Body Mass Index as a Measure of Obesity: Racial Differences in Predictive Value for Health Parameters During Pregnancy

Gillespie, Shannon L.; Christian, Lisa M.

doi:10.1089/jwh.2016.5761

Cited by 9 publications

(4 citation statements)

References 54 publications

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“…The observed interaction between BMI, race, and leptin level indicates that in the obese state leptin levels may be differentially regulated between black and white women. Of note, prior data from others, as well as our group, indicates that the predictive value of BMI varies based on race ( Gillespie and Christian, 2016 ). For example, prior data from our group show that BMI is more strongly associated with both serum cytokine levels and birthweight among pregnant European American than black women ( Gillespie and Christian, 2016 ).…”

Section: Discussionmentioning

confidence: 60%

“…Of note, prior data from others, as well as our group, indicates that the predictive value of BMI varies based on race ( Gillespie and Christian, 2016 ). For example, prior data from our group show that BMI is more strongly associated with both serum cytokine levels and birthweight among pregnant European American than black women ( Gillespie and Christian, 2016 ). It has been suggested that this may be due to differential fat distribution in women of different races.…”

Section: Discussionmentioning

confidence: 60%

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The association of maternal obesity and race with serum adipokines in pregnancy and postpartum: Implications for gestational weight gain and infant birth weight

Jara

Dreher

Porter

et al. 2020

Brain, Behavior, & Immunity - Health

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Adiponectin and leptin are hormones known to play roles in maternal metabolism during pregnancy. Levels of these hormones have been demonstrated to vary based on adiposity and race. However, there is a lack of data concerning the relationship between race and the change of adiponectin and leptin throughout pregnancy. The purpose of this study was to examine serum levels of adiponectin, leptin, and leptin-to-adiponectin ratio (LAR) throughout pregnancy and to assess their association with gestational weight gain (GWG) and infant birth weight while considering the effects of race and pre-pregnancy body mass index (BMI). Serum levels of adiponectin, leptin, gestational weight gain, and infant birth weight were measured in 80 pregnant women at early (12.4 ± 1.3 weeks gestation), mid (20.6 ± 1.3 weeks gestation), late pregnancy (29.2 ± 1.4 weeks gestation), and 7–11 weeks postpartum (8.8 ± 0.8 weeks). In women overall, serum adiponectin decreased across pregnancy and increased at postpartum (p = 0.17.) At each prenatal timepoint, both black race and obesity were associated with lower adiponectin (ps < 0.05). In women overall, serum leptin increased across pregnancy, and declined at postpartum. At every assessment, a stepwise increase in leptin was observed in relation to BMI class. Black women with obesity had markedly higher LAR in mid- and late pregnancy and postpartum than all other groups (p < 0.05). Serum leptin during pregnancy was significantly associated with total GWG in both black and white women (ps < 0.005). Neither adiponectin, leptin, nor LAR were associated with infant birth weight. Race and BMI both have significant effects on serum adiponectin, leptin, and LAR levels in pregnancy and postpartum. Notably, the combined effects of race and BMI result in markedly higher LAR among black women with obesity. Implications for racial disparities in metabolic syndrome and postpartum weight retention remain to be explicated.

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Section: Discussionmentioning

confidence: 60%

Section: Discussionmentioning

confidence: 60%

The association of maternal obesity and race with serum adipokines in pregnancy and postpartum: Implications for gestational weight gain and infant birth weight

Jara

Dreher

Porter

et al. 2020

Brain, Behavior, & Immunity - Health

Self Cite

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“…There are significant differences on body structure, BMI classifications, race and ethnicity between these populations and Chinese population 14–16,28 . In fact, several studies showed that pre-pregnancy BMI was associated with birth weight among European Americans but not African Americans, suggesting a racial/ethnic difference on the relationship between pre-pregnancy BMI and fetal growth 29,30 ; secondly, negative results came most frequently from small samples 17 ; Lastly, animal studies demonstrated that pre-pregnancy and/or gestational high fat diets (HFD)-induced obesity differentially disturbed fetal growth development 18,19,31 . Pre-pregnancy HFD-induced obesity caused fetal SGA.…”

Section: Discussionmentioning

confidence: 99%

Pre-pregnancy underweight and obesity are positively associated with small-for-gestational-age infants in a Chinese population

