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Plasma Levels of Free Fatty Acids in Women with Gestational Diabetes and Its Intrinsic and Extrinsic Determinants: Systematic Review and Meta-Analysis

BACKGROUND: Free fatty acids, also known as nonesterified fatty acids, are proinflammatory molecules that induce insulin resistance in nonpregnant individuals. Nevertheless, the concentration of these molecules has not been systematically addressed in pregnant women. OBJECTIVE: This meta-analysis is...

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Autores principales: Villafan-Bernal, Jose Rafael, Acevedo-Alba, Mariana, Reyes-Pavon, Rodrigo, Diaz-Parra, Guillermo Andres, Lip-Sosa, Diana Lucia, Vazquez-Delfin, Hilda Imelda, Hernandez-Muñoz, Martha, Bravo-Aguirre, Daniel Ely, Figueras, Francesc, Martinez-Portilla, Raigam Jafet
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6721400/
https://www.ncbi.nlm.nih.gov/pubmed/31531374
http://dx.doi.org/10.1155/2019/7098470
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author Villafan-Bernal, Jose Rafael
Acevedo-Alba, Mariana
Reyes-Pavon, Rodrigo
Diaz-Parra, Guillermo Andres
Lip-Sosa, Diana Lucia
Vazquez-Delfin, Hilda Imelda
Hernandez-Muñoz, Martha
Bravo-Aguirre, Daniel Ely
Figueras, Francesc
Martinez-Portilla, Raigam Jafet
author_facet Villafan-Bernal, Jose Rafael
Acevedo-Alba, Mariana
Reyes-Pavon, Rodrigo
Diaz-Parra, Guillermo Andres
Lip-Sosa, Diana Lucia
Vazquez-Delfin, Hilda Imelda
Hernandez-Muñoz, Martha
Bravo-Aguirre, Daniel Ely
Figueras, Francesc
Martinez-Portilla, Raigam Jafet
author_sort Villafan-Bernal, Jose Rafael
collection PubMed
description BACKGROUND: Free fatty acids, also known as nonesterified fatty acids, are proinflammatory molecules that induce insulin resistance in nonpregnant individuals. Nevertheless, the concentration of these molecules has not been systematically addressed in pregnant women. OBJECTIVE: This meta-analysis is aimed at evaluating the difference in free fatty acid plasma levels between women with gestational diabetes and healthy pregnant controls and their intrinsic and extrinsic determinants. METHODS: We performed a systematic search to find relevant studies published in English and Spanish using PubMed, SCOPUS, and ISI Web of Knowledge. We included observational studies measuring the mean plasma levels of free fatty acids among gestational diabetes and healthy pregnant women, with at least ten subjects being analyzed in each group. The standardized mean difference (SMD) by random effects modeling was used. Heterogeneity was assessed using Cochran's Q, H, and I (2) statistics. RESULTS: Among the 290 identified studies, twelve were selected for analysis. A total of 2426 women were included, from which 21% were diagnosed as having gestational diabetes. There were significantly higher levels of free fatty acids among women with gestational diabetes (SMD: 0.86; 0.54-1.18; p < 0.001) when compared to healthy pregnant controls and between-study heterogeneity (I (2) = 91%). The metaregression analysis showed that the gestational age at inclusion was the only cofactor influencing the mean levels of free fatty acids, indicating a trend towards lower plasma levels of free fatty acids later in gestation (estimate: -0.074; -0.143 to -0.004; p = 0.036). No significant publication bias was found nor a trend towards greater results in small studies. CONCLUSIONS: Women with gestational diabetes have higher levels of free fatty acids when compared to healthy pregnant controls. More investigation is needed to assess the potential role of free fatty acids in the prediction of gestational diabetes earlier in pregnancy.
