Association of maternal obesity and gestational diabetes mellitus with overweight/obesity and fatty liver risk in offspring

Table 1 Characteristics of mothers and their offspring stratified into groups based on maternal body mass index quartiles at follow-up

Variables	All (n = 430)	Quartiles of maternal BMI (kg/m2)
		Q1 (n = 108): 15.00-19.13	Q2 (n = 105): 19.14-20.76	Q3 (n = 115): 20.77-23.44	Q4 (n = 102): 23.45-42.00	P value
Maternal characteristics
Age, yr	29.33 ± 4.89	29.21 ± 4.59	28.97 ± 3.14	29.59 ± 3.73	29.44 ± 7.36	0.805
Height, cm	162.97 ± 16.46	162.77 ± 5.09	161.84 ± 4.93	161.61 ± 4.29	162.26 ± 6.18	0.358
Weight, kg	56.73 ± 9.77	47.48 ± 3.45	52.21 ± 3.53	57.76 ± 3.53	69.9 ± 9.1	0.000
BMI, kg/m2	21.55 ± 3.59	17.92 ± 0.97	19.91 ± 0.43	22.1 ± 0.79	26.57 ± 3.3	0.000
GDM, n (%)	48 (11.2)	6 (5.6)	8 (7.6)	11 (9.6)	23 (22.5)	0.000
Offspring characteristics
Birth weight, kg	3.40 ± 0.48	3.33 ± 0.42	3.34 ± 0.39	3.42 ± 0.55	3.51 ± 0.51	0.021
Boy, n (%)	210 (48.8)	47 (43.5)	53 (50.5)	53 (46.1)	57 (55.9)	0.304
Height, cm	122.78 ± 29.93	121.59 ± 31.31	129.03 ± 4.91	118.81 ± 36.96	123.35 ± 31.01	0.242
Weight, kg	25.58 ± 10.57	22.98 ± 8.83	26.37 ± 7.8	25.18 ± 10.25	28.15 ± 13.12	0.070
BMI, kg/m2	15.89 ± 4.42	14.58 ± 3.81	15.70 ± 4.00	16.20 ± 3.69	17.25 ± 5.81	0.025
Waist circumference, cm	58.70 ± 10.79	54.33 ± 12.76	58.33 ± 7.08	59.15 ± 9.32	63.13 ± 9.42	0.000
Hip circumference, cm	69.04 ± 13.73	65.3 ± 14.55	69.17 ± 13.47	69.39 ± 7.36	72.14 ± 13.39	0.041
Chest circumference, cm	56.19 ± 21.03	49.79 ± 22.55	53.44 ± 22.62	56.72 ± 16.15	63.41 ± 14.73	0.003
Waist-height ratio	0.46 ± 0.05	0.44 ± 0.05	0.45 ± 0.05	0.46 ± 0.04	0.48 ± 0.06	0.000
Waist-hip ratio	0.84 ± 0.08	0.83 ± 0.06	0.84 ± 0.07	0.84 ± 0.06	0.86 ± 0.12	0.292
Chest-height ratio	0.44 ± 0.14	0.4 ± 0.16	0.44 ± 0.12	0.41 ± 0.17	0.48 ± 0.11	0.023
CAP, dB/m	167.71 ± 46.09	151.76 ± 37.01	164.33 ± 41.45	169.97 ± 40.76	188.38 ± 58.89	0.001
LSM, kPa	3.36 ± 0.75	3.31 ± 0.8	3.52 ± 0.8	3.35 ± 0.73	3.4 ± 0.71	0.480
Overweight, n (%)	37 (8.6)	4 (3.7)	7 (6.7)	5 (4.4)	21 (20.6)	0.000
Obesity, n (%)	14 (3.3)	0 (0)	0 (0)	2 (1.7)	12 (11.8)	0.000
Fatty liver, n (%)	60 (14.0)	2 (1.9)	10 (9.5)	19 (16.5)	29 (28.4)	0.001

BMI: Body max index; GDM: Gestational diabetes mellitus; CAP: Controlled attenuation parameter; LSM: Liver stiffness measurement.

