levels <22U/L as the referent, the middle ALT levels (22to <40U/L) [odds ratio (OR) (95% confidence intervals): 1.41(1.21-1.65)] and high ALT levels (40U/L) [1.62 (1.31-2.00)] were associated with increased GDM risk. Maternal overweight/obesity greatly enhanced the OR of ALT 22U/L from 1.44 (1.23-1.69) to 3.46 (2.79-4.29) with significant additive interactions. In conclusion, elevated ALT levels in the first trimester even within normal range predicted GDM risk, further enhanced by overweight/obesity.


PubMed | Chinese University of Hong Kong, Tianjin Women and Childrens Health Center, Tianjin Medical University, Pennington Biomedical Research Center and Dalhousie University
Type: Journal Article | Journal: Diabetic medicine : a journal of the British Diabetic Association | Year: 2016

To examine the association between sleep disturbances during pregnancy and risk of gestational diabetes mellitus.From 2010 to 2012, 12 506 women in Tianjin, China, were screened using a 50-g 1-h glucose challenge test at 24-28 weeks gestation. Those with glucose challenge test values of 7.8 mmol/l were invited to further undergo a 75-g 2-h oral glucose tolerance test. Gestational diabetes was determined according to the International Association of Diabetes and Pregnancy Study Groups definition. Self-reported sleep duration and sleep quality during pregnancy was documented using a modified questionnaire. Logistic regression was used to obtain odds ratios and 95% CIs.A total of 919 women (7.3%) had gestational diabetes. Sleep duration was found to have an approximate J-shaped association with gestational diabetes risk after adjusting for covariates. Compared with a sleep duration of 7-9 h/day (43% of 12 506 women), the adjusted odds ratios for sleep duration of 9 h/day (55%) and < 7 h/day (2%) for gestational diabetes were 1.21 (95% CI 1.03-1.42) and 1.36 (95% CI 0.87-2.14), respectively. Compared with good sleep quality (37.9% of 12 506 women), the adjusted odds ratios of moderate (59.9%) and poor sleep quality (2.2%) for gestational diabetes were 1.19 (95% CI 1.01-1.41) and 1.61 (95% CI 1.04-2.50), respectively.In pregnant Chinese women, poor sleep quality, and shorter and longer duration of sleep during pregnancy were independently associated with an increased risk of gestational diabetes.


PubMed | Pennington Biomedical Research Center, Tianjin Medical University, Chinese University of Hong Kong, Tianjin Women and Childrens Health Center and 2 more.
Type: | Journal: Diabetes/metabolism research and reviews | Year: 2016

Passive smoking increased type 2 diabetes mellitus risk, but it is uncertain whether it also increased gestational diabetes mellitus (GDM) risk. We aimed to examine the association of passive smoking during pregnancy and its interaction with maternal obesity for GDM.From 2010 to 2012, 12786 Chinese women underwent a 50-g 1-hour glucose challenge test at 24 to 28weeks of gestation and further underwent a 75-g 2-hour oral glucose tolerance test if the glucose challenge test result was 7.8mmol/L. GDM was defined by the International Association of Diabetes and Pregnancy Study Groups cut points. Self-reported passive smoking during pregnancy was collected by a questionnaire. Logistic regression was used to obtain odds ratios (ORs) and 95% confidence intervals (CIs). Additive interaction between maternal obesity and passive smoking was estimated using relative excess risk due to interaction (RERI), attributable proportion due to interaction (AP), and synergy index (S). Significant RERI>0, AP>0, or S>1 indicated additive interaction.A total of 8331 women (65.2%) were exposed to passive smoking during pregnancy. More women exposed to passive smoking developed GDM than nonexposed women (7.8% versus 6.3%, P=0.002) with an adjusted OR of 1.29 (95%CI, 1.11 to 1.50). Compared with nonobesity and nonpassive smoking, prepregnancy obesity and passive smoking was associated with GDM risk with an adjusted OR of 3.09 (95%CI, 2.38-4.02) with significant additive interaction (P<.05 for RERI and AP).Passive smoking during pregnancy increased GDM risk in Chinese women independently and synergistically with prepregnancy obesity.


PubMed | Tianjin Women and Childrens Health Center, Brock University, Tianjin Medical University and Pennington Biomedical Research Center
Type: | Journal: Preventive medicine reports | Year: 2016

The aim of this study is to investigate the association between leg-length-to-height ratio (LLHR) and metabolic syndrome (MetS) among Chinese children.1236 children (619 obese and 617 nonobese children) aged 3-6years participated in a cross-sectional survey in 2005 in Tianjin, China. Information on body adiposity, metabolic traits, and related covariates was obtained using a standardized protocol. LLHR was calculated as the ratio of leg length to stature.In the multivariable logistic regression analyses, compared with those in the lowest quartile, odds ratios (OR) and 95% confidence intervals (CI) of MetS among children in the second through the highest quartiles of LLHR Z-score were 0.89 (95% CI, 0.64-1.25), 0.45 (95% CI, 0.32-0.63), and 0.37 (95% CI, 0.26-0.53), respectively, (P for trend<0.0001 across LLHR Z-score quartiles). Compared with children with both higher levels of LLHR and lower levels of adipose indices, the corresponding ORs of MetS for those with both lower levels of LLHR and higher levels of anthropometric indices were 4.51 (95% CI, 3.08-6.62) for BMI Z-score, 3.86 (95% CI, 2.60-5.73) for waist circumference, and 2.75 (95% CI, 1.85-4.10) for waist-to-hip ratio, respectively.Greater LLHR is inversely associated with MetS in Chinese children.


