tbuckley/cabot-search huggingface dataset:
Concurrent systemic antibiotics at catheter insertion and intravascular catheter-related infection in the ICU: a post hoc analysis using individual data from five large RCTs
Authors: Niccolò Buetti, Bertrand Souweine, Leonard Mermel, Olivier Mimoz, Stéphane Ruckly, Ambre Loiodice, Nicolas Mongardon, Jean-Christophe Lucet, Jean-Jacques Parienti, Jean-François Timsit
Journal: Clinical Microbiology and Infection (2020)
Thromboembolic Outcomes of Hospitalized COVID-19 Patients in the 90-Day Post-Discharge Period: Early Data from the Northwell CORE-19 Registry
Authors: Dimitrios Giannis, Steven L. Allen, Anne Davidson, Galina S. Marder, Sarah Flint, David Garrett, Richa Thakur, Matthew Snyder, Cristina Ghiuzeli, Thomas G. McGinn, Karina W. Davidson, Michael Qiu, Matthew Barish, Alex C. Spyropoulos
Journal: Blood (2020)
Integrated Genomic, Functional, and Prognostic Characterization of Atypical Chronic Myeloid Leukemia
Authors: Diletta Fontana, Daniele Ramazzotti, Andrea Aroldi, Sara Redaelli, Vera Magistroni, Alessandra Pirola, Antonio Niro, Luca Massimino, Cristina Mastini, Virginia Brambilla, Silvia Bombelli, Silvia Bungaro, Alessandro Morotti, Delphine Rea, Fabio Stagno, Bruno Martino, Leonardo Campiotti, Giovanni Caocci, Emilio Usala, Michele Merli, Francesco Onida, Marco Bregni, Elena Maria Elli, Monica Fumagalli, Fabio Ciceri, Roberto A. Perego, Fabio Pagni, Luca Mologni, Rocco Piazza, Carlo Gambacorti‐Passerini
Journal: HemaSphere (2020)

Supplemental Digital Content is available for this article.
Phlebotomy-Induced Iron Deficiency Increases the Expression of Prothrombotic Genes
Authors: Jihyun Song, Adelina Sergueeva, Galina Miasnikova, Soo Jin Kim, Binal N. Shah, Tsewang Tashi, Xu Zhang, Perumal Thiagarajan, Victor R. Gordeuk, Josef T. Prchal
Journal: Blood (2020)
Diagnosis and Treatment of Lower Extremity Venous Thromboembolism
Authors: Romain Chopard, Ida Ehlers Albertsen, Gregory Piazza
Journal: JAMA (2020)

<h3>Importance</h3> Incidence rates for lower extremity deep vein thrombosis (DVT) range from 88 to 112 per 100 000 person-years and increase with age. Rates of recurrent VTE range from 20% to 36% during the 10 years after an initial event. <h3>Observations</h3> PubMed and Cochrane databases were searched for English-language studies published from January 2015 through June 2020 for randomized clinical trials, meta-analyses, systematic reviews, and observational studies. Risk factors for venous thromboembolism (VTE), such as older age, malignancy (cumulative incidence of 7.4% after a median of 19 months), inflammatory disorders (VTE risk is 4.7% in patients with rheumatoid arthritis and 2.5% in those without), and inherited thrombophilia (factor V Leiden carriers with a 10-year cumulative incidence of 10.9%), are associated with higher risk of VTE. Patients with signs or symptoms of lower extremity DVT, such as swelling (71%) or a cramping or pulling discomfort in the thigh or calf (53%), should undergo assessment of pretest probability followed by D-dimer testing and imaging with venous ultrasonography. A normal D-dimer level (ie, D-dimer &lt;500 ng/mL) excludes acute VTE when combined with a low pretest probability (ie, Wells DVT score ≤1). In patients with a high pretest probability, the negative predictive value of a D-dimer less than 500 ng/mL is 92%. Consequently, D-dimer cannot be used to exclude DVT without an assessment of pretest probability. Postthrombotic syndrome, defined as persistent symptoms, signs of chronic venous insufficiency, or both, occurs in 25% to 50% of patients 3 to 6 months after DVT diagnosis. Catheter-directed fibrinolysis with or without mechanical thrombectomy is appropriate in those with iliofemoral obstruction, severe symptoms, and a low risk of bleeding. The efficacy of direct oral anticoagulants—rivaroxaban, apixaban, dabigatran, and edoxaban—is noninferior to warfarin (absolute rate of recurrent VTE or VTE-related death, 2.0% vs 2.2%). Major bleeding occurs in 1.1% of patients treated with direct oral anticoagulants vs 1.8% treated with warfarin. <h3>Conclusions and Relevance</h3> Greater recognition of VTE risk factors and advances in anticoagulation have facilitated the clinical evaluation and treatment of patients with DVT. Direct oral anticoagulants are noninferior to warfarin with regard to efficacy and are associated with lower rates of bleeding, but costs limit use for some patients.
