All-Trans Retinoic Acid Prevents the Progression of Gastric Precancerous Lesions by Regulating Disordered Retinoic Acid Metabolism.

Retinoic acid (RA) is the most biologically active metabolite of vitamin A and is important for stomach physiological function. However, little is known about the metabolic status of RA in human gastric lesions. From 2015 to 2018, 1,392 local residents in Lujiang County were recruited into a cross-sectional survey program, which included a questionnaire interview and blood collection. We detected the mRNA and protein expression of RA metabolism-relevant factors in gastric tissues from 68 local patients with gastric lesions. The effects of all-trans retinoic acid (ATRA) supplementation were investigated in a gastric precancerous lesions (GPLs) rat model. In the cross-sectional survey, no significant differences in the level of RA precursor (P > 0.05) between the H. pylori seronegative and seropositive residents were observed. However, the mRNA and protein expression of RA synthesizing enzymes (RDH10 and ALDH1A1) were significantly decreased and catabolic enzyme (CYP26B1) was significantly increased in the patients (P < 0.05). Consistently, in the GPL rat model, we observed a similar disorder; however, ATRA supplementation significantly not only corrected the disorder by increasing Rdh10, Aldh1a1 and decreasing Cyp26b1, but also reduced claudin-18 (P < 0.05). Our study suggested that RA metabolism is disrupted in individuals with gastric lesions, while ATRA supplementation can prevent GPL from progressing to gastric cancer.

All-trans retinoic acid suppressed GES-1 cell proliferation induced by exosomes from patients with precancerous lesions by arresting the cell cycle in S-phase.

We aimed to detect the expression of specific LncRNAs in exosomes isolated from the serum of patients with precancerous lesions and to study the effect of these serum exosomes on the activity of GES-1 cells in patients with precancerous lesions, as well as the activity of all-trans retinoic acid on GES-1 cells with or without the exosomes. Exosomes were extracted from the serum of patients with precancerous lesions and normal controls. Based on our previous sequencing results, quantitative real time-PCR was used to detect differentially expressed LncRNAs. Exosomes from the serum of patients with precancerous lesions were cocultured with GES-1 cells, and 5 µM all-trans retinoic acid was added as an intervention. Changes in cell viability and expression of LncHOXA10 were observed. Compared with the blank group, the proliferation activity of GES-1 cells cocultured with exosomes derived from the serum of patients with precancerous lesions was increased (P < 0.01), the proportion of cells in S phase was increased (P < 0.05). After adding 5 µM all-trans retinoic acid, the viability of cells decreased significantly (P < 0.01), the proportion of cells in S phase decreased significantly (P < 0.05). The expression of LncHOXA10 was decreased (P < 0.05). All-trans retinoic acid can conduct its chemopreventive effects by inhibiting the expression of LncHOXA10, thereby reducing the activity of LncHOXA10 in GES-1 cells cocultured with serum exosomes from patients with precancerous lesions.

Neurodevelopmental outcome at 1 year in offspring of women with gestational diabetes mellitus.

OBJECTIVE: To study the metabolic derangements in the second half of pregnancy caused by gestational diabetes mellitus(GDM), on the short term neurodevelopment of infants. DESIGN: A prospective cohort study of 555 mother-child pairs were recruited, which included 177 GDM patients and 378 pregnant women with normal glucose tolerance as controls. Clinical and demographic characteristics were obtained at enrollment, birth and follow-up. Neurodevelopment was examined with the Bayley Scales of Infant Development V.1 mental development index (MDI) and psychomotor development index (PDI). Fatty acids (FA) were analyzed by gas chromatography mass spectrometry (GC-MS). RESULTS: Statistically significant differences were found between the two groups in fasting plasma glucose (FPG) and triglyceride (TG). The scores of MDI and PDI of control group were higher than those of GDM group. The regression analysis showed that maternal age and saturated fatty acid (SFA) were independently associated with lower scores on the MDI whereas gestational age and docosahexaenoic acid (DHA) were associated with higher scores; in addition, lower scores on the PDI were associated with FPG and neonatal weigh associated with higher scores. CONCLUSION: SFA, DHA and FPG as indicators of lipid metabolism were associated with neurodevelopmental outcome at 1 year in offspring of women with gestational diabetes mellitus. Control the level of blood glucose and lipid during pregnancy and the appropriate supplementation of DHA during pregnancy in the second half of pregnancy may be beneficial to the neurodevelopment of infants.

