2014 Fiscal Year Annual Research Report
Comprehensive Assessment of Prevalence and Trends of Gestational Diabetes Mellitus among Bangladeshi Rural Women: A multidisciplinary investigation from basic epidemiology to genetic screening
| Project/Area Number |
25305034
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| Research Institution | University of Tsukuba |
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Principal Investigator |
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| Co-Investigator(Kenkyū-buntansha) |
水谷 太郎 筑波大学, 医学医療系, 教授 (80181890)
岩嶋 義雄 独立行政法人国立循環器病研究センター, その他部局等, その他 (80448068)
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| Project Period (FY) |
2013-04-01 – 2016-03-31
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| Keywords | 妊娠中糖尿病 / バングラデシュ / 疫学 / 遺伝学 |
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| Outline of Annual Research Achievements |
We have completed two years of this research project. In 1st and 2nd years of this project, we estimated the prevalence, the associated risk factors of diabetes in pregnant (gestational diabetes mellitus, GDM) women in Bangladesh and also investigated the important biomarkers of GDM pathogenesis for Bangladesh rural context. Prevalence of GDM was 9.7% according to the WHO criteria and 12.9 % according to the new ADA criteria in this study population. The prevalence of GDM increased significantly with increased age and parity. Prevalence of GDM was higher among women with higher monthly household income. Prevalence was also higher among pregnant women who had hypertension, and had parental history of hypertension and diabetes. Percentage of metabolic syndrome is much higher in GDM pregnant women compared to that in pregnant women without GDM. In addition, BMI is not an important factor for GDM pathogenesis in Bangladesh. Average fasting blood glucose level is twofold higher in GDM positive cases than in non-GDM pregnant women. Vascular endothelial growth factor (VEGF) which is now a potential therapeutic and diagnostic target for various diabetic complications is significantly higher in GDM positive cases compared to GDM negative cases. In general plasma VEGF is upregulated in diabetes subjects compared to non-diabetic subjects. From our analysis, we could not find any significant alterations in angiopoietin system in pregnant women with or without GDM. VEGF has potential alteration in GDM pathogenesis in Bangladeshi women whereas angiopoietin systems are not.
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| Current Status of Research Progress |
Current Status of Research Progress
1: Research has progressed more than it was originally planned.
Reason
The current research is on right track both from the contexts of time line and the amount of research activities scheduled to be done (100% done with target milestone achievement). As mentioned in our original research application, in first year of this project, we already we performed a cross sectional study undertaken in pregnant women in Bangladesh to determine the prevalence of gestational diabetes mellitus (GDM) in Bangladesh. We could include the planned number of pregnant women in this cross sectional study and we could ensure the quality control of blood sugar estimation in rural aspect in Bangladesh. We already published those findings to two international scientific journals (Jesmin et al, Diabetes Research and Clinical Practice, 2014; Jesmin et al, Journal of Shaheed Ziaur Rahman Medical College, 2014). Through the in depth analysis of that cross sectional study, we also explored the possible risk factors for GDM in Bangladesh (Jesmin et al, submitted, 2015). We already presented GDM project findings in more than ten international meeting with four invited talks to date. In the second year of this project, we started a cohort study including pregnant women as planned during the start of this project and now the regular follow up is done for that cohort study. We could recruit the estimated number of pregnant women to that cohort. The case control study on GDM is also on progress. The measurements of biochemical parameters and the advanced biomarkers are going on smoothly. The genetic analysis of this project has also already begun and is now on progress.
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| Strategy for Future Research Activity |
We are now running a cohort study on pregnant women in Bangladesh. In the third year of this project, we will still continue the ongoing cohort study. We included the pregnant women who were free of diabetes either at the early phase of first trimester or suspecting to be pregnant with pregnancy confirmation and are now longitudinally followed up monthly through sociodemographic data (questionnaire and interview), physical assessment with pregnancy profile, biochemical measurement, till delivery of babies and subsequent followed up for one year. In addition, in 2015 the rest of the part of a case control study will be conducted already started in 2014 using the pregnant women with GDM as cases and pregnant women without GDM as control in rural Bangladesh.
In 2015 we will estimate the followings:
Estimation of incidence rate of GDM; Estimation of clinical outcomes for both mother and child from cohort design; Biochemical measurement: Blood glucose, insulin, lipid profile;Assessment of biomarkers: Inflammatory markers TNF-alpha and hsCRP, pro-atherogenic marker PAI-1, adiponectin, splice variants of VEGF (121,165,188), its downstream signaling cascades (Flk-1, Flt-1, eNOS, Akt, NO) by ELISA;Assessment of fetal fatality;Blood collection for genetic screening
Intensive analysis with specialist statistician of present project data
Data interpretation, publication; Comparison of data on GDM of Bangladeshi women with Japanese women;Presentation of research findings at various national and international meeting;Making a review report on GDM situation in South Asian countries.
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| Causes of Carryover |
Last two years we did not measure the expensive biomarkers from this grant money, we had some donations from local Bangladesh to buy some expensive re-agents.
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| Expenditure Plan for Carryover Budget |
This year we will use the saved money from last two years to measure more expensive biomarkers and also for genetic study.
