Maternal Adipose Tissue and Placental Dysfunction Programs the Fetus for Type 2 Diabetes (PlacentA-DM) (PlacentA-DM)
24 de abril de 2018 atualizado por: AdventHealth Translational Research Institute
The purpose of this study is to discover the characteristics of pregnant women which increases risk for their babies to develop diabetes, later on in life.
Visão geral do estudo
Status
Concluído
Condições
Descrição detalhada
Obesity has been recently diagnosed in a younger population and currently in the United States more than two thirds of women of childbearing age are overweight or obese. These women will have children at high risk for developing obesity and Type 2 diabetes (T2DM). There is an acute need for preventing these complications in children so that we can break the cycle of obesity and T2DM. Numerous interventions have attempted but failed to improve outcomes in obese pregnancies by weight loss. Clinicians do not currently have specific recommendation for identifying the obese mothers and risk and for the prevention of infant's complication in healthy obese pregnancies.
The global objective of this study is to identify the relevant maternal phenotype at risk and the mechanism(s) of fetal environment predisposing the offspring for T2DM. This will enhance T2DM early screening and prevention.
The global hypothesis is that dysfunctional adipose tissue secretes angiostatic and pro-inflammatory factors that lead to the formation of a dysfunctional placenta, which through a hypoxic and inflamed environment alters the epigenome to program the fetus for T2DM.
Tipo de estudo
Observacional
Inscrição (Real)
3
Contactos e Locais
Esta seção fornece os detalhes de contato para aqueles que conduzem o estudo e informações sobre onde este estudo está sendo realizado.
Locais de estudo
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Florida
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Orlando, Florida, Estados Unidos, 32804
- Translational Research Institute for Metabolism and Diabetes
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Critérios de participação
Os pesquisadores procuram pessoas que se encaixem em uma determinada descrição, chamada de critérios de elegibilidade. Alguns exemplos desses critérios são a condição geral de saúde de uma pessoa ou tratamentos anteriores.
Critérios de elegibilidade
Idades elegíveis para estudo
18 anos a 40 anos (Adulto)
Aceita Voluntários Saudáveis
Sim
Gêneros Elegíveis para o Estudo
Fêmea
Método de amostragem
Amostra Não Probabilística
População do estudo
Vulnerable populations- Pregnant Women, Fetuses and Neonates
Propose to study pregnant women in order to determine the relevant phenotype with offspring at risk for obesity and T2DM.
Descrição
Pregnant women Inclusion Criteria:
- Pregnant women undergoing planned cesarean section at 39 weeks of gestation due to: a) elective cesarean section; b) breach presentation c) repeat cesarean section (the rationale for choosing these women is to select only women that have no other risk factors or complications during pregnancy that might affect the outcome)
- Age between 18 and 40 years old
- Pre-pregnancy BMI between 20 and 25 kg/m2 (lean) and >30 kg/m2 (obese)
- Singleton pregnancies
- Allowing their neonates to participate in the trial
Pregnant women Exclusion Criteria:
- Taking any medication except pre-natal vitamins and medication to treat normal symptoms of pregnancy like: constipation, nausea, vomiting, gastric reflux, insomnia and pain.
- Type 1 diabetes, type 2 diabetes or gestational diabetes; chronic or gestational hypertension
- Pre-eclampsia, eclampsia during this pregnancy
- Liver, kidney, thyroid disease, cancer
- Smoking or using illegal drugs or alcohol during this pregnancy
- Fetal umbilical blood and/or placenta are collected for another reason, i.e. parents decide on cord blood storage
Neonate Inclusion criteria:
- Live neonates born to the study participating mothers
Neonate exclusion criteria:
- Neonate distress as to require admission to the Neonatal Intensive Care Unit.
Plano de estudo
Esta seção fornece detalhes do plano de estudo, incluindo como o estudo é projetado e o que o estudo está medindo.
Como o estudo é projetado?
Detalhes do projeto
Coortes e Intervenções
Grupo / Coorte |
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ObeseDYS
Obese subjects with dysfunctional vascularization and inflammation of placenta.
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ObeseNL
Obese subjects with normal vascularization and inflammation of placenta
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LeanNL
Lean subjects with normal vascularization and inflammation of placenta.
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O que o estudo está medindo?
Medidas de resultados primários
Medida de resultado |
Descrição da medida |
Prazo |
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Quantity of Blood Vessels and Capillaries
Prazo: Visit 3, at 39 weeks
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Measurements will be immunohistochemistry and measured from placental tissue.
