Diabetes Metab J.  2021 Sep;45(5):730-738. 10.4093/dmj.2020.0154.

Maternal Hyperglycemia during Pregnancy Increases Adiposity of Offspring

Affiliations
  • 1Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea
  • 2Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
  • 3Department of Pediatrics, Korea Cancer Center Hospital, Seoul, Korea
  • 4Department of Pediatrics, Seoul National University Children’s Hospital, Seoul, Korea
  • 5Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Korea
  • 6Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea

Abstract

Background
The effect of intrauterine hyperglycemia on fat mass and regional fat proportion of the offspring of mothers with gestational diabetes mellitus (OGDM) remains to be determined.
Methods
The body composition of OGDM (n=25) and offspring of normoglycemic mothers (n=49) was compared using dualenergy X-ray absorptiometry at age 5 years. The relationship between maternal glucose concentration during a 100 g oral glucose tolerance test (OGTT) and regional fat mass or proportion was analyzed after adjusting for maternal prepregnancy body mass index (BMI).
Results
BMI was comparable between OGDM and control (median, 16.0 kg/m2 vs. 16.1 kg/m2 ). Total, truncal, and leg fat mass were higher in OGDM compared with control (3,769 g vs. 2,245 g, P=0.004; 1,289 g vs. 870 g, P=0.017; 1,638 g vs. 961 g, P=0.002, respectively), whereas total lean mass was lower in OGDM (15,688 g vs. 16,941 g, P=0.001). Among OGDM, total and truncal fat mass were correlated with fasting and 3-hour glucose concentrations of maternal 100 g OGTT during pregnancy (total fat mass, r=0.49, P=0.018 [fasting], r=0.473, P=0.023 [3-hour]; truncal fat mass, r=0.571, P=0.004 [fasting], r=0.558, P=0.006 [3-hour]), but there was no correlation between OGDM leg fat mass and maternal OGTT during pregnancy. Regional fat indices were not correlated with concurrent maternal 75 g OGTT values.
Conclusion
Intrauterine hyperglycemia is associated with increased fat mass, especially truncal fat, in OGDM aged 5 years.

Keyword

Adiposity; Body composition; Child; Diabetes, gestational

Figure

  • Fig. 1. Offspring adiposity and glycemic indices across categories of maternal glucose levels during pregnancy. (A) Total fat mass, (B) total fat %, (C) truncal fat %, (D) Matsuda index, (E) insulinogenic index, and (F) disposition index. Offspring of mothers with gestational mellitus diabetes (n=25) were divided into tertiles of maternal glucose concentrations of 100 g oral glucose tolerance test (OGTT) during pregnancy. Glucose categories of 100 g OGTT during pregnancy are defined as follows: fasting glucose (category 1, <90 mg/dL; category 2, 90 to 101 mg/dL; category 3, >101 mg/dL); 1-hour glucose (category 1, <190 mg/dL; category 2, 190 to 209 mg/dL; category 3, >209 mg/dL); 2-hour glucose (category 1, <165 mg/dL; category 2, 165 to 184 mg/dL; category 3, >184 mg/dL); 3-hour glucose (category 1, <140 mg/dL; category 2, 140 to 158 mg/dL; category 3, >158 mg/dL). Error bar represents standard error of mean.


Cited by  1 articles

Gestational Diabetes Mellitus: Diagnostic Approaches and Maternal-Offspring Complications
Joon Ho Moon, Hak Chul Jang
Diabetes Metab J. 2022;46(1):3-14.    doi: 10.4093/dmj.2021.0335.


