Showing papers by "Anny H. Xiang published in 2013"
TL;DR: Prepregnancy overweight and obesity account for a high proportion of LGA, even in the absence of GDM, and interventions that focus on maternal overweight/obesity and gestational weight gain, regardless of G DM status have the potential to reach far more women at risk for having an LGA infant.
Abstract: OBJECTIVE The International Association of Diabetes in Pregnancy Study Groups (IADPSG) criteria for diagnosis of gestational diabetes mellitus (GDM) identifies women and infants at risk for adverse outcomes, which are also strongly associated with maternal overweight, obesity, and excess gestational weight gain.
RESEARCH DESIGN AND METHODS We conducted a retrospective study of 9,835 women who delivered at ≥20 weeks’ gestation; had a prenatal, 2-h, 75-g oral glucose tolerance test; and were not treated with diet, exercise, or antidiabetic medications during pregnancy. Women were classified as having GDM based on IADPSG criteria and were categorized into six mutually exclusive prepregnancy BMI/GDM groups: normal weight ± GDM, overweight ± GDM, and obese ± GDM.
RESULTS Overall, 5,851 (59.5%) women were overweight or obese and 1,892 (19.2%) had GDM. Of those with GDM, 1,443 (76.3%) were overweight or obese. The prevalence of large-for-gestational-age (LGA) infants was significantly higher for overweight and obese women without GDM compared with their normal-weight counterparts. Among women without GDM, 21.6% of LGA infants were attributable to maternal overweight and obesity, and the combination of being overweight or obese and having GDM accounted for 23.3% of LGA infants. Increasing gestational weight gain was associated with a higher prevalence of LGA in all groups.
CONCLUSIONS Prepregnancy overweight and obesity account for a high proportion of LGA, even in the absence of GDM. Interventions that focus on maternal overweight/obesity and gestational weight gain, regardless of GDM status, have the potential to reach far more women at risk for having an LGA infant.
263 citations
TL;DR: Mexican–American women with recent GDM had a faster deterioration in insulin sensitivity and beta cell compensation than their parous counterparts without GDM, suggesting more deleterious effects of existing fat and/or reduced beta cell robustness in women with GDM.
Abstract: Aims/hypothesis
The aim of the study was to compare longitudinal changes in insulin sensitivity (SI) and beta cell function between women with and without a history of gestational diabetes mellitus (GDM).
57 citations
TL;DR: It is suggested that high-fat diets may contribute to increased adiposity and concomitant insulin resistance and β-cell dysfunction in Mexican Americans.
Abstract: Consumption of energy-dense, nutrient-poor foods has contributed to the rising incidence of obesity and may underlie insulin resistance and β-cell dysfunction. Macronutrient intake patterns were examined in relation to anthropometric and metabolic traits in participants of BetaGene, a family-based study of obesity, insulin resistance, and β-cell dysfunction in Mexican Americans. Dietary intake, body composition, insulin sensitivity (SI), and β-cell function [Disposition Index (DI)] were assessed by food-frequency questionnaires, dual-energy X-ray absorptiometry, and intravenous glucose-tolerance tests, respectively. Patterns of macronutrient intake were identified by using a K-means model based on the proportion of total energy intake per day attributable to carbohydrate, fat, and protein and were tested for association with anthropometric and metabolic traits. Among 1150 subjects aged 18-65 y (73% female), tertiles of fat intake were associated with greater adiposity and lower SI, after adjustment for age, sex, and daily energy intake. Moreover, 3 distinct dietary patterns were identified: "high fat" (35% fat, 44% carbohydrate, 21% protein; n = 238), "moderate fat" (28% fat, 54% carbohydrate, 18% protein; n = 520), and "low fat" (20% fat, 65% carbohydrate, 15% protein; n = 392). Compared with the low-fat group, the high-fat group had higher age- and sex-adjusted mean body mass index, body fat percentage, and trunk fat and lower SI and DI. Further adjustment for daily energy intake by matching individuals across dietary pattern groups yielded similar results. None of the observed associations were altered after adjustment for physical activity; however, associations with SI and DI were attenuated after adjustment for adiposity. These findings suggest that high-fat diets may contribute to increased adiposity and concomitant insulin resistance and β-cell dysfunction in Mexican Americans.