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spelling pubmed-67214002019-09-17 Plasma Levels of Free Fatty Acids in Women with Gestational Diabetes and Its Intrinsic and Extrinsic Determinants: Systematic Review and Meta-Analysis Villafan-Bernal, Jose Rafael Acevedo-Alba, Mariana Reyes-Pavon, Rodrigo Diaz-Parra, Guillermo Andres Lip-Sosa, Diana Lucia Vazquez-Delfin, Hilda Imelda Hernandez-Muñoz, Martha Bravo-Aguirre, Daniel Ely Figueras, Francesc Martinez-Portilla, Raigam Jafet J Diabetes Res Review Article BACKGROUND: Free fatty acids, also known as nonesterified fatty acids, are proinflammatory molecules that induce insulin resistance in nonpregnant individuals. Nevertheless, the concentration of these molecules has not been systematically addressed in pregnant women. OBJECTIVE: This meta-analysis is aimed at evaluating the difference in free fatty acid plasma levels between women with gestational diabetes and healthy pregnant controls and their intrinsic and extrinsic determinants. METHODS: We performed a systematic search to find relevant studies published in English and Spanish using PubMed, SCOPUS, and ISI Web of Knowledge. We included observational studies measuring the mean plasma levels of free fatty acids among gestational diabetes and healthy pregnant women, with at least ten subjects being analyzed in each group. The standardized mean difference (SMD) by random effects modeling was used. Heterogeneity was assessed using Cochran's Q, H, and I (2) statistics. RESULTS: Among the 290 identified studies, twelve were selected for analysis. A total of 2426 women were included, from which 21% were diagnosed as having gestational diabetes. There were significantly higher levels of free fatty acids among women with gestational diabetes (SMD: 0.86; 0.54-1.18; p < 0.001) when compared to healthy pregnant controls and between-study heterogeneity (I (2) = 91%). The metaregression analysis showed that the gestational age at inclusion was the only cofactor influencing the mean levels of free fatty acids, indicating a trend towards lower plasma levels of free fatty acids later in gestation (estimate: -0.074; -0.143 to -0.004; p = 0.036). No significant publication bias was found nor a trend towards greater results in small studies. CONCLUSIONS: Women with gestational diabetes have higher levels of free fatty acids when compared to healthy pregnant controls. More investigation is needed to assess the potential role of free fatty acids in the prediction of gestational diabetes earlier in pregnancy. Hindawi 2019-08-18 /pmc/articles/PMC6721400/ /pubmed/31531374 http://dx.doi.org/10.1155/2019/7098470 Text en Copyright © 2019 Jose Rafael Villafan-Bernal et al. http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review Article
Villafan-Bernal, Jose Rafael
Acevedo-Alba, Mariana
Reyes-Pavon, Rodrigo
Diaz-Parra, Guillermo Andres
Lip-Sosa, Diana Lucia
Vazquez-Delfin, Hilda Imelda
Hernandez-Muñoz, Martha
Bravo-Aguirre, Daniel Ely
Figueras, Francesc
Martinez-Portilla, Raigam Jafet
Plasma Levels of Free Fatty Acids in Women with Gestational Diabetes and Its Intrinsic and Extrinsic Determinants: Systematic Review and Meta-Analysis
title Plasma Levels of Free Fatty Acids in Women with Gestational Diabetes and Its Intrinsic and Extrinsic Determinants: Systematic Review and Meta-Analysis
title_full Plasma Levels of Free Fatty Acids in Women with Gestational Diabetes and Its Intrinsic and Extrinsic Determinants: Systematic Review and Meta-Analysis
title_fullStr Plasma Levels of Free Fatty Acids in Women with Gestational Diabetes and Its Intrinsic and Extrinsic Determinants: Systematic Review and Meta-Analysis
title_full_unstemmed Plasma Levels of Free Fatty Acids in Women with Gestational Diabetes and Its Intrinsic and Extrinsic Determinants: Systematic Review and Meta-Analysis
title_short Plasma Levels of Free Fatty Acids in Women with Gestational Diabetes and Its Intrinsic and Extrinsic Determinants: Systematic Review and Meta-Analysis
title_sort plasma levels of free fatty acids in women with gestational diabetes and its intrinsic and extrinsic determinants: systematic review and meta-analysis
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6721400/
https://www.ncbi.nlm.nih.gov/pubmed/31531374
http://dx.doi.org/10.1155/2019/7098470
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