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Diabetologia. 2015 May;58(5):937-41. doi: 10.1007/s00125-015-3505-z. Epub 2015 Jan 28.

Testing the fuel-mediated hypothesis: maternal insulin resistance and glucose mediate the association between maternal and neonatal adiposity, the Healthy Start study.

Author information

1
Department of Epidemiology, Colorado School of Public Health, Campus Box B119, 13001 East 17th Ave, Room W3110, Aurora, CO, 80045, USA.

Abstract

AIMS/HYPOTHESIS:

In women who are overweight or obese before or during pregnancy there is an associated risk of increased fetal growth and higher birthweight. The metabolic phenotype of the overweight/obese pregnant woman, characterised by higher than normal insulin resistance (IR) and increased circulating fuels, suggests a mechanism resulting in fetal overnutrition and subsequent increased adiposity. We tested the fuel-mediated hypothesis in an observational pre-birth cohort of 951 mother-offspring pairs, the Healthy Start study.

METHODS:

We conducted a path analysis to estimate the simultaneous effects of maternal IR and maternal fuels (fasting glucose, triacylglycerol [TG] and NEFA levels) in late pregnancy in mediating the relationship between maternal pre-pregnancy BMI and neonatal adiposity (per cent fat mass [%FM]).

RESULTS:

The total effect of maternal BMI on neonatal %FM was significant (total effect 0.16, 95% CI 0.08, 0.22, pā€‰<ā€‰0.001). The mediated path including maternal IR and glucose levels together accounted for 21% (pā€‰<ā€‰0.01) of the total effect of maternal BMI on neonatal %FM while the mediating effects of all other fuels were non-significant.

CONCLUSIONS/INTERPRETATION:

Using a novel application of path analysis our data implicate maternal IR and glucose levels as important mediators of the association between maternal and infant adiposity.

PMID:
25628236
PMCID:
PMC4393770
DOI:
10.1007/s00125-015-3505-z
[Indexed for MEDLINE]
Free PMC Article

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