Shapiro Allison L B, Sauder Katherine A, Tregellas Jason R, Legget Kristina T, Gravitz Stephanie L, Ringham Brandy M, Glueck Deborah H, Johnson Susan L, Dabelea Dana
Department of Epidemiology, Colorado School of Public Health (CoSPH), University of Colorado at Anschutz (UC-Anschutz), Mail Stop F426, 12474 E. 19th Ave., Aurora, CO 80045, USA.
Department of Pediatrics, Section of Nutrition, School of Medicine, UC-Anschutz, Mail Stop F426, 12474 E. 19th Ave., Aurora, CO 80045, USA.
Appetite. 2017 Sep 1;116:610-615. doi: 10.1016/j.appet.2017.05.005. Epub 2017 May 3.
The risk of becoming overweight among offspring exposed to gestational diabetes (GDM) in utero is two-fold higher than in the general population. The responsible mechanisms are likely multifactorial, with some evidence that GDM exposure alters brain satiety signaling, which may impact eating behavior. To better understand these effects, we investigated the relationship between GDM exposure, eating behavior, and total energy intake in 268 adolescents from the Exploring Perinatal Outcomes among Children cohort, who were exposed (n = 50) or not exposed (n = 217) to GDM in utero. Eating behavior was measured by the Eating in the Absence of Hunger in Children and Adolescents (EAH-C) questionnaire, which included subscale scores for Negative Affect, External Stimuli, and Fatigue/Boredom. Total energy intake (kcal/day) was derived from the Block Kid's Food Questionnaire. The associations between GDM exposure and the outcomes of total score and each EAH-C subscale were evaluated in separate multivariable models. In addition to the main predictor, GDM, the models included a GDM-by-sex interaction term and were adjusted for important covariates. The associations between EAH-C total and subscale scores and the outcome of total energy intake were also tested in separate multivariable models. Female offspring exposed to GDM in utero (vs unexposed males and females) were more likely to continue eating beyond satiation due to feelings of boredom and fatigue (β = 0.47, 95% CI: 0.11, 0.83), and in general (EAH-C total score; β = 4.20, 95% CI: 0.56, 7.86) compared to unexposed males. All EAH-C subscale and total scores were significantly, positively associated with higher energy intake (p < 0.05 for all, respectively). Our findings highlight the need for further investigation into the possible early life programming of eating behaviors by GDM exposure in utero.
子宫内暴露于妊娠期糖尿病（GDM）的后代超重风险比普通人群高两倍。其相关机制可能是多因素的，有证据表明暴露于GDM会改变大脑饱腹感信号，这可能会影响饮食行为。为了更好地理解这些影响，我们在“儿童围产期结局探索”队列中的268名青少年中，研究了子宫内暴露于GDM（n = 50）或未暴露于GDM（n = 217）与饮食行为和总能量摄入之间的关系。饮食行为通过“儿童和青少年非饥饿进食”（EAH-C）问卷进行测量，该问卷包括负面影响、外部刺激和疲劳/无聊等子量表得分。总能量摄入（千卡/天）来自“布洛克儿童食物问卷”。在单独的多变量模型中评估了GDM暴露与总分及每个EAH-C子量表结果之间的关联。除了主要预测因素GDM外，模型还包括GDM与性别的交互项，并针对重要协变量进行了调整。在单独的多变量模型中还测试了EAH-C总分和子量表得分与总能量摄入结果之间的关联。子宫内暴露于GDM的雌性后代（与未暴露的雄性和雌性相比）由于无聊和疲劳感更有可能在饱腹后继续进食（β = 0.47，95%CI：0.11，0.83），并且与未暴露的雄性相比，总体上（EAH-C总分；β = 4.20，95%CI：0.56，7.86）。所有EAH-C子量表和总分均与较高的能量摄入显著正相关（所有p均<0.05）。我们的研究结果强调需要进一步调查子宫内暴露于GDM对饮食行为可能的早期生活编程影响。
