Impact of gestational diabetes mellitus on pubertal changes in adiposity and metabolic profiles in Latino offspring

J Pediatr. 2013 Apr;162(4):741-5. doi: 10.1016/j.jpeds.2012.10.001. Epub 2012 Nov 10.

Abstract

Objective: To examine the impact of maternal gestational diabetes mellitus (GDM) status on longitudinal changes in adiposity and metabolic variables in overweight Latino offspring (from age 8-20 years) across puberty.

Study design: This longitudinal cohort of 210 overweight Latino children was measured annually for a period of 3 ± 1 years for Tanner stage through physical examination, adiposity by dual-energy X-ray absorptiometry and magnetic resonance imaging, lipids, and glucose and insulin action via the oral glucose tolerance test and frequently sampled intravenous glucose tolerance test. Linear mixed-effects modeling estimated the impact of maternal GDM status on baseline and changes in adiposity and metabolic variables across puberty.

Results: In our cohort, 22% of offspring were from GDM pregnancies. At baseline, the GDM offspring were heavier at birth, more likely to have a family history of type 2 diabetes, and less likely to have been breastfed (for any duration). Compared with the non-GDM offspring, the GDM offspring had greater increases in total body fat (+6.5% vs +4.5%; P = .03) and steeper declines in acute insulin response (-39% vs -17%; P < .001) and disposition index (-57% vs -35%; P < .001) across Tanner stages, independent of ethnicity, sex, breastfeeding status, family history of diabetes, and baseline and changes in body composition.

Conclusion: These findings confirm the elevated risk for excess adiposity and type 2 diabetes in GDM offspring, and further underscore the need for interventions targeting Latino GDM and their offspring.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Absorptiometry, Photon / methods
  • Adiposity
  • Adolescent
  • Adult
  • Blood Glucose / metabolism
  • Child
  • Cohort Studies
  • Diabetes, Gestational / physiopathology*
  • Female
  • Glucose Tolerance Test
  • Hispanic Americans
  • Humans
  • Insulin / metabolism
  • Lipids / chemistry
  • Longitudinal Studies
  • Magnetic Resonance Imaging / methods
  • Male
  • Pregnancy
  • Prenatal Exposure Delayed Effects
  • Puberty

Substances

  • Blood Glucose
  • Insulin
  • Lipids