Impact of lifestyle intervention for obese women during pregnancy on maternal metabolic and inflammatory markers.

Autor: Renault KM; Department of Obstetrics and Gynecology, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.; Obstetric Clinic, JMC, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark., Carlsen EM; Department of Pediatrics, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark., Hædersdal S; Department of Obstetrics and Gynecology, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.; Center for Diabetes Research, Copenhagen University Hospital Gentofte, Hellerup, Denmark., Nilas L; Department of Obstetrics and Gynecology, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.; Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark., Secher NJ; The Research Unit Women's and Children's Health, the Juliane Marie Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark., Eugen-Olsen J; Clinical Research Centre, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark., Cortes D; Department of Pediatrics, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.; Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark., Olsen SF; Centre for Fetal Programming, Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark.; Department of Nutrition, Harvard School of Public Health, Boston, MA, USA., Halldorsson TI; Centre for Fetal Programming, Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark.; Faculty of Food Science and Nutrition, University of Iceland, Reykjavik, Iceland.; Unit for Nutrition Research, Landspitali University Hospital, Reykjavik, Iceland., Nørgaard K; Department of Endocrinology, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.
Jazyk: angličtina
Zdroj: International journal of obesity (2005) [Int J Obes (Lond)] 2017 Apr; Vol. 41 (4), pp. 598-605. Date of Electronic Publication: 2017 Jan 17.
DOI: 10.1038/ijo.2017.9
Abstrakt: Background: Offspring of obese mothers have increased risk of developing obesity and related short- and long-term disease. The cause is multifactorial and may partly be explained by the unfavorable intrauterine environment. Intervention during pregnancy leading to a healthier lifestyle among obese may alter this.
Objective: To assess the effect of lifestyle intervention on markers of maternal metabolism and inflammation in 'the TOP (Treatment of Obese Pregnant Women) study', a randomized controlled trial.
Methods: In the TOP-study 425 participants with body mass index ⩾30 kg/m 2 were randomized to intervention with dietary advices and physical activity assessed by pedometer (PA+D), physical activity assessed by pedometer (PA) or control (C). Of 389 participants completing the study 376 had available blood samples. Serum was analyzed for insulin, c-peptide, lipid profile, leptin, high-sensitivity CRP (hsCRP) and Soluble urokinase Plasminogen Activator Receptor (suPAR), in week 18-20 and 28-30, and simultaneously a 2-h oral glucose-tolerance-test was performed. Diet was assessed in gestational week 11-14 and 36-37 using a validated 360-item Food Frequency Questionnaire.
Results: Median levels of hsCRP in gestational week 28-30 were lower in each of the intervention groups (8.3 mg/l in PA+D group, P=0.03; and 8.8 mg/l in PA group, P=0.02) versus the control group (11.5 mg/l). Obtaining 11 000 steps per day as aimed for resulted in a 21% lower hsCRP compared to non-compliant women. Women reporting high carbohydrate intake had around 30% higher hsCRP concentrations in late gestation than women reporting the lowest intake. There were no differences in lipid profile or any of the metabolic markers in gestational week 28-30 when comparing the intervention and control groups.
Conclusions: Lifestyle intervention in obese women can reduce hsCRP representing a marker of inflammation during pregnancy. The effect may partly be mediated by more physical activity and partly by changes in intake of carbohydrates and the glycaemic load.
Databáze: MEDLINE
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