Association of maternal diabetes during pregnancy with high refractive error in offspring: a nationwide population-based cohort study

Du, Jiangbo; Li, Jiong; Liu, Xiaoqin; Hu, Liu; Obel, Carsten; Shen, Hongbing; Hu, Zhibin; Yu, Yongfu

doi:10.1007/s00125-021-05526-z

Cited by 18 publications

(20 citation statements)

References 48 publications

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“…3,4 Growing evidence has shown that prenatal adversity, such as maternal gestational diabetes and maternal smoking during pregnancy, is associated with increased risk of overall or type-specific REs in offspring. [5][6][7][8][9][10][11] These findings indicate that adverse prenatal or intrauterine environments might contribute to the development of high RE later in life. 12 Hypertensive disorder of pregnancy (HDP) is one of the most common complications during pregnancy, affecting 5% to 10% of pregnancies.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Hypertensive Disorder of Pregnancy and High Refractive Error in Offspring During Childhood and Adolescence

Huang

Yang

et al. 2023

JAMA Netw Open

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ImportanceGrowing evidence indicates that adverse prenatal or intrauterine environments might contribute to the development of high refractive error (RE) later in life. However, the association of maternal hypertensive disorder of pregnancy (HDP) with high RE in offspring during childhood and adolescence remains unknown.ObjectiveTo investigate the association between maternal HDP and overall and type-specific high REs in offspring in childhood and adolescence.Design, Setting, and ParticipantsThis nationwide population-based cohort study included live-born individuals born in Denmark from 1978 to 2018 in the Danish national health registers. Follow-up started at the date of birth and ended at the date of RE diagnosis, 18th birthday, death, emigration, or December 31, 2018, whichever came first. Data analyses were conducted from November 12, 2021, through June 30, 2022.ExposuresMaternal HDP (n = 104 952), including preeclampsia or eclampsia (n = 70 465) and hypertension (n = 34 487).Main Outcomes and MeasuresThe main outcomes were the first occurrence of high RE (hyperopia, myopia, and astigmatism) in offspring. A Cox proportional hazards regression model was used to examine the association between maternal HDP and risk of high RE in offspring from birth until age 18 years, adjusting for multiple potential confounders.ResultsThis study included 2 537 421 live-born individuals, 51.30% of whom were male. During the follow-up of up to 18 years, 946 offspring of 104 952 mothers with HDP (0.90%) and 15 559 offspring of 2 432 469 mothers without HDP (0.64%) were diagnosed with high RE. The cumulative incidence of high RE was higher in the exposed cohort (1.12%; 95% CI, 1.05%-1.19%) than in the unexposed cohort (0.80%; 95% CI, 0.78%-0.81%) at 18 years of age (difference: 0.32%; 95% CI, 0.25%-0.40%). Offspring born to mothers with HDP had a 39% increased risk of overall high RE (hazard ratio [HR], 1.39; 95% CI, 1.31-1.49). Sibling-matched analysis revealed an increased risk of overall high RE in half siblings (HR, 1.21; 95% CI, 1.05-1.39) and full siblings (HR, 1.15; 95% CI, 0.99-1.34), but the difference was not significant for the latter. The elevated risks were observed for hypermetropia (HR, 1.41; 95% CI, 1.30-1.52), myopia (HR, 1.30; 95% CI, 1.10-1.53), and astigmatism (HR, 1.45; 95% CI, 1.22-1.71). The increased risk of high RE persisted among offspring aged 0 to 6 years (HR, 1.51, 95% CI, 1.38-1.65), 7 to 12 years (HR, 1.28; 95% CI, 1.11-1.47), and 13 to 18 years (HR, 1.16; 95% CI, 0.95-1.41), but the difference was not significant for the oldest group. When considering both timing of diagnosis and severity of maternal preeclampsia, the highest risk was observed in offspring prenatally exposed to early-onset and severe preeclampsia (HR, 2.59; 95% CI, 2.17-3.08).Conclusions and RelevanceIn this cohort study of the Danish population, maternal HDP, especially early-onset and severe preeclampsia, was associated with an increased risk of high RE in offspring during childhood and adolescence. These findings suggest that early and regular RE screening should be recommended for children of mothers with HDP.