Adenine Base Editing of the Sickle Allele in CD34+ Hematopoietic Stem and Progenitor Cells Eliminates Hemoglobin S
Authors: S. Haihua Chu, Daisy Lam, Michael S. Packer, Jennifer Olins, Alexander Liquori, Jeffrey Marshall, Calvin Lee, Bo Yan, Jeremy Decker, Bob Gantzer, Scott J. Haskett, Tanggis Bohnuud, David Born, Luis Barrera, Ian Slaymaker, Nicole M. Gaudelli, Adam J. Hartigan, Giuseppe Ciaramella
Journal: Blood (2020)
Abstract 101: Novel Inhibitors for Temporal Modulation of T-lymphocytes During Chronic Heart Failure
Authors: Shyam S Bansal, Rachel Rosenzweig, SARITA NEHRA, Oscar Bermeo Blanco, Matthew Stratton, Richard J Gumina, Chad Bennett, Christopher Coss
Journal: Circulation Research (2020)

CD4+ T-cells mediate wound-healing post-myocardial infarction (MI) but exacerbate left-ventricular (LV) remodeling during chronic heart failure (HF). Mechanisms that lead to this transition are unknown. Therefore, we hypothesized that as opposed to MI, T-cells activate specific pathological signals to promote LV-remodeling during chronic HF. To identify such signals, we conducted limited cell RNA-sequencing of CD4+ T-cells sorted from the failing hearts (8 weeks post-MI) of male mice and, surprisingly, found activation of estrogen receptor (ER)-α signaling. As ERα effects are antagonized by ERβ, we tested a novel ERβ agonist (OSU-ERB-012) to modulate T-cell activity and LV remodeling. In-vitro assays showed that OSU-ERB-012 dose dependently inhibit activation and proliferation of T-cells isolated from male mice (IC 50 3.4 μM). In-vivo assays (60 mg/kg/day; oral) showed no overt toxicity and a significant reduction in circulating T cells without affecting neutrophils, monocytes, or B-cells indicating specificity against T-cells. Furthermore, this effect was specific to TCR-mediated T-cell activation and the drug did not affect T-cells stimulated with PMA/Ionomycin suggesting preferential inhibition of antigenically-activated T-cells. To test therapeutic efficacy, male 10-12 week old mice underwent coronary ligation or sham operation and at 4 weeks post-MI randomized according to their cardiac function to receive either the vehicle or OSU-ERB-012 (60 mg/kg/day, oral) for the next 4 weeks. Consistently, at 8 weeks we observed a significant reduction in T-cells in the circulation and the spleens of drug-treated mice when compared with the vehicle treatment. As expected, vehicle treated HF mice showed progressive LV dilatation with significantly increased end-diastolic and end-systolic volumes (EDV and ESV, respectively) from 4-8 weeks post-MI. Importantly, treatment with OSU-ERB-012 significantly inhibited these changes and blunted LV remodeling from 4-8 weeks post-MI. Significant reduction in tibia-normalized heart weights supported these results. Our studies indicate that OSU-ERB-012 is a novel orally-active drug molecule that selectively inhibits T-cell activation and blunts pathological LV-remodeling during chronic HF.
