Mya-Thway Tint1,2, Suresh A Sadananthan2, Shu-E Soh2, Izzuddin M Aris2, Navin Michael2, Kok H Tan3,4, Lynette P C Shek5, Fabian Yap6,7,8, Peter D Gluckman2,9, Yap-Seng Chong1,2, Keith M Godfrey10,11, S Sendhil Velan2,12, Shiao-Yng Chan1,2, Johan G Eriksson1,2,13,14, Marielle V Fortier15, Cuilin Zhang16, Yung S Lee2,5,17. 1. Department of Obstetrics & Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore. 2. Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (ASTAR), Singapore. 3. Department of Maternal Fetal Medicine, KK Women's and Children's Hospital, Singapore. 4. Academic Medicine, Duke-National University of Singapore Graduate Medical School, Singapore. 5. Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore. 6. Department of Pediatric Endocrinology, KK Women's and Children's Hospital, Singapore. 7. Duke-National University of Singapore Graduate Medical School, Singapore. 8. Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore. 9. Liggins Institute, University of Auckland, Auckland, New Zealand. 10. Medical Research Council Lifecourse Epidemiology Unit, Univeristyof Southhampton, Southampton, United Kingdom. 11. National Institute for Health Research Southampton Biomedical Research Centre, University Hospital Southampton, NHS Foundation Trust, Southhampton, United Kingdom. 12. Singapore Bioimaging Consortium, Agency for Science, Technology and Research (A*STAR), Singapore. 13. Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland. 14. Folkhälsan Research Center, Helsinki, Finland. 15. Department of Diagnostic and Interventional Imaging, KK Women's and Children's Hospital, Singapore. 16. Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, Rockville, MD, USA. 17. Division of Pediatric Endocrinology, Department of Pediatrics, Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore.
Abstract
BACKGROUND: Gestational diabetes is associated with unfavorable body fat distribution in offspring. However, less is known about the effects across the range of maternal gestational glycemia on offspring abdominal adiposity (AA) in infancy and early childhood. OBJECTIVES: This study determined the association between gestational glycemia and offspring AA measured by MRI in the neonatal period and during the preschool years. METHODS: Participants were mother-offspring pairs from the GUSTO (Growing Up in Singapore Towards healthy Outcomes) prospective cohort study. Children who underwent MRI within 2 wk postdelivery (n = 305) and/or at preschool age, 4.5 y (n = 273), and whose mothers had a 2-h 75-g oral-glucose-tolerance test (OGTT) at 26-28 weeks of gestation were included. AA measured by adipose tissue compartment volumes-abdominal superficial (sSAT), deep subcutaneous (dSAT), and internal (IAT) adipose tissue-was quantified from MRI images. RESULTS: Adjusting for potential confounders including maternal prepregnancy BMI, each 1-mmol/L increase in maternal fasting glucose was associated with higher SD scores for sSAT (0.66; 95% CI: 0.45, 0.86), dSAT (0.65; 95% CI: 0.44, 0.87), and IAT (0.64; 95% CI: 0.42, 0.86) in neonates. Similarly, each 1-mmol/L increase in 2-h OGTT glucose was associated with higher neonatal sSAT (0.11; 95% CI: 0.03, 0.19) and dSAT (0.09; 95% CI: 0.00, 0.17). These associations were stronger in female neonates but only persisted in girls between fasting glucose, and sSAT and dSAT at 4.5 y. CONCLUSIONS: A positive association between maternal glycemia and neonatal AA was observed across the whole range of maternal mid-gestation glucose concentrations. These findings may lend further support to efforts toward optimizing maternal hyperglycemia during pregnancy. The study also provides suggestive evidence on sex differences in the impact of maternal glycemia, which merits further confirmation in other studies.This trial was registered at clinicaltrials.gov as NCT01174875.
BACKGROUND:Gestational diabetes is associated with unfavorable body fat distribution in offspring. However, less is known about the effects across the range of maternal gestational glycemia on offspring abdominal adiposity (AA) in infancy and early childhood. OBJECTIVES: This study determined the association between gestational glycemia and offspring AA measured by MRI in the neonatal period and during the preschool years. METHODS:Participants were mother-offspring pairs from the GUSTO (Growing Up in Singapore Towards healthy Outcomes) prospective cohort study. Children who underwent MRI within 2 wk postdelivery (n = 305) and/or at preschool age, 4.5 y (n = 273), and whose mothers had a 2-h 75-g oral-glucose-tolerance test (OGTT) at 26-28 weeks of gestation were included. AA measured by adipose tissue compartment volumes-abdominal superficial (sSAT), deep subcutaneous (dSAT), and internal (IAT) adipose tissue-was quantified from MRI images. RESULTS: Adjusting for potential confounders including maternal prepregnancy BMI, each 1-mmol/L increase in maternal fasting glucose was associated with higher SD scores for sSAT (0.66; 95% CI: 0.45, 0.86), dSAT (0.65; 95% CI: 0.44, 0.87), and IAT (0.64; 95% CI: 0.42, 0.86) in neonates. Similarly, each 1-mmol/L increase in 2-h OGTT glucose was associated with higher neonatal sSAT (0.11; 95% CI: 0.03, 0.19) and dSAT (0.09; 95% CI: 0.00, 0.17). These associations were stronger in female neonates but only persisted in girls between fasting glucose, and sSAT and dSAT at 4.5 y. CONCLUSIONS: A positive association between maternal glycemia and neonatal AA was observed across the whole range of maternal mid-gestation glucose concentrations. These findings may lend further support to efforts toward optimizing maternal hyperglycemia during pregnancy. The study also provides suggestive evidence on sex differences in the impact of maternal glycemia, which merits further confirmation in other studies.This trial was registered at clinicaltrials.gov as NCT01174875.
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