Subtle thyroid problem triples the risk of placental separation in birth, study finds

Subtle Thyroid Problem Triples the Risk of Placental Separation in Birth, Study Finds


ScienceDaily (July 22, 2010) — Pregnant women with antibodies that can indicate early thyroid disease are three times as likely to have placental separation during labor, researchers at UT Southwestern Medical Center have found in a study of more than 17,000 women.



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Health & Medicine

Thyroid Disease
Hormone Disorders
Diseases and Conditions
Gynecology
Menopause
Pregnancy and Childbirth

Reference

Hypothyroidism
Menopause
Pituitary gland
Hyperthyroidism

The findings, however, do not indicate that there would be any benefit from routinely screening pregnant women for thyroid problems, the researchers said. The study appears in the August issue of Obstetrics and Gynecology.
"Our work shows a link between anti-TPO antibodies and placental abruption, but that does not necessarily mean that thyroid supplementation would improve the health of the women or babies," said Dr. Brian Casey, professor of obstetrics and gynecology at UT Southwestern and the study's co-lead author.
The thyroid, a small butterfly-shaped gland at the base of the throat, produces hormones that regulate many of the body's metabolic functions. Thyroid disorders can disrupt sleep, mood and mental sharpness, and cause weight gain or loss.
The thyroid uses an enzyme called thyroid peroxidase (TPO) to incorporate iodine into thyroid hormones. Table salt often contains added iodine so people can produce adequate levels of thyroid hormones.
TPO function is disrupted in some autoimmune diseases, when the body creates antibodies against it. As a result, hormone levels decrease and the body's metabolism slows. But when antibody levels are still low, the thyroid can sometimes compensate and produce normal amounts of hormone.
In the current study, the researchers took samples of serum -- the clear, liquid fraction of blood -- from women before 20 weeks of pregnancy, and compared the levels of anti-TPO antibodies with the mothers' and babies' health after birth. Only singleton births were included in the study.
Almost 6 percent of the 17,298 women (1,012 participants) tested positive for the anti-TPO antibody, the researchers found. Ethnicity affected the rate: 8.4 percent of white women were antibody-positive, compared to 6.1 percent of Hispanic women and 2.6 percent of African-American women. The antibody-positive women had normal levels of thyroid hormones.
The researchers found that the rates of birth complications were the same between the antibody-positive and -negative groups, except for placental abruption, a rare but potentially fatal complication in which the placenta separates from the uterus too early. Abruption occurred in 1 percent of antibody-positive women, compared to 0.3 percent of antibody-negative women.
Antibody status made no difference to the health of the babies, including their birth weight, rates of admission to intensive care and so on, the researchers found.
UT Southwestern researchers are participating in a national study, led by Maternal-Fetal Medicine Units Network of the National Institutes of Child Health and Human Development (NICHD), to test whether supplementation with thyroid hormones can improve pregnancy outcomes, Dr. Casey said.
In addition, UT Southwestern researchers are testing for possible relationships between other thyroid-related measurements and birth outcome.
Other UT Southwestern obstetrics and gynecology researchers involved in the study were co-lead author Dr. Mina Abbassi-Ghanavati, assistant instructor; Dr. Donald McIntire, professor; Dr. Lisa Halvorson, associate professor; and Dr. Gary Cunningham, professor. Dr. Catherine Spong of the Eunice Kennedy Shriver National Institute of Child Health and Human Development in Bethesda, Md., also participated.
The study was partially supported by a grant from the NICHD.

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Toxic trio identified as the basis of celiac disease

Toxic Trio Identified as the Basis of Celiac Disease


ScienceDaily (July 22, 2010) — Walter and Eliza Hall Institute scientists have identified the three protein fragments that make gluten -- the main protein in wheat, rye and barley -- toxic to people with coeliac disease.



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Chronic Illness
Healthy Aging
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Reference

