Research Description
More than half of all women entering pregnancy are overweight (OW) or obese (OB), and 15% will develop Gestational Diabetes (GDM). Poor maternal diet, OW/OB, excess gestational weight gain (GWG) and each increase risk for Non-Alcoholic Fatty Liver Disease (NAFLD) – nicknamed “the silent killer” for its asymptomatic progression. NAFLD affects 1 in 3 adults and is on the rise in children. However, the impact of nutrition on advancing risk for NAFLD, in mothers with OB or GDM has not been studied. Further, the transmission of NAFLD risk to infants may begin in utero and may affect the progression of pediatric form of NAFLD. The goal of this pilot study is to, A) Determine what changes, if any, occur in liver fat and stiffness in late pregnancy and after childbirth in mothers with OW/OB, excess GWG, and/or GDM, B) Establish a panel of blood tests for detection of changes in liver health during and after pregnancy, C) Explore whether changes in maternal body composition and liver fat are related to excess liver and body fat in infants during the first 6 months of life. Liver fat and stiffness, key components of NAFLD, will be measured using a non-invasive ultrasound method (FibroScan) during the second trimester, and at 1 and 6-month post-partum. At those same times we will measure diet quality body composition), whole-body resting metabolism, and standard and novel blood biomarkers of liver and metabolic health in mother/infant pairs.Research Profile
What area of diabetes research does your project cover? What role will this particular project play in preventing, treating and/or curing diabetes?My project aims to evaluate how maternal health during pregnancy shapes the health of both mother and baby. Specifically, this study will evaluate the presence/development of non-alcoholic fatty liver disease (NAFLD (soon widely referred to as metabolic dysfunction-associated steatotic liver disease MASLD and nicknamed “the silent killer” for its asymptomatic progression) during pregnancy, postpartum, and infancy through a non-invasive ultrasound technique. Rates of NALD are increasing worldwide in both adults and children. Although obesity is a primary driver of NAFLD development, there is a large percentage of children who develop NAFLD that do not have obesity. Furthermore, NAFLD increases the risk for type 2 diabetes, kidney disease, cancer of the liver, and liver transplant. Risk for many chronic conditions begin in-utero; however, whether this is true for NAFLD remains poorly understood. I intend to evaluate several known and proposed health factors that are thought to drive the development of NAFLD and influence maternal and infant health, including: maternal weight status and body composition (e.g., body fat), maternal dietary intake and quality, presence of gestational diabetes, and daily estimated caloric requirements. Following delivery, these factors will be assessed at month-1 and -6 postpartum in both mother and infant. Additionally, I intend to determine if common laboratory biomarker tests, such as liver enzymes, can be utilized to predict changes in liver steatosis during and after pregnancy. I hypothesize that changes in maternal body composition and liver steatosis are related to excess liver and body fat in infants during the first 6 months of life.
If a person with diabetes were to ask you how your project will help them in the future, how would you respond?One of the long-term goals of my project is to develop a data driven intervention to improve maternal health in pregnancy. By improving maternal health, I believe we can truly prevent the development of chronic conditions like type 2 diabetes and non-alcoholic fatty liver disease (or metabolic dysfunction-associated steatotic liver disease) in future generations! My work will help women with type 2 or gestational diabetes have healthier, lower-risk pregnancies, thereby reducing the infant’s future risk for diabetes.
Why important for you, personally, to become involved in diabetes research? What role will this award play?Oklahoma is home to 39 Indigenous Nations, including mine. I am a proud member of the Citizen Potawatomi Nation and a first-generation college student. To me, diabetes isn't simply a chronic disease, it bears the face of nmezodanek (my family). Indigenous Americans are nearly 3 times more likely to develop type 2 diabetes, and twice as likely to develop end-stage renal disease and die from diabetes than non-Hispanic white adults. Although the rates of non-alcoholic fatty liver disease (NAFLD) are thought to be underestimated among Indigenous adults, global research indicates that NAFLD rates mirror obesity rates, with Indigenous adults being 50% more likely to be obese than non-Hispanic white adults. Although this project does not target any singular ethnic demographic, Oklahoma has the second-highest number and percentage of Indigenous residents among the U.S. Through the funding from the ADA I hope that my project will be able to generate preliminary data that can be used to leverage additional research aimed at elevating the health of Indigenous adults and children in Oklahoma by reducing the burden and incidence of diabetes and liver disease.
In what direction do you see the future of diabetes research going?With the rapid evolution of genomic data, precision medicine, and novel therapeutic drugs I think the future of diabetes research will promote superior personalized medicine and nutrition. In turn, I think personalized medicine will ultimately reduce risk of diabetes for future generations.