Maternal prepregnancy overweight and obesity and the risk of preeclampsia: A meta-analysis of cohort studies.

OBJECTIVE: The aim of our meta-analysis was to explore whether overweight and obesity was associated with preeclampsia or not. DESIGN: Three databases were systematically reviewed and reference lists of relevant articles were checked. Meta-analysis of published cohort studies comparing whether overweight and obesity was associated with preeclampsia and adjusting for potential confounding factors. Calculations of pooled estimates were conducted in random-effects models. Heterogeneity was tested by using Chi-square test with Cochrane and heterogeneity was explored with meta-regression. Publication bias was estimated from Egger's test (linear regression method) and Begg's test (rank correlation method). RESULTS: Nineteen studies met the inclusion criteria. The meta-analysis showed that overweight and obesity was associated with an increased risk of preeclampsia. The aOR calculated for 13 studies (compared overweight to normal weight) was 1.71, 95% CI (1.52, 1.91) for random-effects models and 19 studies (compared obesity to normal weight) was 2.48, 95% CI (2.05, 2.90) for random-effects models, stratified analyses showed no differences regarding quality grade, location of study and period of anthropometric measurement. There was no indication of a publication bias either from the result of Egger's test or Begg's test. CONCLUSIONS: Our results suggested that prepregnancy maternal overweight and obesity are significantly associated with an increased risk of preeclampsia.

The Association between Advanced Maternal Age and Macrosomia: A Meta-Analysis.

PURPOSE: The aim of our meta-analysis was to explore whether advanced maternal age (AMA) is regarded as an important risk factor for predicting macrosomia or not. METHODS: Three databases were systematically reviewed and reference lists of relevant articles were checked. Meta-analysis of published cohort studies was done comparing whether AMA was associated with macrosomia and adjusting for potential confounding factors. Calculations of pooled estimates were conducted in random-effects models. Heterogeneity was tested by using chi-square test and I2 statistics. Publication bias was estimated from Egger's test (linear regression method) and Begg's test (rank correlation method). RESULTS: Twelve cohort studies met the inclusion criteria. The meta-analysis showed that AMA was associated with macrosomia as an important risk factor. The adjusted odds ratio calculated for 12 studies (compared aged 35-39 years to aged <30 years) was 1.42, 95% confidence interval (CI) (1.25-1.60) for random-effect model and 6 studies (compared aged ≥40 years to aged <30 years) was 1.40, 95% CI (1.02-1.78) for random-effect model. There was no indication of a publication bias either from the result of Egger's test or Begg's test. CONCLUSION: Regardless of the underlying mechanism, our finding indicated that AMA should be considered as an important risk factor for macrosomia. To adequately evaluate the clinical evolution of AMA, the effect of AMA on macrosomia need to be carefully assessed and monitored.

Downregulation of peroxisome proliferator-activated receptor gamma in the placenta correlates to hyperglycemia in offspring at young adulthood after exposure to gestational diabetes mellitus.

AIMS/INTRODUCTION: Children who are exposed to gestational diabetes mellitus (GDM) in utero are at high risk of developing related illnesses, such as type 2 diabetes mellitus in young adulthood, but the underlying mechanism and related predictive biomarkers are not known. MATERIALS AND METHODS: The present study identified the related biomarkers of hyperglycemia in young adults from the relationship between fetal blood glucose and placental lipid transporters at messenger ribonucleic acid (mRNA) and protein expression levels. We recruited patients from a prospective cohort, and determined the mRNA and protein levels of placental fatty acid transporters. Diet-induced mouse models of GDM were established, and the mRNA and protein levels of the same transporters in placentas were validated. RESULTS: Only the mRNA levels of peroxisome proliferator-activated receptor gamma correlated with the levels of neonatal blood glucose in GDM patients using linear regression and Spearman's correlation analyses (r = 0.774, P = 0.001). The mRNA levels of peroxisome proliferator-activated receptor gamma, matrix metalloproteinase-2 and fatty acid transport protein-6 correlated with blood glucose levels in mouse offspring (r = 0.82, P = 0.001, r = 0.737, P = 0.006 and r = -0.891, P = 0.001, respectively) at young adulthood using the same analyses. Notably, we observed significantly higher blood glucose levels in GDM offspring at 12 weeks-of-age compared with the control and rosiglitazone-supplemented groups (P < 0.05). CONCLUSIONS: The downregulation of peroxisome proliferator-activated receptor gamma in the placenta might predict hyperglycemia in offspring at young adulthood.