Safety and Efficacy of Purine Analogs for Treatment of Waldenstrom Macroglobulinemia
Authors: Abdul Jabbar Dar, Qasim Khurshid, Muhaddis Ejaz Ahmad, Muhammad Ali Mirza, Farhan Khalid, Muhammad Tayyeb, Syed Maaz Abdullah, Muhammad Saad Farooqi, Sana Irfan Khan, Richi Kashyap, Saad Javed, Unaiza Faizan, Faiz Anwer
Journal: Blood (2020)
Impact of Comorbidities on Response Outcomes in Patients with Chronic Myeloid Leukemia in Chronic Phase Treated with First-Line Dasatinib Versus Imatinib: Exploratory Post Hoc Analysis of DASISION
Authors: Massimo Breccia, Michael J. Mauro, Elias Jabbour, Giuseppe Saglio, Antonio Jiménez-Velasco, Philipp D le Coutre, Irene DeGutis, Wasiulla Khan, Oumar Sy, Rene Swanink, Jorge E. Cortes
Journal: Blood (2020)
M1 and M2 Macrophages Play Different Roles in the Pathogenesis of Acute Graft-Versus-Host Disease Post-Allotransplant By Modulating Immune Microenvironment
Authors: Qi Wen, Hong-Yan Zhao, Zhong-Shi Lyu, Yao Weili, Ting-Ting Han, Yu-Hong Chen, Yu Wang, Lan-Ping Xu, Xiao-Hui Zhang, Yuan Kong, Xiao-Jun Huang
Journal: Blood (2020)
Global Treatment Satisfaction Levels and Treatment Patterns from the International Sickle Cell World Assessment Survey (SWAY): Hydroxyurea (HU) Versus No HU
Authors: Fuad A El Rassi, John James, Biree Andemariam, Baba PD Inusa, Beverley Francis-Gibson, Alecia C Nero, Caterina P Minniti, Cassandra Trimnell, Miguel R Abboud, Jean-Benoît Arlet, Raffaella Colombatti, Mariane de Montalembert, Suman Jain, Wasil Jastaniah, Erfan Nur, Marimilia Pita, Nicholas Ramscar, Tom Bailey, Olivera Rajkovic-Hooley, Ifeyinwa Osunkwo
Journal: Blood (2020)
Long-Term Outcome of Low-Dose Hypomethylating Agents in Lower-Risk Myelodysplastic Syndromes: A Randomized Phase 2 Study
Authors: Koji Sasaki, Elias Jabbour, Guillermo Montalban Bravo, Nicholas J. Short, Rashmi Kanagal-Shamanna, Tapan M. Kadia, Gautam Borthakur, Naveen Pemmaraju, Jorge E. Cortes, Farhad Ravandi, Yesid Alvarado, Kelly S. Chien, Hui Yang, Hagop M. Kantarjian, Guillermo Garcia-Manero
Journal: Blood (2020)
Treatment Patterns and Outcomes of Multiple Myeloma (MM) with Chromosome Translocation (11;14) in United States (US) Routine Clinical Practice
Authors: Shebli Atrash, Evelyn M. Flahavan, Tao Xu, Esprit Ma, Sudeep Karve, Wan-Jen Hong, Gilbert Jirau-Lucca, Michael Nixon, Sikander Ailawadhi
Journal: Blood (2020)
Colon cancer screening should begin at 45, says US task force
Authors: Janice Hopkins Tanne
Journal: BMJ (2020)

The US Preventive Services Task Force has suggested that Americans should begin screening for colon cancer at age 45, not 50, because of an increase in colon cancer among younger adults.

The new guidelines are in line with the American Cancer Society’s recommendation to begin screening at 45, issued two years ago.1 The increase in colon cancer among younger people has been in the news in the US since the death of the popular actor Chadwick Boseman at age 43. The star of Black Panther and other films died in August of colon cancer that had been diagnosed years earlier.

