Deng Yuzhi, Tam Claudia H T, Yang Aimin, Shi Mai, Yuen Lai Yuk, Ng Noel Y H, Tsang Atta Y T, Tsoi Kit Ying, Ozaki Risa, Li Albert M, Chow Elaine, Hui Lai Ling, Chan Juliana C N, Wang Chi Chiu, Tam Wing Hung, Ma Ronald C W
Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China.
Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong, China.
Diabetologia. 2025 Jun 17. doi: 10.1007/s00125-025-06468-6.
AIMS/HYPOTHESIS: We aimed to examine offspring adiposity trajectories from birth to age 9-14 years and to assess the joint associations of maternal overweight and gestational diabetes mellitus (GDM) with these trajectories.
This is a prospective cohort study with 564 mother-child dyads from the Hyperglycemia and Adverse Pregnancy Outcome study Hong Kong field centre. Assessments and anthropometric measurements were taken during pregnancy, at delivery and at median ages of 7 and 10 years postpartum. Offspring adiposity was primarily assessed using sum of skinfold thickness. We used linear mixed-effect models to evaluate the independent and joint associations of maternal overweight and GDM with the offspring adiposity trajectories, and applied group-based trajectory modelling to identify distinct patterns of adiposity development based on both statistical indices and clinical interpretability.
Offspring skinfold thickness trajectories varied significantly based on maternal overweight and GDM (p<0.05). Group-based trajectory modelling identified two trajectory groups for skinfold thickness: 52.1% with slow increase and 47.9% with rapid increase. Combined maternal overweight and GDM was associated with 6.90-fold increased risk (95% CI 1.89, 33.32; p=0.006) of the rapidly increasing trajectory. Linear mixed-effect model analysis showed greater increases in skinfold thickness among offspring of mothers with either condition, with the highest trajectory observed in offspring of mothers with both conditions (β 1.62; 95% CI 0.69, 2.54; p=0.001).
CONCLUSIONS/INTERPRETATION: Maternal overweight and GDM are independently and jointly associated with rapidly increasing adiposity trajectories from birth to early adolescence. The findings underscore the importance of considering both maternal metabolic conditions when evaluating offspring adiposity risk.
目的/假设：我们旨在研究从出生到9 - 14岁子代的肥胖轨迹，并评估母亲超重和妊娠期糖尿病（GDM）与这些轨迹的联合关联。
这是一项前瞻性队列研究，纳入了来自香港高血糖与不良妊娠结局研究中心的564对母婴。在孕期、分娩时以及产后7岁和10岁的中位年龄时进行评估和人体测量。子代肥胖主要通过皮褶厚度总和进行评估。我们使用线性混合效应模型来评估母亲超重和GDM与子代肥胖轨迹的独立及联合关联，并应用基于组的轨迹模型，根据统计指标和临床可解释性来识别肥胖发展的不同模式。
根据母亲超重和GDM情况，子代皮褶厚度轨迹存在显著差异（p<0.05）。基于组的轨迹模型确定了皮褶厚度的两个轨迹组：52.1%为缓慢增加组，47.9%为快速增加组。母亲超重与GDM合并出现时，快速增加轨迹的风险增加6.90倍（95%CI 1.89，33.32；p = 0.006）。线性混合效应模型分析显示，患有任何一种情况的母亲的子代皮褶厚度增加幅度更大，两种情况都有的母亲的子代观察到最高轨迹（β 1.62；95%CI 0.69，2.54；p = 0.001）。
结论/解读：母亲超重和GDM独立且共同与从出生到青春期早期肥胖轨迹的快速增加相关。这些发现强调了在评估子代肥胖风险时考虑母亲两种代谢状况的重要性。
