Anitha Pitchika1,2,3, Kendra Vehik4, Sandra Hummel1,2,3, Jill M Norris5, Ulla M Uusitalo4, Jimin Yang4, Suvi M Virtanen6,7,8,9, Sibylle Koletzko10, Carin Andrén Aronsson11, Anette-G Ziegler1,2,3, Andreas Beyerlein1,2,3. 1. Institute of Diabetes Research, Helmhtoltz Zentrum München, Munich, Germany. 2. Forschergruppe Diabetes, Klinikum rechts der Isar, Technische Universität München, Munich, Germany. 3. Forschergruppe Diabetes e.V, Helmhtoltz Zentrum München, Munich, Germany. 4. Health Informatics Institute, Morsani College of Medicine, University of South Florida, Tampa, Florida, USA. 5. Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA. 6. Unit of Nutrition, National Institute for Health and Welfare, Helsinki, Finland. 7. Faculty of Social Sciences/Health Sciences, University of Tampere, Tampere, Finland. 8. Center for Child Health Research, University of Tampere and Tampere University Hospital, Tampere, Finland. 9. The Science Center of Pirkanmaa Hospital District, Tampere, Finland. 10. Dr. v. Hauner Children's Hospital, University Medical Center, LMU, Munich, Germany. 11. Department of Clinical Sciences, Lund University, Skåne University Hospital SUS, Malmö, Sweden.
Abstract
OBJECTIVE: This study aimed to determine the relationship between different forms of, and potential pathways between, maternal diabetes and childhood obesity at different ages. METHODS: Prospective cohort data from The Environmental Determinants of Diabetes in the Young (TEDDY) study, which was composed of 5,324 children examined from 0.25 to 6 years of age, were analyzed. Cross-sectional and longitudinal analyses taking into account potential confounders and effect modifiers such as maternal prepregnancy BMI and birth weight z scores were performed. RESULTS: Offspring of mothers with gestational diabetes mellitus (GDM) or type 1 diabetes mellitus (T1DM) showed a higher BMI standard deviation score and increased risk for overweight and obesity at 5.5 years of age than offspring of mothers without diabetes. While these associations could be substantially explained by maternal prepregnancy BMI in offspring of mothers with GDM, significant associations disappeared after adjustment for birth weight z scores in offspring of T1DM mothers. Furthermore, overweight risk became stronger with increasing age in offspring of mothers with diabetes compared with offspring of mothers without diabetes. CONCLUSIONS: Maternal diabetes is associated with increased risk of offspring overweight, and the association appears to get stronger as children grow older. Indeed, intrauterine exposure to maternal T1DM may predispose children to later obesity through increased birth weight, while maternal BMI is more important in children exposed to GDM.
OBJECTIVE: This study aimed to determine the relationship between different forms of, and potential pathways between, maternal diabetes and childhood obesity at different ages. METHODS: Prospective cohort data from The Environmental Determinants of Diabetes in the Young (TEDDY) study, which was composed of 5,324 children examined from 0.25 to 6 years of age, were analyzed. Cross-sectional and longitudinal analyses taking into account potential confounders and effect modifiers such as maternal prepregnancy BMI and birth weight z scores were performed. RESULTS: Offspring of mothers with gestational diabetes mellitus (GDM) or type 1 diabetes mellitus (T1DM) showed a higher BMI standard deviation score and increased risk for overweight and obesity at 5.5 years of age than offspring of mothers without diabetes. While these associations could be substantially explained by maternal prepregnancy BMI in offspring of mothers with GDM, significant associations disappeared after adjustment for birth weight z scores in offspring of T1DM mothers. Furthermore, overweight risk became stronger with increasing age in offspring of mothers with diabetes compared with offspring of mothers without diabetes. CONCLUSIONS: Maternal diabetes is associated with increased risk of offspring overweight, and the association appears to get stronger as children grow older. Indeed, intrauterine exposure to maternal T1DM may predispose children to later obesity through increased birth weight, while maternal BMI is more important in children exposed to GDM.
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