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Dybdahl M, Dalgård C, Glintborg D, Andersen MS, Christesen HT. Maternal Testosterone Concentrations in Third Trimester and Offspring Handgrip Strength at 5 Years: Odense Child Cohort. J Clin Endocrinol Metab 2022; 107:e3029-e3038. [PMID: 35276008 PMCID: PMC9202699 DOI: 10.1210/clinem/dgac143] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND Maternal testosterone in pregnancy may have conditioning effects on offspring muscle strength. PURPOSE To investigate possible associations between maternal testosterone concentrations in third trimester and offspring handgrip strength (HGS) at 5 years. METHODS In the prospective, population-based Odense Child Cohort, total testosterone (TT) at gestational week 27-28 and 5-year HGS were measured in 1017 mother-child pairs. TT was measured by liquid chromatography-tandem mass spectrometry and free testosterone (FT) was calculated from TT and sex hormone-binding globulin (SHBG). Multivariable regression analyses were performed with HGS < 10th percentile as cutoff for low HGS. RESULTS Third-trimester FT concentration was 0.004 (0.002-0.007) nmol/L, geometric mean (mean - SD; mean + SD). The mean (SD) 5-year HGS was 8.7 (1.8) kg in boys and 8.1 (1.7) kg in girls (P < 0.001). Higher FT concentrations were associated with lower HGS (β = -0.186, P = 0.048), after adjustment for maternal age, parity, offspring sex, and 5-year height and weight. FT > 0.004 nmol/L was associated with higher risk of 5-year HGS < 10th percentile with odds ratios (95% CI) of 1.58 (1.01, 2.47; P = 0.047; n = 1,017) and 1.69 (1.05, 2.74; P = 0.032) after further adjustment for children's organized sports in subgroup analysis (n = 848). Lower HGS in relation to higher FT concentrations was found in all linear models but was not always statistically significant. HGS was not associated with maternal TT and SHBG levels. CONCLUSION Third trimester FT was inversely associated with offspring muscle strength assessed by HGS at 5 years of age, which may suggest a negative effect of maternal FT on offspring muscle strength.
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Affiliation(s)
- Malene Dybdahl
- Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense C, Denmark
- Hans Christian Andersen Children’s Hospital, Odense University Hospital, Odense C, Denmark
| | - Christine Dalgård
- Clinical Pharmacology, Pharmacy and Environmental Medicine, Department of Public Health, University of Southern Denmark, Odense C, Denmark
| | - Dorte Glintborg
- Department of Endocrinology, Odense University Hospital, University of Southern Denmark, Odense C, Denmark
| | - Marianne Skovsager Andersen
- Department of Endocrinology, Odense University Hospital, University of Southern Denmark, Odense C, Denmark
- Odense Patient Data Exploratory Network (OPEN), University of Southern Denmark, Odense C, Denmark
| | - Henrik Thybo Christesen
- Correspondence: Henrik Thybo Christesen, MD, PhD, Hans Christian Andersen Children’s Hospital, Odense University Hospital, Kløvervænget 23, 5000 Odense C, Denmark.
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Abstract
PURPOSE OF REVIEW To review recent evidence linking maternal body mass index and gestational diabetes mellitus (GDM) with offspring health outcomes. RECENT FINDINGS It is now established that the rising prevalences of maternal obesity and GDM are both making substantial contributions to the growing burden of childhood obesity and associated disorders. Strengthening evidence also links maternal obesity with increased offspring risks of cardiovascular disease, nonalcoholic fatty liver disease, lower respiratory tract infections during infancy, wheezing illnesses, asthma and attention deficit hyperactivity disorder during childhood, and with higher risks of psychiatric disorders and colorectal cancer in adulthood. GDM has been associated with increased offspring risks of cardiovascular disease, childhood wheeze/asthma (but not allergic sensitization), and with high refractive error, attention deficit hyperactivity and psychiatric disorders from childhood onwards. SUMMARY The long-term consequences of maternal obesity and GDM for the offspring in childhood and later adult life present major challenges for public health across the life course and for future generations. Tackling these challenges requires a systems-based approach to support achieving a healthy weight in young people prior to conception, alongside new insights into population based preventive measures against gestational diabetes.
