母亲妊娠期糖尿病使孕期遗传体重指数与儿童肥胖之间的关系发生改变。
Maternal Gestational Diabetes Mellitus Modifies the Relationship Between Genetically Determined Body Mass Index During Pregnancy and Childhood Obesity.
机构信息
Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA; Department of Obstetrical, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China.
Tianjin Women's and Children's Health Center, Tianjin, China.
出版信息
Mayo Clin Proc. 2020 Sep;95(9):1877-1887. doi: 10.1016/j.mayocp.2020.04.042.
OBJECTIVE
To analyze the interactions between maternal gestational diabetes mellitus (GDM) and genetically determined maternal body mass index (BMI) during pregnancy on offspring childhood obesity.
RESEARCH DESIGN AND METHODS
A total of 1114 Chinese mother-child pairs (560 GDM and 554 non-GDM) were included between August 2009 and July 2011. Maternal genetic risk score (GRS) of BMI during pregnancy was derived on the basis of 12 single nucleotide polymorphisms identified from a genome-wide association study. Offspring's BMI, BMI-for-age z score, weight, weight-for-age z score, waist circumference, sum of skinfolds, and body fat percentage during childhood were measured or calculated.
RESULTS
Maternal GRS of BMI during pregnancy significantly interacted with maternal GDM status on childhood risks of overweight and obesity (all P for interaction <.05). After multivariable adjustment, per unit of GRS was associated with a 24% (P<.001) and a 28% (P<.001) increased risk of overweight and obesity among children of GDM mothers, whereas no significant associations were observed among children of mothers without GDM. In addition, per unit GRS of BMI during pregnancy was significantly associated with 0.16 kg/m higher BMI (P=.002), 0.09 higher BMI-for-age z score (P=.002), 0.24 kg higher weight (P=.04), 0.06 higher weight-for-age z score (P=.02), 0.28 cm higher waist circumference (P=.03), 0.94 mm higher sum of skinfolds (P=.004), and 0.37% higher body fat percentage (P=.03) among children of GDM mothers. There were no significant associations between maternal GRS of BMI during pregnancy and offspring's obesity-related outcomes among children of mothers without GDM.
CONCLUSION
Our findings for the first time indicate that maternal GDM status may modify the relation between genetically determined maternal BMI during pregnancy and offspring's obesity risk during childhood.
目的
分析妊娠期母体糖尿病（GDM）与妊娠期间遗传决定的母体体重指数（BMI）之间的相互作用对后代儿童肥胖的影响。
研究设计和方法
共纳入 2009 年 8 月至 2011 年 7 月期间的 1114 对中国母婴对子（560 例 GDM 和 554 例非 GDM）。基于全基因组关联研究确定的 12 个单核苷酸多态性，得出妊娠期间母体 BMI 的遗传风险评分（GRS）。测量或计算儿童期的 BMI、BMI-年龄 z 评分、体重、体重-年龄 z 评分、腰围、皮褶厚度总和和体脂百分比。
结果
妊娠期间母体 BMI 的 GRS 与母体 GDM 状态显著相互作用，影响儿童超重和肥胖的风险（所有交互作用 P<.05）。在多变量调整后，GRS 每增加一个单位，GDM 母亲的孩子超重和肥胖的风险分别增加 24%（P<.001）和 28%（P<.001），而在非 GDM 母亲的孩子中则无显著关联。此外，妊娠期间 BMI 的 GRS 每增加一个单位，与 BMI 增加 0.16kg/m（P=.002）、BMI-年龄 z 评分增加 0.09（P=.002）、体重增加 0.24kg（P=.04）、体重-年龄 z 评分增加 0.06（P=.02）、腰围增加 0.28cm（P=.03）、皮褶厚度总和增加 0.94mm（P=.004）和体脂百分比增加 0.37%（P=.03）有关。在非 GDM 母亲的孩子中，妊娠期间母体 BMI 的 GRS 与后代肥胖相关结局之间无显著关联。
结论
我们的研究结果首次表明，GDM 母亲的状态可能会改变妊娠期间遗传决定的母体 BMI 与后代儿童肥胖风险之间的关系。
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