Pregnancy glycaemia and cord-blood levels of insulin and leptin in Pakistani and white British mother–offspring pairs: findings from a prospective pregnancy cohort

Lawlor, D. A., West, J., Fairley, L., Nelson, S. M. , Bhopal, R. S., Tuffnell, D., Freeman, D. J. , Wright, J., Whitelaw, D. C. and Sattar, N. (2014) Pregnancy glycaemia and cord-blood levels of insulin and leptin in Pakistani and white British mother–offspring pairs: findings from a prospective pregnancy cohort. Diabetologia, 57(12), pp. 2492-2500. (doi: 10.1007/s00125-014-3386-6)

Abstract

Aims/hypothesis: To determine the extent to which gestational fasting and postload levels of glucose explain differences in infant fat mass between UK-born Pakistani and white British infants.<p></p> Methods: Analyses were undertaken in a prospective pregnancy cohort study of 1,415 women and their singleton live-born infants (629 white British and 786 Pakistani). Infant fat mass was assessed by cord-blood leptin levels and fetal insulin secretion by cord-blood insulin levels. Maternal OGTTs were completed at 26–28 weeks of gestation.<p></p> Results: Pakistani women had higher fasting and postload glucose levels and greater incidence of gestational diabetes than white British women. Higher fasting and postload glucose levels were associated with higher cord-blood levels of insulin and leptin in all participants, irrespective of ethnicity. Cord-blood leptin levels were 16% (95% CI 6, 26) higher in Pakistani than in white British infants. After adjustment for fasting glucose levels, this difference attenuated to 7% (−3, 16), and with additional adjustment for cord-blood insulin levels it attenuated further to 5% (−4, 14). Path analyses supported the hypothesis that fasting glucose levels mediate the relationship of Pakistani ethnicity to greater fat mass at birth, as measured by cord-blood leptin levels; on average, 19% of this mediation involved fetal insulin secretion. Postload glucose levels did not act as an important mediator of ethnic differences in cord-blood leptin levels. Results were very similar when 130 women with gestational diabetes were removed.<p></p> Conclusions/interpretation: These novel findings suggest a role of maternal pregnancy glycaemia in mediating differences in fat mass between Pakistani and white British infants.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Nelson, Professor Scott and Freeman, Dr Dilys and Sattar, Professor Naveed
• Authors: Lawlor, D. A., West, J., Fairley, L., Nelson, S. M., Bhopal, R. S., Tuffnell, D., Freeman, D. J., Wright, J., Whitelaw, D. C., and Sattar, N.
• College/School: College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health; College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
• Journal Name: Diabetologia
• Publisher: Springer Berlin Heidelberg
• ISSN: 0012-186X
• ISSN (Online): 1432-0428
• Copyright Holders: Copyright © 2014 The Authors
• First Published: First published in Diabetologia 57(12):2492-2500
• Publisher Policy: Reproduced under a Creative Commons License