Effects of maternal obesity and gestational diabetes on offspring health

母亲肥胖和妊娠糖尿病对后代健康的影响

• 批准号: 7617987
• 负责人: Paula Catherine Chandler-Laney
• 金额: $ 4.51万
• 依托单位: UNIVERSITY OF ALABAMA AT BIRMINGHAM
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-02-01 至 2011-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7617987
• 关键词: 8 year old; Adverse effects; African; African American; American; Area; Attenuated; Authorization documentation; Body Composition; Body fat; Boxing; Child; Childhood; Chronic; Clinical Research; Communities; Comorbidity; Diabetic intrauterine environment; Diet; Dietary intake; Dyslipidemias; Eating; Enrollment; Ensure; Environment; Epigenetic Process; Exhibits; Exposure to; Family; Fasting; Fatty acid glycerol esters; Female of child bearing age; Genotype; Gestational Diabetes; Health; High Density Lipoprotein Cholesterol; High Prevalence; Home environment; Hormones; Hour; Hypertriglyceridemia; Inpatients; Insulin; Insulin Resistance; Intake; Interleukin-6; LDL Cholesterol Lipoproteins; Lipids; Measures; Metabolic; Metabolic Diseases; Mothers; Nutritional; Obesity; Overweight; Parents; Physical activity; Population; Pregnancy; Recruitment Activity; Relative (related person); Reporting; Research; Risk; Satiation; Testing; United States; Visit; Weight; Woman; blood glucose regulation; blood lipid; cytokine; diabetes risk; disorder risk; environmental intervention; feeding; ghrelin; glucagon-like peptide 1; glucose tolerance; high risk; in utero; insulin secretion; insulin sensitivity; offspring; prenatal exposure; transmission process

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.

描述（由申请人提供）：超过一半的育龄妇女超重或肥胖，产妇肥胖增加了患妊娠期糖尿病（GDM）的风险，在美国，妊娠期糖尿病发生率为2-5%。妊娠合并肥胖和/或GDM的儿童自身患慢性肥胖和胰岛素抵抗等代谢健康问题的风险增加。非洲裔美国人（AA）儿童的风险特别高，因为黑人妇女肥胖的患病率很高（70%的育龄黑人妇女超重或肥胖），而且肥胖和GDM之间存在合并症。宫内环境提供了一种机制，通过这种机制，肥胖和糖尿病的风险可能会从母亲传给孩子。本研究旨在探讨母亲肥胖和GDM对AA儿童体成分和代谢健康的独立和交互影响。我们假设，暴露于致肥性和/或糖尿病宫内环境的儿童会有更多的体脂，更多的胰岛素分泌和更低的胰岛素敏感性，血脂异常，细胞因子水平升高，饱腹激素水平降低。我们将招募有妊娠期葡萄糖耐量信息的AA女性，并寻求允许将其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GDM （GDM或非GDM）状况进行分组。在住院临床研究中心访问期间，为了确保控制食物摄入条件，将通过双能x线吸收仪（DXA）评估儿童的身体成分，获得他们的血脂、细胞因子和饱腹激素谱，并通过混合膳食耐受性测试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，以确定这些变量的组间差异是否会导致身体成分和代谢健康的差异。通过了解母亲肥胖和GDM对儿童健康的独立和相互作用，我们可以在慢性健康问题发展之前更好地确定最危险的人群，并可能阐明克服产前暴露于肥胖和/或GDM不利影响的机制。