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The study aims to assess the utility of the triglyceride-glucose index (TyG) as a marker of insulin resistance (IR) in neonates. TyG and the homeostatic model assessment (HOMA-IR) values were compared in 196 singleton, term normoweight and without distress newborns. A Decision Tree procedure (CHAID) was used to classify cases into groups or predict values of a dependent (Ln HOMA-IR) variable. Three nodes were drawn for TyG: ≤ 6.7, > 6.7-7.8 and > 7.8 (p < 0.0001; F = 20.52). The predictability of those TyG values vs HOMA-IR was statistically significant (p < 0.0001). It was neither affected by gender (p = 0.084), glucose challenge test (p = 0.138) classifications nor by the TyG node* glucose challenge test and TyG node*gender interactions (p = 0.456 and p = 0.209, respectively). Glucose, HOMA-IR, and the triglyceride/HDL cholesterol ratio increased progressively from node 1 to 3 for TyG while QUICKI decreased., Conclusion: In conclusion, TyG appears to be a suitable tool for identifying IR at birth, justifying the further insulin determination in those neonates. TyG ≥ 7.8 is recommended as cut-off point in neonates. The need for a follow-up study to confirm the TyG as early IR marker is desirable., What Is Known: • HOMA-IR and the triglyceride-glucose index (TyG) show a high correlation. • The TyG has been used as an insulin resistance marker in adults., What Is New: • This is the first study where TyG has been assessed in neonates. • TyG appears to be a suitable and cheap tool for identifying insulin resistance at birth.

Metabolic syndrome (MS) has a multifactorial and not yet fully clarified origin. Insulin resistance is a key element that connects all the accepted components of MS (obesity, dyslipemia, high blood pressure, and hyperglycemia). There is strong evidence that epigenetic changes during fetal development are key factors in the development of MS. These changes are induced by maternal nutrition, among different factors, affecting the intrauterine environment. The Mediterranean diet has been shown to be a healthy eating pattern that protects against the development of MS in adults. Similarly, the Mediterranean diet could have a similar action during pregnancy, protecting the fetus against the development of MS throughout life. This review assembles studies carried out, both in animals and humans, on the epigenetic modifications associated with the consumption, during pregnancy, of Mediterranean diet main components. The relationship between these modifications and the occurrence of factors involved in development of MS is also explained. In addition, the results of our group relating adherence to the Mediterranean diet with MS markers are discussed. The paper ends suggesting future actuation lines in order to increase knowledge on Mediterranean diet adherence as a prevention tool of MS development.

Several endocrine regulators are implicated in the development of metabolic syndrome. The aim of our study was to assess normal ranges for glucose, growth hormone (GH), insulin-like growth factor-1 (IGF-1), cortisol, insulin and the yet-to-be-published quantitative insulin sensitivity check index (QUICKI) for newborns and a number of homeostatic model assessment (HOMA)-related equations that have been proposed as indicators of insulin sensitivity (HOMA-S) and insulin resistance (HOMA-R). The study included 115 (54 males, 61 females) singleton, normoweight, Spanish Caucasian neonates delivered without foetal distress from mothers of the Mérida (Spain) Birth Cohort who tested negative in the O'Sullivan screen. Neonatal normal values given as the mean (95% confidence interval) were: glucose, 75.3 mg/dL (68.29-82.29); cortisol, 7.4 microg/dL (6.85-7.97); GH, 16.7 ng/mL (14.87-18.60); insulin, 5.5 microUI/mL (4.12-6.88), IGF-155.2 ng/mL (50.82-59.53); QUICKI, 0.45 (0.43-0.48); HOMA-R, 1.36 (0.84-1.88); HOMA-S, 4.07 (2.66-5.49), the glucose/insulin ratio, 33.6 (24.58-42.67); the insulin/cortisol ratio, 0.8 (0.61-1.05). Hormone ranges (except for cortisol, whose values were lower) were equivalent to those of other studies. Cortisolaemia values cannot be associated with the type of delivery, as only three births (2.6%) were by caesarean section, while 20 (17.4%) were instrumental deliveries. Neonates from the lowest quartile of the insulin/cortisol ratio presented higher (p < 0.001) HOMA-S and QUICKI and lower (p < 0.01) HOMA-R values. The results of our study indicate normal ranges for insulin resistance and sensitivity at birth. The insulin/cortisol ratio at birth appears to be a good early indicator of insulin resistance.