Gluten
Gluten-free, casein-free diet
Meat analogue
Coeliac disease

Their discovery opens the way for a new generation of diagnostics, treatments, prevention strategies and food tests for the millions of people worldwide with coeliac disease.
When people with coeliac disease eat products containing gluten their body's immune response is switched on and the lining of the small intestine is damaged, hampering their ability to absorb nutrients. The disease is currently treated by permanently removing gluten from the patient's diet.
Dr Bob Anderson, head of the Walter and Eliza Hall Institute's coeliac disease research laboratory, said it had been 60 years since gluten was discovered to be the environmental cause of coeliac disease.
"In the years since, the holy grail in coeliac disease research has been to identify the toxic peptide components of gluten; and that's what we've done," Dr Anderson said.
The research, done in collaboration with Dr Jason Tye-Din, Dr James Dromey, Dr Stuart Mannering, Dr Jessica Stewart and Dr Tim Beissbarth from the institute as well as Professor Jamie Rossjohn at Monash University and Professor Jim McCluskey at the University of Melbourne, is published in the journal Science Translational Medicine.
The study was started by Professor Anderson nine years ago and has involved researchers in Australia and the UK as well as more than 200 coeliac disease patients.
The patients, recruited through the Coeliac Society of Victoria and the Coeliac Clinic at John Radcliffe Hospital, UK, ate bread, rye muffins or boiled barley. Six days later, blood samples were taken to measure the strength of the patients' immune responses to 2700 different gluten fragments. The responses identified 90 fragments as causing some level of immune reaction, but three gluten fragments (peptides) were revealed as being particularly toxic.
"These three components account for the majority of the immune response to gluten that is observed in people with coeliac disease," Dr Anderson said.
This knowledge has already been used by Melbourne-based biotech company, Nexpep Pty Ltd, to develop a 'peptide-based' immunotherapy that aims to desensitise people with coeliac disease to the toxic effects of gluten. Nexpep's Phase 1 trials of the therapy were completed in June and final results are expected in coming months.
The immunotherapy works by exposing people with coeliac disease to small amounts of the three toxic peptides and is based upon the same principles as desensitisation for allergies.
Dr Anderson said although coeliac disease could be managed with a gluten-free diet, compliance with the diet is often challenging and nearly half the people on the diet still have residual damage to their small intestine. "Consequently, the immunotherapy and three other drugs are under development to help people with coeliac disease."
The research was supported by the National Health and Medical Research Council, Coeliac UK, the Coeliac Research Fund, Nexpep Pty Ltd, BTG International and the Victorian Government.

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Vitamins needed to help celiacs stave off bone disease, researchers find

Vitamins Needed to Help Celiacs Stave Off Bone Disease, Researchers Find


ScienceDaily (July 22, 2010) — Children with celiac disease need to include certain must-have vitamins in their diets to stave off weak bones and osteoporosis, say researchers at the University of Alberta.



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A study of 43 children and teens from three to 18 years of age diagnosed with celiac disease showed that they also tended to have low bone density, likely due to poor intake and absorption of vitamins and minerals. That means they should be getting more of bone-boosting vitamins such as K and D in their diets, says Diana Mager, a professor of agricultural, food and nutritional science at the U of A, and one of the researchers on the project.
"Children with celiac disease are at risk for poor bone health, but by adding vitamins K and D to their diets, it can help reduce the risk of fractures and osteoporosis," Mager said.
The study revealed that the children were getting less than 50 per cent of their recommended dietary intake of Vitamin K, and that they also suffered from low levels of Vitamin D, which can be raised through increased exposure to sunlight and by eating fortified dairy products.
Mager also recommends that children with celiac disease include physical activity in their daily routines to build their bone strength and boost their Vitamin D intake by exercising outside.
"Enjoying activities such as walking and running outdoors when there is more sunshine is a great way to contribute to healthy bones," Mager said.

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Muscular heart failure patients may have a better chance at survival, study suggests

Muscular Heart Failure Patients May Have a Better Chance at Survival, Study Suggests


ScienceDaily (July 21, 2010) — University of Alberta research has discovered heart failure patients with more muscle have the potential to increase their length of life.



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Antigone Oreopoulos, a researcher from the U of A's School of Public Health, studied 140 patients with heart failure. Study participants underwent a special scan to measure their muscle mass and body fat.
Oreopoulos' research found that having more muscle was associated with better nutritional status and lower severity of heart failure, while higher body fat was associated with increased inflammation and reduced exercise capacity. This suggests that in patients with heart failure having more muscle mass and lower fat may be beneficial.
Oreopoulos' research was published this month in the journal Mayo Clinic Proceedings.
The study also discovered that testing just the body mass index (BMI) of heart failure patients doesn't accurately measure their body fat status. Oreopoulos found 41 per cent of the participants were inaccurately classified by BMI. Many who had a high body weight but not high body fat were mislabelled as obese and others who did not weigh a lot but had a high amount of body fat were mislabelled as normal by BMI. Oreopoulos says this research has direct implications for weight management guidelines and adds that to date there is a shortage of evidence to guide a clinician's decision about when to recommend weight loss to a patient with heart failure.
While this study provides potential explanations of how muscle and fat could possibly play a role in the survival of heart failure patients, Oreopoulos says there isn't enough evidence to make specific recommendations. Her team plans to conduct treatment studies that examine the effects of intentional weight gain and loss on the survival and quality of life in these patients.

