Retrospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Apr 28, 2022; 28(16): 1681-1691
Published online Apr 28, 2022. doi: 10.3748/wjg.v28.i16.1681
Association of maternal obesity and gestational diabetes mellitus with overweight/obesity and fatty liver risk in offspring
Jing Zeng, Feng Shen, Zi-Yuan Zou, Rui-Xu Yang, Qian Jin, Jing Yang, Guang-Yu Chen, Jian-Gao Fan
Jing Zeng, Feng Shen, Zi-Yuan Zou, Rui-Xu Yang, Qian Jin, Jing Yang, Guang-Yu Chen, Jian-Gao Fan, Department of Gastroenterology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
Jian-Gao Fan, Shanghai Key Lab of Pediatric Gastroenterology and Nutrition, Shanghai 200092, China
Author contributions: Zeng J and Shen F contributed equally to this work; Zeng J, Shen F, and Yang RX carried out the experiments; Zeng J, Shen F, Yang RX, Jin Q, Yang J, and Chen GY contributed to acquisition, analysis, or interpretation of the data; Zeng J and Zou ZY wrote the paper; Fan JG made critical revision of the manuscript for important intellectual content.
Supported by Collaborative Innovation Program of Shanghai Municipal Health Commission, No. 2020CXJQ01; National Natural Science Foundation of China, No. 81873565 and No. 82100605; SJTU Trans-med Awards Research, No. 20190104; Star Program of Shanghai Jiao Tong University, No. YG2021QN54; WBE Liver Fibrosis Foundation, No. CFHPC2020061; and Hospital Funded Clinical Research, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, No. 17CSK04 and No. 15LC06.
Institutional review board statement: The study was reviewed and approved by the ethics committees of all hospitals involved. All procedures were performed in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008.
Informed consent statement: Informed consent was obtained from all individual participants included in the study.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jian-Gao Fan, MD, PhD, Professor, Department of Gastroenterology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, No. 1665 Kongjiang Road, Shanghai 200092, China. fanjiangao@xinhuamed.com.cn
Received: August 29, 2021
Peer-review started: August 29, 2021
First decision: October 16, 2021
Revised: October 30, 2021
Accepted: March 16, 2022
Article in press: March 16, 2022
Published online: April 28, 2022
Processing time: 237 Days and 18.3 Hours
Abstract
BACKGROUND

Childhood obesity and fatty liver are associated with adverse outcomes such as diabetes, metabolic syndrome, and cardiovascular diseases in adulthood. It is very important to identify relevant risk factors and intervene as early as possible. At present, the relationship between maternal and offspring metabolic factors is conflicting.

AIM

To estimate the association of maternal obesity and gestational diabetes mellitus (GDM) with overweight/obesity and fatty liver risk in offspring at 8 years of age.

METHODS

The prospective study included mothers who all had a 75-g oral glucose tolerance test at 24-28 wk of gestation and whose offspring completed follow-up at 8 years of age. Offspring birth weight, sex, height, weight, and body mass index (BMI) were measured and calculated. FibroScan-502 examination with an M probe (Echosens, Paris, France) was prospectively conducted in offspring aged 8 years from the Shanghai Prenatal Cohort Study.

RESULTS

A total of 430 mother-child pairs were included in the analysis. A total of 62 (14.2%) mothers were classified as obese, and 48 (11.1%) were classified as having GDM. The mean age of the offspring at follow-up was 8 years old. Thirty-seven (8.6%) offspring were overweight, 14 (3.3%) had obesity, and 60 (14.0%) had fatty liver. The prevalence of overweight, obesity and fatty liver in offspring increased significantly across maternal BMI quartiles (all P < 0.05). Among offspring of mothers with GDM, 12 (25.0%) were overweight, 4 (8.3%) were obese, and 12 (25.0%) had fatty liver vs. 25 (6.5%), 10 (2.6%) and 48 (12.6%), respectively, for offspring of mothers without GDM (all P < 0.05). In multiple logistic regression, after adjustment for variables, the OR for fatty liver in offspring was 8.26 (95%CI: 2.38-28.75) for maternal obesity and GDM.

CONCLUSION

This study showed that maternal obesity can increase the odds of overweight/obesity and fatty liver in offspring, and GDM status also increases the odds of overweight/obesity in offspring. Weight management and glycemic control before and during pregnancy need to be highlighted in primary prevention of pediatric obesity and fatty liver.

Keywords: Maternal obesity; Gestational diabetes mellitus; Offspring overweight/obesity; Offspring fatty liver; FibroScan

Core Tip: It is very important to identify relevant risk factors for childhood obesity and fatty liver and intervene as early as possible, considering their adverse outcomes. In this work, we reported the association of maternal obesity and gestational diabetes mellitus (GDM) with overweight/obesity and fatty liver risk in offspring at 8 years of age. This study showed that maternal obesity can increase the odds of overweight/obesity and fatty liver in offspring, and GDM status also increases the odds of overweight/obesity in offspring. Weight management and glycemic control before and during pregnancy need to be highlighted in primary prevention of pediatric obesity and fatty liver.