University of Oulu

Nina Kaseva, Marja Vääräsmäki, Jouko Sundvall, Hanna-Maria Matinolli, Marika Sipola, Marjaana Tikanmäki, Kati Heinonen, Aulikki Lano, Karoliina Wehkalampi, Dieter Wolke, Aimo Ruokonen, Sture Andersson, Marjo-Riitta Järvelin, Katri Räikkönen, Johan G Eriksson, Eero Kajantie, Gestational Diabetes But Not Prepregnancy Overweight Predicts for Cardiometabolic Markers in Offspring Twenty Years Later, The Journal of Clinical Endocrinology & Metabolism, Volume 104, Issue 7, July 2019, Pages 2785–2795, https://doi.org/10.1210/jc.2018-02743

Gestational diabetes but not prepregnancy overweight predicts for cardiometabolic markers in offspring twenty years later

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Author: Kaseva, Nina1; Vääräsmäki, Marja1,2; Sundvall, Jouko1;
Organizations: 1National Institute for Health and Welfare, 00271 Helsinki, Finland
2PEDEGO Research Unit (Research Unit for Pediatrics, Dermatology, Clinical Genetics, Obstetrics and Gynecology), Medical Research Center Oulu, Oulu University Hospital and University of Oulu, 90570 Oulu, Finland
3Department of Nursing Science, University of Turku, 02500 Turku, Finland
4Institute of Health Sciences, University of Oulu, 90014 Oulu, Finland
5Department of Psychology and Logopedics, University of Helsinki, 00014 Helsinki, Finland
6Children’s Hospital, Pediatric Research Center, Helsinki University Hospital and University of Helsinki, 00014 Helsinki, Finland
7Department of Psychology, University of Warwick, Warwick CV4 7AL, United Kingdom
8NordLab Oulu, Oulu University Hospital, 90014 Oulu, Finland
9Department of Clinical Chemistry, University of Oulu, 90014 Oulu, Finland
10Department of Epidemiology and Biostatistics, MRC–PHE Centre for Environment & Health, School of Public Health, Imperial College London, London W2 1PG, United Kingdom
11Center for Life Course Health Research, Faculty of Medicine, University of Oulu, 90014 Oulu, Finland
12Biocenter Oulu, University of Oulu, 90014 Oulu, Finland
13Unit of Primary Care, Oulu University Hospital, 90014 Oulu, Finland
14Department of Life Sciences, College of Health and Life Sciences, Brunel University London, Uxbridge UB8 3PH, United Kingdom
15Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, 00014 Helsinki, Finland
16Folkhälsan Research Center, 00271 Helsinki, Finland
17Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, NO-7491 Trondheim, Norway
Format: article
Version: accepted version
Access: embargoed
Persistent link: http://urn.fi/urn:nbn:fi-fe2019110636813
Language: English
Published: Endocrine society, 2019
Publish Date: 2020-03-05
Description:

Abstract

Context: Maternal gestational diabetes mellitus (GDM) and prepregnancy overweight/obesity [body mass index (BMI) ≥25 kg/m²] might adversely affect offspring cardiometabolic health.

Objective: To assess the associations between maternal GDM and prepregnancy overweight/obesity with adult offspring cardiometabolic risk factors.

Design: Longitudinal cohort study (ESTER Maternal Pregnancy Disorders Study and the Arvo Ylppö Longitudinal Study).

Setting: Province of Uusimaa and Northern Finland.

Participants: At a mean age of 24.1 ± 1.3 years, we classified offspring as offspring of mothers with GDM regardless of the prepregnancy BMI (OGDM; n = 193); normoglycemic mothers with prepregnancy overweight/obesity (ONO; n = 157); and normoglycemic mothers with prepregnancy BMI <25 kg/m² (controls; n = 556).

Main Outcome Measures: We assessed the cardiometabolic biomarkers from blood and measured the blood pressure at rest and heart rate.

Results: Compared with the controls, the OGDM and ONO groups had greater fasting glucose (1.6%; 95% CI, 0.1% to 3.1%; and 2.3%; 95% CI, 0.5% to 4.3%, respectively) and insulin (12.7%; 95% CI, 4.4% to 21.9%; and 8.7%; 95% CI, 0.2% to 17.8%). These differences attenuated to nonsignificance when adjusted for confounders and/or current offspring characteristics, including BMI or body fat percentage. The OGDM group had lower SHBG (men, −12.4%; 95% CI, −20.2% to −3.9%; women, −33.2%; 95% CI, −46.3% to −16.8%), high-density lipoprotein (−6.6%; 95% CI, −10.9% to −2.2%), and apolipoprotein A1 (−4.5%; 95% CI, −7.5% to −1.4%). These differences survived the adjustments. The heart rate and other biomarkers were similar among the groups.