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Subtle thyroid problem triples the risk of placental separation in birth, study finds

Subtle Thyroid Problem Triples the Risk of Placental Separation in Birth, Study Finds


ScienceDaily (July 21, 2010) — Pregnant women with antibodies that can indicate early thyroid disease are three times as likely to have placental separation during labor, researchers at UT Southwestern Medical Center have found in a study of more than 17,000 women.



See Also:
Health & Medicine

Thyroid Disease
Hormone Disorders
Diseases and Conditions
Gynecology
Menopause
Pregnancy and Childbirth

Reference

Hypothyroidism
Menopause
Pituitary gland
Hyperthyroidism

The findings, however, do not indicate that there would be any benefit from routinely screening pregnant women for thyroid problems, the researchers said. The study appears in the August issue of Obstetrics and Gynecology.
"Our work shows a link between anti-TPO antibodies and placental abruption, but that does not necessarily mean that thyroid supplementation would improve the health of the women or babies," said Dr. Brian Casey, professor of obstetrics and gynecology at UT Southwestern and the study's co-lead author.
The thyroid, a small butterfly-shaped gland at the base of the throat, produces hormones that regulate many of the body's metabolic functions. Thyroid disorders can disrupt sleep, mood and mental sharpness, and cause weight gain or loss.
The thyroid uses an enzyme called thyroid peroxidase (TPO) to incorporate iodine into thyroid hormones. Table salt often contains added iodine so people can produce adequate levels of thyroid hormones.
TPO function is disrupted in some autoimmune diseases, when the body creates antibodies against it. As a result, hormone levels decrease and the body's metabolism slows. But when antibody levels are still low, the thyroid can sometimes compensate and produce normal amounts of hormone.
In the current study, the researchers took samples of serum -- the clear, liquid fraction of blood -- from women before 20 weeks of pregnancy, and compared the levels of anti-TPO antibodies with the mothers' and babies' health after birth. Only singleton births were included in the study.
Almost 6 percent of the 17,298 women (1,012 participants) tested positive for the anti-TPO antibody, the researchers found. Ethnicity affected the rate: 8.4 percent of white women were antibody-positive, compared to 6.1 percent of Hispanic women and 2.6 percent of African-American women. The antibody-positive women had normal levels of thyroid hormones.
The researchers found that the rates of birth complications were the same between the antibody-positive and -negative groups, except for placental abruption, a rare but potentially fatal complication in which the placenta separates from the uterus too early. Abruption occurred in 1 percent of antibody-positive women, compared to 0.3 percent of antibody-negative women.
Antibody status made no difference to the health of the babies, including their birth weight, rates of admission to intensive care and so on, the researchers found.
UT Southwestern researchers are participating in a national study, led by Maternal-Fetal Medicine Units Network of the National Institutes of Child Health and Human Development (NICHD), to test whether supplementation with thyroid hormones can improve pregnancy outcomes, Dr. Casey said.
In addition, UT Southwestern researchers are testing for possible relationships between other thyroid-related measurements and birth outcome.
Other UT Southwestern obstetrics and gynecology researchers involved in the study were co-lead author Dr. Mina Abbassi-Ghanavati, assistant instructor; Dr. Donald McIntire, professor; Dr. Lisa Halvorson, associate professor; and Dr. Gary Cunningham, professor. Dr. Catherine Spong of the Eunice Kennedy Shriver National Institute of Child Health and Human Development in Bethesda, Md., also participated.
The study was partially supported by a grant from the NICHD.

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Toxic trio identified as the basis of celiac disease

Toxic Trio Identified as the Basis of Celiac Disease


ScienceDaily (July 21, 2010) — Walter and Eliza Hall Institute scientists have identified the three protein fragments that make gluten -- the main protein in wheat, rye and barley -- toxic to people with coeliac disease.



See Also:
Health & Medicine

Hormone Disorders
Alzheimer's Research
Chronic Illness
Healthy Aging
Diseases and Conditions
Gastrointestinal Problems