Colon cancer is still far more common among older people: about …
Thrombotic Events with <i>Neisseria Meningitidis</i> Vaccination in Patients with Paroxysmal Nocturnal Hemoglobinuria, UK Experience
Authors: Louise Arnold, Richard Kelly, Talha Munir, Petra Muus, Alexandra Pike, Kathryn Riley, Briony Forrest, Jeanifer Gachev, Morag Griffin, Peter Hillmen
Journal: Blood (2020)
Phase II Trial of In Vivo Purging with Daratumumab in Newly Diagnosed Multiple Myeloma
Authors: Shebli Atrash, Myra Robinson, Barry Paul, Sarah Norek, David M. Foureau, Carrie Ann Syfert, Ami P Ndiaye, James T Symanowski, Jordan Robinson, Manisha Bhutani, Peter M. Voorhees, Saad Z. Usmani
Journal: Blood (2020)
Low- Versus Moderate-Dose Hydroxyurea for Secondary Stroke Prevention in Children with Sickle Cell Disease in Sub-Saharan Africa: Final Results of a Randomized Controlled Trial, Sprint Trial
Authors: Shehu Umar Abdullahi, Surayya M. Sunusi, Mohammed Sani Abba, Saifuddeen Sani, Aisha Galadanci, Hauwa Inuwa, Binta W. Jibir, Brittany Covert Greene, Adetola A. Kassim, Lori C. Jordan, Muktar Aliyu, Mark Rodeghier, Awwal Musa Borodo, Bilya Sani Musa, Habu Abdu, Michael R. DeBaun
Journal: Blood (2020)
A Novel Inflammatory Index Is Sufficient to Identify Hemophagocytic Lymphohistiocytosis in Adult Patients with Hematologic Malignancies
Authors: Adi Zoref-Lorenz, Jun Murakami, Liron Hofstetter, Swaminathan P Iyer, Ahmad S. Alotaibi, Peter Miller, Elad Guber, Shiri Weinstein, Joanne Yacobovich, Sarah Nikiforow, Benjamin L. Ebert, Oren Pasvolsky, Pia Raanani, Arnon Nagler, Nancy Berliner, Naval Daver, Martin H Ellis, Michael B. Jordan
Journal: Blood (2020)
Abstract PO-101: Transcriptional heterogeneity in lung adenocarcinoma reveals distinct therapeutic vulnerabilities
Authors: Anneleen Daemen, Jonathan E. Cooper, Szymon Myrta, Matthew J. Wongchenko, Eva Lin, Jason E. Long, Oded Foreman, Zora Modrusan, Jarrod Tremayne, Cecile C. de la Cruz, Mark Merchant, Scott E. Martin, Yibing Yan, Melissa R. Junttila
Journal: Cancer Research (2020)

Abstract Lung adenocarcinomas comprise the largest fraction of non-small cell lung cancer, which is the leading cause of cancer deaths. 75% of adenocarcinomas lack targeted therapies due to scarcity of druggable drivers. Here we leverage transcriptional data from &amp;gt;800 early-stage and advanced patients to classify tumors based on signaling similarities and discover subgroups within this unmet patient population. We identify three robust subtypes dubbed Mucinous, Proliferative, and Mesenchymal with respective pathway phenotypes. These transcriptional states lack discrete and causative mutational etiology as evidenced by similarly distributed oncogenic drivers including KRAS and EGFR. The subtypes capture heterogeneity even amongst tumors lacking known oncogenic drivers. Paired multi-regional intratumoral biopsies demonstrate unified subtypes despite divergently evolved pro-oncogenic mutations, indicating subtype stability during selective pressure. Heterogeneity amongst in vitro and in vivo preclinical models is expounded by the human lung adenocarcinoma subtypes and can be leveraged to discover subtype-specific vulnerabilities. As proof-of-concept, we identify differential subtype response to MEK pathway inhibition in a chemical library screen of 89 lung cancer cell lines, which reproduces across model systems and a clinical trial, supporting prognostic utility of transcriptional subtyping. Our findings support forward translational relevance of transcriptional subtypes, where further exploration therein may improve lung adenocarcinoma treatment. Citation Format: Anneleen Daemen, Jonathan E. Cooper, Szymon Myrta, Matthew J. Wongchenko, Eva Lin, Jason E. Long, Oded Foreman, Zora Modrusan, Jarrod Tremayne, Cecile C. de la Cruz, Mark Merchant, Scott E. Martin, Yibing Yan, Melissa R. Junttila. Transcriptional heterogeneity in lung adenocarcinoma reveals distinct therapeutic vulnerabilities [abstract]. In: Proceedings of the AACR Virtual Special Conference on Tumor Heterogeneity: From Single Cells to Clinical Impact; 2020 Sep 17-18. Philadelphia (PA): AACR; Cancer Res 2020;80(21 Suppl):Abstract nr PO-101.