45 citations
TL;DR: While the majority of validated loci for type 2 diabetes and related traits do not appear to influence insulin clearance in Hispanics, several of these loci do show evidence of association with this trait, suggesting they could have pleiotropic effects on insulin secretion, insulin sensitivity and insulin clearance.
Abstract: Aims/hypothesis
Insulin clearance is a highly heritable trait, for which few quantitative trait loci have been discovered. We sought to determine whether validated type 2 diabetes and/or glycaemic trait loci are associated with insulin clearance.
37 citations
TL;DR: An increasing level of PA is associated with a better glucose and insulin profile and enhanced β-cell function that is not explained by differences in BMI or percent body fat.
Abstract: OBJECTIVES To examine the association between self-reported physical activity (PA) and diabetes-related quantitative traits. RESEARCH DESIGN AND METHODS The observational cohort was 1,152 Mexican American adults with dual-energy X-ray absorptiometry, oral and intravenous glucose tolerance tests, and self-reported dietary and PA questionnaires. PA was categorized into three mutually exclusive groups according to the U.S. Department of Health and Human Services PA guidelines for Americans: low (vigorous RESULTS The participants’ mean age was 35 years (range, 18–66 years), mean BMI was 29.6 kg/m 2 , and 73% were female. Among them, 501 (43%), 448 (39%), and 203 (18%) were classified as having low, moderate, and high PA, respectively. After adjustment for age, a higher PA was significantly associated with lower 2-h glucose, fasting insulin, and 2-h insulin and greater β-cell function ( P = 0.001, 0.0003, 0.0001, and 0.004, respectively). The association did not differ significantly by sex. Results were similar after further adjustment for age, sex, BMI, or percent body fat. CONCLUSIONS An increasing level of PA is associated with a better glucose and insulin profile and enhanced β-cell function that is not explained by differences in BMI or percent body fat. Our results suggest that PA can be beneficial to β-cell function and glucose regulation independent of obesity.
18 citations
TL;DR: The analysis revealed that the majority (75%) of GDM women were overweight or obese at the start of pregnancy, and 21.6% of large-for-gestational-age infants were attributable to overweight/obesity among women who never developed GDM.
Abstract: We thank McIntyre and Catalano (1) for their interest in our article (2). In this study, we examined the relative effects of prepregnancy overweight/obesity, excess gestational weight gain, and IADPSG-defined gestational diabetes mellitus (GDM) on fetal overgrowth and other adverse outcomes, in a sample of 9,835 women who had a 2-h 75-g oral glucose tolerance test and were not treated with diet, exercise, or antidiabetic medications during pregnancy. Our analysis revealed that the majority (75%) of GDM women were overweight or obese at the start of pregnancy, and 21.6% of large-for-gestational-age (LGA) infants were attributable to overweight/obesity among women who never developed GDM. We also found that the effects of overweight/obesity and GDM …
17 citations
TL;DR: In this paper, the authors investigated the racial/ethnic differences in the time to treatment among patients with prostate cancer and found that minimal racial and ethnic differences exist in the treatment after the diagnosis of prostate cancer in this equal access setting.
4 citations
01 Jan 2013
TL;DR: It is suggested that PA can be beneficial to b-cell function and glucose regulation independent of obesity and an increasing level of PA is associated with a better glucose and insulin profile and enhanced b- cell function that is not explained by differences in BMI or percent body fat.
Abstract: RESULTSdThe participants’mean age was 35 years (range, 18–66 years), mean BMI was 29.6 kg/m 2 , and 73% were female. Among them, 501 (43%), 448 (39%), and 203 (18%) were classified as having low, moderate, and high PA, respectively. After adjustment for age, a higher PA was significantly associated with lower 2-h glucose, fasting insulin, and 2-h insulin and greater b-cell function (P = 0.001, 0.0003, 0.0001, and 0.004, respectively). The association did not differ significantly by sex. Results were similar after further adjustment for age, sex, BMI, or percent body fat. CONCLUSIONSdAn increasing level of PA is associated with a better glucose and insulin profile and enhanced b-cell function that is not explained by differences in BMI or percent body fat. Our results suggest that PA can be beneficial to b-cell function and glucose regulation independent of obesity. Diabetes Care 36:638–644, 2013
1 citations