Trends and sociocultural factors for childhood overweight in La Reunion Island

Sexual dimorphism in the association between gestational diabetes mellitus and overweight in offspring at 5-7 years: The OBEGEST cohort study

Evidence from literature is mixed regarding a possible association of maternal gestational diabetes mellitus (GDM) and overweight in the offspring. Sexual dimorphism, or sex disparities in the pathogenesis linking GDM exposure to overweight, could be at play. The objective of this study was to investigate the association between GDM and child overweight at 5–7 years. Six hundred pairs (1:1) of Reunionese liveborn singletons selected from a hospital-based birth registry, matched for sex, gestational age, and birth period, underwent a prospective in-home follow-up and were analyzed with respect to their exposure to GDM. The primary outcome was child overweight at 5–7 years, as defined by the International Obesity Task Force. The association between GDM exposure and child overweight was estimated by the odds ratio (OR) using conditional logistic regression models. For the subset of children exposed to GDM with available maternal glycemic data, we analyzed the relationship between maternal glycemic levels during pregnancy and child body mass index (BMI) at 5–7 years with a linear regression model. In light of the significant interaction between sex and GDM, all statistical analyses were then stratified by sex. After controlling for pre-pregnancy BMI and maternal sociodemographic characteristics, the risk of overweight increased with exposure to GDM for boys (adjusted OR: 2.34; 95% confidence interval = 1.26–4.34, P = 0.007) but not for girls (adjusted OR: 0.56; 95%CI = 0.28–1.10, P = 0.093). Consistent with this, the linear increase of boys’ BMI at 5–7 years with maternal blood glucose levels during pregnancy, in the exposed group, displayed a dose-response relationship. Our findings indicate that exposure to GDM is a risk factor for childhood overweight in boys but not in girls, which adds to the growing body of evidence suggesting greater sensitivity of male offspring to intrauterine hyperglycemia.

Type 2 diabetes increases risk for obesity among subsequent generations

BACKGROUND

Childhood obesity is increasing worldwide. Although the prevalence of obesity is low in India, it is being perceived as an emerging problem among affluent urban Indian children. There is little information regarding the profile of obese Indian children. The aim of this study was to assess the clinical profile of children and adolescents attending our hospital (a tertiary-care center) with the main complaint of obesity or overweight.

STUDY DESIGN

Children and adolescents attending our pediatric and adolescent endocrine clinic with the main complaint of overweight or obesity were included in this study. All subjects underwent detailed history, physical examination, hemogram liver function tests, oral glucose tolerance test, plasma insulin, and body fat estimation.

RESULTS

One hundred nine children (70 boys and 39 girls), ranging in age from 5 to 18 years (mean 13.8 +/- 2.9 years), were enrolled for the study. Twenty boys and 13 girls were overweight, while 50 boys and 26 girls were obese. Twenty-five of these children had hypertension, 48 had dyslipidemia, and 27 had abnormal glucose tolerance. Plasma insulin levels were significantly higher than what is observed in healthy lean controls. The most significant observation was that 75 children had grandparents and/or parents with diabetes mellitus. Possible reasons for this association are discussed.

CONCLUSIONS

Children from families with diabetes mellitus are at risk for obesity. Hyperinsulinemia, by its action on the brain, induces behaviors and lifestyles conducive to obesity.