Gestational diabetes and childhood obesity: what is the link?
ABSTRACT PURPOSE OF REVIEW: To review recently published studies examining the role of prepregnancy obesity in the relationship between gestational diabetes mellitus and childhood obesity. RECENT FINDINGS: Seven epidemiologic studies published from January 2011 to February 2012 differentiate between preexisting diabetes mellitus and gestational diabetes mellitus, and six of them examine the role of maternal obesity. In studies that account for maternal obesity as a covariate, the association between gestational diabetes mellitus and childhood obesity is attenuated significantly after adjustment for prepregnancy BMI. In the one study that does not adjust for maternal obesity, maternal glucose level during pregnancy is associated with greater offspring adiposity, independent of the child's diet and lifestyle. SUMMARY: This review shows a positive association between maternal gestational diabetes mellitus and offspring overweight and obesity that is attenuated significantly after adjustment for prepregnancy BMI. The relationship between maternal gestational diabetes mellitus and offspring overweight and obesity could reflect fetal programming, shared genes and/or shared environments, such as postnatal diet and physical activity. Maternal gestational hyperglycemia and subsequent fetal hyperinsulinemia may predispose offspring to increased adiposity, impaired glucose tolerance, hyperinsulinemia, and insulin resistance. Because maternal obesity is a more prevalent condition than gestational diabetes mellitus and strongly associated with offspring obesity, effective interventions addressing prepregnancy obesity need to be further explored as they may have a greater public health impact on childhood overweight and obesity than those targeting women with gestational diabetes mellitus.
SourceAvailable from: Atul Malhotra[Show abstract] [Hide abstract]
ABSTRACT: The prevalence of gestational diabetes mellitus (GDM) is rising worldwide, along with overweight and obesity. In utero exposure to hyperglycemia increases perinatal complications including preterm birth, macrosomia, neonatal respiratory distress, hypoglycemia, and polycythemia. More significantly, GDM places the offspring at risk of insulin resistance and type 2 diabetes mellitus, obesity and cardiovascular disease. The relative contributory roles of the intrauterine environment, shared genes, and postnatal environment on long-term outcomes are not yet fully understood. Maternal obesity in particular remains a significant confounding factor. Opportunities for ameliorating both the perinatal effects and long-term and intergenera-tional effects of GDM exist at the level of prevention of GDM, screening for and treatment of GDM, and postnatal interventions in offspring.02/2015; 20155:31-39. DOI:10.2147/RRN.S30971
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ABSTRACT: Gestational diabetes is associated with risk for metabolic disease later in life. Using a cross species approach in rat and humans we examined the hypothesis that gestational diabetes during pregnancy triggers changes in the methylome of the offspring that might be mediating these risks. We show in a gestation diabetes rat model, the Cohen diabetic rat that gestational diabetes triggers wide alterations in DNA methylation in the placenta in both candidate diabetes genes and genome wide promoters thus providing evidence for causal relationship between diabetes during pregnancy and DNA methylation alterations. There is a significant overlap between differentially methylated genes in the placenta and the liver of the rat offspring. Several genes differentially methylated in rat placenta exposed to maternal diabetes are also differentially methylated in the human placenta of offspring exposed to gestational diabetes in utero. DNA methylation changes inversely correlate with changes in expression. The changes in DNA methylation affect known functional gene pathways involved in endocrine function, metabolism, and insulin responses. These data provide support to the hypothesis that early life exposures and their effects on metabolic disease are mediated by DNA methylation changes. This has important diagnostic and therapeutic implications.Endocrinology 12/2014; DOI:10.1210/en.2014-1643 · 4.64 Impact Factor
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ABSTRACT: The impact of fatty acids in early nutrition on later body composition and obesity risk remains elusive. Aim of this review was to summarize and discuss recent studies on the role of early supply with long-chain polyunsaturated fatty acids (LCPUFAs) through maternal nutrition during pregnancy and lactation for later offspring obesity. Recent human studies, either interventional or observational, investigating the role of dietary fatty acids, in particular of LCPUFAs, on body composition and later obesity risk provide inconsistent results concerning BMI as well as fat mass development in the offspring. A recent meta-analysis of randomized controlled trials found no significant effect of maternal supplementation with n-3 LCPUFA on BMI in both preschool and school-aged children. There is currently no conclusive evidence that dietary intervention to modify fat intake during pregnancy and lactation is a reasonable strategy to prevent childhood obesity in humans, but more research is clearly needed to address this issue.