Neonate's anthropometrics and sex will be recorded within 48 hours of the delivery by the Pediatrician and will last approximately 15 minutes.
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Visit 3, at 39 weeks
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Quantity of macrophages
Prazo: Visit 3 at 39 weeks + 1 day
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Measured by immunohistochemistry, flow cytometry (FACS) of placental tissue
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Visit 3 at 39 weeks + 1 day
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Colaboradores e Investigadores
É aqui que você encontrará pessoas e organizações envolvidas com este estudo.
Patrocinador
Colaboradores
Investigadores
- Investigador principal: Steven R Smith, MD, Translational Research Institute for Metabolism and Diabetes
Publicações e links úteis
A pessoa responsável por inserir informações sobre o estudo fornece voluntariamente essas publicações. Estes podem ser sobre qualquer coisa relacionada ao estudo.
Publicações Gerais
- Vucetic Z, Kimmel J, Reyes TM. Chronic high-fat diet drives postnatal epigenetic regulation of mu-opioid receptor in the brain. Neuropsychopharmacology. 2011 May;36(6):1199-206. doi: 10.1038/npp.2011.4. Epub 2011 Feb 16.
- Catalano PM, Farrell K, Thomas A, Huston-Presley L, Mencin P, de Mouzon SH, Amini SB. Perinatal risk factors for childhood obesity and metabolic dysregulation. Am J Clin Nutr. 2009 Nov;90(5):1303-13. doi: 10.3945/ajcn.2008.27416. Epub 2009 Sep 16.
- Catalano PM, Presley L, Minium J, Hauguel-de Mouzon S. Fetuses of obese mothers develop insulin resistance in utero. Diabetes Care. 2009 Jun;32(6):1076-80. doi: 10.2337/dc08-2077.
- Ling C, Groop L. Epigenetics: a molecular link between environmental factors and type 2 diabetes. Diabetes. 2009 Dec;58(12):2718-25. doi: 10.2337/db09-1003. No abstract available.
- Aagaard-Tillery KM, Grove K, Bishop J, Ke X, Fu Q, McKnight R, Lane RH. Developmental origins of disease and determinants of chromatin structure: maternal diet modifies the primate fetal epigenome. J Mol Endocrinol. 2008 Aug;41(2):91-102. doi: 10.1677/JME-08-0025. Epub 2008 May 30.
- Dabelea D, Crume T. Maternal environment and the transgenerational cycle of obesity and diabetes. Diabetes. 2011 Jul;60(7):1849-55. doi: 10.2337/db11-0400. No abstract available.
- Sullivan EL, Smith MS, Grove KL. Perinatal exposure to high-fat diet programs energy balance, metabolism and behavior in adulthood. Neuroendocrinology. 2011;93(1):1-8. doi: 10.1159/000322038. Epub 2010 Nov 13.
- Crume TL, Ogden L, Daniels S, Hamman RF, Norris JM, Dabelea D. The impact of in utero exposure to diabetes on childhood body mass index growth trajectories: the EPOCH study. J Pediatr. 2011 Jun;158(6):941-6. doi: 10.1016/j.jpeds.2010.12.007. Epub 2011 Jan 15.
- Dabelea D, Mayer-Davis EJ, Lamichhane AP, D'Agostino RB Jr, Liese AD, Vehik KS, Narayan KM, Zeitler P, Hamman RF. Association of intrauterine exposure to maternal diabetes and obesity with type 2 diabetes in youth: the SEARCH Case-Control Study. Diabetes Care. 2008 Jul;31(7):1422-6. doi: 10.2337/dc07-2417. Epub 2008 Mar 28.
- Mingrone G, Manco M, Mora ME, Guidone C, Iaconelli A, Gniuli D, Leccesi L, Chiellini C, Ghirlanda G. Influence of maternal obesity on insulin sensitivity and secretion in offspring. Diabetes Care. 2008 Sep;31(9):1872-6. doi: 10.2337/dc08-0432. Epub 2008 Jun 5.
- Samuelsson AM, Matthews PA, Argenton M, Christie MR, McConnell JM, Jansen EH, Piersma AH, Ozanne SE, Twinn DF, Remacle C, Rowlerson A, Poston L, Taylor PD. Diet-induced obesity in female mice leads to offspring hyperphagia, adiposity, hypertension, and insulin resistance: a novel murine model of developmental programming. Hypertension. 2008 Feb;51(2):383-92. doi: 10.1161/HYPERTENSIONAHA.107.101477. Epub 2007 Dec 17.
- Bayol SA, Simbi BH, Bertrand JA, Stickland NC. Offspring from mothers fed a 'junk food' diet in pregnancy and lactation exhibit exacerbated adiposity that is more pronounced in females. J Physiol. 2008 Jul 1;586(13):3219-30. doi: 10.1113/jphysiol.2008.153817. Epub 2008 May 8.
- Muhlhausler BS, Duffield JA, McMillen IC. Increased maternal nutrition stimulates peroxisome proliferator activated receptor-gamma, adiponectin, and leptin messenger ribonucleic acid expression in adipose tissue before birth. Endocrinology. 2007 Feb;148(2):878-85. doi: 10.1210/en.2006-1115. Epub 2006 Oct 26.
- Chang GQ, Gaysinskaya V, Karatayev O, Leibowitz SF. Maternal high-fat diet and fetal programming: increased proliferation of hypothalamic peptide-producing neurons that increase risk for overeating and obesity. J Neurosci. 2008 Nov 12;28(46):12107-19. doi: 10.1523/JNEUROSCI.2642-08.2008.
- Walker CD, Naef L, d'Asti E, Long H, Xu Z, Moreau A, Azeddine B. Perinatal maternal fat intake affects metabolism and hippocampal function in the offspring: a potential role for leptin. Ann N Y Acad Sci. 2008 Nov;1144:189-202. doi: 10.1196/annals.1418.023.
- Shankar K, Kang P, Harrell A, Zhong Y, Marecki JC, Ronis MJ, Badger TM. Maternal overweight programs insulin and adiponectin signaling in the offspring. Endocrinology. 2010 Jun;151(6):2577-89. doi: 10.1210/en.2010-0017. Epub 2010 Apr 6.
- Ng SF, Lin RC, Laybutt DR, Barres R, Owens JA, Morris MJ. Chronic high-fat diet in fathers programs beta-cell dysfunction in female rat offspring. Nature. 2010 Oct 21;467(7318):963-6. doi: 10.1038/nature09491.
- Suter MA, Chen A, Burdine MS, Choudhury M, Harris RA, Lane RH, Friedman JE, Grove KL, Tackett AJ, Aagaard KM. A maternal high-fat diet modulates fetal SIRT1 histone and protein deacetylase activity in nonhuman primates. FASEB J. 2012 Dec;26(12):5106-14. doi: 10.1096/fj.12-212878. Epub 2012 Sep 14.
- Sohi G, Marchand K, Revesz A, Arany E, Hardy DB. Maternal protein restriction elevates cholesterol in adult rat offspring due to repressive changes in histone modifications at the cholesterol 7alpha-hydroxylase promoter. Mol Endocrinol. 2011 May;25(5):785-98. doi: 10.1210/me.2010-0395. Epub 2011 Mar 3.
- Gong L, Pan YX, Chen H. Gestational low protein diet in the rat mediates Igf2 gene expression in male offspring via altered hepatic DNA methylation. Epigenetics. 2010 Oct 1;5(7):619-26. doi: 10.4161/epi.5.7.12882. Epub 2010 Oct 1.
- van Straten EM, Bloks VW, Huijkman NC, Baller JF, van Meer H, Lutjohann D, Kuipers F, Plosch T. The liver X-receptor gene promoter is hypermethylated in a mouse model of prenatal protein restriction. Am J Physiol Regul Integr Comp Physiol. 2010 Feb;298(2):R275-82. doi: 10.1152/ajpregu.00413.2009. Epub 2009 Nov 4.
- Zheng S, Rollet M, Pan YX. Maternal protein restriction during pregnancy induces CCAAT/enhancer-binding protein (C/EBPbeta) expression through the regulation of histone modification at its promoter region in female offspring rat skeletal muscle. Epigenetics. 2011 Feb;6(2):161-70. doi: 10.4161/epi.6.2.13472. Epub 2011 Feb 1.
- Zhou D, Pan YX. Gestational low protein diet selectively induces the amino acid response pathway target genes in the liver of offspring rats through transcription factor binding and histone modifications. Biochim Biophys Acta. 2011 Oct;1809(10):549-56. doi: 10.1016/j.bbagrm.2011.07.003. Epub 2011 Jul 18.
- Jousse C, Parry L, Lambert-Langlais S, Maurin AC, Averous J, Bruhat A, Carraro V, Tost J, Letteron P, Chen P, Jockers R, Launay JM, Mallet J, Fafournoux P. Perinatal undernutrition affects the methylation and expression of the leptin gene in adults: implication for the understanding of metabolic syndrome. FASEB J. 2011 Sep;25(9):3271-8. doi: 10.1096/fj.11-181792. Epub 2011 Jun 13.
