Newborn Adiposity and Cord Blood C-Peptide as Mediators of the Maternal Metabolic Environment and Childhood Adiposity
Jami L. Josefson, Denise Scholtens, Alan Kuang, Patrick M. Catalano, Lynn P. Lowe, Alan R. Dyer, Lucia C. Petito, William L. Lowe, Boyd E. Metzger, Chaicharn Deerochanawong, Thadchanan Tanaphonpoonsuk, Sukeeta Binratkaew Uraiwan Chotigeat, Wanee Manyam, Martinette Forde, André Greenidge, Kathleen Neblett, Paula Michele Lashley, Desiree Walcott, Katie Corry, Loraine Francis, Jo-anne Irwin, Anne Langan, David R. McCance, Maureen Mousavi, Ian Young, Jennifer Gutierrez, Jennifer Jimenez, Jean M. Lawrence, David A. Sacks, Harpreet S. Takhar, Elizabeth Tanton, Wendy J. Brickman, Jennifer Howard, Jami L. Josefson, Lauren A. Miller, Jacqui Bjaloncik, Patrick M. Catalano, Ajuah Davis, Michaela B. Koontz, Larraine Presley, Shoi Smith, Amanda Tyhulski, Albert Martin Li, Ronald C.W., Risa Ozaki, Wing Hung Tam, Michelle S. Wong, Cindy Siu Man Yuen, Peter Clayton, Aysha Habib Khan, Avni Vyas, Michael Maresh, Hadasse Benzaquen, Naama Glickman, Alona Hamou, Orna Hermon, Orit Horesh, Yael Keren, Yael Lebenthal, Shlomit Shalitin, Kristina Cordeiro, Jill Hamilton, Hahn Y. Nguyen, Shawna Steele, Fei Chen, Alan R. Dyer, Wenyu Huang, Alan Kuang, M. Ángeles Jiménez, Lynn P. Lowe, William L. Lowe, Boyd E. Metzger, Michael Nodzenski, Anna C. Reisetter, Denise Scholtens, Octavious Talbot, Paul Yim, David B. Dunger, Alicia Thomas, Mary Horlick, Barbara Linder, Aynur Ünalp–Arida, Gilman D. Grave
Abstract
OBJECTIVE: Excessive childhood adiposity is a risk factor for adverse metabolic health. The objective was to investigate associations of newborn body composition and cord C-peptide with childhood anthropometrics and explore whether these newborn measures mediate associations of maternal midpregnancy glucose and BMI with childhood adiposity. RESEARCH DESIGN AND METHODS: = 4,832) from the epidemiological Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Study and HAPO Follow-up Study (HAPO FUS) were analyzed. Linear regression was used to study associations between newborn and childhood anthropometrics. Structural equation modeling was used to explore newborn anthropometric measures as potential mediators of the associations of maternal BMI and glucose during pregnancy with childhood anthropometric outcomes. RESULTS: -score (0.072, 0.033-0.11, <0.001), fat mass (kg) (0.51, 0.26-0.76, <0.001), percentage of body fat (0.61, 0.27-0.95, <0.001), and sum of skinfolds (mm) (1.14, 0.43-1.86, 0.0017). Structural equation models demonstrated significant mediation by newborn sum of skinfolds and cord C-peptide of maternal BMI effects on childhood BMI (proportion of total effect 2.5% and 1%, respectively), fat mass (3.1%, 1.2%), percentage of body fat (3.6%, 1.8%), and sum of skinfolds (2.9%, 1.8%), and significant mediation by newborn sum of skinfolds and cord C-peptide of maternal glucose effects on child fat mass (proportion of total association 22.0% and 21.0%, respectively), percentage of body fat (15.0%, 18.0%), and sum of skinfolds (15.0%, 20.0%). CONCLUSIONS: Newborn adiposity is independently associated with childhood adiposity and, along with fetal hyperinsulinemia, mediates, in part, associations of maternal glucose and BMI with childhood adiposity.