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Role of maternal ethnicity, adverse risk factors and gestational diabetes on offspring body composition and adipocytokines
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Bagias, Christos (2019) Role of maternal ethnicity, adverse risk factors and gestational diabetes on offspring body composition and adipocytokines. PhD thesis, University of Warwick.
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Official URL: http://webcat.warwick.ac.uk/record=b3714336
Abstract
Childhood obesity has reached epidemic proportions globally. There is increasing evidence that factors acting during early development, such as maternal obesity, excessive gestational weight gain and gestational diabetes mellitus increase the chances of obesity and metabolic syndrome in later life. However, the major limitation of the available literature is the lack of accurate body composition measurement. In order to understand the mechanisms underpinning the developmental origins of metabolic diseases in adulthood, data on the evolution of body composition in early childhood is required. We hypothesize that offspring born to high metabolic risk mothers have altered body composition at birth and early infancy, which leads to adverse developmental programming of obesity and metabolic diseases.
Objective and methods: Purpose of the current research work was to study the effect of maternal adverse metabolic profile on infant’s body composition. Secondary aim was to assess whether early life biomarkers can predict infant and early childhood adiposity, allowing the implementation of targeted prevention strategies on high risk groups from the early stages of life. A longitudinal observational study was performed. Air displacement plethysmography was used to assess infant body composition up to 5 months of age. A systematic review looking at the association between cord blood leptin, adiponectin and infant adiposity was also conducted.
Results: Maternal obesity, gestational weight gain and hyperglycaemia independently predict infant adiposity. Maternal insulin resistance seems to be the “missing link” between adverse maternal metabolic profile and neonatal adiposity. Current practices in the management of gestational diabetes that reduce the incidence of macrosomia happens at the expense of fat free mass. This may drive early adiposity rebound, which itself has shown to be an independent driver for metabolic diseases in adult life. Ethnic subgroup analysis revealed no difference in infant body composition, provided that maternal characteristics and intrauterine environment remain constant across ethnicity. Cord blood leptin is strongly and positively associated with fat mass at birth but inversely predicts adiposity up to 3 years of age.
Conclusion: Despite genotype being determined at conception, the phenotype is modulated and determined by maternal and intrauterine factors. Antenatal and early postnatal life are critical periods of developmental plasticity for offspring fat and fat free mass. Such adverse body composition at birth and early infancy are setting lifelong metabolic trajectories.
Item Type: | Thesis (PhD) | ||||
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Subjects: | R Medicine > RA Public aspects of medicine R Medicine > RC Internal medicine R Medicine > RG Gynecology and obstetrics R Medicine > RJ Pediatrics |
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Library of Congress Subject Headings (LCSH): | Obesity in children, Diabetes in pregnancy, Obesity -- Genetic aspects, Obesity in women | ||||
Official Date: | October 2019 | ||||
Dates: |
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Institution: | University of Warwick | ||||
Theses Department: | Warwick Medical School | ||||
Thesis Type: | PhD | ||||
Publication Status: | Unpublished | ||||
Supervisor(s)/Advisor: | Saravanan, Ponnusamy ; Oyebode, Oyinlola | ||||
Format of File: | |||||
Extent: | 328 leaves : illustrations | ||||
Language: | eng |
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