Risk for Gestational Diabetes: A Condition of Abdominal Fatness or Sedentariness?

宫内暴露于妊娠期糖尿病(GDM)与儿童肥胖的高风险相关，并解释了超过47%的儿童2型糖尿病。为了减轻妊娠期糖尿病对儿童的这种影响，必须及早确定高危妊娠，并制定有效的干预措施。母亲肥胖，尤其是中心性肥胖，是妊娠期糖尿病的已知预测因素，研究表明，运动具有保护作用。目前尚不清楚的是久坐的作用。 以及肥胖与妊娠期糖尿病之间的心肺功能(CRF)。本研究的目的是确定腹部肥胖、久坐状态和慢性肾功能衰竭的超声测量对妊娠期胰岛素敏感性和胰腺β细胞反应性的独立和交互影响。一旦这些关系被描绘出来，那么 可以开发有效的生活方式干预措施。这是一项前瞻性队列研究，研究对象为115名不同种族、未分娩、18-35岁、超重或肥胖(BMI 25-35)且无代谢性疾病病史的孕妇。措施将包括身体成分，包括腹部脂肪组织的腹部内和皮下超声评估，通过4天加速度法评估久坐行为，通过频繁采样的2小时口服葡萄糖耐量测试最小模型计算胰岛素敏感性和胰腺β细胞反应性，以及通过分级运动测试评估慢性肾功能衰竭。将在肯纳索州立大学运动科学(ES)生理学实验室进行四次访问，分别在基线(12-15周)、孕中期(18-19周)、晚期(26-28周)和产后(4周)。将测试腹部脂肪组织厚度、久坐行为和慢性肾功能衰竭对妊娠胰岛素敏感性和胰腺β细胞反应性的独立和交互影响。

Intrauterine exposure to gestational diabetes (GDM) is associated with a high risk of childhood obesity and explains over 47% of pediatric type 2 diabetes. To mitigate this impact of GDM on children, high-risk pregnancies must be identified earlier and effective interventions must be developed. Maternal obesity, and especially central obesity, is a known predictor of GDM and research shows that exercise is protective. What remains unknown are the roles of sedentariness and cardiorespiratory fitness (CRF) within the obesity-GDM relationship. The purpose of the proposed study is to determine the independent and interaction effects among ultrasound measures of abdominal adiposity, sedentariness, and CRF on insulin sensitivity and pancreatic β-cell responsivity in pregnancy. Once these relationships are delineated, then effective lifestyle interventions can be developed. This is a prospective cohort study of 115 racially diverse, nulliparous pregnant women,18-35 years old, and overweight or obese (BMI 25-35) with no history of metabolic disease. Measures will include body composition, including ultrasound assessment of abdominal adipose tissue as intra-abdominal and subcutaneous, sedentary behavior via 4-day accelerometry, minimal model computation of insulin sensitivity and pancreatic β-cell responsivity from 2-hour frequently sampled oral glucose tolerance test, and CRF via graded exercise test. Four visits will take place in the Kennesaw State University Exercise Science (ES) Physiology Laboratory at baseline (12-15 weeks), mid-gestation (18-19 weeks), third trimester (26-28 weeks), and post-partum (4 weeks). Independent and interaction effects of abdominal adipose tissue thickness, sedentary behavior, and CRF on gestational insulin sensitivity and pancreatic β-cell responsivity will be tested.