Children Exposed to Maternal Obesity or Gestational Diabetes Mellitus During Early Fetal Development Have Hypothalamic Alterations That Predict Future Weight Gain

Abstract

OBJECTIVE Exposure in utero to maternal obesity or gestational diabetes mellitus (GDM) is linked to a high risk for obesity in offspring. Animal studies suggest that these exposures disrupt the development of the hypothalamus, a brain region that regulates body weight, predisposing offspring to develop obesity. This study tested the hypothesis in humans that in utero exposure to maternal obesity and/or GDM is associated with alterations in the hypothalamic response to glucose and the altered hypothalamic response would predict greater increases in child adiposity 1 year later. RESEARCH DESIGN AND METHODS Participants were 91 children aged 7–11 years with and without in utero exposure to GDM. Maternal prepregnancy BMI and GDM exposures were determined from electronic medical records. Arterial spin labeling MRI was used to determine the child’s hypothalamic blood flow response to oral glucose. Anthropometric measures were acquired in all children at their initial visit and again 1 year later in a subset of 44 children. RESULTS Children exposed to GDM diagnosed at ≤26 weeks' gestation had increased hypothalamic blood flow (a marker of hypothalamic activation) in response to glucose when compared with unexposed children, and results remained after adjustments for child age, sex, BMI, and maternal prepregnancy BMI. Maternal prepregnancy BMI was positively associated with the child’s hypothalamic response to glucose. Greater hypothalamic response to glucose predicted greater increases in child’s BMI 1 year later. CONCLUSIONS Increased glucose-linked hypothalamic activation during childhood represents a possible mechanism by which exposure to maternal metabolic disorders during fetal development increases future risk for obesity.

<p>Khat Chewing and Type 2 Diabetes Mellitus</p>

“…22 A1C ≥7% was categorized as poor glycemic control, while A1C <7% was good glycemic control. 23 Waist circumference was measured and classified as obese if ≥94 cm for males and ≥80 cm for females, following the Arabian-specific waist circumference. 24 Physical activity of less than 150 mins per week was categorized as physically inactive, following the American Diabetes Association's guidelines.…”

“…24 Physical activity of less than 150 mins per week was categorized as physically inactive, following the American Diabetes Association's guidelines. 25 Saudi citizens in primary health care centers in Jazan, Saudi Arabia The Jazan Hospital Institutional Review Board (reference number: H-10-Z-068) 26 granted ethical approval (No. 1851) for the study, which also complied with the Helsinki Declaration.…”

Molecular Modelling of Islet β-Cell Adaptation to Inflammation in Pregnancy and Gestational Diabetes Mellitus

“…GDM is also associated with adverse outcomes for the progeny, such as respiratory distress syndrome, metabolic and cardiac dysfunction, obesity, brain disorders [39,[43][44][45]. In general, a higher prevalence of obesity and diabetes, more than what genetics alone would predict, was observed in the children from women with diabetes during pregnancy, when compared to children from nondiabetic women [10,46,47].…”

The relationship between health-related quality of life, acceptance of illness and characteristics of pregnant women with hyperglycemia

“…Globally, the rates of being overweight and obese are growing, which also entails an increasing prevalence of diabetes mellitus. Therefore, it is extremely important to offer prompt diagnostics for hyperglycemia to women who are pregnant or planning a pregnancy, as uncontrolled hyperglycemia may cause a number of complications related to conception, the course of pregnancy, and fetal development, and may affect the future life of the mother and her child [4][5][6][7][8].…”