503: Metabolic assessments of the offspring of women with mild gestational diabetes mellitus (GDM)

Abstract

Childhood obesity is a growing epidemic; nutritional environment before birth and in early infancy may determine later metabolic health. Infants of mothers with gestational diabetes (GDM) have a higher risk for childhood obesity and metabolic syndrome. Leptin and adiponectin are known biomarkers for metabolic syndrome in adults and may be useful to guide interventions to reduce later obesity. We sought to examine relationship between birthweight, early infancy feeding practices and biomarkers for metabolic syndrome in offspring of women with mild GDM. Secondary analysis of a multicenter randomized treatment trial of women with mild GDM (an abnormal result on an oral glucose-tolerance test with fasting glucose level below 95 mg/dl). The children of these women were evaluated by trained research coordinators and biospecimen obtained at 5-10 years of age. Plasma concentrations of leptin and adiponectin (assayed by ELISA) were compared for those born large for gestational age (LGA >90%ile by Alexander nomogram) versus average birthweights (AGA 10-90 %ile), and whether solid foods were introduced early (<6 months of age) in comparison to recommended age (≥6 months of age). Multivariable analysis adjusted for fetal sex, race/ethnicity, maternal BMI and type of feeding. Of children born to women with mild GDM, 336 plasma samples (67% of parent trial follow up) were assessed for leptin and adiponectin concentrations. LGA children had higher neonatal fat mass (p < 0.001), childhood BMI (p = 0.001) and childhood waist circumference (p = 0.01) compared to AGA children. In bivariable analysis, compared to AGA children, LGA children had lower leptin (p = 0.01) and similar adiponectin (p = 0.49) concentrations. Maternal/child characteristics were similar between the early fed/delayed feeding groups. Leptin and adiponectin concentrations were similar in the early fed and delayed feeding groups (p = 0.50 and p = 0.85, respectively). After controlling for covariates, LGA and AGA children had similar leptin concentrations. Birthweight and early infancy feeding practice are not associated with alterations in biomarkers (leptin and adiponectin) for metabolic syndrome in offspring of women with mild GDM.