Persistent effects of in utero overnutrition on offspring adiposity: the Exploring Perinatal Outcomes among Children (EP
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ARTICLE
Persistent effects of in utero overnutrition on offspring adiposity: the Exploring Perinatal Outcomes among Children (EPOCH) study Christine W. Hockett 1 & Kylie K. Harrall 1 & Brianna F. Moore 1 & Anne P. Starling 1,2 & Anna Bellatorre 1 & Katherine A. Sauder 1,3 & Wei Perng 1,2 & Ann Scherzinger 4 & Kavita Garg 4 & Brandy M. Ringham 1 & Deborah H. Glueck 1,3 & Dana Dabelea 1,2,3 Received: 1 May 2019 / Accepted: 19 July 2019 # Springer-Verlag GmbH Germany, part of Springer Nature 2019
Abstract Aims/hypothesis We previously showed that intrauterine exposure to gestational diabetes mellitus (GDM) increases selected markers of adiposity in pre-pubertal adolescents. In the present study, we examined these associations in adolescence, and explored whether they are strengthened as the participants transition through puberty. Methods Data from 597 individuals (505 unexposed, 92 exposed) participating in the longitudinal Exploring Perinatal Outcomes among Children (EPOCH) study in Colorado were collected at two research visits when the participants were, on average, 10.4 and 16.7 years old. Adiposity measures included BMI, waist/height ratio, and visceral and subcutaneous adipose tissue (as determined by MRI). Separate general linear mixed models were used to assess the longitudinal relationships between exposure to maternal GDM and each adiposity outcome. We tested whether the effect changed over time by including an interaction term between exposure and age in our models, and whether the associations were explained by postnatal behaviours. Results Compared with unexposed participants, those exposed to maternal GDM had higher BMI (β = 1.28; 95% CI 0.35, 2.21; p < 0.007), waist/height ratio (β = 0.03; 95% CI 0.01, 0.04; p = 0.0004), visceral adipose tissue (β = 4.81; 95% CI 1.08, 8.54; p = 0.01) and subcutaneous adipose tissue (β = 35.15; 95% CI 12.43, 57.87; p < 0.003). The magnitude of these differences did not change over time and the associations did not appear to be explained by postnatal behaviours. Conclusions/interpretation Our data provide further evidence that intrauterine exposure to maternal GDM is associated with increased offspring adiposity, an effect that appears early in life and tracks throughout adolescence. Efforts to prevent childhood obesity following intrauterine exposure to maternal GDM should target the prenatal or early life periods. Keywords Fetal programming . GDM . Maternal diabetes . Obesity . Puberty . SAT . VAT
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00125-019-04981-z) contains peer-reviewed but unedited supplementary material, which is available to authorised users. * Christine W. Hockett [email protected] 1
Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, Colorado School of Public Health, 12474 E. 19th Avenue – Mail Stop F426, Aurora, CO 80045, USA
2
Department of Epidemiology, Colorado School of Public Health, Aurora, CO, USA
3
Department of Pediatrics, University of Colorado School of Med
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