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Section: Introductionmentioning

confidence: 99%

Evaluation of Hypertensive Disorder of Pregnancy and High Refractive Error in Offspring During Childhood and Adolescence

Huang

Yang

et al. 2023

JAMA Netw Open

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“…The concept of developmental origins of health and disease (DOHaD) theory has been widely accepted, which proposed that early life environmental factors have profound effects on vulnerability to disease in adulthood ( Haugen et al, 2015 ). Extensive range of clinical and epidemiological data suggested that gestational obesity and diabetes leave lasting impacts on the next generation, and so, the cycle of risk is perpetuated ( Godfrey et al, 2017 ; Chen et al, 2021b ; Du et al, 2021a ; Jiang et al, 2021 ; Lorenzon et al, 2021 ). Experimental research in animal models also showed that maternal high-fat diet (HF) during pregnancy and lactation predisposed offspring to metabolic disorders ( Zheng et al, 2014 ; Ribaroff et al, 2017 ).…”

Section: Introductionmentioning

confidence: 99%

Maternal Dietary Betaine Prevents High-Fat Diet-Induced Metabolic Disorders and Gut Microbiota Alterations in Mouse Dams and Offspring From Young to Adult

et al. 2022

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Early life is a critical window for preventing the intergenerational transmission of metabolic diseases. Betaine has been proven to play a role in improving glucose and lipid metabolism disorders in animal models. However, whether maternal betaine supplementation plays a role in regulating gut microbiota in both dams and offspring remains unclear. In this study, C57BL/6 female mice were fed with control diet (Ctr), high-fat diet (HF), and high-fat with betaine supplementation (0.3% betaine in the diet, HFB) from 3 weeks prior to mating and lasted throughout pregnancy and lactation. After weaning, the offspring got free access to normal chow diet until 20 weeks of age. We found that maternal dietary betaine supplementation significantly improved glucose and insulin resistance, as well as reduced free fatty acid (FFA) concentration in dams and offspring from young to adult. When compared to the HF group, Intestinimonas and Acetatifactor were reduced by betaine supplementation in dams; Desulfovibrio was reduced in 4-week-old offspring of the HFB group; and Lachnoclostridium was enriched in 20-week-old offspring of the HFB group. Moreover, the persistent elevated genus Romboutsia in both dams and offspring in the HFB group was reported for the first time. Overall, maternal betaine could dramatically alleviate the detrimental effects of maternal overnutrition on metabolism in both dams and offspring. The persistent alterations in gut microbiota might play critical roles in uncovering the intergenerational metabolic benefits of maternal betaine, which highlights evidence for combating generational metabolic diseases.

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“…We performed sibling comparison analyses to control for the influence of unmeasured familial and shared genetic characteristics [ 29 , 30 ]. A sub-sample of 6908 families including 17,315 siblings born to the same mother discordant for both DM and subsequent kidney diseases contributed to the effect estimate.…”

Section: Methodsmentioning

confidence: 99%

Childhood diabetes mellitus and early-onset kidney diseases later in life: a nationwide population-based matched cohort study

Sun

Zhao

Lee

et al. 2022

BMC Med

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Background The empirical evidence remains inconclusive for an association between diabetes mellitus (DM) in children and early-onset kidney disease later in life, and little is known about the effects of DM types (i.e., type 1 diabetes [T1DM] and type 2 diabetes [T2DM]) in childhood on type-specific kidney diseases. We aimed to evaluate the association of childhood DM with overall and type-specific early-onset kidney diseases later in life. Methods The population-based matched cohort study included 9356 individuals with DM (T1DM: 8470, T2DM: 886) diagnosed in childhood (< 18 years) who were born between 1977 and 2016, and 93,560 individuals without DM matched on sex and year of birth in Denmark. The main outcomes were overall and type-specific early-onset kidney diseases. The follow-up period of all included participants was from the date of DM diagnosis in the exposure group until the first diagnosis of kidney disease, emigration, or 31 December 2018, whichever came first. Results During a median follow-up of 13 years, children with DM had a 154% increased risk of early-onset kidney diseases than children without DM (adjusted hazard ratios 2.54, 95% confidence intervals 2.38–2.72), and T1DM (2.48, 2.31–2.67) and T2DM (2.75, 2.28–3.31) showed similar results. Children with DM also had a higher risk of multiple specific kidney diseases including glomerular diseases, renal tubulo-interstitial diseases, renal failure, and urolithiasis. The risks of type-specific kidney diseases including glomerular diseases and renal failure tended to be higher for children with T2DM (glomerular diseases: 5.84, 3.69–9.24; renal failure: 14.77, 8.53–25.59) than those with T1DM (glomerular diseases: 3.14, 2.57–3.83; renal failure: 8.24, 6.66–10.20). Conclusions Children with DM had a higher increased risk of early-onset overall and specific kidney diseases later in life. Early prevention and treatment of both T1DM and T2DM in childhood may significantly reduce the risk of kidney diseases later in life.

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Association of maternal diabetes during pregnancy with high refractive error in offspring: a nationwide population-based cohort study

Cited by 18 publications

References 48 publications

Evaluation of Hypertensive Disorder of Pregnancy and High Refractive Error in Offspring During Childhood and Adolescence

Evaluation of Hypertensive Disorder of Pregnancy and High Refractive Error in Offspring During Childhood and Adolescence

Maternal Dietary Betaine Prevents High-Fat Diet-Induced Metabolic Disorders and Gut Microbiota Alterations in Mouse Dams and Offspring From Young to Adult

Childhood diabetes mellitus and early-onset kidney diseases later in life: a nationwide population-based matched cohort study

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