Refereed journal article or data article (A1)
Gestational Diabetes But Not Prepregnancy Overweight Predicts for Cardiometabolic Markers in Offspring Twenty Years Later
List of Authors: Nina Kaseva, Marja Vääräsmäki, Jouko Sundvall, Hanna-Maria Matinolli, Marika Sipola, Marjaana Tikanmäki, Kati Heinonen, Aulikki Lano, Karoliina Wehkalampi, Dieter Wolke, Aimo Ruokonen, Sture Andersson, Marjo-Riitta Järvelin, Katri Räikkönen, Johan G Eriksson, Eero Kajantie
Publisher: Oxford University Press
Publication year: 2019
Journal: Journal of Clinical Endocrinology and Metabolism
Volume number: 104
Issue number: 7
Start page: 2785
End page: 2795
Number of pages: 11
ISSN: 0021-972X
eISSN: 1945-7197
DOI: http://dx.doi.org/10.1210/jc.2018-02743
URL: https://doi.org/10.1210/jc.2018-02743
Self-archived copy’s web address: https://research.utu.fi/converis/portal/detail/Publication/40661735
ContextMaternal gestational diabetes mellitus (GDM) and prepregnancy overweight/obesity [body mass index (BMI) ≥25 kg/m2] might adversely affect offspring cardiometabolic health.ObjectiveTo assess the associations between maternal GDM and prepregnancy overweight/obesity with adult offspring cardiometabolic risk factors.DesignLongitudinal cohort study (ESTER Maternal Pregnancy Disorders Study and the Arvo Ylppö Longitudinal Study).SettingProvince of Uusimaa and Northern Finland.ParticipantsAt a mean age of 24.1 ± 1.3 years, we classified offspring as offspring of mothers with GDM regardless of the prepregnancy BMI (OGDM; n = 193); normoglycemic mothers with prepregnancy overweight/obesity (ONO; n = 157); and normoglycemic mothers with prepregnancy BMI <25 kg/m2 (controls; n = 556).Main Outcome MeasuresWe assessed the cardiometabolic biomarkers from blood and measured the blood pressure at rest and heart rate.ResultsCompared with the controls, the OGDM and ONO groups had greater fasting glucose (1.6%; 95% CI, 0.1% to 3.1%; and 2.3%; 95% CI, 0.5% to 4.3%, respectively) and insulin (12.7%; 95% CI, 4.4% to 21.9%; and 8.7%; 95% CI, 0.2% to 17.8%). These differences attenuated to nonsignificance when adjusted for confounders and/or current offspring characteristics, including BMI or body fat percentage. The OGDM group had lower SHBG (men, −12.4%; 95% CI, −20.2% to −3.9%; women, −33.2%; 95% CI, −46.3% to −16.8%), high-density lipoprotein (−6.6%; 95% CI, −10.9% to −2.2%), and apolipoprotein A1 (−4.5%; 95% CI, −7.5% to −1.4%). These differences survived the adjustments. The heart rate and other biomarkers were similar among the groups.ConclusionsAdult offspring of mothers with GDM have increased markers of insulin resistance and a more atherogenic lipid profile. These were only partly explained by confounders or current offspring adiposity. Maternal prepregnancy overweight/obesity was associated with impaired offspring glucose regulation, which was explained by confounders and/or current adiposity.
Downloadable publication This is an electronic reprint of the original article. |