Maternal obesity and gestational diabetes: Impact on arterial wall layer thickness and stiffness in early childhood - RADIEL study six-year follow-up

Sundholm, Johnny K. M.; Litwin, Linda; Rönö, Kristiina; Koivusalo, Saila B.; Eriksson, Johan G.; Sarkola, Taisto

doi:10.1016/j.atherosclerosis.2019.01.037

Cited by 35 publications

(43 citation statements)

References 45 publications

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“…Recent evidence suggests that children of obese mothers have increased BMI, blood pressure, and carotid intima-media-adventitia thickness. 69 Our results indicate that there is a transgenerational effect of maternal obesity and GDM in infants. The strengths of our study are that it is by far the largest pregnancy cohort in the public-sector health facilities in India to assess the relationship between maternal hyperglycemia and neonatal adiposity as a marker for later chronic conditions.…”

Section: Discussionmentioning

confidence: 60%

<p>Do Gestational Obesity and Gestational Diabetes Have an Independent Effect on Neonatal Adiposity? Results of Mediation Analysis from a Cohort Study in South India</p>

Babu

Deepa

Lewis

et al. 2019

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Purpose: Neonates born to mothers with obesity or gestational diabetes mellitus (GDM) have an increased chance of various metabolic disorders later in life. In India, it is unclear whether maternal obesity or GDM is related to offspring adiposity. We aimed to understand the independent effect of maternal obesity and GDM with neonatal adiposity and whether GDM has a mediating effect between maternal obesity and neonatal adiposity. Methods: We recruited a cohort of 1120 women (between April 2016 and February 2019) from the public hospitals in Bangalore, India, who voluntarily agreed to participate and provided written informed consent. The primary outcome was neonatal adiposity, defined as the sum of skinfold thickness >85 th percentile. Exposure included maternal obesity, defined as >90 th percentile of skinfold thickness. GDM, the potential mediator, was classified using the World Health Organization criteria by oral glucose tolerance test. Binary logistic regression was applied to test the effect of maternal obesity and GDM on neonatal adiposity, adjusting for potential confounders. We used Paramed command in STATA version 14 for analyzing mediating effects. Results: We found that maternal obesity (odds ratio (OR)=2.16, 95% CI 1.46, 3.18) and GDM (OR=2.21, 95% CI1.38, 3.52) have an independent effect on neonatal adiposity. GDM significantly mediates 25.2% of the total effect between maternal obesity and neonatal adiposity, (natural direct effect OR = 1.16 95% CI 1.04, 1.30) with significant direct effect of maternal obesity (natural direct effect OR = 1.90 95% CI 1.16, 3.10) and significant total effect (OR=2.20 95% CI 1.35, 3.58). Conclusion: We showed that maternal obesity and GDM are independently associated with offspring adiposity. Also, GDM mediates the association of maternal obesity on adiposity in children. Interventions focused on obesity prevention in women, and effective screening and management of GDM may contribute to reducing childhood obesity in India.

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Section: Discussionmentioning

confidence: 60%

<p>Do Gestational Obesity and Gestational Diabetes Have an Independent Effect on Neonatal Adiposity? Results of Mediation Analysis from a Cohort Study in South India</p>

Babu

Deepa

Lewis

et al. 2019

CLEP

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“…Especially for an adequate description of IDR, further influence factors on IMT and D must be taken into account. Higher IMT has been described in children and adolescents with the preload of familial hypercholesterolemia [6], increased concentrations of serum C-reactive protein [11], serum uric acid [54], plasma total homocysteine [55], increased cholesterol level [56], pubertal maturation [57], maternal obesity [58], parental smoking during pregnancy [59], severe intrauterine growth retardation [60], preterm birth [61,62], and excess postnatal weight gain [63]. Therefore, these points should be investigated in future studies.…”

Section: Discussionmentioning

confidence: 99%

Vascular diameter and intima-media thickness to diameter ratio values of the carotid artery in 642 healthy children

