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妊娠期糖尿病暴露与儿童肥胖之间的关联,不能用后代肥胖遗传风险来充分解释。

Association between gestational diabetes mellitus exposure and childhood adiposity is not substantially explained by offspring genetic risk of obesity.

机构信息

Veterans Affairs Eastern Colorado Healthcare System, Denver, CO, USA.

Division of General Internal Medicine, Department of Medicine, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO, USA.

出版信息

Diabet Med. 2017 Dec;34(12):1696-1700. doi: 10.1111/dme.13529.

Abstract

AIM

To examine the extent to which offspring obesity-associated genetic risk explains the association between gestational diabetes mellitus and childhood adiposity.

METHODS

We studied 282 children aged 7-12 years who were enrolled in the Exploring Perinatal Outcomes in Children Study. A genetic risk score for BMI was calculated as the count of 91 established BMI-raising risk alleles. Multivariable linear and logistic regression models were used to estimate associations between the offspring genetic risk score and exposure to gestational diabetes and childhood adiposity (BMI and waist circumference), adjusting for clinical and demographic covariates. The contribution of offspring genetic risk to associations between maternal gestational diabetes and childhood outcomes was estimated by comparing the regression coefficients for the gestational diabetes variable in models with and without the genetic risk score.

RESULTS

The offspring BMI genetic risk score was associated with childhood BMI (P = 0.006) and waist circumference (P = 0.02), and marginally with gestational diabetes (P = 0.05). Offspring BMI genetic risk did not contribute significantly to associations between gestational diabetes and childhood BMI [7.7% (95% CI -3.3, 18.8)] or waist circumference [5.8% (95% CI -3.1, 14.8); P = 0.2 for both].

CONCLUSIONS

Offspring obesity genetic risk does not explain a significant proportion of the association between gestational diabetes exposure and childhood adiposity. The association between gestational diabetes and childhood adiposity is probably explained through alternative pathways, including direct intrauterine effects or a shared postnatal environment.

摘要

目的

探讨子女肥胖相关遗传风险在多大程度上解释了妊娠糖尿病与儿童肥胖之间的关联。

方法

我们研究了 282 名 7-12 岁的儿童,他们参加了探索儿童围产期结局研究。BMI 遗传风险评分是通过计算 91 个已确定的 BMI 升高风险等位基因来计算的。多变量线性和逻辑回归模型用于估计后代遗传风险评分与暴露于妊娠糖尿病和儿童肥胖(BMI 和腰围)之间的关联,同时调整临床和人口统计学协变量。通过比较模型中有无遗传风险评分的妊娠糖尿病变量的回归系数,估计后代遗传风险对母亲妊娠糖尿病与儿童结局之间关联的贡献。

结果

子女 BMI 遗传风险评分与儿童 BMI(P=0.006)和腰围(P=0.02)相关,与妊娠糖尿病相关(P=0.05)。子女 BMI 遗传风险对妊娠糖尿病与儿童 BMI [7.7%(95%CI-3.3,18.8)]或腰围 [5.8%(95%CI-3.1,14.8)]之间的关联没有显著贡献(P=0.2 均)。

结论

子女肥胖遗传风险并不能解释妊娠糖尿病暴露与儿童肥胖之间关联的很大一部分。妊娠糖尿病与儿童肥胖之间的关联可能通过其他途径解释,包括宫内直接影响或共同的产后环境。

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