Rachel A Tinius1, Maire M Blankenship2, Karen E Furgal3, W Todd Cade4, Kevin J Pearson5, Naomi S Rowland6, Regis C Pearson7, Donald L Hoover8, Jill M Maples9. 1. School of Kinesiology, Recreation, and Sport, Western Kentucky University, Bowling Green, KY 42101, USA. Electronic address: Rachel.tinius@wku.edu. 2. School of Nursing and Allied Health, Western Kentucky University, Bowling Green, KY 42101, USA. Electronic address: maire.blankenship@wku.edu. 3. Department of Physical Therapy, Western Kentucky University, Bowling Green, KY 42101, USA. Electronic address: karen.furgal@wku.edu. 4. Program in Physical Therapy, Washington University School of Medicine, St. Louis, MO 63110, USA. Electronic address: tcade@wustl.edu. 5. Department of Pharmacology and Nutritional Sciences, University of Kentucky College of Medicine, Lexington, KY 40536, USA. Electronic address: kevin.pearson@uky.edu. 6. Department of Biology, Western Kentucky University, Bowling Green, KY 42101, USA. Electronic address: naomi.rowland@wku.edu. 7. Department of Kinesiology, University of Georgia, Athens, GA 30601, USA. Electronic address: regis.pearson@uga.edu. 8. Department of Physical Therapy, Western Michigan University, Kalamazoo, MI 49008, USA. Electronic address: don.hoover@wmich.edu. 9. Department of Obstetrics and Gynecology, University of Tennessee Graduate School of Medicine, Knoxville, TN 37920, USA. Electronic address: jmaples1@utmck.edu.
Abstract
CONTEXT: Maternal obesity is a significant public health concern that contributes to unfavorable outcomes such as inflammation and insulin resistance. Women with obesity may have impaired metabolic flexibility (i.e. an inability to adjust substrate metabolism according to fuel availability). Impaired metabolic flexibility during pregnancy may mediate poor pregnancy outcomes in women with obesity. PURPOSE: The purposes of this study were to: 1) compare metabolic flexibility between overweight/obese and lean women; and 2) determine the relationships between metabolic flexibility, inflammation following a high-fat meal, and maternal metabolic health outcomes (i.e. gestational weight gain and insulin resistance). PROCEDURES: This interventional physiology study assessed lipid oxidation rates via indirect calorimetry before and after consumption of a high-fat meal. The percent change in lipid metabolism was calculated to determine 'metabolic flexibility.' Maternal inflammatory profiles (CRP, IL-6, IL-8, IL-10, IL-12, TNF-α) and insulin resistance (HOMA-IR) were determined via plasma analyses. MAIN FINDINGS: 64 women who were pregnant (lean = 35, overweight/obese = 29) participated between 32 and 38 weeks gestation. Lean women had significantly higher metabolic flexibility compared to overweight/obese women (lean 48.0 ± 34.1% vs overweight/obese 29.3 ± 34.3%, p = .035). Even when controlling for pre-pregnancy BMI, there was a negative relationship between metabolic flexibility and percent change in CRP among the overweight/obese group (r = -0.526, p = .017). Metabolic flexibility (per kg fat free mass) was negatively correlated with postprandial HOMA-IR (2 h: r = -0.325, p = .016; 4 h: r = -0.319, p = .019). CONCLUSIONS: Overweight and obese women who are pregnant are less 'metabolically flexible' than lean women, and this is related to postprandial inflammation and insulin resistance.
CONTEXT: Maternal obesity is a significant public health concern that contributes to unfavorable outcomes such as inflammation and insulin resistance. Women with obesity may have impaired metabolic flexibility (i.e. an inability to adjust substrate metabolism according to fuel availability). Impaired metabolic flexibility during pregnancy may mediate poor pregnancy outcomes in women with obesity. PURPOSE: The purposes of this study were to: 1) compare metabolic flexibility between overweight/obese and lean women; and 2) determine the relationships between metabolic flexibility, inflammation following a high-fat meal, and maternal metabolic health outcomes (i.e. gestational weight gain and insulin resistance). PROCEDURES: This interventional physiology study assessed lipid oxidation rates via indirect calorimetry before and after consumption of a high-fat meal. The percent change in lipid metabolism was calculated to determine 'metabolic flexibility.' Maternal inflammatory profiles (CRP, IL-6, IL-8, IL-10, IL-12, TNF-α) and insulin resistance (HOMA-IR) were determined via plasma analyses. MAIN FINDINGS: 64 women who were pregnant (lean = 35, overweight/obese = 29) participated between 32 and 38 weeks gestation. Lean women had significantly higher metabolic flexibility compared to overweight/obesewomen (lean 48.0 ± 34.1% vs overweight/obese 29.3 ± 34.3%, p = .035). Even when controlling for pre-pregnancy BMI, there was a negative relationship between metabolic flexibility and percent change in CRP among the overweight/obese group (r = -0.526, p = .017). Metabolic flexibility (per kg fat free mass) was negatively correlated with postprandial HOMA-IR (2 h: r = -0.325, p = .016; 4 h: r = -0.319, p = .019). CONCLUSIONS: Overweight and obesewomen who are pregnant are less 'metabolically flexible' than lean women, and this is related to postprandial inflammation and insulin resistance.
Authors: Kristen E Boyle; Sean A Newsom; Rachel C Janssen; Martha Lappas; Jacob E Friedman Journal: J Clin Endocrinol Metab Date: 2013-08-16 Impact factor: 5.958
Authors: Boyd E Metzger; Lynn P Lowe; Alan R Dyer; Elisabeth R Trimble; Udom Chaovarindr; Donald R Coustan; David R Hadden; David R McCance; Moshe Hod; Harold David McIntyre; Jeremy J N Oats; Bengt Persson; Michael S Rogers; David A Sacks Journal: N Engl J Med Date: 2008-05-08 Impact factor: 91.245
Authors: Jessica A Grieger; Tina Bianco-Miotto; Luke E Grzeskowiak; Shalem Y Leemaqz; Lucilla Poston; Lesley M McCowan; Louise C Kenny; Jenny E Myers; James J Walker; Gus A Dekker; Claire T Roberts Journal: PLoS Med Date: 2018-12-04 Impact factor: 11.069
Authors: Jill M Maples; Charlotte McCarley; Maire M Blankenship; Kristin Yoho; K Paige Johnson; Kimberly B Fortner; Rachel A Tinius Journal: Int J Exerc Sci Date: 2020-12-01
Authors: Jill M Maples; Samantha F Ehrlich; Nikki B Zite; Kevin J Pearson; W Todd Cade; Courtney J Riedinger; Maire M Blankenship; Rachel A Tinius Journal: BMC Pregnancy Childbirth Date: 2021-08-21 Impact factor: 3.007
Authors: Jemina Kivelä; Heidi Sormunen-Harju; Polina V Girchenko; Emilia Huvinen; Beata Stach-Lempinen; Eero Kajantie; Pia M Villa; Rebecca M Reynolds; Esa K Hämäläinen; Marius Lahti-Pulkkinen; Katja K Murtoniemi; Hannele Laivuori; Johan G Eriksson; Katri Räikkönen; Saila B Koivusalo Journal: J Clin Endocrinol Metab Date: 2021-10-21 Impact factor: 5.958