Chen

et al. 2019

Sci Rep

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The association between suboptimal pre-pregnancy body mass index (BMI) and small-for-gestational-age (SGA) infants is not well defined. We investigated the association between pre-pregnancy BMI and the risk of SGA infants in a Chinese population. We performed a cohort study among 12029 mothers with a pregnancy. This cohort consisted of pregnant women that were: normal-weight (62.02%), underweight (17.09%), overweight (17.77%) and obese (3.12%). Birth sizes were reduced in the underweight and obese groups compared with the normal-weight group. Linear regression analysis indicated that birth size was positively associated with BMI in both the underweight and normal-weight groups. Further analysis showed that 12.74% of neonates were SGA infants in the underweight group, higher than 7.43% of neonates reported in the normal-weight group (adjusted RR = 1.92; 95% CI: 1.61, 2.30). Unexpectedly, 17.60% of neonates were SGA infants in the obese group, much higher than the normal-weight group (adjusted RR = 2.17; 95% CI: 1.57, 3.00). Additionally, 18.40% of neonates were large-for-gestational-age (LGA) infants in the obese group, higher than 7.26% of neonates reported in the normal-weight group (adjusted RR = 3.00; 95% CI: 2.21, 4.06). These results suggest that pre-pregnancy underweight increases the risk of SGA infants, whereas obesity increases the risks of not only LGA infants, but also SGA infants.

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“…Body mass index may not be an accurate measurement of determining body fat difference between African Americans and European Americans, as it is well documented that African Americans generally have higher lean mass and lower fat mass. [40][41][42] African Americans may have a higher body mass index because they generally have more muscle mass as opposed to fat mass, which is linked with poor cardiovascular and cerebrovascular health. [43][44][45] Future studies should investigate the insidious effects of obesity on white matter integrity over time.…”

Section: Limitationsmentioning

confidence: 99%

Obesity and Race May Explain Differential Burden of White Matter Hyperintensity Load

Seixas¹,

Turner²,

Bubu³

et al. 2021

CIA

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Compared to European Americans, research indicates that African Americans have higher white matter hyperintensity (WMH) load; however, the clinical and biological bases underlying this higher burden are poorly understood. We hypothesize that obesity may explain differences in WMH between African and European Americans. Methods: Participants enrolled in longitudinal brain aging studies (n=292; 61% Female; 92% European American; mean age=69.6±7.7) completed evaluations including medical exams, neuroimaging, and sociodemographic surveys. Overweight/obese status defined as body mass index ≥30 kg/m 2 , and WMH load, captured by FLAIR images, as sum of deep and periventricular volumes, scored using the Fazekas scale (0-6), WMH≥4 considered high. Results: Logistic regression analyses, adjusted for age, sex, hypertension, and smoking history, indicated that age and interaction between race and obesity were significant predictors of WMH, demonstrating that obesity significantly moderated the relationship between race and WMH. Age independently increased the odds of high WMH by 16% (OR=1.16, 95% CI=1.09-1.23, p<0.001). Stratified analysis indicates that older European Americans had increased WMH (OR=1.17, 95% CI=1.09-1.23, p<0.001), while obese African Americans had increased WMH (OR=27.65, 95% CI=1.47-519.13, p<0.05). In a case controlled subgroup matched by age, sex, and education (n=48), African Americans had significantly higher WMH load (27% vs 4%, Χ 2 =5.3, p=0.02). Conclusion:Results denote that age predicted WMH among European Americans, while obesity predicted WMH among African Americans. Matched sample analyses indicate that obesity increases the odds of WMH, though more pronounced in African Americans. These findings suggest that obesity may explain the differential burden of white matter hyperintensity load, signifying public health and clinical importance.

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Body Mass Index as a Measure of Obesity: Racial Differences in Predictive Value for Health Parameters During Pregnancy

Abstract: Background: As a measure of obesity, body mass index (BMI; kg/m

Cited by 9 publications

References 54 publications

The association of maternal obesity and race with serum adipokines in pregnancy and postpartum: Implications for gestational weight gain and infant birth weight

The association of maternal obesity and race with serum adipokines in pregnancy and postpartum: Implications for gestational weight gain and infant birth weight

Pre-pregnancy underweight and obesity are positively associated with small-for-gestational-age infants in a Chinese population

Obesity and Race May Explain Differential Burden of White Matter Hyperintensity Load

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