Outcomes of Patients of Eastern Mediterranean Region with Lymphoma and COVID-19.Does Recent Chemo Immunotherapy Have a Role on Severity?
Authors: Imran K Tailor, Nawal F Alshehry, Kamran Sabir, Abdul Rehman Z Zaidi, Mohammed Marei, Ibraheem Motabi, Mansour Alfayez, Syed Ziauddin A Zaidi, Syed Y Altaf
Journal: Blood (2020)
The importance of assessing blood tumour burden in cutaneous T‐cell lymphoma*
Authors: M.H. Vermeer, J.P. Nicolay, J.J. Scarisbrick, P.L. Zinzani
Journal: British Journal of Dermatology (2020)

Mycosis fungoides (MF) and Sézary syndrome (SS) are the best‐studied subtypes of cutaneous T‐cell lymphoma. The level of blood tumour burden in patients is important for diagnosis, disease staging, prognosis and management, as well as assessing treatment response. Until recently, the assessment of blood involvement was made using manual counts of morphologically atypical T cells (Sézary cells), but this approach may be subjective, and is affected by interobserver variability. Objective and consistent approaches to accurately quantifying blood involvement are required to ensure appropriate stage‐related management of patients and to improve our understanding of the prognostic implications of blood tumour burden in these diseases. While assessment of blood involvement is common in SS and advanced‐stage MF, an improved understanding of the implications of blood involvement at early disease stages could help identify patients more likely to progress to late‐stage disease, and hence guide treatment decisions and frequency of follow‐up assessment, ultimately improving patient outcomes. This concise review discusses the development of flow cytometry‐based classifications for assessing blood involvement in MF and SS, and summarizes current recommendations for blood classification and assessment of blood response to treatment.
Nilotinib Vs. Dasatinib in Achieving MR4.5 for Newly Diagnosed Chronic Myeloid Leukemia: Results of the Prospective Randomized Phase 3 Study, JALSG CML212
Authors: Itaru Matsumura, Shigeki Ohtake, Yoshiko Atsuta, Mio Kurata, Yosuke Minami, Naoto Takahashi, Chiaki Nakaseko, Noriyoshi Iriyama, Katsumichi Fujimaki, Kazuhiko Kakihana, Yoji Ogasawara, Takaaki ONO, Masaya Okada, Tetsuzo Tauchi, Toshihiro Miyamoto, Kazunori Ohnishi, Emiko Sakaida, Shin Fujisawa, Yukio Kobayashi, Norio Asou, Hitoshi Kiyoi, Yasushi Miyazaki, Tomoki Naoe
Journal: Blood (2020)
Clinical and Prognostic Implications of <i>PTPN11</i> Mutations in Acute Myeloid Leukemia (Alliance)
Authors: Sydney Fobare, Jessica Kohlschmidt, Hatice Gulcin Ozer, Krzysztof Mrózek, Deedra Nicolet, Alice S. Mims, Ramiro Garzon, James S. Blachly, Shelley Orwick, Andrew J Carroll, Richard M. Stone, Eunice S. Wang, Jonathan E. Kolitz, Bayard L. Powell, Christopher C. Oakes, Ann-Kathrin Eisfeld, Erin Hertlein, John C. Byrd
Journal: Blood (2020)
FRI0153 Cardiovascular autonomic functions and sympathetic skin responses in behÇet’s disease
Authors: K Aksu, Z Colakoglu, G Keser, N Kýylýoglu, V Inal, G Gumusdýs, E Doganavsargýl
Journal: Annals of the Rheumatic Diseases (2001)