Reference

1. HAPO Study Cooperative Research Group, Metzger BE, Lowe LP, Dyer AR, Trimble ER, Chaovarindr U, et al. Hyperglycemia and adverse pregnancy outcomes. N Engl J Med. 2008; 358:1991–2002.
Article
2. Kim MH, Kwak SH, Kim SH, Hong JS, Chung HR, Choi SH, et al. Pregnancy outcomes of women additionally diagnosed as gestational diabetes by the International Association of the Diabetes and Pregnancy Study Groups criteria. Diabetes Metab J. 2019; 43:766–75.
Article
3. Freinkel N. Banting lecture 1980. Of pregnancy and progeny. Diabetes. 1980; 29:1023–35.
Article
4. Lowe WL Jr, Lowe LP, Kuang A, Catalano PM, Nodzenski M, Talbot O, et al. Maternal glucose levels during pregnancy and childhood adiposity in the Hyperglycemia and Adverse Pregnancy Outcome Follow-up Study. Diabetologia. 2019; 62:598–610.
Article
5. Lowe WL Jr, Scholtens DM, Lowe LP, Kuang A, Nodzenski M, Talbot O, et al. Association of gestational diabetes with maternal disorders of glucose metabolism and childhood adiposity. JAMA. 2018; 320:1005–16.
Article
6. Wright CS, Rifas-Shiman SL, Rich-Edwards JW, Taveras EM, Gillman MW, Oken E. Intrauterine exposure to gestational diabetes, child adiposity, and blood pressure. Am J Hypertens. 2009; 22:215–20.
Article
7. Crume TL, Ogden L, West NA, Vehik KS, Scherzinger A, Daniels S, et al. Association of exposure to diabetes in utero with adiposity and fat distribution in a multiethnic population of youth: the Exploring Perinatal Outcomes among Children (EPOCH) Study. Diabetologia. 2011; 54:87–92.
Article
8. Chandler-Laney PC, Bush NC, Granger WM, Rouse DJ, Mancuso MS, Gower BA. Overweight status and intrauterine exposure to gestational diabetes are associated with children’s metabolic health. Pediatr Obes. 2012; 7:44–52.
Article
9. Whitaker RC, Pepe MS, Seidel KD, Wright JA, Knopp RH. Gestational diabetes and the risk of offspring obesity. Pediatrics. 1998; 101:E9.
Article
10. Boney CM, Verma A, Tucker R, Vohr BR. Metabolic syndrome in childhood: association with birth weight, maternal obesity, and gestational diabetes mellitus. Pediatrics. 2005; 115:e290–6.
Article
11. Philipps LH, Santhakumaran S, Gale C, Prior E, Logan KM, Hyde MJ, et al. The diabetic pregnancy and offspring BMI in childhood: a systematic review and meta-analysis. Diabetologia. 2011; 54:1957–66.
Article
12. Thaware PK, McKenna S, Patterson CC, Hadden DR, Pettitt DJ, McCance DR. Untreated mild hyperglycemia during pregnancy and anthropometric measures of obesity in offspring at age 5-7 years. Diabetes Care. 2015; 38:1701–6.
Article
13. Barlow SE; Expert Committee. Expert committee recommendations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity: summary report. Pediatrics. 2007; 120 Suppl 4:S164–92.
Article
14. Cole TJ, Lobstein T. Extended international (IOTF) body mass index cut-offs for thinness, overweight and obesity. Pediatr Obes. 2012; 7:284–94.
Article
15. World Medical Association. World Medical Association Declaration of Helsinki. Ethical principles for medical research involving human subjects. Bull World Health Organ. 2001; 79:373–4.
16. Kim E, Kwak SH, Chung HR, Ohn JH, Bae JH, Choi SH, et al. DNA methylation profiles in sibling pairs discordant for intrauterine exposure to maternal gestational diabetes. Epigenetics. 2017; 12:825–32.
Article
17. Lim JS, Hwang JS, Cheon GJ, Lee JA, Kim DH, Park KD, et al. Gender differences in total and regional body composition changes as measured by dual-energy X-ray absorptiometry in Korean children and adolescents. J Clin Densitom. 2009; 12:229–37.
Article
18. Moon JH, Kwak SH, Jung HS, Choi SH, Lim S, Cho YM, et al. Weight gain and progression to type 2 diabetes in women with a history of gestational diabetes mellitus. J Clin Endocrinol Metab. 2015; 100:3548–55.
Article
19. American Diabetes Association. 2. Classification and diagnosis of diabetes: standards of medical care in diabetes-2020. Diabetes Care. 2020; 43(Suppl 1):S14–31.
20. Moon JS, Lee SY, Nam CM, Choi JM, Choe BK, Seo JW, et al. 2007 Korean national growth charts: review of developmental process and an outlook. Korean J Pediatr. 2008; 51:1–25.
Article
21. VanItallie TB, Yang MU, Heymsfield SB, Funk RC, Boileau RA. Height-normalized indices of the body’s fat-free mass and fat mass: potentially useful indicators of nutritional status. Am J Clin Nutr. 1990; 52:953–9.
Article
22. Matsuda M, DeFronzo RA. Insulin sensitivity indices obtained from oral glucose tolerance testing: comparison with the euglycemic insulin clamp. Diabetes Care. 1999; 22:1462–70.
Article
23. Tura A, Kautzky-Willer A, Pacini G. Insulinogenic indices from insulin and C-peptide: comparison of beta-cell function from OGTT and IVGTT. Diabetes Res Clin Pract. 2006; 72:298–301.
Article
24. Retnakaran R, Qi Y, Goran MI, Hamilton JK. Evaluation of proposed oral disposition index measures in relation to the actual disposition index. Diabet Med. 2009; 26:1198–203.
Article
25. Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985; 28:412–9.
26. Chandler-Laney PC, Bush NC, Rouse DJ, Mancuso MS, Gower BA. Maternal glucose concentration during pregnancy predicts fat and lean mass of prepubertal offspring. Diabetes Care. 2011; 34:741–5.
Article
27. Unger RH. Minireview: weapons of lean body mass destruction: the role of ectopic lipids in the metabolic syndrome. Endocrinology. 2003; 144:5159–65.
Article
28. Laurson KR, Eisenmann JC, Welk GJ. Body fat percentile curves for U. S. children and adolescents. Am J Prev Med. 2011; 41(4 Suppl 2):S87–92.
29. Tam WH, Ma RCW, Ozaki R, Li AM, Chan MHM, Yuen LY, et al. In utero exposure to maternal hyperglycemia increases childhood cardiometabolic risk in offspring. Diabetes Care. 2017; 40:679–86.
Article
30. Ministry of Health and Welfare: The Third Korea National Health and Nutrition Examination Survey (KNHANES III). Available from: https://knhanes.cdc.go.kr (cited 2021 Jan 12).
Full Text Links
  • DMJ
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr