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Obesity Studies
Glucose metabolism among obese and non-obese children of mothers with gestational diabetes
  1. Jun Lu1,2,
  2. Yuying Gu2,3,
  3. Leishen Wang4,
  4. Weiqin Li4,
  5. Shuang Zhang4,
  6. Huikun Liu4,
  7. Junhong Leng4,
  8. Jin Liu4,
  9. Shuo Wang4,
  10. Andrea A Baccarelli5,
  11. Lifang Hou6,
  12. Gang Hu2
  1. 1Department of Endocrinology and Metabolism, Fengxian Hospital Affiliated to Southern Medical University, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital South Campus, Shanghai University of Medicine and Health Sciences Affiliated Shanghai Sixth People’s Hospital South Campus, Shanghai, China
  2. 2Chronic Disease Epidemiology, Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
  3. 3Department of Mathematics, Shanghai Business School–Fengpu Campus, Shanghai, China
  4. 4Tianjin Health and Family Planning Commission, Tianjin, China
  5. 5Columbia University Mailman School of Public Health, New York, New York, USA
  6. 6Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
  1. Correspondence to Dr Gang Hu; gang.hu{at}pbrc.edu

Abstract

Objectives Abdominal obesity is more closely associated with diabetes than general obesity in adults, however, it is unknown which kind of obesity is more closely associated with abnormal glucose metabolism in children.

Research design and methods We recruited 973 children (aged 3.08±1.06) of mothers with prior gestational diabetes mellitus (GDM). Children’s height, weight, waist circumstance, fasting glucose and insulin were measured using standardized methods. Logistic regression models were used to assess the single and joint associations of general and abdominal obesity with the risks of hyperglycemia (the upper quartile of fasting glucose), insulin resistance (the upper quartile of homeostatic model assessment of insulin resistance (HOMA-IR)), and β-cell dysfunction (the lower quartile of HOMA-%β).

Results Compared with normal weight children, children with general overweight/obesity had higher levels of HOMA-IR and HOMA-%β, higher ORs for hyperglycemia (1.56, 95% CI 1.06 to 2.30) and insulin resistance (3.44, 95% CI 2.32 to 5.09), but a lower OR for β-cell dysfunction (0.65, 95% CI 0.41 to 1.04). Children with abdominal obesity had an increased risk of insulin resistance (2.54, 95% CI 1.71 to 3.76) but not hyperglycemia and β-cell dysfunction compared with children with normal waist circumstance. In the joint analyses, general overweight children with and without abdominal obesity had an increased risk of hyperglycemia and insulin resistance compared with normal weight children.

Conclusions General obesity was more closely associated with abnormal glucose metabolism than abdominal obesity in children of mothers with GDM.

  • general overweight/obesity
  • insulin resistance
  • β-cell dysfunction
  • childhood
http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjdrc-2019-000822

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    Footnotes

    • Contributors JLu, YG and GH conceptualized and designed the study, performed statistical analyses, interpreted the results, and drafted, reviewed and revised the manuscript. LW, WL, SZ, HL, JLe, JLi and SW collected the data and revised the manuscript. AAB and LH critically revised the manuscript for important intellectual content. All authors critically reviewed the scientific content and approved the final manuscript. GH is the guarantor of this work, and has full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

    • Funding This study was supported by the European Foundation for the Study of Diabetes (EFSD)/Chinese Diabetes Society (CDS)/Lilly Program for Collaborative Research between China and Europe. GH was partly supported by grant from the National Institute of Diabetes and Digestive and Kidney Diseases (R01DK100790) and the National Institute of General Medical Sciences (U54GM104940) of the National Institutes of Health. JLu was supported by Shanghai key specialty construction projects (ZK2019B23).

    • Disclaimer The sponsors had no role in the preparation or approval of the manuscript.

    • Competing interests None declared.

    • Ethics approval This study was approved by the Human Subjects Committee of Tianjin Women’s and Children’s Health Center.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement Data are available upon reasonable request. Data are available upon the permission of the corresponding author GH.