Department of Nutrition Sciences, The University of Alabama at Birmingham (UAB), Birmingham, Alabama, USA.
Pediatr Obes. 2021 Jun;16(6):e12757. doi: 10.1111/ijpo.12757. Epub 2020 Nov 25.
Intrauterine exposure to gestational diabetes mellitus (GDM) increases risk for type 2 diabetes (T2D). Ghrelin and GLP-1 have opposite functions in nutritional homeostasis and are associated with insulin secretion, but it is not known if individuals exposed to GDM exhibit dysregulation in these associations.
Test the hypothesis that children exposed to GDM in utero will exhibit dysregulation among ghrelin, GLP-1, and C-peptide (reflecting insulin secretion).
Data from N = 43 children aged 5 to 10 years were included in this secondary analysis of ghrelin, GLP-1, and C-peptide response to a liquid meal test. Repeated measures mixed model analyses were used to measure associations among hormones.
The association of ghrelin and GLP-1 was moderated by GDM group (P < .01), such that ghrelin was inversely associated with GLP-1 in children without GDM exposure, but not for those exposed to GDM. GLP-1 was positively associated with C-peptide in both groups, but the association was stronger in those exposed to GDM (estimate = 1.06 vs 1.01).
Differences in the associations among ghrelin, GLP-1, and C-peptide displayed here suggest novel lines of research about whether the regulation of gut hormones and insulin secretion contribute to obesity and risk for T2D in children exposed to GDM.
宫内暴露于妊娠期糖尿病（GDM）会增加 2 型糖尿病（T2D）的风险。Ghrelin 和 GLP-1 在营养稳态中具有相反的功能，与胰岛素分泌有关，但目前尚不清楚是否暴露于 GDM 的个体在这些关联中存在失调。
检验以下假设，即宫内暴露于 GDM 的儿童会表现出 Ghrelin、GLP-1 和 C 肽之间的失调（反映胰岛素分泌）。
对 43 名 5 至 10 岁儿童进行了二次分析，这些儿童的 Ghrelin、GLP-1 和 C 肽对液体餐测试的反应数据包括在内。使用重复测量混合模型分析来测量激素之间的关联。
Ghrelin 和 GLP-1 的关联受到 GDM 组的调节（P<.01），即 Ghrelin 与未暴露于 GDM 的儿童的 GLP-1 呈负相关，而与暴露于 GDM 的儿童则无此关联。GLP-1 在两组中均与 C 肽呈正相关，但在暴露于 GDM 的组中相关性更强（估计值=1.06 对 1.01）。
这里显示的 Ghrelin、GLP-1 和 C 肽之间关联的差异表明，关于肠道激素和胰岛素分泌的调节是否会导致暴露于 GDM 的儿童肥胖和 T2D 风险，存在新的研究方向。
