Early Biomarkers of Neurodevelopment in Offspring of Diabetic Mothers (GD-BRAIN)

Early Biomarkers of Neurodevelopment in Offspring of Diabetic Mothers (GD-BRAIN)

The prospective multicenter study GD-Brain provides a better knowledge on the basis of neurological impairment in children born to mothers with gestational diabetes (GDM). GDM modifies placental structure and affect materno-fetal nutrient transfer. Docosahexaenoic acid (DHA) play an important role on neurodevelopment, and it is reduced in venous cord blood of newborns born to GDM. In previous studies, we have already demonstrated impaired DHA fetal levels not only using label fatty acids with stable isotopes administrated to pregnant women, but also in observational studies in GDM as the prevention of obesity study (PREOBE study) in Granada and other similar study in Murcia. The impaired cord DHA levels were associated to disturbed neurodevelopment in these children during the first year of life. However, it is uncertain the mechanisms underlying this impaired materno-fetal DHA transfer and implications for later life.

The recent publication in Nature Journal of a selective transmembrane carrier for DHA in brain named "major facilitator superfamily domain 2a" (MFSD2a) open new expectations. We detected disturbed MFSD2a levels in placentas from GDM which could be due to structural problems in this organ; inflammation, oxidation and metabolic changes related to diabetes might affect MFSD2a activity. Moreover, it is difficult to know whether disturbed MFSD2a levels in placenta may also indicate altered levels of this carrier in the brain from children born to GDM mothers, which could contribute to neurodevelopment impairment in these subjects. Recent studies also indicate that obesity alters the biosynthesis of eicosanoids derived from DHA, with a decrease of protectins and resolvin of D-series, which have powerful anti-inflammatory properties.

The main aim of this study is to analyse potential differences on neurodevelopment, and brain structure and functioning, in children 8 years old born to GDM respect to those born to healthy normoweight mothers, as well as to identify early biomarkers consistently related to neurodevelopment from early stages of life.

Study Overview

• Status: Unknown
• Conditions: Neurodevelopmental Disorders; Gestational Diabetes Mellitus in Childbirth

Detailed Description

We will contact to participants from the PREOBE study and Murcia's cohorts study to get involved a total of 174 children at 8 years of age. The results from neurodevelopment evaluation by neuropsychological testing, neurological functions rhythms and neuroimaging (fMRI and DTI) at 8 years old will be associated to clinical and metabolic data recorded during pregnancy.

As secondary aim, we would discern whether the decrease on DHA levels in offspring of GDM at birth is associated to disturbed neurodevelopment at 8 years old.

The impact of maternal diabetes on placental MFSD2a and children's resolvin and protectins derived from DHA will be measured in urine samples at 8 years old.

Gut microbiota composition and function will be also studied to detect its role in the potential disturbances regarding the production of anti-inflammatory mediators.

A part from the clinical study, we will perform an intervention trial using animal models. Gestational rats with diabetes and control rats will be treated with antioxidants and adipoRon in order to delay neuro-degeneration in these animals because of the diabetes, as well as their influence on MFSD2a levels in placenta and brain. All these studies may provide to the industry of valuable information to improve nutritional supplements during gestation or infancy to avoid potential delay of cognitive functions in offspring of diabetic mothers.

• Study Type: Observational
• Enrollment (Anticipated): 174

Contacts and Locations

Study Locations

• Spain
  • Murcia, Spain, 30100
    • Recruiting
    • Elvira Larqué
    • Contact: Elvira Larqué, Dr; Phone Number: 0034868884239; Email: elvirada@um.es
    • Contact: Cristina Campoy, MD; Phone Number: 0034958240740; Email: ccampoy@ugr.es

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 8 years to 9 years (Child)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Probability Sample

Study Population

174 Children born between 2008-2011 from 2 previous studies:

• PREOBE study from the University of Granada
• GDM Murcia study from the University of Murcia

Description

Inclusion Criteria:

• Children from healthy pregnancies and GDM pregnancies from the ^PREOBE study and GDM Murcia study.

Exclusion Criteria:

-

Study Plan

How is the study designed?

Design Details

• Observational Models: Case-Control
• Time Perspectives: Prospective

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort
Control; Children at 8 years old born from healthy pregnancies
GDM; Children at 8 years old born from mothers with gestational diabetes during pregnancy

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Neuropsychological battery	Neuropsychological battery to cover different neuropsychological domains: processing speed, memory, attention, language, executive functions, and behaviour (parent-completed measure).	8 years old
Neuroimaging ( functional MRI)	Anatomical magnetic resonance imaging (fMRI)	8 years
Electroencephalography (EEG)	Stereotyped electrophysiological response to several external stimulus	8 years

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Fatty acids	Fatty acid profile in oral mucose	8 years old
Metabolomic	Prostaglandins, thromboxans, isoprostanes, resolvin in urine samples	8 years old

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Microbiome	Metagenome	8 years old
Maturation of circadian rhythm	Analysis of the circadian rhythm of temperature, activity and sleep	8 years old
Nutritional evaluation	Dietary assessment by food frequency questionnaire and by 3 day of dietary record	8 years old
Physical activity	questionnaires	8 years old
Physical Activity	Accelerometers will be used also to record activity of the subjects	8 years old

Collaborators and Investigators

• Sponsor: Universidad de Murcia
• Collaborators: Universidad de Granada
• Investigators: Principal Investigator: Elvira Larqué, Dr., Universidad de Murcia; Principal Investigator: Cristina Campoy, MD, Universidad de Granada

Study record dates

Study Major Dates

• Study Start: January 1, 2016
• Primary Completion (Anticipated): December 1, 2020
• Study Completion (Anticipated): December 1, 2020

Study Registration Dates

• First Submitted: January 13, 2017
• First Submitted That Met QC Criteria: January 23, 2017
• First Posted (Estimate): January 26, 2017

Study Record Updates

• Last Update Posted (Estimate): January 26, 2017
• Last Update Submitted That Met QC Criteria: January 23, 2017
• Last Verified: January 1, 2017

More Information

Terms related to this study

• Keywords: Gut microbiota; Neurodevelopment; Gestational diabetes; Placenta; Protectins; MFSD2a; AdipoRon
• Additional Relevant MeSH Terms: Mental Disorders; Glucose Metabolism Disorders; Metabolic Diseases; Endocrine System Diseases; Diabetes Mellitus; Pregnancy Complications; Neurodevelopmental Disorders; Diabetes, Gestational
• Other Study ID Numbers: SAF2015-69265

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No