Gestational diabetes but not prepregnancy overweight predicts for cardiometabolic markers in offspring twenty years later
Kaseva, Nina; Vääräsmäki, Marja; Sundvall, Jouko; Matinolli, Hanna-Maria; Sipola, Marika; Tikanmäki, Marjaana; Heinonen, Kati; Lano, Aulikki; Wehkalampi, Karoliina; Wolke, Dieter; Ruokonen, Aimo; Andersson, Sture; Järvelin, Marjo-Riitta; Räikkönen, Katri; Eriksson, Johan G.; Kajantie, Eero (2019-03-05)
Nina Kaseva, Marja Vääräsmäki, Jouko Sundvall, Hanna-Maria Matinolli, Marika Sipola, Marjaana Tikanmäki, Kati Heinonen, Aulikki Lano, Karoliina Wehkalampi, Dieter Wolke, Aimo Ruokonen, Sture Andersson, Marjo-Riitta Järvelin, Katri Räikkönen, Johan G Eriksson, Eero Kajantie, Gestational Diabetes But Not Prepregnancy Overweight Predicts for Cardiometabolic Markers in Offspring Twenty Years Later, The Journal of Clinical Endocrinology & Metabolism, Volume 104, Issue 7, July 2019, Pages 2785–2795, https://doi.org/10.1210/jc.2018-02743
© 2019 Endocrine Society. This is a pre-copyedited, author-produced version of an article accepted for publication in Journal of Clinical Endocrinology and Metabolism following peer review. The version of record Nina Kaseva, Marja Vääräsmäki, Jouko Sundvall, Hanna-Maria Matinolli, Marika Sipola, Marjaana Tikanmäki, Kati Heinonen, Aulikki Lano, Karoliina Wehkalampi, Dieter Wolke, Aimo Ruokonen, Sture Andersson, Marjo-Riitta Järvelin, Katri Räikkönen, Johan G Eriksson, Eero Kajantie, Gestational Diabetes But Not Prepregnancy Overweight Predicts for Cardiometabolic Markers in Offspring Twenty Years Later, The Journal of Clinical Endocrinology & Metabolism, Volume 104, Issue 7, July 2019, Pages 2785–2795, https://doi.org/10.1210/jc.2018-02743 is available online at:https://doi.org/10.1210/jc.2018-02743.
https://rightsstatements.org/vocab/InC/1.0/
https://urn.fi/URN:NBN:fi-fe2019110636813
Tiivistelmä
Abstract
Context: Maternal gestational diabetes mellitus (GDM) and prepregnancy overweight/obesity [body mass index (BMI) ≥25 kg/m²] might adversely affect offspring cardiometabolic health.
Objective: To assess the associations between maternal GDM and prepregnancy overweight/obesity with adult offspring cardiometabolic risk factors.
Design: Longitudinal cohort study (ESTER Maternal Pregnancy Disorders Study and the Arvo Ylppö Longitudinal Study).
Setting: Province of Uusimaa and Northern Finland.
Participants: At a mean age of 24.1 ± 1.3 years, we classified offspring as offspring of mothers with GDM regardless of the prepregnancy BMI (OGDM; n = 193); normoglycemic mothers with prepregnancy overweight/obesity (ONO; n = 157); and normoglycemic mothers with prepregnancy BMI <25 kg/m² (controls; n = 556).
Main Outcome Measures: We assessed the cardiometabolic biomarkers from blood and measured the blood pressure at rest and heart rate.
Results: Compared with the controls, the OGDM and ONO groups had greater fasting glucose (1.6%; 95% CI, 0.1% to 3.1%; and 2.3%; 95% CI, 0.5% to 4.3%, respectively) and insulin (12.7%; 95% CI, 4.4% to 21.9%; and 8.7%; 95% CI, 0.2% to 17.8%). These differences attenuated to nonsignificance when adjusted for confounders and/or current offspring characteristics, including BMI or body fat percentage. The OGDM group had lower SHBG (men, −12.4%; 95% CI, −20.2% to −3.9%; women, −33.2%; 95% CI, −46.3% to −16.8%), high-density lipoprotein (−6.6%; 95% CI, −10.9% to −2.2%), and apolipoprotein A1 (−4.5%; 95% CI, −7.5% to −1.4%). These differences survived the adjustments. The heart rate and other biomarkers were similar among the groups.
Conclusions: Adult offspring of mothers with GDM have increased markers of insulin resistance and a more atherogenic lipid profile. These were only partly explained by confounders or current offspring adiposity. Maternal prepregnancy overweight/obesity was associated with impaired offspring glucose regulation, which was explained by confounders and/or current adiposity.
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