The link between a mother's body mass index (BMI) before pregnancy and the metabolic traits of her children is likely mediated by shared genetics and familial lifestyle rather than effects on the fetus during gestation, according to study published this week in PLOS Medicine by Debbie Lawlor of the University of Bristol, UK, and colleagues.
20 to 50 percent of women in Western populations now start pregnancy overweight or obese, and researchers have hypothesized that this may lead to metabolic disruptions in offspring. Lawlor's group used data on 5,337 mother-father-offspring trios collected in three European birth cohorts. Each dataset included maternal pre-pregnancy BMI, paternal BMI, offspring BMI, and information on 153 metabolic traits in the offspring, based on a blood sample taken at age 16, 17, or 31.
The researchers found associations between parental BMIs and offspring metabolic traits including VLDL-lipoproteins, VLDL-C, VLDL-triglycerides, VLDL-diameter, glycoprotein acetyls, triglycerides, HDL-lipoprotein, and HDL-C (all P<0.003). However, the association was not significantly stronger for maternal compared with paternal BMI, arguing against an intra-uterine mechanism. In addition, after taking offspring BMI into account, the data suggested that the apparent link between parental BMI and offspring metabolic traits could be largely explained by the association between parental BMI and offspring BMI. The study was limited by the fact that BMI was self-reported, as well as the fact that BMI may not fully capture the complexity of different body compositions.
"Our findings are more supportive of shared familial factors than an intrauterine developmental overnutrition mechanism for associations of maternal BMI with offspring metabolic traits," the authors say. "Interventions to reduce BMI in all family members may be more beneficial for cardio-metabolic health than focusing on reducing maternal pre-conception or pregnancy BMI.
This study was funded by the European Research Council under the European Union's Seventh Framework Programme (FP7/2007-2013)/ERC grant agreement (Grant number 669545; DevelopObese) and the US National Institute of Health (R01 DK10324). The UK Medical Research Council and the Wellcome Trust (Grant ref: 102215/2/13/2) and the University of Bristol provide core support for ALSPAC. DLSF, DAL, GDS, and MA-K, work in a Unit that receives funds from the University of Bristol and the UK Medical Research Council (MC_UU_12013/1, MC_UU_12013/ 5), and DAL is a UK National Institute of Health Research Senior Investigator (NF-SI-0166-10196). MA-K was supported by the Sigrid Juselius Foundation and the Strategic Research Funding from the University of Oulu. DMW is funded by a European Union Horizon 2020 research and innovation program grant (agreement 634821). No funding bodies had any role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
DAL has received support from Medtronic LTD, Roche Diagnostics, and Ferring Pharmaceuticals for biomarker research that is not related to the study presented in this paper. AJK and PS are shareholders and work for Nightingale Health Ltd. (formerly Brainshake Ltd.), a company offering NMR-based metabolite profiling. AJK is also a member of the board for Nightingale Health Ltd. MA-K has been a shareholder and a board member of Nightingale Health Ltd. during the last 5 years. GDS is a member of the Editorial Board of PLOS Medicine. The other authors report no conflicts.
Santos Ferreira DL, Williams DM, Kangas AJ, Soininen P, Ala-Korpela M, Smith GD, et al. (2017) Association of pre-pregnancy body mass index with offspring metabolic profile: Analyses of 3 European prospective birth cohorts. PLoS Med 14(8): e1002376. https://doi.org/10.1371/journal.pmed.1002376.
MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, United Kingdom
School of Social and Community Medicine, University of Bristol, United Kingdom
Department of Epidemiology and Biostatistics, MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, London, United Kingdom
Department of Medical Epidemiology & Biostatistics, Karolinska Institutet, Stockholm
Computational Medicine, Faculty of Medicine, University of Oulu, Oulu, Finland
Biocenter Oulu, University of Oulu, Oulu, Finland
NMR Metabolomics Laboratory, School of Pharmacy, University of Eastern Finland, Kuopio, Finland
Center for Life-Course Health Research and Northern Finland Cohort Center, Faculty of Medicine, University of Oulu, Oulu, Finland
Unit of Primary Care, Oulu University Hospital, Oulu, Finland
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