High Maternal DHA Levels in Hawaiian Women Decrease Insulin Resistance

Abstract

Obesity prevalence during pregnancy (PG), a significant risk factor for metabolic inflammation and subsequent increase in insulin resistance (IR), has increased ∼ 35% in the last 20 years. Offspring of obese (OB) women are at a higher risk of metabolic dysfunction. Omega-3 fatty acids such as DHA have been shown to decrease IR in animals, though the effects of DHA in PG women are unclear. We hypothesize that high plasma DHA levels are associated with lower IR in PG women in an environment of high omega-3 intake (Hawaii), but differ in metabolic effect in OB vs. lean (LN) women. We evaluated 54 healthy, normal glucose tolerant women and their offspring at term elective C-section in Honolulu. We grouped subjects according to their pre-PG BMI into LN and OB. We measured maternal plasma insulin, glucose, C-reactive protein (CRP), and DHA concentration (gas chromatography/mass spectrophotometry) and calculated the homeostatic model assessment for IR (HOMA-IR). As expected, IR was higher in OB women (Table 1). Maternal DHA was negatively correlated with maternal HOMA-IR (R2= 0.25 p = 0.001), and CRP (R2=0.15 p= 0.004) among all women. These correlations persisted for OB women: HOMA-IR (R2=38 p=0.0007), CRP (R2=0.20 p=0.01); but not for LN women. High maternal DHA is associated with lower inflammation and IR in OB PG women at term. We speculate that high pre-PG omega-3 intake has a significant metabolic impact on insulin sensitivity, especially in OB women.Table 1Lean (BMI: 16-24.9 kg/m2 n=29)Obese (BMI>30, n=26)P.valueGestational Age at delivery (wks)38.8 ± 0.639.1 ± 0.40.088Pre-Pregnancy BMI (kg/m2)21.1 ± 2.236.8 ± 6.9<0.0001DHA (µmol/L)453 ± 187347 ± 1200.02HOMA IR1.1 ± 0.82.4 ± 1.4<0.0001CRP (ng/mL)5180 ± 2688 7859 ± 23180.0005Birth Weight (kg)3.3 ± 0.43.5 ± 0.40.04 Disclosure F. Alvarado: None. P. Tsai: None. J. Minium: None. P. Catalano: None. P. O'Tierney-Ginn: None.