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NUS Women

Global Centre for Asian Women's Health
Yong Loo Lin School of Medicine

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Overview

To win the battle against diabetes, obesity, and cardiovascular disease through a multi-disciplinary platform and from a new angle – a family/community-based approach, focusing on early life origins and a life-course approach

Goals

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To investigate the determinants and health consequences of diabetes, obesity and comorbidities based on a life-course approach

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To identify and implement sustainable and effective interventions for interrupting the “diabetes begetting diabetes” vicious circle over a woman’s lifespan and across generations, targeting the preconception, pregnancy, and postpartum periods

Study Initiatives & Collaborations

1. DWH Study (Diabetes & Women’s Health Study)

The DWH Study, based on a retrospective cohort design, aims to understand and discover novel pathways and determinants underlying the progression from gestational diabetes mellitus (GDM) to type 2 diabetes (T2DM), cardiovascular diseases, and other complications in two large existing cohorts: the Nurses’ Health Study II (NHS-II) and the Danish National Birth Cohort (DNBC). Please see here for updates on our publications.

2. GDM-CARE Study

This study is entitled “Studying the Heterogeneity of Gestational Diabetes Mellitus: Cardio-Metabolic Alteration and Treatment Response in A Multi-Ethnic Population in Singapore”. It aims to define gestational diabetes mellitus phenotypes in relation to women’s cardiometaboilc profiles and treatment responses during pregnancy.

3. Metabolome - Pregnancy & Fetal Growth

We will employ emerging high throughput Omics technology to investigate the metabolomic antecedents of pregnancy complications such as gestational diabetes mellitus and abnormal fetal growth. Interplays with other measures in exposome, such as environmental chemicals, diet, and physical activity, will also be investigated. The study will leverage comprehensive and longitudinal data and biospecimen collected in the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Fetal Growth Study, which included 2,802 pregnant women of four races/ethnicities.

4. Etiology and Prediction of Gestational Diabetes from Preconception

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Identification of risk factors, such as diet and lifestyle, reproductive, early-life, and genetic factors, for the development of gestational diabetes mellitus based on data from the Nurses’ Health Study II (NHS-II) and the NICHD Fetal Growth Study in the United States and from the Growing Up in Singapore Toward healthy Outcomes (GUSTO) study and the Singapore PREconception Study of long-Term maternal and child Outcomes (S-PRESTO).
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Investigation of the pathogenesis of gestational diabetes mellitus using prospectively and longitudinally collected biospecimens from pregnancy cohorts, such as the NICHD Fetal Growth Study. Currently, this line of research focuses on a comprehensive panel of biochemical markers that are putatively implicated in glucose homeostasis, fetal growth, or both. Targeted and non-targeted metabolomics are being analysed to discover of new pathways and/or biochemical markers related to glucose intolerance and subsequent adverse fetal outcomes.

Please see here for updates on our publications.

Selected Publications

Adherence to healthy lifestyle and risk of gestational diabetes mellitus: prospective cohort study
Zhang C , Tobias DK, Chavarro JE, Bao W, Wang D, Ley SH, Hu FB.
BMJ, 2014.
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Assessment of caffeine consumption and maternal cardiometabolic pregnancy complications
Hinkle SN , Gleason JL, Yisahak SF, Zhao SK, Mumford SL, Sundaram R, Grewal J, Grantz KL, Zhang C.
JAMA Network Open, 2021.
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Association of history of gestational diabetes with long-term cardiovascular disease risk in a large prospective cohort of US women
Tobias DK , Stuart JJ, Li S, Chavarro J, Rimm EB, Rich-Edwards J, Hu FB, Manson JE, Zhang C.
JAMA Internal Medicine, 2017.
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Gestational diabetes mellitus
McIntyre HD , Catalano P, Zhang C, Desoye G, Mathiesen ER, Damm P.
Nature Reviews Disease Primers, 2019.
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Gestational diabetes mellitus and renal function: a prospective study with 9- to 16-year follow-up after pregnancy
Rawal S , Olsen SF, Grunnet LG, Ma RC, Hinkle SN, Granström C, Wu J, Yeung E, Mills JL, Zhu Y, Bao W, Ley SH, Hu FB, Damm P, Vaag A, Tsai MY, Zhang C.
Diabetes Care, 2018.
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Glycaemic status during pregnancy and longitudinal measures of fetal growth in a multi-racial US population: a prospective cohort study
Li M , Hinkle SN, Grantz KL, Kim S, Grewal J, Grobman WA, Skupski DW, Newman RB, Chien EK, Sciscione A, Zork N, Wing DA, Nageotte M, Tekola-Ayele F, Louis GMB, Albert PS, Zhang C.
Lancet Diabetes Endocrinol, 2020.
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Lifestyle changes and long-term weight gain in women with and without a history of gestational diabetes mellitus: a prospective study of 54,062 women in the Nurses’ Health Study II
Yang J , Zhang C, Chavarro JE, Rich-Edwards JW, Wang M, Fawzi WW, Manson JE, Lee IM, Hu FB, Tobias DK.
Diabetes Care, 2022.
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Modifiable risk factors and long term risk of type 2 diabetes among individuals with a history of gestational diabetes mellitus: prospective cohort study
Yang J , Qian F, Chavarro JE, Ley SH, Tobias DK, Yeung E, Hinkle SN, Bao W, Li M, Liu A, Mills JL, Sun Q, Willett WC, Hu FB, Zhang C.
BMJ, 2022.
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Plasma phospholipid n-3 and n-6 polyunsaturated fatty acids in relation to cardiometabolic markers and gestational diabetes: A longitudinal study within the prospective NICHD fetal growth studies
Zhu Y , Li M, Rahman ML, Hinkle SN, Wu J, Weir NL, Lin Y, Yang H, Tsai MY, Ferrara A, Zhang C.
PLoS Med, 2019.
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Screening for gestational diabetes
Zhang C , Catalano P.
JAMA, 2021.
Read more