Conclusions: Adult offspring of mothers with GDM have increased markers of insulin resistance and a more atherogenic lipid profile. These were only partly explained by confounders or current offspring adiposity. Maternal prepregnancy overweight/obesity was associated with impaired offspring glucose regulation, which was explained by confounders and/or current adiposity.

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Series: Journal of clinical endocrinology & metabolism
ISSN: 0021-972X
ISSN-E: 1945-7197
ISSN-L: 0021-972X
Volume: 104
Issue: 7
Pages: 2784 - 2795
DOI: 10.1210/jc.2018-02743
OADOI: https://oadoi.org/10.1210/jc.2018-02743
Type of Publication: A1 Journal article – refereed
Field of Science: 3121 General medicine, internal medicine and other clinical medicine
3123 Gynaecology and paediatrics
Subjects:
Funding: The present study was supported by the Academy of Finland (SALVE program for 2009–2012 and grants 127437, 129306, 130326, 134791, 263924, and 274794 to E.K., J.G.E., K.R., K.H.), Arvo and Lea Ylppö Foundation (to A.L.), Doctoral Programme for Public Health, University of Tampere (to M.S.), Emil Aaltonen Foundation (to E.K.), European Commission (Framework 5 award QLG1-CT-2000-001643 to M.-R.J.; H2020 award SC1-2016-RTD-733180 RECAP to E.K.), Foundation for Pediatric Research (to E.K., M.T., and A.L.), Finnish Government Special Subsidiary for Health Sciences (to J.G.E.), and Finnish Medical Societies; Duodecim (to E.K.), Finska Läkaresällskapet (to J.G.E., S.A., N.K.), Stiftelsen Dorothea Olivia, Karl Walter och Jarl Walter Perkléns minne (to N.K.), Svenska Kulturfonden (to N.K.), Jalmari and Rauha Ahokas Foundation (to E.K.), Juho Vainio Foundation (to E.K., M.S., M.T., M.V., N.K.), National Graduate School of Clinical Investigation (to M.T.), the Novo Nordisk Foundation (to E.K., M.V.), Signe and Ane Gyllenberg Foundation (to E.K., J.G.E., N.K.), Sigrid Jusélius Foundation (to E.K.), Yrjö Jahnsson Foundation (E.K., M.S., N.K., M.V.), Bundesministerium für Forschung und Technik (Federal Government of Germany, Ministry of Science and Technology) program grants PKE 4 and JUG 14 (grants 0706224, 0706564, and 01EP9504 to D.W.), Samfundet Folkhälsan (to J.G.E.), and Päivikki and Sakari Sohlberg Foundation (to S.A.). The supporters of the study had no role in the study design; collection, analysis, or interpretation of the data; writing of the report; or the decision to submit the report for publication.
Academy of Finland Grant Number: 127437
129306
130326
134791
263924
274794
Detailed Information: 127437 (Academy of Finland Funding decision)
129306 (Academy of Finland Funding decision)
130326 (Academy of Finland Funding decision)
134791 (Academy of Finland Funding decision)
263924 (Academy of Finland Funding decision)
274794 (Academy of Finland Funding decision)
Copyright information: © 2019 Endocrine Society. This is a pre-copyedited, author-produced version of an article accepted for publication in Journal of Clinical Endocrinology and Metabolism following peer review. The version of record Nina Kaseva, Marja Vääräsmäki, Jouko Sundvall, Hanna-Maria Matinolli, Marika Sipola, Marjaana Tikanmäki, Kati Heinonen, Aulikki Lano, Karoliina Wehkalampi, Dieter Wolke, Aimo Ruokonen, Sture Andersson, Marjo-Riitta Järvelin, Katri Räikkönen, Johan G Eriksson, Eero Kajantie, Gestational Diabetes But Not Prepregnancy Overweight Predicts for Cardiometabolic Markers in Offspring Twenty Years Later, The Journal of Clinical Endocrinology & Metabolism, Volume 104, Issue 7, July 2019, Pages 2785–2795, https://doi.org/10.1210/jc.2018-02743 is available online at:https://doi.org/10.1210/jc.2018-02743.