1.
Myo-inositol lowers the risk of developing gestational diabetic mellitus in pregnancies: A systematic review and meta-analysis of randomized controlled trials with trial sequential analysis.
Guo, X, Guo, S, Miao, Z, Li, Z, Zhang, H
Journal of diabetes and its complications. 2018;(3):342-348
Abstract
AIMS: to explore the potential benefit of myo-inositol on pregnant women with high risk of developing gestational diabetes mellitus (GDM). METHODS Pubmed, Embase, and Cochrane library were systematically searched for randomized controlled trials (RCTs) comparing myo-inositol with placebo for pregnant women with risk factors of GDM. Primary outcome were the incidence of GDM and birth weight. Secondary outcomes included fasting, 1h, and 2h oral glucose tolerance test (OGTT), and complications. Trial sequential analysis (TSA) was performed on primary outcomes to confirm the pooled results. Number needed to treat (NNT) was calculated to show the efficacy of myo-inositol supplement. RESULTS Four RCTs with 586 patients were included. Compared with placebo, patients with myo-inositol supplement had significantly lower the risk of developing GDM (RR=0.44, 95% CI [0.32, 0.62], P<0.0001) without heterogeneity (I2=0%, P=0.99), which was confirmed by TSA. NNT was 6.2 and rounded to 7. Myo-inositol did not significantly decrease birth weight (60.60g, 95% CI [-177.21, 56.02], P=0.31) with significant heterogeneity (I2=52%, P=0.12), but was not confirmed by TSA. Myo-inositol supplement was related to significantly lower fasting, 1h, and 2h OGTT value and the incidence of pre-term delivery. Difference was not significant between myo-inositol and placebo regarding incidence of other complications. CONCLUSION Myo-inositol is related to lower incidence of GDM, as well as fasting, 1h, and 2h OGTT value, in pregnant women with high risk of this condition. Myo-inositol might not be related to a lower birth weight, which needs further confirmation.
2.
Prospective investigation of folic acid supplements before and during early pregnancy and paediatric and adult cancers in the Chinese children and families cohort: a pilot study in a sample of rural and urban families.
Linet, MS, Wang, L, Wang, N, Berry, RJ, Chao, A, Hao, L, Li, Z, Fang, L, Yin, P, Potischman, N, et al
BMJ open. 2018;(7):e022394
Abstract
OBJECTIVE To determine the feasibility of long-term prospective follow-up and ascertainment of cancer in offspring and mothers from the 1993-1995 Chinese Community Intervention Program that provided folic acid supplements before and during early pregnancy to reduce neural tube defects. DESIGN Feasibility pilot study for a prospective cohort study. SETTING Families residing during 2012-2013 in one rural and one urban county from 21 counties in 3 provinces in China included in the Community Intervention Program campaign. PARTICIPANTS The feasibility study targeted 560 families, including 280 from the rural and 280 from the urban county included in the large original study; about half of mothers in each group had taken and half had not taken folic acid supplements. INTERVENTION The planned new study is observational. PRIMARY AND SECONDARY OUTCOME MEASURES Primary: incidence of paediatric cancers in offspring; secondary: other chronic diseases in offspring and chronic diseases in mothers RESULTS Only 3.4% of pilot study families could not be found, 3.9% had moved out of the study area and 8.8% refused to participate. Interviews were completed by 82% of mothers, 79% of fathers and 83% of offspring in the 560 families. Almost all mothers and offspring who were interviewed also participated in anthropometric measurements. We found notable urban-rural differences in sociodemographic and lifestyle characteristics of the parents, but fewer differences among the offspring. In eight catchment area hospitals, we identified a broad range of paediatric cancers diagnosed during 1994-2013, although paediatric brain tumours, lymphomas and rarer cancers were likely under-represented. CONCLUSIONS Overall, 20 years after the original Community Intervention Program, the pilot study achieved high levels of follow-up and family member interview participation, and identified substantial numbers of paediatric malignancies during 1994-2013 in catchment area hospitals. Next steps and strategies for overcoming limitations are described.