- Zhang S, Rattanatray L, MacLaughlin SM, Cropley JE, Suter CM, Molloy L, Kleemann D, Walker SK, Muhlhausler BS, Morrison JL, McMillen IC. Periconceptional undernutrition in normal and overweight ewes leads to increased adrenal growth and epigenetic changes in adrenal IGF2/H19 gene in offspring. FASEB J. 2010 Aug;24(8):2772-82. doi: 10.1096/fj.09-154294. Epub 2010 Apr 6.
- Raychaudhuri N, Raychaudhuri S, Thamotharan M, Devaskar SU. Histone code modifications repress glucose transporter 4 expression in the intrauterine growth-restricted offspring. J Biol Chem. 2008 May 16;283(20):13611-26. doi: 10.1074/jbc.M800128200. Epub 2008 Mar 7.
- Thompson RF, Fazzari MJ, Niu H, Barzilai N, Simmons RA, Greally JM. Experimental intrauterine growth restriction induces alterations in DNA methylation and gene expression in pancreatic islets of rats. J Biol Chem. 2010 May 14;285(20):15111-15118. doi: 10.1074/jbc.M109.095133. Epub 2010 Mar 1.
- Tobi EW, Lumey LH, Talens RP, Kremer D, Putter H, Stein AD, Slagboom PE, Heijmans BT. DNA methylation differences after exposure to prenatal famine are common and timing- and sex-specific. Hum Mol Genet. 2009 Nov 1;18(21):4046-53. doi: 10.1093/hmg/ddp353. Epub 2009 Aug 4.
- Durmus B, Arends LR, Ay L, Hokken-Koelega AC, Raat H, Hofman A, Steegers EA, Jaddoe VW. Parental anthropometrics, early growth and the risk of overweight in pre-school children: the Generation R Study. Pediatr Obes. 2013 Oct;8(5):339-50. doi: 10.1111/j.2047-6310.2012.00114.x. Epub 2012 Dec 13.
- Drong AW, Lindgren CM, McCarthy MI. The genetic and epigenetic basis of type 2 diabetes and obesity. Clin Pharmacol Ther. 2012 Dec;92(6):707-15. doi: 10.1038/clpt.2012.149. Epub 2012 Oct 10.
- Toperoff G, Aran D, Kark JD, Rosenberg M, Dubnikov T, Nissan B, Wainstein J, Friedlander Y, Levy-Lahad E, Glaser B, Hellman A. Genome-wide survey reveals predisposing diabetes type 2-related DNA methylation variations in human peripheral blood. Hum Mol Genet. 2012 Jan 15;21(2):371-83. doi: 10.1093/hmg/ddr472. Epub 2011 Oct 12.
Datas de registro do estudo
Essas datas acompanham o progresso do registro do estudo e os envios de resumo dos resultados para ClinicalTrials.gov. Os registros do estudo e os resultados relatados são revisados pela National Library of Medicine (NLM) para garantir que atendam aos padrões específicos de controle de qualidade antes de serem publicados no site público.
Datas Principais do Estudo
Início do estudo
1 de dezembro de 2013
Conclusão Primária (Real)
1 de dezembro de 2016
Conclusão do estudo (Real)
1 de janeiro de 2017
Datas de inscrição no estudo
Enviado pela primeira vez
16 de maio de 2014
Enviado pela primeira vez que atendeu aos critérios de CQ
6 de agosto de 2014
Primeira postagem (Estimativa)
7 de agosto de 2014
Atualizações de registro de estudo
Última Atualização Postada (Real)
25 de abril de 2018
Última atualização enviada que atendeu aos critérios de controle de qualidade
24 de abril de 2018
Última verificação
1 de abril de 2018
Mais Informações
Termos relacionados a este estudo
Palavras-chave
Termos MeSH relevantes adicionais
Outros números de identificação do estudo
- TRIMDFH 499458
- 499458 (Outro identificador: Florida Hospital IRB)
Essas informações foram obtidas diretamente do site clinicaltrials.gov sem nenhuma alteração. Se você tiver alguma solicitação para alterar, remover ou atualizar os detalhes do seu estudo, entre em contato com register@clinicaltrials.gov. Assim que uma alteração for implementada em clinicaltrials.gov, ela também será atualizada automaticamente em nosso site .