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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| Format: | Article |
| Language: | English |
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Wiley
2019-01-01
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| Series: | Journal of Diabetes Research |
| Online Access: | http://dx.doi.org/10.1155/2019/7098470 |
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| author | Jose Rafael Villafan-Bernal Mariana Acevedo-Alba Rodrigo Reyes-Pavon Guillermo Andres Diaz-Parra Diana Lucia Lip-Sosa Hilda Imelda Vazquez-Delfin Martha Hernandez-Muñoz Daniel Ely Bravo-Aguirre Francesc Figueras Raigam Jafet Martinez-Portilla |
| author_facet | Jose Rafael Villafan-Bernal Mariana Acevedo-Alba Rodrigo Reyes-Pavon Guillermo Andres Diaz-Parra Diana Lucia Lip-Sosa Hilda Imelda Vazquez-Delfin Martha Hernandez-Muñoz Daniel Ely Bravo-Aguirre Francesc Figueras Raigam Jafet Martinez-Portilla |
| author_sort | Jose Rafael Villafan-Bernal |
| collection | DOAJ |
| 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 I2 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 (I2=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. |
| format | Article |
| id | doaj-art-c7a735c25b2f47e994e61e4907bb5c51 |
| institution | Kabale University |
| issn | 2314-6745 2314-6753 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Diabetes Research |
| spelling | doaj-art-c7a735c25b2f47e994e61e4907bb5c512025-02-03T06:13:08ZengWileyJournal of Diabetes Research2314-67452314-67532019-01-01201910.1155/2019/70984707098470Plasma Levels of Free Fatty Acids in Women with Gestational Diabetes and Its Intrinsic and Extrinsic Determinants: Systematic Review and Meta-AnalysisJose Rafael Villafan-Bernal0Mariana Acevedo-Alba1Rodrigo Reyes-Pavon2Guillermo Andres Diaz-Parra3Diana Lucia Lip-Sosa4Hilda Imelda Vazquez-Delfin5Martha Hernandez-Muñoz6Daniel Ely Bravo-Aguirre7Francesc Figueras8Raigam Jafet Martinez-Portilla9CONACYT Cathedratic at Health Science Center, Autonomous University of Aguascalientes, MexicoHealth Science Center, Autonomous University of Aguascalientes, MexicoHealth Science Center, Autonomous University of Aguascalientes, MexicoHealth Science Center, Autonomous University of Aguascalientes, MexicoFetal Medicine Research Center, BCNatal-Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Déu), IDIBAPS, University of Barcelona, Catalonia, SpainWomen’s Hospital of the State of Aguascalientes-ISSEA, Aguascalientes, MexicoWomen’s Hospital of the State of Aguascalientes-ISSEA, Aguascalientes, MexicoWomen’s Hospital of the State of Aguascalientes-ISSEA, Aguascalientes, MexicoFetal Medicine Research Center, BCNatal-Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Déu), IDIBAPS, University of Barcelona, Catalonia, SpainMaternal-Fetal Medicine and Therapy Research Center, Evidence-Based Health Care Department, in Behalf of the Iberoamerican Research Network in Translational, Molecular and Maternal-Fetal Medicine, Mexico City, MexicoBackground. 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 I2 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 (I2=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.http://dx.doi.org/10.1155/2019/7098470 |
| spellingShingle | Jose Rafael Villafan-Bernal Mariana Acevedo-Alba Rodrigo Reyes-Pavon Guillermo Andres Diaz-Parra Diana Lucia Lip-Sosa Hilda Imelda Vazquez-Delfin Martha Hernandez-Muñoz Daniel Ely Bravo-Aguirre Francesc Figueras Raigam Jafet Martinez-Portilla Plasma Levels of Free Fatty Acids in Women with Gestational Diabetes and Its Intrinsic and Extrinsic Determinants: Systematic Review and Meta-Analysis Journal of Diabetes Research |
| 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 |
| url | http://dx.doi.org/10.1155/2019/7098470 |
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