Tian Z.,Tianjin Women and Childrens Health Center | Ye T.,Tianjin Women and Childrens Health Center | Zhang X.,Tianjin Women and Childrens Health Center | Liu E.,Tianjin Women and Childrens Health Center | And 6 more authors.
Archives of Pediatrics and Adolescent Medicine | Year: 2010

Objective: To investigate the association between sleep duration and risk of hyperglycemia among preschool Chinese children. Design: A population-based cross-sectional study. Setting: Seventy-one randomly selected kindergartens in Tianjin, China. Participants: Six hundred nineteen obese (body mass index z score ≥1.65) and 617 nonobese (body mass index z score <1.65) children aged 3 to 6 years were recruited and matched by age. Main Exposure: Sleep duration. Main Outcome Measures: Hyperglycemia, defined as a fasting glucose level of 100 mg/dL or higher. Results: Obese children were more likely to have shorter sleep duration (≤8 hours) compared with their nonobese counterparts (P<.001). Compared with those who slept for 9 or 10 hours per night, those who slept for 8 hours or less had a significantly higher likelihood of having hyperglycemia, controlling for age and sex (odds ratio [OR], 1.65; 95% confidence interval [CI], 1.12-2.45). After further adjustment for other potential confounders, the association still remained statistically significant (OR, 1.64; 95% CI, 1.09-2.46). In the stratified multivariable analyses, those who were obese and slept for 8 hours or less had an increased risk of having hyperglycemia (OR, 2.12; 95% CI, 1.06-4.21) compared with those who were nonobese and slept for 9 hours or more. Conclusions: Shorter sleep duration is associated with an increased risk of having hyperglycemia among preschool Chinese children. Whether adequate sleep may help maintain euglycemia among children, especially for those who are overweight or obese, warrants further investigation. ©2010 American Medical Association. All rights reserved.


Qiao Y.J.,Tianjin Women and Childrens Health Center
Zhonghua liu xing bing xue za zhi = Zhonghua liuxingbingxue zazhi | Year: 2012

To understand the level of blood-lipid and prevalence of dyslipidemia of children aged 3 to 6 in Tianjin, so as to provide evidence for large-scale blood screening strategy and to develop intervention of dyslipidemia and cardiovascular in children. 20,041 children aged 3 to 6 from 48 kindergartens were involved in this study, in Tianjin. Peripheral blood was collected from right leech-finger of these children, after fatless breakfast. Total cholesterol (TC) and triglyceride (TG) of plasma were tested using Toshiba 120 Automatic Biochemical Analyzer. The average levels of TC and TG were (4.17±0.69) mmol/L and (0.86±0.44) mmol/L in these children. 11.4% of the children had either TC or TG dyslipidemia, with 7.1% had only TC dyslipidemia, 4.9% had only TG dyslipidemia, and 0.6% of them had both TC and TG dyslipidemia. The prevalence of TC dyslipidemia was significantly higher among girls than boys. The prevalence rates of TC dyslipidemia and TG dyslipidemia were different among age groups, but with no significant changes among age groups. The prevalence of TG dyslipidemia was significantly different, with obese children higher than those with normal or overweight children. Different residential areas seemed to be related to the difference on the prevalence of dyslipidemia. Prevalence of TC dyslipidemia was higher in urban than in rural areas. Prevalence of TG dyslipidemia was higher in rural than urban areas. The prevalence of dyslipidemia for children aged 3 to 6 was high in Tianjin, and showed differences among genders, age groups and residential regions. Screening and intervention programs on dyslipidemia should be undertaken routinely in children, in order to prevent adult atherosclerosis and coronary heart disease.


Song C.,Tianjin Medical University | Li J.,Tianjin Medical University | Leng J.,Tianjin Medical University | Leng J.,Tianjin Women and Childrens Health Center | And 2 more authors.
Obesity Reviews | Year: 2016

This study aimed to examine the effect of lifestyle intervention on the risk of gestational diabetes mellitus (GDM). We searched PubMed, Springer and other databases to retrieve articles published in English and Chinese up to 30 September 2015. The inclusion criteria were randomized controlled trials evaluating the effects of lifestyle intervention on risk of GDM. Exclusion criteria were studies with prepregnancy diabetes mellitus or interventions with nutrient supplements. Random-effect and fixed-effect model analyses were used to obtain pooled relative risks and 95% confidence intervals (CIs) of diet and physical activity on the risk of GDM. Subgroup analyses were performed to check the consistency of effect sizes across groups where appropriate. We identified 29 randomized controlled trials with 11,487 pregnant women, addressing the effect of lifestyle intervention on the risk of GDM. In the pooled analysis, either diet or physical activity resulted in an 18% (95%CI 5–30%) reduction in the risk of GDM (P = 0.0091). Subgroup analysis showed that such intervention was effective among women with intervention before the 15th gestational week (relative risk: 0.80, 95%CI 0.66–0.97), but not among women receiving the intervention afterwards. We conclude that lifestyle modification during pregnancy, especially before the 15th gestational week, can reduce the risk of GDM. © 2016 World Obesity. © 2016 World Obesity

Loading Tianjin Women and Childrens Health Center collaborators
Loading Tianjin Women and Childrens Health Center collaborators