Pregnancy is a vital period where several hyperplasic, hypertrophic processes together with metabolic adaptation and preparation for extra-uterine life take place. Present review accounts for central aspects of nutrition throughout gestation on the embryonic and fetal periods. It is centered in the major changes occurring in fetal pancreas, with special mention to the susceptibility of this main glucose homeostasis organ to support nutritional changes during maturation and development. Studies performed in animal models as human are conunented considering the role of maternal nutrition on β-cell mass size, insulin and other pancreatic hormones production, and insulin sensitivity. Details of both the thrifty genotype and phenotype hypothesis are given, indicating that hypo/subnutrition causes metabolic adaptations that permit the future body to grow and develop itself in limited environmental and energetic conditions. The Barker hypothesis is considered suggesting that this metabolic hypothesis is a double-edged sword in the actual abundance World. Lastly the review, taking into account our own research and other papers, analyses less known aspects that relate maternal diet with insulin resistance/sensitivity markers at delivery. Particularly the role of the saturated fatty acid/carbohydrate and omega-6/omega-3 ratios in the frame of maternal diet is reviewed considering the quality of those diets under the Healthy Eating Index and the Adherence to Mediterranean Diet scores and the relationship with insulin resistance profile at birth. Present review ends indicating that nutritional habits should be strongly stated before gestation in order to assure a proper nutrition since the first moment of pregnancy. This will support an adequate fetal and pancreatic growth and development, and in turn, adequate glucose homeostasis during pregnancy and later in life, slowing down or preventing from degenerative diseases related with metabolic syndrome and type 2 diabetes mellitus. [ABSTRACT FROM AUTHOR]

Background/Objectives:Few studies have used healthy eating index (HEI) and mediterranean diet adherence (MDA) scores to evaluate the diet quality during pregnancy. To determine the relationship between first trimester diet quality and insulin sensitivity/resistance biomarkers at birth.Subjects/Methods:Cord-blood insulin sensitivity/resistance biomarkers of the offspring of 35 women whose diets were 'adequate' or 'inadequate' according to their HEI score (>70 or 70, respectively) and their 13-point MDA score (7 or <7, respectively).Results:Low HEI-score diets contained less (g/1000 kcal) carbohydrates (CHO; P=0.027) and fibre (P=0.011), and more fats (P<0.001) and cholesterol (P<0.001), and contributed (percentage contribution to total energy (%En)) fewer CHO (P=0.005), more fats (P=<0.001) and saturated fatty acid (SFA; P=0.002) than their high HEI-score counterparts. Low MDA-score diets contained less (g/1000 kcal) fibre (P<0.001) and more cholesterol (P=0.05), had lower polyunsaturated fatty acids+monounsaturated fatty acid/SFA (PUFA+MUFA/SFA; P=0.05) and higher SFA/CHO (P=0.021) and ω-6/ω-3 PUFA ratios (P=0.044) than their respective counterparts. Women consuming the low HEI- or low MDA-score diets had low-fasting glycaemia (P=0.016 or P=0.025, respectively) but delivered infants with high insulinaemia (P=0.048 or P=0.017, respectively), homeostatic model assessment for insulin resistance (HOMA-IR; P=0.031 or P=0.049, respectively) and glycaemia (P=0.018 or P=0.048, respectively). The relative risk (RR) of high-neonatal glycaemia and insulinaemia were 7.6 (P=0.008) and 6.7 (P=0.017) for low vs high HEI-score groups. High HOMA-IR and high glucose RR were, respectively, 3.4 (P=0.043) and 3.9 (P=0.016) in neonates from the <7 MDA- vs 7 MDA-score group. These RRs were not affected by potential confounders.Conclusion:Maternal diets with low HEI- or MDA-scores during the first trimester of pregnancy negatively affect insulin resistance markers at birth. [ABSTRACT FROM AUTHOR]

Introduction: Differences in neonatal insulin sensitivity/ resistance markers due to the maternal impaired glucose tolerance (IGT) have not been tested. The Healthy Eating Index (HEI) score has been employed for evaluating pregnancy diet quality. Aims: To study, the effect of neonatal insulinemia, maternal IGT and diet HEI score upon insulin sensitivity/ resistance at birth. Methods: 176 singleton, normoweight, full-term, Caucasian Spanish neonates, delivered without fetal distress whose mothers were screened for gestational IGT were studied. Quantitative Insulin Sensitivity Check Index (QUICKI) and Homeostatic Model Assessment (HOMAIR) were calculated. Diet followed during the third month of pregnancy was recorded and the respective HEI score calculated in a sample of 29 mothers. Results: As quartile for cord blood insulin levels increased, glucose, the insulin/cortisol ratio and HOMA-IR (all p < 0.001) and IGF-I (p < 0.01) increased while QUICKI and the glucose/insulin ratio (both p < 0.001) and GH (p < 0.05) decreased. Neonates from IGT mothers had higher insulin, HOMA-IR (both p < 0.01) and insulin/cortisol ratio (p < 0.05) and lower GH, QUICKI (both p < 0.01) and glucose/ insulin ratio (p < 0.05) than their normal maternal glucose tolerance (NGT) counterparts. Neonatal insulinemia influences more than IGT on the insulin resistance/sensitivity markers at birth. Mothers of hyperinsulinemic neonates showed lower HEI scores (p < 0.05). Conclusion: A large percentage of full-term normoweight infants with hyperinsulinemia showed altered insulin resistance markers. Their mothers consumed low quality diets. Screening strategies focused on neonatal glycemia and insulinemia together with maternal nutritional assessment and advice during pregnancy should be considered. [ABSTRACT FROM AUTHOR]