<h3>Background</h3> Unlike other systemic necrotizing vasculitides, such as periarteritis nodosa and Churg-Strauss Syndrome, peripheral and autonomic nervous system involvement is rare Behçet's disease. <h3>Objectives</h3> We examined the peripheral nervous system involvement, cardiovascular autonomic functions and sympathetic skin responses in Behçet's patients. <h3>Methods</h3> Fifteen age and sex matched healthy controls, besides 26 Behçet's patients were included in this study. In order to exclude the effects of colchicine an the parameters tested, 16 patients with familial mediterranean fever (FMF) were also studied. In addition to electromyographic studies and sympathetic skin potentials, variations of R-R interval in electrocardiograhpy in response to hyperventilation and Valsalva manoeuvre were recorded. Patients with disorders that may cause autonomic dysfunction were excluded from the study. <h3>Results</h3> There was no difference among the three groups in evaluations performed during hyperventilation and Valsalva manoeuvres. No pathologic electromyographic finding was recorded except the sensory motor polyneuropathy detected in a single Behçet's patient. The amplitude and latencies of skin potentials obtained in Behcet's patients were not significantly different when compared with healthy controls and FMF patients. Colchicine usage did not significantly alter the electrophysiological measurements in Behcet's and FMF patients. <h3>Conclusion</h3> There was no evidence of peripheral autonomic nervous system involvement in Behçet's disease. We conclude that autonomic nervous system involvement is not significant in Behçet's disease.
Environmental sustainability in dermatological surgery
Authors: C.L. Chaplin, A.G.H. Wernham, D. Veitch
Journal: British Journal of Dermatology (2020)

The health and social care sector have a substantial environmental impact, accounting for 6.3% of England's carbon footprint 1 . In view of this, clinicians must ensure all aspects of clinical practice take environmental sustainability into account. Surgical procedures play a significant role in dermatological practice and are particularly energy and resource intensive. This article discusses a range of behavioural, procedural and structural interventions, which could help minimise the environmental impact of dermatologic surgery, categorised according to the 5 R's: Reduce, Reuse, Recycle, Rethink and Research.
Ktx-120, a Novel Irakimid Degrader of IRAK4 and IMiD Substrates Shows Preferential Activity and Induces Regressions in MYD88-Mutant DLBCL CDX and PDX Models
Authors: Duncan Walker, Michele Mayo, Christine Klaus, Dapeng Chen, Samyabrata Bhaduri, Kirti Sharma, Scott Rusin, Alice McDonald, Jared Gollob, Nello Mainolfi, Matt Weiss
Journal: Blood (2020)
Whimsical (Waldenstrom's Macroglobulinemia Study Involving CArt-wheeL): A Global Patient-Derived Data Registry Capturing Treatment, Quality of Life and COVID-19 Data
Authors: Ibrahim Tohidi-Esfahani, Andrew Warden, Elena Malunis, Peter Liburdi deNardis, Javier Haurat, Marita Black, Stephen Opat, Shirley D'Sa, Marie José Kersten, Ruth Spearing, Maria Lia Palomba, Adam J Olszewski, Carl Harrington, Clare Scott, Judith Trotman
Journal: Blood (2020)
Chimeric Antigen Receptor T Cell Therapy in the Relapsed or Refractory Multiple Myeloma with Extramedullary Disease--a Single Institution Observation in China