Eating problems and associated factor among 1 873 preschool children in Hefei / 中国学校卫生

Objective@#To explore the prevalence of eating problems of preschool children in Hefei and its influencing factors, and to provide references for reducing the occurrence of dietary behavior problems of local children and strengthening the construction of children nutrition clinic in maternal and children health care institutions.@*Methods@#A total of 1 873 children aged 3-6 years in urban and rural areas of Hefei were selected by random cluster sampling. Demographic and eating behavior of the child, as well as caregiver’s feeding behavior were investigated.@*Results@#The study found that 72.77% of children had eating problems. The feeding behavior of feeders and the family environment factors had an impact on children’s eating behavior problems, and the main influencing factors of children’s eating behavior included father’s education level, family economic monthly income level, family members’ eating behavior problems, number of children living together and whether they are the only-child in the family(P<0.05).@*Conclusion@#The prevalence of eating problems of children aged 3-6 years in Hefei is higher. Family demographic, caregiver feeding behavior, as well as the environment of the family affect children’s eating behavior. Child nutrition clinics, promotion of caregivers’feeding practices could be effective interventions aiming to address eating problems among preschool children.

Impairment of learning and memory of mice offspring at puberty, young adulthood, and adulthood by low-dose Cd exposure during pregnancy and lactation via GABAAR α5 and δ subunits.

Cadmium (Cd) is a pervasive carcinogen and environmental endocrine disruptor. We studied the changes in learning and memory of offspring mice, whose mothers were exposed to 10 mg Cd/L via the drinking water during pregnancy and lactation period, as well as the changes of testosterone and estrogen levels, serum Cd levels, the histopathological changes and the changes in the mRNA and protein levels of different subunits of γ-aminobutyric acid receptor subtype A subunits (GABAARs) in the hippocampus at the prepuberty, puberty, young adult, and adult stages. At birth, Cd had no obvious effect on mice offspring as statistically accessed based on their body weight, body length, and tail length (all p > 0.05). After grouped, the serum Cd levels increased in the three exposed groups more than in the normal control group at stages (all p < 0.05). Only serum estradiol of female offspring at age 7 weeks was significantly decreased compared with other groups (all p < 0.05). Histopathological results showed that the arrangement of the cells in hippocampal CA1 area of mice offspring was significantly sparse in the exposed groups compared with the control group. At 5 and 7 weeks, two Cd-exposed groups showed prolonged escape latency and exploring time for the platform compared with the normal group in the Morris water maze (all p < 0.05). Only increased protein expression of GABAARα5 was found in the Cd group at these two ages. At age 12 weeks, similar impaired learning and memory of female mice, and decreased protein expression of GABAARδ was found in Cd-exposed groups. Collectively, low-dose Cd had no effect on the growth of mice offspring but affected their learning and memory, especially female offspring, at puberty, young adulthood, and adulthood through changed structure in the hippocampal CA1 area and protein expression of GABAARα5 and GABAARδ.

Serum Concentrations of 15 Elements Among Helicobacter Pylori-Infected Residents from Lujiang County with High Gastric Cancer Risk in Eastern China.

