Babu Giridhara R, Garadi Lavanya, Murthy G V S, Kinra Sanjay
IIPH-H, Bangalore Campus, Public Health Foundation of India, Bangalore, Karnataka, India.
IIPH Hyderabad, Hyderabad, Andhra Pradesh, India Faculty of Infectious and Tropical Diseases, Department of Clinical Research, Public Health Disability, London School of Hygiene & Tropical Medicine, London, UK.
BMJ Open. 2014 Jun 27;4(6):e005417. doi: 10.1136/bmjopen-2014-005417.
The carbohydrate 'fuel' metabolism in a pregnant woman may have a long-term impact on the development of her offspring ('fuel-mediated teratogenesis' hypothesis) including in utero exposure to maternal hyperglycaemia leading to fetal hyperinsulinaemia, and the consequent increase in fetal fat cells. Therefore, a feed-forward loop can exist of rising adiposity and hyperinsulinaemia throughout childhood, perhaps leading to obesity and diabetes in later life. There is a need for prospective examination of body fat distribution in children born to mothers with different glycaemic levels to understand the plausible association between glucose metabolism and future risk of diabetes in offspring. The hypothesis is that maternal glucose levels in pregnant women are related to skinfold thickness in their infants.
Hyperglycaemia in pregnancy and adiposity in infants is a multicentre cohort study to evaluate the effects of glucose levels in pregnancy on the risk of adverse infant outcomes, especially in predicting the risk of chronic diseases in infants. The study aims to recruit 1045 participants over a period of 1 year, who will be followed up irrespective of their glycaemia status for a period of 15 months, beginning in the 24th week of gestation. The glucose levels in pregnant women would be obtained through oral glucose tolerance testing. The primary outcome of our study was skinfold thickness in infants at the age of 6 weeks, 3rd and 9th month (as a proxy for fat distribution/adiposity).
The institutional review board at The Indian Institute of Public Health (IIPH)-Hyderabad, Public Health Foundation of India has approved the protocol. All participants are required to provide written informed consent.
孕妇的碳水化合物“燃料”代谢可能会对其后代的发育产生长期影响（“燃料介导的致畸作用”假说），包括子宫内暴露于母体高血糖导致胎儿高胰岛素血症，以及随之而来的胎儿脂肪细胞增加。因此，在整个儿童期可能存在肥胖和高胰岛素血症的前馈循环，这可能导致日后肥胖和糖尿病。有必要对不同血糖水平母亲所生儿童的体脂分布进行前瞻性研究，以了解葡萄糖代谢与后代未来糖尿病风险之间可能存在的关联。假说是孕妇的母体血糖水平与其婴儿的皮褶厚度有关。
孕期高血糖与婴儿肥胖多中心队列研究旨在评估孕期血糖水平对婴儿不良结局风险的影响，尤其是预测婴儿患慢性病的风险。该研究旨在在1年时间内招募1045名参与者，从妊娠第24周开始，无论其血糖状态如何，均进行为期15个月的随访。孕妇的血糖水平将通过口服葡萄糖耐量试验获得。我们研究的主要结局是婴儿在6周、3个月和9个月时的皮褶厚度（作为脂肪分布/肥胖的指标）。
印度公共卫生基金会海得拉巴印度公共卫生研究所的机构审查委员会已批准该方案。所有参与者均需提供书面知情同意书。
