Department of Health, Chronic Disease Prevention Unit, National Institute for Health and Welfare, Helsinki and Oulu, Finland.
PEDEGO Research Unit (Research Unit for Pediatrics, Dermatology, Clinical Genetics, Obstetrics and Gynecology), Medical Research Center Oulu (MRC Oulu), Oulu University Hospital and University of Oulu, Oulu, Finland.
Int J Obes (Lond). 2018 Apr;42(4):872-879. doi: 10.1038/ijo.2017.277. Epub 2017 Nov 17.
Global prevalence of overweight/obesity and gestational diabetes (GDM) is increasing. In pregnant women both conditions affect offspring's later health. Overweight/obesity is a risk factor of GDM; to what extent maternal overweight/obesity explains long-term effects of GDM in offspring is unknown.
To evaluate effects of maternal pre-pregnancy overweight/obesity (body mass index (BMI) ⩾25 kg m) and GDM, occurring together or separately, on body composition among adult offspring.
Participants include 891 individuals aged 24.1 years (s.d. 1.4) from two longitudinal cohort studies (ESTER and AYLS). Adult offspring of normoglycemic mothers with overweight/obesity (ONOO, n=153), offspring of mothers with GDM (OGDM; n=191) and controls (n=547) underwent anthropometric measurements and bioimpedance analysis. Gestational diabetes mellitus was diagnosed by oral glucose tolerance test. Data were analyzed by linear regression models adjusted for confounders.
Compared with controls, ONOO-participants showed higher BMI (men 1.64 kg m (95% confidence interval 0.57, 2.72); women 1.41 kg m (0.20, 2.63)) and fat percentage (men 2.70% (0.99, 4.41); women 2.98% (0.87, 5.09)) with larger waist circumferences (men 3.34 cm (0.68, 5.99); women 3.09 cm (0.35, 5.83)). Likewise, OGDM-participants showed higher fat percentage (men 1.97% (0.32, 3.61); women 2.32% (0.24, 4.41)). Body mass index was non-significantly different between OGDM-participants and controls (men 0.88 kg m (-0.17, 1.92); women 0.82 kg m (-0.39, 2.04)). Also waist circumferences were larger (men 2.63 cm (-0.01, 5.28); women 3.39 cm (0.60, 6.18)); this difference was statistically significant in OGDM-women only. Differences in body composition measures were stronger among offspring of women with both GDM and overweight/obesity. For instance, fat mass was higher among OGDM-participants of overweight mothers (men 4.24 kg (1.36, 7.11) vs controls; women 5.22 kg (1.33, 9.11)) than OGDM participants of normal weight mothers (men 1.50 kg (-2.11, 5.11) higher vs controls; women 1.57 kg (-3.27, 6.42)).
Maternal pre-pregnancy overweight and GDM are associated with unhealthy body size and composition in offspring over 20 years later. Effects of maternal pre-pregnancy overweight appear more pronounced.
超重/肥胖和妊娠期糖尿病（GDM）的全球患病率正在上升。在孕妇中，这两种情况都会影响后代的后期健康。超重/肥胖是 GDM 的一个危险因素；母体超重/肥胖在多大程度上解释了 GDM 对后代的长期影响尚不清楚。
评估母亲孕前超重/肥胖（体重指数（BMI）⩾25 kg/m ）和 GDM 同时或单独发生对成年后代身体成分的影响。
参与者包括来自两项纵向队列研究（ESTER 和 AYLS）的 891 名年龄为 24.1 岁（标准差 1.4）的个体。正常血糖母亲的超重/肥胖（ONOO，n=153）、母亲 GDM（OGDM；n=191）和对照组（n=547）的成年后代进行了人体测量和生物阻抗分析。妊娠期糖尿病通过口服葡萄糖耐量试验诊断。数据通过调整混杂因素的线性回归模型进行分析。
与对照组相比，ONOO 组参与者的 BMI 更高（男性 1.64 kg/m（95%置信区间 0.57，2.72）；女性 1.41 kg/m（0.20，2.63））和体脂百分比更高（男性 2.70%（0.99，4.41）；女性 2.98%（0.87，5.09）），腰围也更大（男性 3.34 cm（0.68，5.99）；女性 3.09 cm（0.35，5.83））。同样，OGDM 组参与者的体脂百分比更高（男性 1.97%（0.32，3.61）；女性 2.32%（0.24，4.41））。OGDM 组与对照组之间 BMI 无显著差异（男性 0.88 kg/m（-0.17，1.92）；女性 0.82 kg/m（-0.39，2.04））。腰围也更大（男性 2.63 cm（-0.01，5.28）；女性 3.39 cm（0.60，6.18））；OGDM 组女性的差异具有统计学意义。GDM 和超重/肥胖的母亲的后代的身体成分指标差异更大。例如，超重母亲的 OGDM 参与者的脂肪量更高（男性 4.24 kg（1.36，7.11）比对照组高；女性 5.22 kg（1.33，9.11））比正常体重母亲的 OGDM 参与者高（男性 1.50 kg（-2.11，5.11）更高比对照组；女性 1.57 kg（-3.27，6.42））。
母亲孕前超重和 GDM 与 20 多年后后代不健康的体型和成分有关。母亲孕前超重的影响似乎更为明显。
