Gut hormone activity of children born to women with and without gestational diabetes

Abstract

What is already known about this subject Children born to women with gestational diabetes have greater risk for obesity. Obesity in adults and children is associated with blunted postprandial gut hormone responses. What this study adds Children of women with gestational diabetes have a blunted postprandial response of GLP-1. Children of women with gestational diabetes have high fasting PYY concentrations.

Background: Intrauterine exposure to gestational diabetes mellitus (GDM) increases risk for obesity. Obesity is associated with a blunted postprandial gut hormone response, which may impair satiety and thereby contribute to weight gain. The postprandial response of gut hormones among children of women with GDM has not previously been investigated.

Objective: To examine whether children of women with GDM have suppressed peptide-tyrosine-tyrosine (PYY) and glucagon-like-peptide-1 (GLP-1), and higher concentrations of ghrelin, following a meal challenge. A secondary objective was to investigate associations of these hormones with children's free-living energy intake.

Methods: Children (n = 42) aged 5-10 years were stratified into two groups: offspring of GDM mothers (OGD) and of non-diabetic mothers (CTRL). Body composition was measured by dual-energy X-ray absorptiometry, and circulating PYY, GLP-1 and total ghrelin were measured during a liquid meal challenge. Energy intake was assessed by three 24-h diet recalls.

Results: Between-groups analyses of fasting and incremental area under the curve (AUC) found no differences in ghrelin. Incremental AUC for GLP-1 was greater among the CTRL vs. OGD (P < 0.05), and fasting PYY, but not incremental AUC, was higher among OGD vs. CTRL (P < 0.01). Associations of fasting and incremental AUC for each gut hormone with children's usual energy intake did not differ significantly by group.

Conclusions: Further research is needed to more fully examine the potential role of postprandial GLP-1 suppression and high-fasting PYY concentrations on the feeding behaviour and risk for obesity among children exposed to GDM in utero.

Keywords: GLP-1; Ghrelin; PYY; obesity.

Figure 1

Fasting and postprandial response of ghrelin did not differ among OGD (□) versus CTRL (•) children. Data shown in the main panel are unadjusted mean ± SEM. Insert shows the incremental AUC, below fasting concentrations, after adjustment for race and total body % fat (mean ± SEM).

Figure 2

Fasting and postprandial response of GLP-1 in OGD (□) versus CTRL (•). Data shown in the main panel are unadjusted mean ± SEM. Insert shows the incremental AUC, above fasting concentrations and after adjustment for race and total body % fat (mean ± SEM), which was greater among CTRL versus OGD (P<0.05).

Figure 3

Fasting and postprandial response of PYY in OGD (□) versus CTRL (•). Data shown in the main panel are unadjusted mean ± SEM. **Fasting PYY was higher among OGD versus CTRL, P<0.01. Insert shows the incremental AUC, above fasting concentrations and after adjustment for race and total body % fat (mean ± SEM).

Figure 4

Partial correlation plots showing association between incremental AUC for ghrelin and average daily energy intake, adjusted for children’s REE, in CTRL (A) and OGD (B). Postprandial ghrelin was not associated with energy intake among CTRL children, but was inversely associated with energy intake among OGD (partial r = −461, P<0.05).

Figure 5

Partial correlation plots showing association between fasting PYY and average daily energy intake, adjusted for children’s REE, in CTRL (A) and OGD (B). PYY was not associated with energy intake among CTRL children, but was positively associated for OGD (partial r = 0.595, P<0.05).