et al. 2020

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In children, arterial alterations occur with increased intima-media thickness as well as vascular diameter enlargement. Both conditions correlate with higher cardiovascular risk in adults, and both the array and proportion of these alterations are important hemodynamic parameters. In terms of functional adaptation processes, they influence several arterial wall properties as for example the shear and tensile stress of the vessel. There are no reference values for the vascular diameter and intima-media thickness/diameter ratio of the carotid artery in children. Therefore, this study aimed to assess vascular diameter, intima-media thickness/diameter ratio and related tensile stress values in children and to further investigate the influence of sex, age, body mass index, and blood pressure. The parameters were measured with high-resolution semi-automated ultrasound. Sex- and age-dependent values were calculated with the LMS method for a cross-sectional sample of 642 healthy, non-obese children aged 8–17 years. The mean vascular diameter was 5.45 ± 0.46 mm; the median intima-media thickness/diameter ratio was 0.085 (0.079–0.092); the median tensile stress was 105.4 (95.2–116.4) kPa. The vascular diameter and the tensile stress were higher, and the intima-media thickness/diameter ratio was lower in boys than in girls. In comparison to the normal weight study population the excludedobese children had a significantly higher diameter, a lower intima-media thickness/diameter ratio, and a higher tensile stress. In multiple regression analyses of diameter, intima-media thickness/diameter ratio, and tensile stress, all parameters were influenced by sex and body mass index. Furthermore, systolic and diastolic blood pressure significantly influenced the vascular diameter, and systolic blood pressure significantly influenced the intima-media thickness/diameter ratio. Conclusion: This study is the first to report values for the diameter, the intima-media thickness/diameter ratio of the carotid artery, and the related tensile stress allowing a more differentiated view of cardiovascular adaptations as it combines structural and functional vascular parameters. What is known:• Intima-media thickness and vascular diameter are related to a higher cardiovascular risk in adults• The intima-media thickness/diameter ratio gives information about hemodynamic and functional vessel adaptationWhat is new:• Values for vascular diameter, intima-media thickness/diameter ratio, and tensile stress of the carotid artery in children are presented in this study• Intima-media thickness as a surrogate marker for arterial health in children should be complemented by intima-media thickness/diameter ratio measurement

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“…Offspring anthropometrics, body composition, BP, and LV mass were not related to GDM exposure, but children following GDM pregnancies had lower resting HR (Table 2 ). Detailed child and maternal background associations have been presented in our previous work [ 9 , 10 ].…”

Section: Resultsmentioning

confidence: 99%

“…In our previous work, we have found that maternal pregravida obesity, but not GDM was associated with offspring early vascular structure changes, but neither had the effect on child LV mass in early childhood [ 9 , 10 ]. In this study, we aim to investigate associations between maternal pre-pregnancy obesity, GDM, offspring body composition, and LV diastolic and systolic function.…”

Section: Introductionmentioning

confidence: 99%

No effect of gestational diabetes or pre-gestational obesity on 6-year offspring left ventricular function—RADIEL study follow-up

et al. 2020

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Aims We aimed to investigate associations between pre-pregnancy obesity, gestational diabetes (GDM), offspring body composition, and left ventricular diastolic and systolic function in early childhood. Methods This is an observational study, including 201 mother–child pairs originating from the Finnish Gestational Diabetes Prevention Study (RADIEL; 96 with GDM, 128 with pre-pregnancy obesity) with follow-up from gestation to 6-year postpartum. Follow-up included dyads anthropometrics, body composition, blood pressure, and child left ventricular function with comprehensive echocardiography (conventional and strain imaging). Results Offspring left ventricular diastolic and systolic function was not associated with gestational glucose concentrations, GDM, or pregravida obesity. Child body fat percentage correlated with maternal pre-pregnancy BMI in the setting of maternal obesity (r = 0.23, P = 0.009). After adjusting for child lean body mass, age, sex, systolic BP, resting HR, maternal lean body mass, pre-gestational BMI, and GDM status, child left atrial volume increased by 0.3 ml (95% CI 0.1, 0.5) for each 1% increase in child body fat percentage. Conclusions No evidence of foetal cardiac programming related to GDM or maternal pre-pregnancy obesity was observed in early childhood. Maternal pre-pregnancy obesity is associated with early weight gain. Child adiposity in early childhood is independently associated with increased left atrial volume, but its implications for long-term left ventricle diastolic function and cardiovascular health remain unknown.

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Maternal obesity and gestational diabetes: Impact on arterial wall layer thickness and stiffness in early childhood - RADIEL study six-year follow-up

Cited by 35 publications

References 45 publications

<p>Do Gestational Obesity and Gestational Diabetes Have an Independent Effect on Neonatal Adiposity? Results of Mediation Analysis from a Cohort Study in South India</p>

<p>Do Gestational Obesity and Gestational Diabetes Have an Independent Effect on Neonatal Adiposity? Results of Mediation Analysis from a Cohort Study in South India</p>

Vascular diameter and intima-media thickness to diameter ratio values of the carotid artery in 642 healthy children

No effect of gestational diabetes or pre-gestational obesity on 6-year offspring left ventricular function—RADIEL study follow-up

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