Helicobacter pylori (H. pylori) infection can interfere with the absorption of most elements, and the variations of some element levels are related to the incidence of gastric cancer. However, there have been conflicting results concerning the influence of H. pylori infection on serum element levels. The present study aimed to compare the serum element concentrations of H. pylori-infected local residents with uninfected residents from Lujiang County with high gastric cancer risk in Eastern China. We used data and serum samples from the H. pylori screening-survey program which was a cross-sectional study. We took 155 samples randomly from the screening survey, identified 74 H. pylori-positive residents and 81 H. pylori-negative residents by a serological test. The serum concentrations of 15 elements (calcium, magnesium, iron, zinc, selenium, copper, molybdenum, chromium, cobalt, nickel, lead, cadmium, mercury, arsenic, and aluminum) were determined using inductively coupled plasma mass spectrometry. Serum cobalt was found at higher levels in the H. pylori-infected residents than the H. pylori-uninfected residents (0.246 vs 0.205 µg/L, P = 0.022), but no statistically significant differences in the serum levels of other elements were found. This is the first study to report the serum concentrations of 15 elements and their relationships with the infection status of H. pylori among local residents from Lujiang County with high gastric cancer risk. Although the International Agency for Research on Cancer has classified cobalt and other soluble cobalt salts as possibly carcinogenic to human beings, our results may provide a clue to the relationships between cobalt, H. pylori, and gastric cancer.

Maternal pre-pregnancy obesity and the risk of macrosomia: a meta-analysis.

PURPOSE: The aim of our meta-analysis was to explore whether pre-pregnancy obesity is regarded as an important risk factor for predicting macrosomia or not. METHODS: Three databases were systematically reviewed and reference lists of relevant articles were checked. Meta-analysis of published cohort studies comparing whether pre-pregnancy obesity was associated with macrosomia and adjusting for potential confounding factors. Calculations of pooled estimates were conducted in random-effect model. Heterogeneity was tested by using Chi-square test and I 2 statistics. Publication bias was estimated from Egger's test (linear regression method) and Begg's test (rank correlation method). RESULTS: Sixteen cohort studies met the inclusion criteria. The meta-analysis showed that pre-pregnancy obesity was associated with macrosomia as an important risk factor. The adjusted odds ratio was 1.93, 95% CI (1.65, 2.27) in random-effect model, stratified analyses showed no differences regarding different quality grade, definition of macrosomia, location of study and number of confounding factors adjusted for. There was no indication of a publication bias either from the result of Egger's test or Begg's test. CONCLUSION: Our findings indicated that pre-pregnancy obesity should be considered as an important risk factor for macrosomia. The effect of pre-pregnancy obesity on macrosomia need to be carefully assessed and monitored.

Maternal and cord blood fatty acid patterns with excessive gestational weight gain and neonatal macrosomia.

BACKGROUND AND OBJECTIVES: This study evaluated the association of maternal excessive gestational weight gain with saturated and polyunsaturated fatty acid concentrations in maternal and cord serum. METHODS AND STUDY DESIGN: We included 77 pairs of women and their newborns and classified them into three groups as follows: mothers with normal gestational weight gain and their babies with normal birth weight in group I (30 pairs), mothers with excessive gestational weight gain and their babies with normal birth weight in group II (30 pairs), and mothers with excessive gestational weight gain and their macrosomic babies in group III (17 pairs). Serum fatty acid concentrations were determined through gas chromatography-mass spectrometry. RESULTS: No remarkable difference in maternal dietary intake was observed among the three groups. C16:0, C18:0, eicosapentaenoic acid, and docosahexaenoic acid concentrations were significantly higher in group III mothers than in group I mothers. Compared with group I neonates, total saturated and polyunsaturated fatty acid concentrations were significantly lower but total n-3 polyunsaturated fatty acid and docosahexaenoic acid concentrations were significantly higher in group II neonates (p<0.05). The n-6: n-3 ratio in maternal and cord serum was approximately 10:1 and 1.5:1, respectively. CONCLUSION: Women with excessive gestational weight gain who deliver a macrocosmic neonate tend to have higher total saturated fatty acid concentrations but lower docosahexaenoic acid concentrations in their neonate cord serum. Fatty acid concentrations in maternal and cord serum are not associated with maternal dietary pattern.

Calorie restriction prevents the development of insulin resistance and impaired lipid metabolism in gestational diabetes offspring.