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Affiliation(s)
- Kathryn V Dalrymple
- Medical Research Council Lifecourse Epidemiology Centre, University of Southampton, Southampton
- Department of Women and Children's Health, School of Life Course and Population Sciences, King's College London, London
| | - Sarah El-Heis
- Medical Research Council Lifecourse Epidemiology Centre, University of Southampton, Southampton
| | - Keith M Godfrey
- Medical Research Council Lifecourse Epidemiology Centre, University of Southampton, Southampton
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
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Alja'nini Z, McNelis KM, Viswanathan S, Goddard GR, Merlino-Barr S, Collin M, Groh-Wargo S. Infant body composition assessment in the neonatal intensive care unit (NICU) using air displacement plethysmography: Strategies for implementation into clinical workflow. Clin Nutr ESPEN 2021; 43:212-222. [PMID: 34024517 DOI: 10.1016/j.clnesp.2021.04.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 04/03/2021] [Accepted: 04/10/2021] [Indexed: 11/19/2022]
Abstract
Nutritional management is integral to infant care in the neonatal intensive care unit (NICU). Recent research on body composition that specifically evaluated fat and fat-free mass has improved our understanding of infant growth and nutritional requirements. The need for body composition monitoring in infants is increasingly recognized as changes in fat mass and fat-free mass associated with early growth can impact clinical outcomes. With the availability of air displacement plethysmography (ADP) as a noninvasive method for assessing infant body composition and published normative gestational age- and sex-specific body composition curves, it is justifiable to integrate this innovation into routine clinical care. Here we describe our experiences in implementing body composition measurement using ADP in routine clinical care in different NICU settings.
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Affiliation(s)
- Zaineh Alja'nini
- Department of Pediatrics, MetroHealth Medical Center Affiliated with Case Western Reserve University, Cleveland, OH, USA.
| | - Kera Michelle McNelis
- Cincinnati Children's Hospital Medical Center, Department of Pediatrics, Perinatal Institute, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Sreekanth Viswanathan
- Division of Neonatology, Department of Pediatrics, Nemours Children's Hospital, University of Central Florida College of Medicine, Orlando, FL, USA
| | - Gillian R Goddard
- Division of Pediatric and General and Thoracic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Stephanie Merlino-Barr
- Department of Pediatrics, MetroHealth Medical Center Affiliated with Case Western Reserve University, Cleveland, OH, USA
| | - Marc Collin
- Department of Pediatrics, MetroHealth Medical Center Affiliated with Case Western Reserve University, Cleveland, OH, USA
| | - Sharon Groh-Wargo
- Department of Pediatrics, MetroHealth Medical Center Affiliated with Case Western Reserve University, Cleveland, OH, USA
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Wiechers C, Balles LS, Kirchhof S, Weber R, Avellina V, Pauluschke-Fröhlich J, Hallschmid M, Fritsche L, Preißl H, Fritsche A, Poets CF, Franz AR. Body composition in term offspring after maternal gestational diabetes does not predict postnatal hypoglycemia. BMC Pediatr 2021; 21:111. [PMID: 33676430 PMCID: PMC7936473 DOI: 10.1186/s12887-021-02578-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 02/23/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Offspring of mothers with gestational diabetes mellitus (GDM) have an increased risk of neonatal complications like birth trauma due to macrosomia or postnatal hypoglycemia, as well as long-term metabolic sequelae. Neonatal body composition may be a sensitive marker of metabolic effects on the fetus caused by suboptimal glycemic control during pregnancy. OBJECTIVE To determine body composition in offspring of mothers with GDM compared to a reference cohort of healthy term neonates and to assess whether increased body fat would be associated with postnatal hypoglycemia. METHODS This prospective, observational, cross-sectional study included 311 full-term, singleton infants born between June 2014 and July 2015. Body composition was measured within 96 h of birth using air displacement plethysmography. Results are indicated as median (1st Quartile - 3rd Quartile). RESULTS Of 311 infants, 40 (12.9%) were born to mothers with GDM. Birth weight standard deviation scores (SDS) (0.24 vs. - 0.07, p = 0.04), fat mass (370 g vs. 333 g, p = 0.02) as well as fat mass/total body mass (BF%; 11.4% vs. 10.8%, p = 0.03) were significantly higher in infants following maternal GDM than in controls. In GDM offspring, anthropometric parameters, fat mass or BF% did not differ between infants with or without postnatal hypoglycemia. In this cohort, SDS for birth weight, fat mass, fat free mass, BF% or postnatal hypoglycemia were not associated with maternal blood glucose levels measured at an oral glucose tolerance test. CONCLUSIONS SDS for birth weight, neonatal fat mass, and BF% were significantly higher in newborns following maternal GDM. In these infants born to mothers with GDM, body composition did not differ between those with or without postnatal hypoglycemia.