Table 2 Adjusted odds ratios (95% confidence interval) of offspring overweight/obesity and fatty liver according to quartiles of maternal body max index

	Quartiles of BMI	Model 1		P value	Model 2		P value	Model 3		P value
		OR	95%CI		OR	95%CI		OR	95%CI
Offspring fatty liver		1.21	1.1-1.33	0.000	1.21	1.1-1.34	0.000	1.23	1.11-1.36	0.000
	Q1	Reference			Reference			Reference
	Q2	5.84	0.67-50.67	0.109	5.70	0.65-49.77	0.115	5.52	0.63-48.36	0.123
	Q3	9.76	1.21-78.83	0.033	9.60	1.18-77.79	0.034	9.50	1.17-77.33	0.035
	Q4	26.3	3.21-215.3	0.002	26.95	3.27-222.23	0.002	26.09	3.08-220.72	0.003
Offspring overweight/obesity		1.19	1.07-1.33	0.002	1.19	1.07-1.33	0.002	1.20	1.07-1.34	0.002
	Q1	Reference			Reference			Reference
	Q2	2.09	0.37-11.60	0.401	2.23	0.40-12.57	0.364	2.17	0.38-12.5	0.385
	Q3	1.30	0.22-7.62	0.770	1.43	0.24-8.49	0.694	1.43	0.24-8.58	0.696
	Q4	10.6	2.17-51.76	0.004	11.66	2.34-58.14	0.003	10.75	2.05-56.28	0.005

Model 1: Adjusted for offspring age and sex; Model 2: Further adjusted for maternal age and nulliparous; Model 3: Further adjusted for gestational diabetes mellitus status of the mothers included in the model and offspring birth weight. OR: Odds ratio; CI: Confidence interval; BMI: Body mass index.

Table 3 Characteristics of mothers with and without gestational diabetes mellitus and their offspring at follow-up

Variables	Mother without GDM (n = 382)	Mother with GDM (n = 48)	P value
Maternal characteristics
Age, yr	29.25 ± 5.1	29.98 ± 3.17	0.172
Height, cm	163.12 ± 17.48	162.02 ± 4.96	0.336
Weight, kg	56.16 ± 9.65	61 ± 9.47	0.001
BMI, kg/m2	21.33 ± 3.59	23.22 ± 3.28	0.000
Obesity, n (%)	42 (11.0)	20 (41.7)	0.000
Children characteristics
Birth weight, kg	3.41 ± 0.45	3.37 ± 0.61	0.653
Boy, n (%)	186 (49.1)	25 (52.1)	0.699
Height, cm	122.19 ± 30.67	125.07 ± 25.75	0.597
Weight, kg	25.13 ± 10.28	29.15 ± 10.38	0.058
BMI, kg/m2	15.74 ± 4.43	17.72 ± 3.94	0.024
Waist circumference, cm	58.2 ± 10.79	61.39 ± 10.23	0.148
Hip circumference, cm	68.15 ± 13.73	73.83 ± 7.94	0.003
Chest circumference, cm	54.38 ± 21.03	64.48 ± 7.96	0.000
Waist-height ratio	0.46 ± 0.05	0.47 ± 0.07	0.202
Waist-hip ratio	0.85 ± 0.08	0.83 ± 0.07	0.265
Chest-height ratio	0.43 ± 0.15	0.49 ± 0.05	0.024
CAP, dB/m	166.49 ± 45.65	187.26 ± 50.59	0.029
LSM, kPa	3.36 ± 0.75	3.53 ± 0.77	0.303
Overweight, n (%)	25 (6.5)	12 (25.0)	0.000
Obesity, n (%)	10 (2.6)	4 (8.3)	0.000
Fatty liver, n (%)	48 (12.6)	12 (25.0)	0.073

BMI: Body max index; GDM: Gestational diabetes mellitus; CAP: Controlled attenuation parameter; LSM: Liver stiffness measurement.

Table 4 Adjusted odds ratios for the association of maternal obesity and gestational diabetes mellitus with outcomes among children in a follow-up study

Outcomes	Risk factors	Model 1		P value	Model 2		P value	Model 3		P value
		OR	95%CI		OR	95%CI		OR	95%CI
Fatty liver	Maternal obesity	4.57	1.96-10.67	0.000	4.79	2.03-11.31	0.000	4.64	1.82-11.87	0.001
	GDM	2.39	0.91-6.29	0.077	2.45	0.93-6.49	0.071	2.49	0.94-6.61	0.068
	Maternal obesity and GDM	7.19	2.15-24.13	0.001	7.72	2.25-26.46	0.001	8.26	2.38-28.75	0.001
Overweight/obesity	Maternal obesity	5.73	2.18-15.10	0.000	5.69	2.14-15.10	0.000	4.15	1.44-11.97	0.009
	GDM	4.70	1.72-12.81	0.003	4.85	1.76-13.37	0.002	4.84	1.76-13.36	0.002
	Maternal obesity and GDM	16.97	4.07-70.88	0.000	16.97	4.07-70.88	0.000	17.22	4.08-72.79	0.000

Model 1: Adjusted for offspring age and sex; Model 2: Further adjusted for maternal age and nulliparity; Model 3: Further adjusted for offspring birth weight. OR: Odds ratio; CI: Confidence interval; BMI: Body mass index; GDM: Gestational diabetes mellitus.