Associations of Gestational Diabetes, Existing Diabetes, and Glycosuria With Offspring Obesity and Cardiometabolic Outcomes

Abstract

OBJECTIVE: To assess associations of gestational diabetes, existing diabetes, and glycosuria with adiposity and cardiometabolic risk factors in offspring at adolescence. RESEARCH DESIGN AND METHODS: Multivariable regression analyses were conducted in a prospective pregnancy cohort (n = 2,563-4,198 for different outcomes). Obstetric data were abstracted from clinical records. Offspring outcomes were assessed at mean age 15.5 years. Compared with those lost to follow-up, participants included in the analysis were of higher socioeconomic position. Outcomes included BMI, waist circumference, fat mass determined by dual-energy X-ray absorptiometry scan, systolic and diastolic blood pressure (sBP and dBP, respectively), fasting glucose, insulin, lipids, and C-reactive protein (CRP). RESULTS: Maternal existing diabetes, gestational diabetes, and glycosuria were associated with higher offspring BMI and fat mass (z scores); however, this effect was attenuated in the confounder-adjusted model, and the CIs included the null value. Existing diabetes and gestational diabetes were associated with higher offspring fasting glucose levels (0.24 mmol/L [95% CI 0.03-0.45] and 0.20 mmol/L [0.02-0.39], respectively). Glycosuria was associated with higher fasting insulin (adjusted ratio of geometric means 1.12 [1.01-1.25]), but there were no clear associations of existing or gestational diabetes with offspring fasting insulin. There was little evidence of an association of maternal diabetes or glycosuria with offspring dBP, sBP, lipids, or CRP. CONCLUSIONS: Maternal pregnancy glycosuria, gestational diabetes, and existing diabetes show some associations with higher offspring fasting glucose and insulin assessed in adolescence but are not clearly associated with a wider range of cardiometabolic risk factors.