Associations of maternal serum concentration of iron-related indicators with birth outcomes in Chinese: a pilot prospective cohort study.

BACKGROUND: Previous studies of maternal iron and birth outcomes have been limited to single indicators that do not reflect the comprehensive relationship with birth outcomes. We aimed to investigate the relationship between maternal iron metabolism and neonatal anthropometric indicators using comprehensive iron-related indicators. METHODS: A total of 914 Chinese mother-child dyads were enrolled in this prospective study. Subjects' blood samples were collected at ≤ 14 weeks of gestation. Serum concentrations of iron-related indicators were measured by enzyme-linked immunosorbent assay (ELISA). Femur length was measured by B-ultrasound nearest delivery. Neonatal anthropometric indicators were collected from medical records. RESULTS: After adjustment for potential covariates, higher iron (per one standard deviation, SD increase) was detrimentally associated with - 0.22 mm lower femur length, whereas higher transferrin (per one SD increase) was associated with 0.20 mm higher femur length. Compared with normal subjects (10th-90th percentiles), subjects with extremely high (> 90th percentile) iron concentration were detrimentally associated with lower femur length, birth weight, and chest circumference, and a higher risk of low birth weight, LBW (HR: 3.92, 95%CI: 1.28, 12.0). Subjects with high concentration of soluble transferrin receptor, sTFR and transferrin (> 90th percentile) were associated with higher femur length. Subjects with low concentration of iron and ferritin concentrations (< 10th percentile) were associated with a higher risk of LBW (HR: 4.10, 95%CI: 1.17, 14.3) and macrosomia (HR: 2.79, 95%CI: 1.06, 7.35), respectively. CONCLUSIONS: Maternal iron overload in early pregnancy may be detrimentally associated with neonatal anthropometric indicators and adverse birth outcomes.

[Effect of ROUX-en-Y anastomosis and Billroth-II anastomosis after subtotal gastrectomy on blood glucose in type 2 diabetic patients].

OBJECTIVE: To evaluate the effect of ROUX-en-Y anastomosis and Billroth-II anastomosis after subtotal gastrectomy on blood glucose in patients with type 2 diabetes. METHODS: From January 2006 to December 2009, 26 and 24 type 2 diabetic patients underwent subtotal gastrectomy for gastric cancer or gastric ulcer and received subsequent ROUX-en-Y anastomosis and Billroth-II anastomosis, respectively. Perioperative and postoperative blood glucose and glycosylated hemoglobin (HbA1c) were detected in these patients to identify the variations. RESULTS: In ROUX-en-Y group, the fasting blood glucose (FBG) of the patients decreased significantly in the first month after the operation (t=4.46, P<0.05), and the 2-hour postprandial glucose (2hPG) and HbA1c also underwent significant reductions in the first postoperative week and month, respectively (t=3.5, P<0.05; t=2.21, P<0.05). In Billroth-II group, the FBG decreased significantly till 6 months after the operation (t=2.0, P<0.05), and HbA1c reduction occurred 3 months after the operation (t=2.61, P<0.05). There were significant differences in FBG in the first postoperative month, 2hPG in the 6th month, and HbA1c in the 3rd month between the two groups (P<0.05). CONCLUSION: The ROUX-en-Y anastomosis and Billroth-II anastomosis after subtotal gastrectomy can both reduce blood glucose of type 2 diabetic patients, but the former approach has better effect.