Reference

Gluten
Gluten-free, casein-free diet
Meat analogue
Coeliac disease

Their discovery opens the way for a new generation of diagnostics, treatments, prevention strategies and food tests for the millions of people worldwide with coeliac disease.
When people with coeliac disease eat products containing gluten their body's immune response is switched on and the lining of the small intestine is damaged, hampering their ability to absorb nutrients. The disease is currently treated by permanently removing gluten from the patient's diet.
Dr Bob Anderson, head of the Walter and Eliza Hall Institute's coeliac disease research laboratory, said it had been 60 years since gluten was discovered to be the environmental cause of coeliac disease.
"In the years since, the holy grail in coeliac disease research has been to identify the toxic peptide components of gluten; and that's what we've done," Dr Anderson said.
The research, done in collaboration with Dr Jason Tye-Din, Dr James Dromey, Dr Stuart Mannering, Dr Jessica Stewart and Dr Tim Beissbarth from the institute as well as Professor Jamie Rossjohn at Monash University and Professor Jim McCluskey at the University of Melbourne, is published in the journal Science Translational Medicine.
The study was started by Professor Anderson nine years ago and has involved researchers in Australia and the UK as well as more than 200 coeliac disease patients.
The patients, recruited through the Coeliac Society of Victoria and the Coeliac Clinic at John Radcliffe Hospital, UK, ate bread, rye muffins or boiled barley. Six days later, blood samples were taken to measure the strength of the patients' immune responses to 2700 different gluten fragments. The responses identified 90 fragments as causing some level of immune reaction, but three gluten fragments (peptides) were revealed as being particularly toxic.
"These three components account for the majority of the immune response to gluten that is observed in people with coeliac disease," Dr Anderson said.
This knowledge has already been used by Melbourne-based biotech company, Nexpep Pty Ltd, to develop a 'peptide-based' immunotherapy that aims to desensitise people with coeliac disease to the toxic effects of gluten. Nexpep's Phase 1 trials of the therapy were completed in June and final results are expected in coming months.
The immunotherapy works by exposing people with coeliac disease to small amounts of the three toxic peptides and is based upon the same principles as desensitisation for allergies.
Dr Anderson said although coeliac disease could be managed with a gluten-free diet, compliance with the diet is often challenging and nearly half the people on the diet still have residual damage to their small intestine. "Consequently, the immunotherapy and three other drugs are under development to help people with coeliac disease."
The research was supported by the National Health and Medical Research Council, Coeliac UK, the Coeliac Research Fund, Nexpep Pty Ltd, BTG International and the Victorian Government.

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The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by Walter and Eliza Hall Institute, via EurekAlert!, a service of AAAS.

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Preterm births higher among overweight and obese mothers, study finds

Preterm Births Higher Among Overweight and Obese Mothers, Study Finds


ScienceDaily (July 20, 2010) — Overweight and obese women are at greater risk of giving birth to a preterm baby compared with normal weight women, finds a study published online in the British Medical Journal.



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The authors believe that overweight and obese women should have counselling before pregnancy so that they are aware of these risks and can try to modify their weight before pregnancy. They also stress the need for appropriate surveillance by health professionals during pregnancy.
Overweight and obesity is now the most common pregnancy complication in many developed countries and also some developing countries. For example, in the United Kingdom, 33% of pregnant women are overweight or obese. In India, 26% of pregnant women are overweight and a further 8% are obese, while in China, 16% are overweight or obese.
Preterm birth and low birth weight are the leading causes of infant death and illness throughout childhood. However, there is still uncertainty about the impact of a mother's weight on both preterm birth and low birth weight.
So a team of researchers in Canada analysed the results of 84 studies to assess the effect of maternal weight on preterm birth (before 37 weeks) and low birth weight (below 2500g) in singleton pregnancies in both developed and developing countries.
They found that the overall risk of preterm birth before 37 weeks was not significantly different among overweight or obese women compared with normal weight women.
However, there was a 30% increased risk of induced preterm birth before 37 weeks among overweight or obese women after accounting for publication bias, which is the tendency for studies to be published only if their results are positive. The heavier the woman, the higher the risk of induced preterm birth before 37 weeks, with very obese women at 70% greater risk than normal weight women.
Overweight or obese women also had a higher risk of early preterm birth (before 32 or 33 weeks). Again, the heavier the woman, the higher the risk of early preterm birth, with very obese women at 82% greater risk than normal weight women.
Although overweight or obese women had a lower risk of delivering a low birth weight baby than normal weight women, especially in developing countries, this effect disappeared after publication bias was taken into account. "Clinicians need to be aware that maternal overweight or obesity is not protective against low birth weight and consider surveillance when indicated," warn the authors.
"Ideally, overweight or obese women should have pregnancy counselling so that they are informed of their perinatal risks and can try to optimise their weight before pregnancy," they conclude.

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Journal Reference:

Sarah D McDonald, Zhen Han, Sohail Mulla, Joseph Beyene, on behalf of the Knowledge Synthesis Group. Overweight and obesity in mothers and risk of preterm birth and low birth weight infants: systematic review and meta-analyses. BMJ, 2010; 341: c3428 DOI: 10.1136/bmj.c3428

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