Advisory Committee Chair
Barbara A Gower
Advisory Committee Members
Betty E Darnell
Jose R Fernandez
Robert A Oster
Cynthia K Sites
Document Type
Dissertation
Date of Award
2010
Degree Name by School
Doctor of Philosophy (PhD) School of Health Professions
Abstract
Background: Evidence suggests that intrauterine exposure to elevated glucose concentrations may be a mediating factor in prenatal programming of offspring disease risk. However, studies examining the effects of maternal glucose concentration on measures of body composition, insulin sensitivity, and ß-cell response in prepubertal children are limited. Therefore, the objective of this study was to determine the associations of maternal glucose concentration with children's fat mass, insulin sensitivity, and ß-cell response using robust and physiologic measures. Methods: Participants were 40 children aged 5-10 years. Children's insulin sensitivity index (SI) and measures of basal, static, dynamic, and total ß-cell response were determined by mathematical modeling using insulin, glucose, and c-peptide values following a liquid meal tolerance test. Dual-energy X-ray absorptiometry was used for the determination of children's total fat mass, total lean mass and percent total body fat. Maternal glucose concentration was determined following a 50-g, 1-hour oral glucose challenge test at 24-28 weeks' gestation and ranged from 75-229 mg/dl. Independent associations of maternal gestational glucose with children's total fat mass, SI, and ß-cell response indices were determined by multiple linear regression analyses. Results: Maternal gestational glucose was significantly, positively associated with children's fat mass independent of energy intake, physical activity, total lean mass, and socioeconomic status (Parameter Estimate ± SE: 1.18 ± 0.19, P<0.001). A significant, inverse association was observed for maternal gestational glucose with children's SI independent of ethnicity, body composition, and socioeconomic status (Parameter Estimate ± SE: -0.87 ± 0.23, P<0.01). Maternal gestational glucose was significantly and positively associated with basal ß-cell response, static ß-cell response, and basal insulin secretion rate independent of body composition and SI (Parameter Estimate ± SE: 0.63 ± 0.26, 1.04 ± 0.43, & 0.62 ± 0.28, respectively, P<0.05 for all). Conclusions: These results suggest that maternal gestational glucose affects prenatal programming of children's adiposity, insulin sensitivity, and ß-cell response, which is evident at 5-10 years of age. Fetal programming of insulin sensitivity and ß-cell function appears to occur at both the level of the pancreas and the level of insulin target tissues such as skeletal muscle and liver.
Recommended Citation
Bush, Nikki C., "Maternal Gestational Glucose Concentration and Offspring Body Composition, Insulin Sensitivity, and ß-Cell Function" (2010). All ETDs from UAB. 1302.
https://digitalcommons.library.uab.edu/etd-collection/1302