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Affiliation(s)
- Cornelia Wiechers
- Department of Neonatology, University Children's Hospital, Eberhard Karls University, Calwerstr. 7, 72076, Tuebingen, Germany.
| | - Lena S Balles
- Department of Neonatology, University Children's Hospital, Eberhard Karls University, Calwerstr. 7, 72076, Tuebingen, Germany
| | - Sara Kirchhof
- Department of Neonatology, University Children's Hospital, Eberhard Karls University, Calwerstr. 7, 72076, Tuebingen, Germany
| | - Romy Weber
- Department of Neonatology, University Children's Hospital, Eberhard Karls University, Calwerstr. 7, 72076, Tuebingen, Germany
| | - Vanessa Avellina
- Department of Neonatology, University Children's Hospital, Eberhard Karls University, Calwerstr. 7, 72076, Tuebingen, Germany
| | - Jan Pauluschke-Fröhlich
- Department of Obstetrics and Gynecology, University Hospital, Eberhard Karls University, Calwerstraße 7, 72076, Tübingen, Germany
| | - Manfred Hallschmid
- Institute for Medical Psychology and Behavioural Neurobiology, Eberhard Karls University, Otfried-Müller-Straße 25, 72076, Tübingen, Germany.,German Center for Diabetes Research, Eberhard Karls University, Tuebingen, Germany.,Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the Eberhard Karls University, Tuebingen, Germany
| | - Louise Fritsche
- German Center for Diabetes Research, Eberhard Karls University, Tuebingen, Germany.,Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the Eberhard Karls University, Tuebingen, Germany
| | - Hubert Preißl
- German Center for Diabetes Research, Eberhard Karls University, Tuebingen, Germany.,Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the Eberhard Karls University, Tuebingen, Germany.,Department of Internal Medicine IV, Eberhard Karls University, Tuebingen, Germany
| | - Andreas Fritsche
- German Center for Diabetes Research, Eberhard Karls University, Tuebingen, Germany.,Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the Eberhard Karls University, Tuebingen, Germany.,Department of Internal Medicine IV, Eberhard Karls University, Tuebingen, Germany
| | - Christian F Poets
- Department of Neonatology, University Children's Hospital, Eberhard Karls University, Calwerstr. 7, 72076, Tuebingen, Germany
| | - Axel R Franz
- Department of Neonatology, University Children's Hospital, Eberhard Karls University, Calwerstr. 7, 72076, Tuebingen, Germany.,Center for Pediatric Clinical Studies, University Children's Hospital, Eberhard Karls University, Tuebingen, Germany
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Wiechers C, Kirchhof S, Maas C, Poets CF, Franz AR. Neonatal body composition by air displacement plethysmography in healthy term singletons: a systematic review. BMC Pediatr 2019; 19:489. [PMID: 31830946 PMCID: PMC6907141 DOI: 10.1186/s12887-019-1867-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2019] [Accepted: 12/02/2019] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND There is increasing evidence that intrauterine environment and, consequently, growth in utero have both immediate and far-reaching consequences for health. Neonatal body composition might be a more sensitive marker of intrauterine environment and neonatal adiposity than birth weight and could serve as a predictor for non-communicable diseases later in life. METHODS To perform a systematic literature review on neonatal body composition determined by air displacement plethysmography in healthy infants. The systematic review was performed using the search terms "air displacement plethysmography", "infant" and "newborn" in Pubmed. Data are displayed as mean (Standard deviation). RESULTS Fourteen studies (including n = 6231 infants) using air displacement plethysmography fulfilled inclusion criteria for meta-analysis. In these, weighted mean body fat percentage was 10.0 (4.1) % and weighted mean fat free mass was 2883 (356) g in healthy term infants. Female infants had a higher body fat percentage (11.1 (4.1) % vs. 9.6 (4.0) %) and lower fat free mass (2827 (316) g vs. 2979 (344) g). In the Caucasian subpopulation (n = 2202 infants) mean body fat percentage was 10.8 (4.1), whereas data for reference values of other ethnic groups are still sparse. CONCLUSIONS Body composition varies depending on gender and ethnicity. These aggregated data may serve as reference for body composition in healthy, term, singletons at least for the Caucasian subpopulation.
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Affiliation(s)
- Cornelia Wiechers
- Department of Neonatology, University Children’s Hospital, Eberhard Karls University, Tuebingen, Calwerstr. 7, 72076 Tuebingen, Germany
| | - Sara Kirchhof
- Department of Neonatology, University Children’s Hospital, Eberhard Karls University, Tuebingen, Calwerstr. 7, 72076 Tuebingen, Germany
| | - Christoph Maas
- Department of Neonatology, University Children’s Hospital, Eberhard Karls University, Tuebingen, Calwerstr. 7, 72076 Tuebingen, Germany
| | - Christian F. Poets
- Department of Neonatology, University Children’s Hospital, Eberhard Karls University, Tuebingen, Calwerstr. 7, 72076 Tuebingen, Germany
| | - Axel R. Franz
- Department of Neonatology, University Children’s Hospital, Eberhard Karls University, Tuebingen, Calwerstr. 7, 72076 Tuebingen, Germany
- Center for Pediatric Clinical Studies, University Children’s Hospital, Eberhard Karls University, Tuebingen, Germany
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