BACKGROUND: Gestational diabetes mellitus (GDM) has long-lasting influence on offspring, which is associated with increased risks of insulin resistance, obesity, and type II diabetes mellitus. Calorie restriction (CR) is one of the most common and available nutritional interventions to prevent obesity and diabetes. We are trying to explore the effect of CR on GDM offspring. METHODS: The streptozotocin was used to stimulate C57BL/6J mice to develop GDM, a number of metabolic characteristics and related protein expressions were determined in GDM offspring that were fed ad-libitum or treated with calorie restriction. RESULTS: CR reduced body weight and glucose levels in GDM offspring. CR modulated the lipid metabolism by decreasing triglyceride and cholesterol levels in plasma. We also found that the effect of CR on insulin sensitivity may involve in signaling pathway through the regulations of phosphatase and tensin homologue deleted on chromosome 10 (PTEN) and protein kinase B (Akt). CONCLUSION: GDM is a high risk factor for GDM offspring to develop insulin resistance, while CR could ameliorate this adverse outcome. Moreover, the specific decrease in PTEN activation and increase in Akt phosphorylation in livers of GDM offspring with CR improved insulin sensitivity and lipid metabolism.

Prognostic value of the expression of cancer stem cell-related markers CD133 and CD44 in hepatocellular carcinoma: From patients to patient-derived tumor xenograft models.

High expression of cancer stem cell (CSC) markers is related to poor prognosis of patients with hepatocellular carcinoma (HCC). However, the expression of these markers in patient-derived xenograft (PDX) models and the relationship of the expression levels of these markers between HCC patients and their PDX models at subsequent low passages are unclear. To investigate the prognostic impact of putative CSC markers in patients with HCC and in related PDX models, the expression of CD133, CD90, CD44, ALDH1, CK7, CK19, OCT4, SOX2, vimentin, nestin, CD13 and EpCam were assessed by quantitative reverse transcription-PCR (qRT-PCR) and then were validated using immunohistochemistry in tumor or peritumoral tissues from patients and tumor tissues from PDX models. Cumulative survival analysis of the patients and animals was conducted using the Kaplan-Meier method and the log-rank test. Only the expression levels of CD133 and CD44 were higher in tumor tissues than in the peritumoral tissues of HCC patients by qRT-PCR. High consistency of the prognostic value of the expression of CD133/CD44 was observed in HCC patients and the PDX models. High expression levels of CD133 and CD44 were positively related to the poor prognosis of HCC patients and to that in the PDX models. PDX HCC models in the present study have been suggested to be predictive of disease outcome, which could shed light on personalized medicine and the mechanisms of CSC marker expression on prognosis.

Excessive weight gain during pregnancy and risk of macrosomia: a meta-analysis.

PURPOSE: This meta-analysis aimed to estimate the relation between excessive gestational weight gain and macrosomia. METHODS: We performed a meta-analysis by searching PubMed, EMBASE and the Cochrane library for English-language literature from inception to 1 October 2014. Studies assessing the relationship between excessive gestational weight gain and macrosomia were included. Characteristics including study design, country, sample size, definition of macrosomia, adjusted odds ratios, CIs and adjustment factors were extracted independently by two reviewers. Summary odds ratios were calculated by using a random-effects model meta-analysis. RESULTS: 15 relevant articles were eligible for the meta-analysis. Incorporated by random-effect model before the heterogeneity tests, the value of OR was 2.35 (95 % CI: 1.95, 2.85). Stratified analysis showed no differences regarding different study design, definition of macrosomia and location of study. There was no indication of a publication bias either from the result of Egger's test (P = 0.572) or Begg's test (P = 0.572). CONCLUSIONS: Our meta-analysis indicated that excessive gestational weight gain might increase the risk of macrosomia.

[Influence of sedentary behavior on weight retention among postpartum women within one year after childbirth].

