Effects of maternal obesity and gestational diabetes on offspring health

描述(由申请人提供)：超过一半的育龄妇女超重或肥胖，母亲肥胖会增加患妊娠期糖尿病(GDM)的风险，在美国，妊娠期糖尿病(GDM)的发病率为2%-5%。妊娠合并母体肥胖和/或妊娠期糖尿病的婴儿自身患慢性肥胖症和胰岛素抵抗等新陈代谢健康问题的风险增加。鉴于非裔美国人(AA)妇女肥胖率很高(70%的育龄妇女超重或肥胖)，以及肥胖和GDM之间的共病，非洲裔美国人(AA)儿童尤其危险。宫内环境提供了一种机制，肥胖和糖尿病风险可能通过这种机制从母亲传给孩子。这项拟议的研究旨在调查母亲肥胖和妊娠期糖尿病对再生障碍性贫血儿童的身体成分和代谢健康的独立和交互影响。我们假设，暴露在肥胖和/或糖尿病宫内环境中的儿童将有更多的体脂，更多的胰岛素分泌和更低的胰岛素敏感性，血脂异常，细胞因子水平增加，饱腹感激素水平降低。我们将招募可获得怀孕期间葡萄糖耐量信息的AA妇女，并寻求许可将其5-8岁的孩子纳入我们的研究。儿童将根据母亲的体重(肥胖与正常体重)和妊娠期糖尿病(妊娠期糖尿病或非妊娠期糖尿病)进行分组。在确保控制食物摄入条件的住院临床研究中心访问期间，将使用双能X射线吸收测量仪(DXA)评估儿童的身体成分，获得他们的血脂、细胞因子和饱腹感激素谱，并通过混合餐耐量试验评估他们的胰岛素敏感性、分泌和清除。此外，我们将通过加速计测量儿童的身体活动，并通过三次24小时回忆来测量他们的饮食摄入量，以确定这些变量在组间的任何差异是否有助于身体成分和代谢健康的差异。通过了解母亲肥胖和妊娠期糖尿病对儿科健康的独立和交互影响，我们可以更好地在慢性健康问题发展之前识别出最大风险的人群，并可能能够阐明克服产前暴露于肥胖和/或妊娠期糖尿病的不利影响的机制。 相关性：最终，这项研究和随后的相关研究将产生有关肥胖和糖尿病风险传播方式的信息，并将确定营养和环境干预措施，以抑制肥胖和代谢性疾病的表观遗传传播。

DESCRIPTION (provided by applicant): Over half of all women of child-bearing age are overweight or obese, and maternal obesity increases the risk of developing gestational diabetes mellitus (GDM), which is found in 2-5% of pregnancies in the United States. Children born from pregnancies complicated by maternal obesity and/or GDM are at increased risk themselves for chronic obesity and metabolic health problems such as insulin resistance. African American (AA) children are at particular risk given the high prevalence of obesity among AA women (70% of AA women of child-bearing age are overweight or obese), and the comorbidity between obesity and GDM. The intrauterine environment provides a mechanism through which obesity and diabetes risk may be transmitted from mother to child. The proposed research aims to investigate the independent and interactive effects of maternal obesity and of GDM on the body composition and metabolic health of AA children. We hypothesize that children exposed to an obesogenic and/or diabetic intrauterine environment will have more body fat, greater insulin secretion and lower insulin sensitivity, dyslipidemia, increased cytokine levels, and reduced satiety hormone levels. We will recruit AA women for whom information is available regarding their glucose tolerance during pregnancy, and seek permission to enroll their 5-8 year-old children in our study. Children will be grouped according to their mothers' weight (obese vs. normal weight) and GDM (GDM or non-GDM) status during pregnancy. During an inpatient clinical research center visit to ensure controlled food intake conditions, children's body composition will be assessed by dual-energy x-ray absorptiometry (DXA), their blood lipid, cytokine, and satiety hormone profiles will be obtained, and their insulin sensitivity, secretion and clearance assessed via a mixed-meal tolerance test. In addition, we will measure children's physical activity via accelerometers, and their dietary intake via three 24-hour recalls, to determine whether any between group differences in these variables contribute to differences in body composition and metabolic health. By gaining an understanding of the independent and interactive effects of maternal obesity and of GDM on pediatric health, we can better identify the population at greatest risk for chronic health problems before they develop, and may be able to elucidate mechanisms to overcome the adverse effects of prenatal exposure to obesity and/or GDM. Relevance: Ultimately, this and subsequent related research will yield information regarding the manner in which obesity and diabetes risk are transmitted, and will identify nutritional and environmental interventions to inhibit the epigenetic transmission of obesity and metabolic disease.