Original ArticleIntrahepatic Fat Is Increased in the Neonatal Offspring of Obese Women with Gestational Diabetes
Section snippets
Methods
After written, informed parental consent was obtained, healthy, full-term infants were studied from 2 groups of mothers. Mothers were recruited during a 17-month period from prenatal care at either the University of Colorado Hospital or Denver Health. The first group consisted of infants born to mothers with a prepregnancy body mass index (BMI) <25 kg/m2 without GDM (normal-weight control). The second group included infants born to mothers with a prepregnancy BMI of >30 kg/m2 and who were
Results
Twenty-five infants from 12 mothers with obesity/GDM and 13 normal-weight mothers with normal glucose tolerance testing were studied. Pregnancy and infant characteristics are listed in Table I.26 Of the 12 obese/GDM mothers, 2 were class A1 (diet-controlled) GDM, and 10 were class A2 (requiring insulin or glyburide) GDM. Prepregnancy BMI (kg/m2) was greater in the obese/GDM group (40.1 vs 21.6, P < .05) by design. Obese/GDM mothers were older than normal-weight mothers (29.9 years vs 24.8
Discussion
Our results demonstrate that maternal prepregnancy BMI is associated with hepatic fat storage at 1-3 weeks of life across a cohort of infants born to both normal-weight and obese mothers with GDM. This relationship is consistent with findings reported by Modi et al.27 All of our obese mothers also had GDM, whereas <10% of mothers had GDM in the cohort described by Modi,27 suggesting that maternal obesity may be more important than the presence of GDM in predicting infant hepatic fat storage.
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2022, American Journal of Obstetrics and GynecologyCitation Excerpt :A “multiple-hit” pathogenic model has been suggested to explain the progressive liver damage that occurs among children with NAFLD.76 Data in humans demonstrated that liver fat is 68% higher in neonates born to mothers with obesity and GDM and is strongly correlated with maternal prepregnancy BMI and, perhaps, maternal triglycerides before subcutaneous fat stores are fully developed.77,78 Moreover, evidence from the national pediatric nonalcoholic steatohepatitis (NASH) network showed that high birthweight or LBW, even when adjusting for childhood BMI, doubles the risk of advanced fibrosis in youth with biopsy-confirmed NAFLD,79 suggesting that changes at birth may precede and possibly predict the rapid onset of NASH in at-risk youth for reasons that remain poorly understood.
Supported by National Institutes of Health (NIH)/National Center for Advancing Translational Sciences Colorado Clinical and Translational Sciences Institute. (UL1 TR000154 and 5 T32 DK067009 to D.B.), Children's Hospital Colorado Research Institute (to D.B.), NIH (5R01DK078645 [to L.B.] and DK504554 [J.F.]) Contents are the authors' sole responsibility and do not necessarily represent official NIH views. The authors declare no conflicts of interest.
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Contributed equally.