OBJECTIVE: To identify the risk factors that affect the postpartum weight retention among women and provide evidence for the prevention of obesity and metabolic disorders due to childbirth. METHODS: The baseline data were collected from 1 220 postpartum women who had given childbirth 42 days ago in Hefei Maternal and Child Health Care Center, Anhui province. Their pre-pregnancy weight, weight gain during pregnancy and childbirth information were obtained from local maternal information management system, and the follow up for the women were conducted at 3, 6, 9, and 12 months after childbirth. The sedentary behaviors of the women were observed. The relationship between postpartum weight retention and sedentary behavior of the women were analyzed by mixed-effects model analysis and repeated measures analysis of variance. RESULTS: The pre-pregnancy average body weight (kg) of the women was (53.22 ± 6.88), and their postpartum average body weight retention was (7.85 ± 5.11), (7.51 ± 5.40), (5.79 ± 5.18), (4.42 ± 4.91) and (3.26 ± 4.65) at 42 days, 3, 6, 9, 12 months later after childbirth, respectively. The differences in body weight retention at different times after childbirth indicated by repeated measures analysis of variance were statistical significant (P < 0.001). Mixed-effects model analysis showed the postpartum sedentary behavior and postpartum body weight retention was statistically associated after adjusting for pre-pregnancy BMI, feeding pattern, delivery mode and other confounding factors (P < 0.001), Mixed-effects model analysis results tended to be stable after step by step adjustment for confounding factors. CONCLUSION: The results of this study suggested that postpartum sedentary behavior is one of the important factors influencing postpartum weight retention.

Weight gain in pregnancy, maternal age and gestational age in relation to fetal macrosomia.

To investigate the possible risk factors related to macrosomia. Pregnant women and their newborns (n = 1041) were recruited from a cohort study in Maternal and Child Care Center of Hefei from January 2011 to July 2012. Questionnaires were applied to collect the demographic data besides the medical records. Detailed health records of the entire pregnancy were obtained using retrospective study. Meanwhile the data of neonatal outcomes was prospectively tracked. Associations between exposure risk factors and macrosomia were analyzed using Pearson's chi squared test. Logistic regression models were used to assess the independent association between these potential predictors and macrosomia. The incidence of macrosomia of this cohort was 11.24% of which male: female = 2.55:1. Male incidence (8.07%) of macrosomia was higher than female (3.17%), p < 0.001. Body mass index (BMI) before pregnancy (pre-BMI), maternal height, parity were not independently associated with macrosomia; multiple logistic regression analysis indicated that macrosomia was mainly independently associated with weight gain in pregnancy (OR=1.14, 95% CI [1.10-1.19]), maternal age (OR = 1.09, 95% CI [1.03-1.15]) and gestational age (OR = 1.62, 95% CI [1.31-1.99]), respectively. Our findings indicate that weight gain in pregnancy, maternal age and gestational age should be considered as independent risk factors for macrosomia.

Breast-feeding and postpartum weight retention: a systematic review and meta-analysis.

OBJECTIVE: Weight gained during pregnancy and postpartum weight retention might contribute to obesity in women of childbearing age. Whether breast-feeding (BF) may decrease postpartum weight retention (PPWR) is still controversial. The purpose of our systematic review and meta-analysis was to investigate the relationship between BF and PPWR. DESIGN: Three databases were systematically reviewed and the reference lists of relevant articles were checked. Meta-analysis was performed to quantify the pooled standardized mean differences (SMD) of BF on PPWR by using a random-effect model. Heterogeneity was tested using the χ 2 test and I 2 statistics. Publication bias was estimated from Egger's test (linear regression method) or Begg's test (rank correlation method). RESULTS: Among 349 search hits, eleven studies met the inclusion criteria for the meta-analysis. Seven studies were conducted in the USA, one in Brazil, one in France, one in Georgia and one in Croatia. Compared with formula-feeding, BF for 3 to ≤6 months seemed to have a negative influence on PPWR and if BF continued for >6 months had little or no influence on PPWR. In a subgroup meta-analysis, the results did not change substantially after the analysis had been classified by available confounding factors. There was no indication of a publication bias from the result of either Egger's test or Begg's test. CONCLUSIONS: Although the available evidence held belief that BF decreases PPWR, more robust studies are needed to reliably assess the impact of patterns and duration of BF on PPWR.

Maternal serum lipid levels during late pregnancy and neonatal body size.

