Relationship Between Maternal Bone Biomarkers and Fetal Adiposity Through Normal Pregnancy

Abstract

Purpose To examine the association of maternal bone markers (sclerostin, sRANKL, osteocalcin, 25OHD3) with fetal intra-abdominal and subcutaneous adipose tissue deposition and birthweight during normal pregnancy. Methods One hundred pregnant women (aged 30.4±5.6 years, mean±SD) with pre-pregnancy BMI=24.1±4.6 kg/m² were seen prospectively during each trimester. At each visit they were submitted to anthropometric measurements, a fasting blood sampling, a 75gr oral glucose tolerance test (OGTT) and a fetal ultrasonogram. At birth, neonates had birth weight measurement. Results In the 2 nd trimester maternal sclerostin concentrations correlated positively with fetal abdominal circumference and birth weight; maternal sRANKL concentrations correlated positively with fetal abdominal subcutaneous fat thickness, sagittal abdominal diameter and abdominal circumference. Fetuses born to mothers with greater (>254 ng/mL) compared to fetuses born to mothers with lower (≤254 ng/mL) sRANKL concentrations had greater abdominal circumference, sagittal diameter and abdominal subcutaneous fat thickness. Maternal serum sclerostin concentrations were the best positive predictors of birth weight. In the 3 rd trimester maternal sclerostin concentrations correlated positively with fetal sagittal abdominal diameter; maternal sRANKL concentrations positively correlated with fetal abdominal circumference and fetal abdominal sagittal diameter. Conclusions Maternal bone markers sclerostin and sRANKL may relate with fetal intra-abdominal adipose tissue deposition through direct or indirect unknown as yet mechanisms contributing thus, to birthweight.

The Gestational Effects of Maternal Bone Marker Molecules on Fetal Growth, Metabolism and Long-Term Metabolic Health: A Systematic Review

“…However, maternal serum sclerostin levels were higher in older mothers and in cases complicated with GDM in the LGA group, with authors suggesting a possible role of elevated sclerostin levels in poor bone quality and increased bone fragility in women suffering from diabetes. The above results oppose those of the beforementioned study by Mastorakos et al [ 49 ], who demonstrated a positive correlation between maternal sclerostin levels and neonatal birthweight. Nevertheless, data should be carefully interpreted, as Briana et al‘s study included mothers with various pathological conditions in the IUGR and LGA group, that may have influenced the outcome.…”

“…Regarding other maternal bone turnover molecules, studies in the literature are scarce. In their recent study of 100 healthy pregnancies, Mastorakos et al [ 49 ] demonstrated that both maternal sclerostin, as well as maternal sRANKL levels, had a positive correlation with fetal abdominal circumference during the second trimester of pregnancy. Moreover, maternal sclerostin was also positively correlated with fetal birthweight, while maternal sRANKL with fetal subcutaneous fat thickness and sagittal abdominal diameter, as assessed by sonography.…”

The Gestational Effects of Maternal Appetite Axis Molecules on Fetal Growth, Metabolism and Long-Term Metabolic Health: A Systematic Review

“…Recently, maternal molecules implicated in bone metabolism such as sclerostin correlated positively with fetal abdominal circumference and birth weight. Further, maternal sRANKL (the soluble form of receptor activator of nuclear factor kappa-Β ligand) was shown to correlate positively with fetal abdominal subcutaneous fat thickness, sagittal abdominal diameter and abdominal circumference [ 7 ]. Maternal adipocytokines and hormones such as visfatin, adiponectin and C peptide also associate (both directly and indirectly) with fetal growth and adiposity in various studies [ 8 , 9 , 10 , 11 ].…”