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[Journal Article] Higher circulatory level of endothelin-1 in hypertensive subjects screened through a cross-sectional study of rural Bangladeshi women.2015
Author(s)
Akter S, Jesmin S, Iwashima Y, Hideaki S, Rahman MA, Islam MM, Moroi M, Shimojo N, Yamaguchi N, Miyauchi T, Kawano S, Mizutani T, Kawano Y.
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Journal Title
Hypertens Res.
Volume: 38
Pages: 208-212
DOI
Peer Reviewed / Open Access / Acknowledgement Compliant
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[Journal Article] Assessment of Circulatory Endothelin-1 Level among Preand Post-Menopausal Rural Women in Bangladesh: Result from a Population-Based Study2015
Author(s)
Khatun T, Jesmin S, Yamaguchi N, Kamiyama J, Akter S, Sultana SN, Islam M, Okazaki O, Kawano S, Akashi H, Mizutani T, Miyauchi T, Rahman A, Habib AKMA
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Journal Title
Annals of Vascular Medicine & Research
Volume: 1
Pages: 1014
Peer Reviewed / Open Access / Acknowledgement Compliant
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[Journal Article] Assessment of Circulatory Levels of Endothelin-1 in Diabetic Subjects Screened Through a Cross Sectional Study from Rural Women in Bangladesh2015
Author(s)
Rahman MA, Jesmin S, Mowa CN, Sohael F, Kamiyama J, Habib AKMA, Shimojo N, Islam MM, Moroi M, Okazaki O, Yamaguchi N, Kawano S, Mizutani T, Iwashima Y
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Journal Title
International Journal of Diabetes and Clinical Research
Volume: 2
Pages: 1
Peer Reviewed / Open Access / Acknowledgement Compliant
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[Journal Article] Screening for gestational diabetes mellitus and its prevalence in Bangladesh.2014
Author(s)
Jesmin S, Akter S, Akashi H, Al-Mamun A, Rahman MA, Islam MM, Sohael F, Okazaki O, Moroi M, Kawano S, Mizutani T.
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Journal Title
Diabetes Res Clin Pract.
Volume: 103
Pages: 57-62
DOI
Peer Reviewed / Open Access / Acknowledgement Compliant
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[Journal Article] Effects of selective endothelin (ET)-A receptor antagonist versus dual ET-A/B receptor antagonist on hearts of streptozotocin-treated diabetic rats.2014
Author(s)
Miyauchi Y, Jesmin S, Sakai S, Kamiyama J, Shimojo N, Rahman A, Islam M, Zaedi S, Maeda S, Maruyama H, Mizutani T, Homma S, Aonuma K, Miyauchi T.
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Journal Title
Life Sci.
Volume: 111
Pages: 6-11
DOI
Peer Reviewed / Open Access / Acknowledgement Compliant
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[Journal Article] Endothelin-1 and Metabolic Syndrome in Bangladeshi Rural Women2014
Author(s)
Islam MM, Jesmin S, Akter S, Mowa CN, Sakuramoto H, Chowdhury SR, Rahman A, Habib AKMA, Okazaki O, Shimojo N, Miyauchi T, Kawano S, Mizutani T
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Journal Title
Annals of Vascular Medicine & Research
Volume: 1
Pages: 1008
Peer Reviewed / Open Access / Acknowledgement Compliant
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[Journal Article] Screening for gestational diabetes mellitus in Bogra sadar, Bogra Bangladesh.2014
Author(s)
Jesmin S, Rahman A, Sohael F, Akter S, Islam MM, Khatun MT, Sultana SN, Mamun AA, Akashi H, Habib AKMA.
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Journal Title
Journal of Shaheed Ziaur Rahman Medical College
Volume: 20
Pages: 19-24
Peer Reviewed / Acknowledgement Compliant
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[Presentation] An investigation on the nationwide prevalence and associated risk factors of anemia in reproductive ever married women in Bangladesh2014
Author(s)
Jesmin S, Rahman MA, Mamun AA, Islam MM, Sakuramoto Hideaki, Sabiruzzaman M, Khatun T, Alam ATMJ, Sultana SN, Sultana SN, Sohael F, Rahamn S
Organizer
Celebration of 2nd Public Health Foundation Day & Scientific Seminar
Place of Presentation
ダッカ、バングラデシュ
Year and Date
2014-12-07 – 2014-12-08
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[Presentation] Higher level of endothelin-1 in hypertensive Rural Women in Bangladesh. Results of a Community based cross-sectional study2014
Author(s)
Rahman MA, Jesmin S, Iwashima Y, Ali A, Akter S, Khan A, Islam MM, Moroi M, Yamaguchi N, Shimojo N, Kawano S
Organizer
The 3rd International Congress on Lipid Metabolism & Atherosclerosis (ICLA 2014)
Place of Presentation
ソウル
Year and Date
2014-09-12 – 2014-09-13
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[Presentation] An analysis of association between circulatory level of endothelin-1 and metabolic syndrome in Bangladeshi rural women2014
Author(s)
Rahman MA, Jesmin S, Islam MM, Habib AKMA, Akter S, Shimojo N, Sohael F, Zaedi S, Yamaguchi N, Moroi M, Okazaki O, Hiroe M, Kawano S
Organizer
The 3rd International Congress on Lipid Metabolism & Atherosclerosis (ICLA 2014)
Place of Presentation
ソウル
Year and Date
2014-09-12 – 2014-09-13
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