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Gestational diabetes, but not pre-pregnancy overweight predicts cardio-metabolic markers in offspring twenty years later
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Kaseva, Nina, Vääräsmäki, Marja, Sundvall, Jouko, Matinolli, Hanna-Maria, Sipola, Marika, Tikanmäki, Marjaana, Heinonen, Kati, Lano, Aulikki, Wehkalampi, Karoliina, Wolke, Dieter, Ruokonen, Aimo, Andersson, Sture, Järvelin, Marjo-Riitta, Räikkönen, Katri, Eriksson, Johan G. and Kajantie, Eero (2019) Gestational diabetes, but not pre-pregnancy overweight predicts cardio-metabolic markers in offspring twenty years later. Journal of Clinical Endocrinology & Metabolism, 104 (7). pp. 2785-2795. doi:10.1210/jc.2018-02743 ISSN 0021-972X.
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Official URL: http://dx.doi.org/10.1210/jc.2018-02743
Abstract
Context
Maternal gestational diabetes (GDM) and pre-pregnancy overweight/obesity (body mass index, BMI ≥25kg/m2) may adversely affect offspring cardio-metabolic health.
Objective
To assess associations of maternal GDM and pre-pregnancy overweight/obesity with adult offspring cardio-metabolic risk factors.
Design
Longitudinal cohort study (ESTER and AYLS).
Setting
Province of Uusimaa and Northern Finland.
Participants
At mean age 24.1 years (SD 1.3), we classified offspring to offspring of mothers with 1) GDM regardless of pre-pregnancy BMI (OGDM; n=193), 2) normoglycemic mothers with pre-pregnancy overweight/obesity (ONO, n=157) and 3) normoglycemic mothers with pre-pregnancy BMI<25kg/m2 (controls, n=556).
Main Outcome Measures
We assessed cardio-metabolic biomarkers from blood and measured resting blood pressure and heart rate.
Results
Compared with controls, OGDM and ONO had higher fasting glucose [1.6% (95% confidence interval 0.1, 3.1)]; [2.3% (0.5, 4.3), respectively]; and insulin [12.7% (4.4, 21.9)]; [8.7% (0.2, 17.8)]. These differences attenuated to non-significance when adjusted for confounders and/or current offspring characteristics including BMI or body fat percentage. OGDM showed lower sex hormone binding globulin [SHBG; men: -12.4% (-20.2, -3.9), women: -33.2% (-46.3, -16.8)], high-density lipoprotein [-6.6% (-10.9, -2.2)] and apolipoprotein A1 [-4.5% (-7.5, -1.4), these differences survived the aforementioned adjustments. Heart rate and other biomarkers were similar between groups.
Conclusions
Adult offspring of mothers with GDM have increased markers of insulin resistance and a more atherogenic lipid profile; these are only partly explained by confounders or current offspring adiposity. Maternal pre-pregnancy overweight/obesity is associated with impaired offspring glucose regulation, which is explained by confounders and/or current adiposity.
Item Type: | Journal Article | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Subjects: | R Medicine > RG Gynecology and obstetrics | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Mental Health and Wellbeing Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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Library of Congress Subject Headings (LCSH): | Diabetes in pregnancy | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Journal or Publication Title: | Journal of Clinical Endocrinology & Metabolism | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Publisher: | The Endocrine Society | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
ISSN: | 0021-972X | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Official Date: | July 2019 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Dates: |
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Volume: | 104 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Number: | 7 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Page Range: | pp. 2785-2795 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
DOI: | 10.1210/jc.2018-02743 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Status: | Peer Reviewed | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Publication Status: | Published | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reuse Statement (publisher, data, author rights): | This is a pre-copyedited, author-produced version of an article accepted for publication in Journal of Clinical Endocrinology & Metabolism following peer review. The version of record 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; Gestational diabetes, but not pre-pregnancy overweight predicts cardio-metabolic markers in offspring twenty years later, The Journal of Clinical Endocrinology & Metabolism, is available online at: https://doi.org/10.1210/jc.2018-02743 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Access rights to Published version: | Restricted or Subscription Access | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Date of first compliant deposit: | 13 March 2019 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Date of first compliant Open Access: | 5 March 2020 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Funder: | scot | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
RIOXX Funder/Project Grant: |
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