Original Article
Lower Resting Energy Expenditure and Fat Oxidation in Native American and Hispanic Infants Born to Mothers with Diabetes

Portions of the study were presented as an abstract at the Pediatric Academic Societies annual meeting, Washington, DC, May 4-7, 2013.
https://doi.org/10.1016/j.jpeds.2014.12.036Get rights and content

Objective

To determine whether exposure to diabetes in utero affects resting energy expenditure (REE) and fuel oxidation in infants.

Study design

At 35 ± 5 days after birth, body composition and REE were measured in full-term offspring of Native American and Hispanic women with either well-controlled diabetes (13 girls, 11 boys) or normal healthy pregnancies (18 girls, 17 boys).

Results

Control of dysglycemia during gestation in the women with diabetes mellitus met current clinical standards, shown by average glycated hemoglobin (5.9 ± 0.2%; 40.6 ± 2.3 mmol/mol). Infant body mass (offspring of women with diabetes: 4.78 ± 0.13, control offspring: 4.56 ± 0.08 kg) and body fatness (offspring of women with diabetes: 25.2 ± 0.6, control offspring: 24.2 ± 0.5 %) did not differ between groups. REE, adjusted for lean body mass, was 14% lower in offspring of women with diabetes (41.7 ± 2.3 kJ/h) than control offspring (48.6 ± 2.0, P = .025). Fat oxidation was 26% lower in offspring of women with diabetes (0.54 ± 0.05 g/h) than control offspring (0.76 ± 0.04, P < .01) but carbohydrate oxidation did not differ. Thus, fat oxidation accounted for a lower fraction of REE in the offspring of women with diabetes (49 ± 4%) than control offspring (60 ± 3%, P = .022). Mothers with diabetes were older and had higher prepregnancy body mass index than control mothers.

Conclusions

Well-controlled maternal diabetes did not significantly affect body mass or composition of offspring at 1-month old. However, infants with mothers with diabetes had reduced REE and fat oxidation, which could contribute to adiposity and future disease risk. Further studies are needed to assess the impact differences in age and higher prepregnancy body mass index.

Section snippets

Methods

Self-declared Native American and Hispanic women experiencing a normal, uncomplicated pregnancy (control group, N = 34) or pregnancy accompanied by diabetes mellitus (gestational or pre-existing type 2 diabetes, diabetes group, N = 27) were recruited before the birth of their child. The current analyses are from a larger ongoing investigation of maternal diabetes on offspring. Native American mothers (N = 25 controls, N = 17 with diabetes) received the majority of their prenatal care and

Results

Characteristics of the mothers during pregnancy and the offspring at birth are presented in Table I. The diabetes group was comprised of 9 women who had type 2 diabetes before becoming pregnant and 18 women diagnosed with gestational diabetes mellitus (GDM). Mothers with diabetes were older, had higher parity and prepregnancy body mass index (BMI), and had slightly shorter gestation than the control group mothers. Glycated hemoglobin (HbA1c) was 5.9 ± 0.2% (40.6 ± 2.3 mmol/mol) in the mothers

Discussion

The main new finding is that offspring from mothers with diabetes have lower REE and fat oxidation than infants from mothers with a nondiabetic, uncomplicated pregnancy. The lower REE in the group of offspring of women with diabetes is primarily explained by reduced fat oxidation because carbohydrate oxidation did not differ between groups. These metabolic alterations occurred in the face of near optimal control of maternal diabetes as evidenced by HbA1c that was 5.9% on average in mothers with

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  • Cited by (0)

    Supported by the National Institute of Diabetes and Digestive and Kidney Diseases (R01 DK089034), the National Institute on Minority Health and Health Disparities/National Institutes of Health (P20 MD000528), the American Diabetes Association (1-10-CT-09), and the Children's Medical Research Institute Metabolic Research Program, Department of Pediatrics, University of Oklahoma Health Sciences Center. The authors declare no conflicts of interest.

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