Kearney M, Perron J, Marc I, Weisnagel S J, Tchernof A, Robitaille J
School of Nutrition, Laval University, Québec, Canada.
Institute of Nutrition and Functional Foods (INAF), Laval University, Québec, Canada.
Clin Obes. 2018 Apr;8(2):81-87. doi: 10.1111/cob.12237. Epub 2017 Dec 13.
The aim of this cohort study was to compare body composition and regional body fat distribution between children exposed (GDM+) or unexposed (GDM-) in utero to gestational diabetes mellitus (GDM) and to investigate the association with the glycaemic and the insulin profile. Data from 56 GDM+ and 30 GDM- were analysed. Height, weight and waist circumference were measured. Total and regional body composition was measured by dual-energy X-ray absorptiometry. Insulin, glucose and HbA were obtained from a fasting plasma sample, and the HOMA-IR index was calculated. anova was performed to compare adiposity measures between GDM+ and GDM-. Associations between the glycaemic and insulin profile and adiposity measures were studied using partial Pearson correlations. Mean age was 6.6 ± 2.3 years. Waist circumference, fat mass percentage, android fat mass, android fat mass percentage and android-to-gynoid fat mass ratio were higher among GDM+, and lean mass percentage was lower (P < 0.05). Among GDM+ children, body mass index (BMI) z score, waist circumference, fat mass percentage, android fat mass percentage and android-to-gynoid fat mass ratio were all positively correlated with HbA (r = 0.32-0.43, P < 0.05). Prenatal exposure to GDM is associated with increased total and abdominal adiposity. This increased adiposity observed among GDM+ children is associated with an altered glycaemic profile. This study is registered in the Clinical Trials.gov registry (NCT01340924).
这项队列研究的目的是比较宫内暴露于妊娠期糖尿病（GDM）（GDM+）或未暴露（GDM-）的儿童之间的身体成分和局部体脂分布，并研究其与血糖和胰岛素谱的关系。分析了56名GDM+儿童和30名GDM-儿童的数据。测量了身高、体重和腰围。通过双能X线吸收法测量全身和局部身体成分。从空腹血浆样本中获取胰岛素、葡萄糖和糖化血红蛋白（HbA），并计算胰岛素抵抗稳态模型评估（HOMA-IR）指数。采用方差分析比较GDM+和GDM-儿童之间的肥胖指标。使用偏Pearson相关性研究血糖和胰岛素谱与肥胖指标之间的关系。平均年龄为6.6±2.3岁。GDM+儿童的腰围、脂肪质量百分比、男性型脂肪质量、男性型脂肪质量百分比和男性型与女性型脂肪质量比更高，而瘦体重百分比更低（P<0.05）。在GDM+儿童中，体重指数（BMI）z评分、腰围、脂肪质量百分比、男性型脂肪质量百分比和男性型与女性型脂肪质量比均与HbA呈正相关（r=0.32-0.43，P<0.05）。产前暴露于GDM与全身和腹部肥胖增加有关。在GDM+儿童中观察到的这种肥胖增加与血糖谱改变有关。本研究已在ClinicalTrials.gov注册中心注册（NCT01340924）。