Authors: Baiyan Wang, Jie Liu, Wan-Hong Zhao, Yin-Xia Chen, Xing-Mei Cao, Yun Yang, Yi-Lin Zhang, Fang-Xia Wang, Peng-Yu Zhang, Bo Lei, Liu-Fang Gu, Jian-Li Wang, Frank Xiao-Hu Fan, Wang-Gang Zhang, Ai-Li He
Journal: Blood (2020)
Peripheral Blood CD26+ Leukemia Stem Cells Monitoring in Chronic Myeloid Leukemia Patients from Diagnosis to Response to TKIs: Interim Results of a Multicenter Prospective Study (PROSPECTIVE FLOWERS)
Authors: Monica Bocchia, Anna Sicuranza, Paola Pacelli, Alessandra Iurlo, Elisabetta Abruzzese, Sara Galimberti, Patrizia Pregno, Giovanni Caocci, Isabella Capodanno, Monica Crugnola, Antonella Gozzini, Claudio Fozza, Mario Annunziata, Sabina Russo, Anna Marina Liberati, Olga Mulas, Daniele Cattaneo, Adele Santoni, Vincenzo Sammartano, Federico Caroni, Donatella Raspadori
Journal: Blood (2020)
Granulocyte Colony-Stimulating Factor Is Safe and Well Tolerated Following Allogeneic Transplantation in Patients with Sickle Cell Disease
Authors: Niketa C. Shah, Sweta Bhoopatiraju, Allistair Abraham, Eric Jon Anderson, Martin Andreansky, Monica Bhatia, Sonali Chaudhury, Geoff D.E. Cuvelier, Kamar Godder, Michael Grimley, Gregory Hale, Naynesh Kamani, David Jacobsohn, Alexander I. Ngwube, Jodi L. Skiles, Lolie C. Yu, Shalini Shenoy
Journal: Blood (2020)
Association of Maternal Folate and Vitamin B12 in Early Pregnancy With Gestational Diabetes Mellitus: A Prospective Cohort Study
Authors: Xiaotian Chen, Yi Zhang, Hongyan Chen, Yuan Jiang, Yin Wang, Dingmei Wang, Mengru Li, Yalan Dou, Xupeng Sun, Guoying Huang, Weili Yan
Journal: Diabetes Care (2020)

OBJECTIVE To investigate the association of folate and vitamin B12 in early pregnancy with gestational diabetes mellitus (GDM) risk. RESEARCH DESIGN AND METHODS The data of this study were from a subcohort within the Shanghai Preconception Cohort Study. We included pregnancies with red blood cell (RBC) folate and vitamin B12 measurements at recruitment (between 9 and 13 gestational weeks) and those with three samples available for glucose measurements under an oral glucose tolerance test. GDM was diagnosed between 24 and 28 weeks’ gestation. Odds ratio (OR) and 95% CI of having GDM was used to quantify the association. RESULTS A total of 1,058 pregnant women were included, and GDM occurred in 180 (17.01%). RBC folate and vitamin B12 were significantly higher in pregnancies with GDM than those without GDM (P values were 0.045 and 0.002, respectively) and positively correlated with 1-h and 2-h serum glucose. Daily folic acid supplementation in early pregnancy increases the risk of GDM; OR (95% CI) was 1.73 (1.19–2.53) (P = 0.004). Compared with RBC folate &amp;lt;400 ng/mL, pregnancies with RBC folate ≥600 ng/mL were associated with ∼1.60-fold higher odds of GDM; the adjusted OR (95% CI) was 1.58 (1.03–2.41) (P = 0.033). A significant trend of risk effect on GDM risk across categories of RBC folate was observed (Ptrend = 0.021). Vitamin B12 was significantly associated with GDM risk (OR 1.14 per 100 pg/mL; P = 0.002). No significant association of serum folate and percentile ratio of RBC folate/vitamin B12 with GDM was observed. CONCLUSIONS Higher maternal RBC folate and vitamin B12 levels in early pregnancy are significantly associated with GDM risk, while the balance of folate/vitamin B12 is not significantly associated with GDM.