Maternal glucose in pregnancy is associated with child's adiposity and leptin at 5 years of age

Abstract

Summary Background Exposure to maternal hyperglycaemia in pregnancy has been associated with childhood obesity. Leptin regulation might be involved in this ‘adiposity programming’ and may depend on timing of exposure. Objectives To investigate associations of maternal glycaemia at different periods in pregnancy with childhood adiposity and leptin levels at 5 years of age. Methods In a prospective pre‐birth cohort, we measured maternal glucose levels after a 50 g oral glucose challenge test at first trimester (9.8 ± 2.3 weeks) and during a 75 g oral glucose tolerance test at second trimester (26.5 ± 0.9 weeks). We followed up children at 5 years; we measured anthropometry and body composition using dual‐energy X‐ray absorptiometry (DXA). We measured fasting leptin levels using immunoassays (Luminex) in 328 children. We conducted linear regression analyses, adjusting for potential confounders. Results Maternal glycaemia at first trimester was associated with childhood leptin levels at 5 years, independently of maternal pre‐pregnancy BMI and other confounders (β = .09 ± .04; P = .03). Higher post‐load glucose levels at second trimester were associated with greater total body fat percentage measured by DXA (1 hour‐glucose: β = .010 ± .004; P = .03 and 2 hours‐glucose: β = .016 ± .005; P = .002), but not with leptin levels. Conclusions Our results suggest that programming of leptin regulation may be sensitive to maternal hyperglycaemia specifically in early pregnancy.

Sexual dimorphism of leptin and adiposity in children between 0 and 10 years: a systematic review and meta-analysis

“…We found high heterogeneity of the effect of sex on leptin level and body fat percentage in some age groups, which can be related to biological factors. For instance, at birth leptin appears to be strongly influenced by maternal weight and BMI before pregnancy, as well as by other maternal variables during gestation such as diabetes, smoking, and level of physical activity [ 89 , 90 ]. Leptin levels in early childhood also appear to be affected by nutritional behaviour and physical activity [ 91 ], as was mentioned above.…”

Associations of maternal insulin sensitivity during pregnancy with childhood central adiposity in the Genetics of Glucose regulation in Gestation and Growth (Gen3G) cohort

“…Some children were unable to keep a leg, arm, or their head steady for the duration of the DXA scan; if the movement of a limb impacted imaging, measurement from the opposing limb was used (20% of scans had arm and/or leg duplicated). Each DXA image involving a child that moved during measurement was reviewed manually by two research staff to determine when duplication of a limb was necessary, and if it was appropriate to include the scan overall (with consultation with lead investigators when there were uncertainties); none were deemed necessary to exclude 16 . We defined body regions using the manufacturer's model of Hologic software (version 5.5.3.1).…”

“…Each DXA image involving a child that moved during measurement was reviewed manually by two research staff to determine when duplication of a limb was necessary, and if it was appropriate to include the scan overall (with consultation with lead investigators when there were uncertainties); none were deemed necessary to exclude. 16 We defined body regions using the manufacturer's model of Hologic software (version 5.5.3.1).…”

“…Maternal BMI is an integral confounder as it is strongly correlated with both maternal insulin sensitivity and offspring BMI. We selected other covariates included in our multivariable models based on our theoretical model containing potential confounders supported by previous published literature 16,17 and known precision variables (child sex and age at adiposity measurements). We compared characteristics at first trimester from participants that were included in these analyses with characteristics of non-included participants (Table S1) to assess potential selection bias.…”

Associations between Cord Blood Leptin Levels and Childhood Adiposity Differ by Sex and Age at Adiposity Assessment

“…For the 5 years post-delivery visit, we assessed children body composition using a whole-body DXA scan with a Horizon DXA System (Hologic). As previously described, scans were performed by a trained research assistant to ensure correct positioning, absence of movement, and absence of potential artifacts [33]. Of 331 children with a DXA scan and cord blood leptin, movements were suspected for 63 (19.0%) resulting in asymmetric results between right and left limb.…”