Division of Metabolic and Nutritional Medicine, Dr. von Hauner Children's Hospital, LMU-Ludwig-Maximilians-Universität München, University of Munich Medical Centre, Campus Innenstadt, Lindwurmstr. 4, 80337, Munich, Germany.
Department of Paediatrics, School of Medicine, EURISTIKOS Excellence Centre for Paediatric Research, University of Granada, Avenida de la Investigación 11, 18016, Granada, Spain.
Acta Diabetol. 2019 Sep;56(9):1073-1082. doi: 10.1007/s00592-019-01349-y. Epub 2019 May 6.
Offspring of mothers suffering from obesity and/or gestational diabetes mellitus (GDM) were reported to be at risk of higher birth weight (BW), later obesity and diabetes. We hypothesize that infant anthropometry changes related to maternal pathological status are due to dysregulated infant metabolism.
First, we inspected differences in BMI z-scores (z-BMI) between three infant groups: born to normal weight (NW; n = 49), overweight/obese (OV/OB; n = 40) and GDM mothers (n = 27) at birth and 1 year. Then, we inspected associations between cord blood metabolites and 1-year Δ z-BMI in the three infant groups at birth and 1 year.
No statistically significant difference was detected in z-BMI between the study groups at birth; however, GDM was associated with heavier infants at 1 year. Regarding the associations between the metabolites and z-BMI, phospholipids, especially those containing polyunsaturated fatty acids, were the species most impacted by the maternal metabolic status, since numerous phosphatidylcholines-PUFA were positively associated with z-BMI in NW but negatively in OV/OB and GDM groups at birth. Conversely, the sum of lysophosphatidylcholines was only positively associated with z-BMI in NW at birth but of no relation in the other two groups. At 1 year, most of the associations seen at birth were reversed in NW and lost in OV/OB and GDM groups. In the NW group, PC-PUFA were found to be negatively associated with Δ z-BMI at 1 year in addition to some medium-chain acylcarnitines, tricarboxylic acid metabolites, Asp and Asn-to-Asp ratio. In OV/OB and GDM groups, the non-esterified fatty acid (NEFA26:0) and His correlated with Δ z-BMI at 1 year in negative and positive directions, respectively.
GDM was associated with overweight in offspring at 1 year, independent of the BW with lack of evidence on existing correlation of this finding with metabolic alterations detected in cord blood metabolome. Associations were found between cord blood metabolites and infant anthropometry at birth and were influenced by maternal OB and GDM. However, an extension of the findings monitored at birth among the three groups was not detected longitudinally showing a lack of predictive power of cord blood metabolome for later development at least 1 year.
有报道称,患有肥胖症和/或妊娠期糖尿病(GDM)的母亲所生的后代出生体重(BW)较高、日后肥胖和糖尿病的风险增加。我们假设与母体病理状态相关的婴儿人体测量学变化是由于婴儿代谢失调引起的。
首先,我们检查了三组婴儿的 BMI 标准差评分(z-BMI)之间的差异:出生时体重正常(NW;n=49)、超重/肥胖(OV/OB;n=40)和 GDM 母亲(n=27),并在出生时和 1 岁时进行了检查。然后,我们检查了三组婴儿在出生时和 1 岁时脐带血代谢物与 1 年 Δ z-BMI 之间的相关性。
研究组在出生时 z-BMI 无统计学差异,但 GDM 与 1 岁时婴儿体重增加有关。关于代谢物与 z-BMI 的相关性,磷脂,尤其是含有多不饱和脂肪酸的磷脂,受母体代谢状态影响最大,因为在 NW 组中,许多含有多不饱和脂肪酸的磷脂胆碱与 z-BMI 呈正相关,而在 OV/OB 和 GDM 组中则呈负相关。相反,在 NW 组中,出生时溶血磷脂酰胆碱的总和仅与 z-BMI 呈正相关,而在其他两组中则没有关系。在 1 岁时,NW 组出生时观察到的大多数相关性在 1 岁时发生逆转,而在 OV/OB 和 GDM 组中则丢失。在 NW 组中,除了一些中链酰基辅酶 A、三羧酸代谢物、天冬氨酸和天冬酰胺与天冬氨酸的比值外,PC-PUFA 还被发现与 1 岁时的 Δ z-BMI 呈负相关。在 OV/OB 和 GDM 组中,非酯化脂肪酸(NEFA26:0)和组氨酸分别以负相关和正相关与 1 岁时的 Δ z-BMI 相关。
GDM 与 1 岁时后代超重有关,与 BW 无关,且缺乏与脐带血代谢组学中检测到的代谢改变相关的证据。在出生时,发现了脐带血代谢物与婴儿人体测量学之间的相关性,并受母体 OB 和 GDM 的影响。然而,在三个组中,出生时监测到的结果没有纵向扩展,这表明脐带血代谢组学对至少 1 年后的后期发育没有预测能力。