OBJECTIVE: The aim of this study was to determine the predictive value of maternal serum lipid levels during late pregnancy for neonatal body size. METHODS: This study was conducted from January 1, 2011 to July 31, 2012 at a Maternal and Child Health Hospital. Fasting blood glucose, serum triglyceride, total cholesterol, HDL and LDL were estimated in maternal collected before delivery. Detailed anthropometry of the neonates was performed. RESULTS: Women who delivered a large for gestational age baby were older, taller, had a higher pre-pregnancy weight, higher pre-pregnancy BMI, and higher weight gain during pregnancy than women who delivered an appropriate for gestational age infant. After adjusting for maternal age, pre-pregnancy BMI, weight gain during pregnancy, parity, neonatal sex and gestational age at delivery, we found that only maternal HDL level was inverse associated with birth weight, length and head circumference (p<0.05). On logistic regression analysis, the significant metabolic predictors of large for gestational age was HDL (OR 0.57, 95%CI: 0.38-0.84, per 1 mmol/L increase) after adjusting for the confounders. CONCLUSIONS: Maternal serum HDL level determined in maternal blood taken close to delivery was independently associated with neonatal size and was the independent predictor for large for gestational age.

Is gestational diabetes mellitus an independent risk factor for macrosomia: a meta-analysis?

PURPOSE: The aim of our meta-analysis was to explore whether gestational diabetes mellitus (GDM) is an independent risk factor for macrosomia or not. METHODS: Three databases were systematically reviewed and reference lists of relevant articles were checked. Meta-analysis of published epidemiological studies (cohort and case-control studies) comparing whether GDM was associated with macrosomia. Calculations of pooled estimates were conducted in random-effect models. Heterogeneity was tested by using Chi square test and I (2) statistics. Publication bias was estimated from Egger's test (linear regression method) and Begg's test (rank correlation method). RESULTS: Twelve studies met the inclusion criteria, including five cohort studies and seven case-control studies. The meta-analysis showed that GDM was associated with macrosomia independent of other risk factors. The adjusted odds ratio was 1.71, 95% CI (1.52, 1.94) in random-effect model, stratified analyses showed no differences regarding different study design, quality grade, definition of macrosomia, location of study and number of confounding factors adjusted for. There was no indication of a publication bias either from the result of Egger's test or Begg's test. CONCLUSION: Our findings indicate that GDM should be considered as an independent risk factor for newborn macrosomia. To adequately evaluate the clinical evolution of GDM need to be carefully assessed and monitored.

Longitudinal effects of psychological symptoms on non-suicidal self-injury: a difference between adolescents and young adults in China.

PURPOSE: Few longitudinal studies have examined the psychological symptoms that may lead to non-suicidal self-injury (NSSI) among Chinese adolescents and young adults. This study determined the predictive effects of psychological symptoms for NSSI during a 9-month follow-up period. METHODS: Data from 17,622 students, 12-24 years of age, were analyzed in a cross-sectional fashion with respect to associations between psychological symptoms and NSSI. Follow-up surveys were performed 3, 6, and 9 months later. Incident cases of NSSI during follow-up were correlated with the psychological symptoms at baseline. RESULTS: A total of 3,001 (17.0%) students reported that they had NSSI in the 12 months before the initial assessment. The total rate of NSSI revealed no statistically significant differences by gender, but marked differences between grades. The response rate 3, 6, and 9 months later was 91.8, 81.8, and 79.1%, respectively. Our cross-sectional study demonstrated statistically significant associations between emotional problems, conduct problems, social adaptation problems, psychological problems, and NSSI (P < 0.01). In the longitudinal study, emotional problems, conduct problems, social adaptation problems, and psychological problems at baseline had statistically significant associations with incident NSSI in follow-up involving the adolescents, while the association in young adults was attenuated after adjustment for confounding variables. Moreover, psychological symptoms at baseline showed a monotonic dose-response relationship with NSSI in follow-up involving adolescents. CONCLUSIONS: The findings suggest that adolescents with psychological symptoms are a group with elevated risks for later NSSI. The prevention programs of NSSI should target attenuating the severity of psychological symptoms.